Obama, Karzai accelerate end of U.S. combat role in Afghanistan

WASHINGTON (Reuters) - President Barack Obama and Afghan President Hamid Karzai agreed on Friday to speed up the handover of combat operations in Afghanistan to Afghan forces, raising the prospect of an accelerated U.S. withdrawal from the country and underscoring Obama's determination to wind down a long, unpopular war.

Signaling a narrowing of differences, Karzai appeared to give ground in talks at the White House on U.S. demands for immunity from prosecution for any U.S. troops who stay in Afghanistan beyond 2014, a concession that could allow Obama to keep at least a small residual force there.

Both leaders also threw their support behind tentative Afghan reconciliation efforts with Taliban insurgents, endorsing the establishment of a Taliban political office in Qatar in hopes of bringing insurgents to inter-Afghan talks.

Outwardly, at least, the meeting appeared to be something of a success for both men, who need to show their vastly different publics they are making progress in their goals for Afghanistan. There were no signs of the friction that has frequently marked Obama's relations with Karzai.

Karzai's visit came amid stepped-up deliberations in Washington over the size and scope of the U.S. military role in Afghanistan once the NATO-led combat mission concludes at the end of next year.

"By the end of next year, 2014, the transition will be complete," Obama said at a news conference with Karzai standing at his side. "Afghans will have full responsibility for their security, and this war will come to a responsible end."

The Obama administration has been considering a residual force of between 3,000 and 9,000 troops - far fewer than some U.S. commanders propose - to conduct counterterrorism operations and to train and assist Afghan forces.

But a top Obama aide said this week that the administration does not rule out a complete withdrawal after 2014, a move that some experts say would be disastrous for the weak Afghan central government and its fledgling security apparatus.

Obama on Friday left open the possibility of that so-called "zero option," when he several times used the word "if" to suggest that a post-2014 U.S. presence was far from guaranteed.

Insisting that Afghan forces were "stepping up" faster than expected, Obama said Afghan troops would take over the lead in combat missions across the country this spring, rather than waiting until the summer, as was originally planned. NATO troops will then assume a "support role," he said.

"It will be a historic moment and another step toward full Afghan sovereignty," Obama said.

Obama said final decisions on this year's troop cuts and the post-2014 U.S. military role were still months away, but his comments suggested he favors a stepped-up withdrawal timetable.

There are some 66,000 U.S. troops currently in Afghanistan. Washington's NATO allies have been steadily reducing their troop numbers as well, despite doubts about the ability of Afghan forces to shoulder full responsibility for security.

"WAR OF NECESSITY"

Karzai voiced satisfaction over Obama's agreement to turn over control of detention centers to Afghan authorities, a source of dispute between their countries, although the White House released no details of the accord on that subject.

Obama once called Afghanistan a "war of necessity," but he is heading into a second term looking for an orderly way out of the conflict, which was sparked by the September 11, 2001 attacks by al Qaeda on the United States.

He faces the challenge of pressing ahead with his re-election pledge to continue winding down the war while preparing the Afghan government to prevent a slide into chaos and a Taliban resurgence once most NATO forces are gone.

Former Senator Chuck Hagel, Obama's nominee to become defense secretary, is likely to favor a sizable troop reduction.

Karzai, meanwhile, is eager to show he is working to ensure Afghans regain full control of their territory after an foreign military presence of more than 11 years.

Asked whether the cost of the war in lives and money was worth it, Obama said: "We achieved our central goal ... or have come very close to achieving our central goal, which is to de-capacitate al Qaeda, to dismantle them, to make sure that they can't attack us again."

He added: "Have we achieved everything that some might have imagined us achieving in the best of scenarios? Probably not. This is a human enterprise, and you fall short of the ideal."

Obama made clear that unless the Afghan government agrees to legal immunity for U.S. troops, he would withdraw them all after 2014 - as happened in Iraq at the end of 2011.

Karzai, who criticized NATO over civilian deaths, said that with Obama's agreement to transfer detention centers and the planned withdrawal of U.S. forces from Afghan villages, "I can go to the Afghan people and argue for immunity" in a bilateral security pact being negotiated.

Many of Obama's Republican opponents have criticized him for setting a withdrawal timetable and accuse him of undercutting the U.S. mission by reducing troop numbers too quickly.

Karzai and his U.S. partners have not always seen eye to eye, even though the American military has been crucial to preventing insurgent attempts to oust him.

In October, Karzai accused Washington of playing a double game by fighting the war in Afghan villages instead of going after insurgents who cross the border from neighboring Pakistan.

In Friday's news conference, Karzai did not back down from his previous comments that foreigners were responsible for some of the official corruption critics say is rampant in Afghanistan. But he acknowledged: "There is corruption in the Afghan government that we are fighting against."

Adding to tensions has been a rash of deadly "insider" attacks by Afghan soldiers and police against NATO-led troops training or working with them. U.S. forces have also been involved in a series of incidents that enraged Afghans, including burning Korans, which touched off days of rioting.

(Additional reporting by Roberta Rampton, Mark Felsenthal, Jeff Mason, Phil Stewart, Tabassum Zakaria, David Alexander; Editing by Warren Strobel and David Brunnstrom)

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Euro adds more gains on dollar

NEW YORK: The euro surged for a second day Friday, adding 0.7 US cents to Thursday's two cent gain, pushed by what one analyst said was short covering and sustained by poor US trade data.

The European currency traded roughly around the break-even line of $1.3261 but then took a leap to the $1.3350 levels the morning opening -- just 15 minutes before US trade data for November showed a wider-than-expected deficit that implied slower growth.

"While a rise in the euro isn't out of the ordinary lately, particularly after yesterday's European Central Bank monetary policy decision and press conference, many euro crosses had settled in to a range in the 18 hours before the spike occurred," said Neal Gilbert of GFT.

He said a Goldman Sachs recommendation with a target for $1.37 could have been the force, but also a squeeze on short sellers.

"Since the market had turned sideways in the Asian and European sessions, many investors were likely assuming a profit taking drop was about to take place."

Now that trade has been flushed out, he added, "the profit taking is more likely to take place."

At 2200 GMT, the euro was at $1.3341, off the day's high of $1.3366.

The yen sagged to its lowest level in more than 30 months, hitting 89.18 yen to the dollar from 88.64 late Thursday.

Against the euro, it hit 119.00 yen, compared to 117.53 Thursday; it was the yens lowest level in 20 months against the euro.

The pound slipped to $1.6129 from $1.6158, and the dollar moved to 0.9135 Swiss francs from 0.9145 francs.

The Chinese currency continued its push higher, to 6.2180 yuan per dollar from 6.2256 a day earlier and 6.2316 a week ago.

-AFP/ac

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Security forces lag behind Maoists in human intelligence

NEW DELHI: Blame it on poor human intelligence network. In the Latehar encounter, while Maoists got real-time information on troop movement in the Karmatiya forests leading to Monday's ambush that killed 10 securitymen, anti-Naxalite forces learnt of the movement of ultras only after they left a village.

A contingent of Central Reserve Police Force (CRPF) and Jharkhand Jaguars was on the trail of senior CPI (Maoist) leader Arvindji since December 10, 2012 when they learnt of his movement in the Karmatiya forests. However, every time they learnt of his location, he had left the place. It was only when he halted at Katiya village, where the encounter took place this week, that forces got there on time.

"We had been tracking Arvindji constantly since December 10. But we always received information on his location late. He stayed in a certain village for a fortnight, but we received information about it only after he left," said a CRPF official privy to operation details.

The Maoists, however, learnt of CRPF planning to raid Katiya village and had positioned themselves on hills abutting the village when the forces reached there leading to an ambush. Sources in the force said there was not only a need for better human intelligence but better technical intelligence, phone interceptions and coordination with the Intelligence Bureau.

Fresh findings with regard to the operation have also revealed that Maoists had put the body of not one but three jawans over landmines. All these mines were strategically connected through cordex wires in such a way that if one exploded, the others would detonate automatically, leading to heavy casualties.

However, due to some technical fault, only one mine exploded when villagers along with a CRPF search party lifted the body of a jawan leading to three civilian deaths. In case of other two bodies, the mines were first defused to lift them.

It has also come to light that IEDs were planted in the abdomen of not one but two jawans. While one was detected and defused in a Ranchi hospital, the other had exploded even before forces could find the body.

Sources said Naxals under Arvindji, who is a member of the central military commission, had been experimenting with this new offensive for the past few days in the Latehar jungles. "They had put IEDs in the body of dogs and goats and blasted them to see its effectiveness," a CRPF official said.

Meanwhile, the home ministry has asked CRPF to continue its offensive against Maoists in Latehar to push them out in a "fight-to-finish" war. A reinforcement of 1,000 CRPF men is being sent to continue operations in Latehar and extend it to Garhwa. The ministry has also asked CRPF to launch a similar offensive in Sukma. The operations are expected to continue till June this year.

"The operations will be intensified. We will take forward the strikes ... There will be no let up in anti-Naxal operations," CRPF DG Pranay Sahay told reporters after he briefed home secretary R K Singh about the Naxal ambush.

Sources said Jharkhand police has also arrested two alleged Maoists suspected to be involved in Monday's encounter. They have been identified as Harinath Singh and Dinesh Singh. The two rebels had been involved in laying landmines and were also part of the firing squad.

CRPF is also on a recruiting spree for offensives in this year and the next with 12,000 more men expected to join the force through centralized exams. The force is also awaiting home ministry nod to launch special recruitment drives in naxal-affected, border and tribal areas which have massive vacancies running up to 90%.

It has asked field units to distribute forms among villagers in these areas for free and help them fill up forms.

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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.

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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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