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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Wanted Ex-Cop Possibly in Shootout, Chase

Fugitive former cop Christopher Dorner has barricaded himself inside a mountain cabin near Big Bear, Calif., and exchanged gunfire with police who had pursued him after he broke into a home in the area, authorities said.

Two San Bernadino County Sheriff's deputies injured in the firefight and subsequently airlifted to a nearby hospital. The extent of their injuries is unknown.

Dozens of local, state and federal authorities are at the scene in the San Bernadino Mountains, surrounding the cabin and engaged in an intense standoff with Dorner, a former Navy marksman who swore to kill police and their family members in a manifesto discovered online last week.

Dorner is believed to have broken into another home nearby and taken two women hostage before stealing a car, police said. Officials say Dorner crashed the vehicle and fled on foot, where sheriff's deputies and state Fish and Game officers exchanged fire with him, before he barricaded himself in the cabin.

The two hostages, who were tied up by Dorner but later escaped, were evaluated by paramedics and were determined to be uninjured.

Police have sealed all roads going into the area and imposed a no-fly zone above the cabin, which is in a wooded area that has received several inches of snow in recent days.

Four Big Bear area schools were briefly placed on lockdown.

The San Bernardino County Sheriff's Department stopped all traffic leaving the area and thoroughly searched vehicles, as SWAT team and tactical units could be seen driving toward the cabin, their sirens blaring.

Los Angeles Police Department/AP Photo

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Authorities believer Dorner may be watching reports of the standoff and have asked media not to broadcast images of police surrounding the cabin.

"If he's watching this, the message... is: Enough is enough. It's time to turn yourself in. It's time to stop the bloodshed. It's time to let this event and let this incident be over," said Los Angeles Police spokesman Andy Smith, told reporters at a press conference.

Dorner faces capital murder charges that involve the killing of Riverside police officer Michael Crain, who was gunned down in an ambush last Thursday.

Since then a massive manhunt has been underway, focused primarily in the San Bernardino Mountains, but extending to neighboring states and as far away as Mexico.

A capital murder charge could result in the death penalty if Dorner is captured alive and convicted. Crain was married with two children, aged 10 and 4.

The charges do not involve the slayings of Monica Quan and her fiance, who were found shot to death Feb. 3. Quan was the daughter of former LAPD Capt. Randal Quan, who was mentioned as a target of Dorner's fury in his so-called "manifesto," which he posted on his Facebook page.

PHOTOS: Former LAPD Officer Suspected in Shootings

In the 6,000 word "manifesto," Dorner outlined his anger at the Los Angeles Police Department for firing him, and made threats against individuals he believed were responsible for ending his career with the police force five years ago.

Dorner's grievance with police goes back five years when he was fired after filing a false report accusing other cops of brutality.

The LAPD has assigned 50 protection details to guard officers and their families who were deemed possible targets.

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North Korean nuclear test draws anger, including from China

SEOUL (Reuters) - North Korea conducted its third nuclear test on Tuesday in defiance of U.N. resolutions, drawing condemnation from around the world, including from its only major ally, China, which summoned the North Korean ambassador to protest.

Pyongyang said the test was an act of self-defense against "U.S. hostility" and threatened stronger steps if necessary.

The test puts pressure on U.S. President Barack Obama on the day of his State of the Union speech and also puts China in a tight spot, since it comes in defiance of Beijing's admonishments to North Korea to avoid escalating tensions.

The U.N. Security Council held an emergency meeting at which its members, including China, "strongly condemned" the test and vowed to start work on appropriate measures in response, the president of the council said.

North Korean leader Kim Jong-un, the third of his line to rule the country, has presided over two long-range rocket launches and a nuclear test during his first year in power, pursuing policies that have propelled his impoverished and malnourished country closer to becoming a nuclear weapons power.

North Korea said the test had "greater explosive force" than those it conducted in 2006 and 2009. Its KCNA news agency said it had used a "miniaturized" and lighter nuclear device, indicating it had again used plutonium, which is suitable for use as a missile warhead.

China, which has shown signs of increasing exasperation with the recent bellicose tone of its reclusive neighbor, summoned the North Korean ambassador in Beijing and protested sternly, the Foreign Ministry said.

Foreign Minister Yang Jiechi said China was "strongly dissatisfied and resolutely opposed" to the test and urged North Korea to "stop any rhetoric or acts that could worsen situations and return to the right course of dialogue and consultation as soon as possible".

Analysts said the test was a major embarrassment to China, which is a permanent member of the Security Council and North Korea's sole major economic and diplomatic ally.

Obama called the test a "highly provocative act" that hurt regional stability.

"The danger posed by North Korea's threatening activities warrants further swift and credible action by the international community. The United States will also continue to take steps necessary to defend ourselves and our allies," Obama said.

U.S. Ambassador to the United Nations Susan Rice said Washington and its allies intended to "augment the sanctions regime" already in place due to Pyongyang's previous atomic tests. North Korea is already one of the most heavily sanctioned states in the world and has few external economic links that can be targeted.

Japanese Prime Minister Shinzo Abe said the test was a "grave threat" that could not be tolerated.

Russian Foreign Minister Sergei Lavrov urged North Korea to abandon its nuclear arms program and return to talks. NATO condemned the test as an "irresponsible act."

South Korea, still technically at war with North Korea after a 1950-53 civil war ended in a mere truce, also denounced the test. Obama spoke to South Korean President Lee Myung-bak on Tuesday and told him the United States "remains steadfast in its defense commitments" to Korea, the White House said.

MAXIMUM RESTRAINT

North Korea's Foreign Ministry said the test was "only the first response we took with maximum restraint".

"If the United States continues to come out with hostility and complicates the situation, we will be forced to take stronger, second and third responses in consecutive steps," it said in a statement carried by the official KCNA news agency.

North Korea - which gave the U.S. State Department advance warning of the test - often threatens the United States and its "puppet", South Korea, with destruction in colorful terms.

North Korea told the U.N. disarmament forum in Geneva that it would never bow to resolutions on its nuclear program and that prospects were "gloomy" for the denuclearization of the divided Korean peninsula because of a "hostile" U.S. policy.

Suzanne DiMaggio, an analyst at the Asia Society in New York, said North Korea had embarrassed China with the test. "China's inability to dissuade North Korea from carrying through with this third nuclear test reveals Beijing's limited influence over Pyongyang's actions in unusually stark terms," she said.

Mark Fitzpatrick of the International Institute for Strategic Studies think tank, said: "The test is hugely insulting to China, which now can be expected to follow through with threats to impose sanctions."

The magnitude of the explosion was roughly twice that of the 2009 test, according to the Vienna-based Comprehensive Nuclear-Test Ban Treaty Organization. The U.S. Geological Survey said that a seismic event measuring 5.1 magnitude had occurred.

U.S. intelligence agencies were analyzing the event and found that North Korea probably conducted an underground nuclear explosion with a yield of "approximately several kilotons", the Office of the Director of National Intelligence said.

Nuclear experts have described Pyongyang's previous two tests as puny by international standards. The yield of the 2006 test has been estimated at less than 1 kiloton (1,000 tons of TNT equivalent) and the second at some 2-7 kilotons, compared with 20 kilotons for a Nagasaki-type bomb.

Initial indications are that the test involved the latest version of a plutonium-based prototype weapon, according to one current and one former U.S. national security official. Both previous tests involved plutonium. If it turns out the test was of a new uranium-based weapon, it would show that North Korea has made more progress on uranium enrichment than previously thought.

The United States uses WC-135 Constant Phoenix "sniffer" aircraft to collect samples to identify nuclear explosions. These would need to be deployed quickly to detect whether highly enriched uranium rather than plutonium was used because uranium decays to undetectable levels within a matter of days. Plutonium takes much longer to decay.

North Korea trumpeted news of the test on its state television channel to patriotic music against a backdrop of its national flag.

"It was confirmed that the nuclear test that was carried out at a high level in a safe and perfect manner using a miniaturized and lighter nuclear device with greater explosive force than previously did not pose any negative impact on the surrounding ecological environment," KCNA said.

North Korea linked the test to its technical prowess in launching a long-range rocket in December, a move that triggered the U.N. sanctions, backed by China, that Pyongyang said prompted it to take Tuesday's action.

The North's ultimate aim, Washington believes, is to design an intercontinental ballistic missile capable of carrying a nuclear warhead that could hit the United States. North Korea says the program is aimed at putting satellites in space.

Despite its three nuclear tests and long-range rocket tests, North Korea is not believed to be close to manufacturing a nuclear missile capable of hitting the United States.

It used plutonium in previous nuclear tests and before Tuesday there had been speculation that it would use highly enriched uranium so as to conserve its plutonium stocks, as testing eats into its limited supply of materials to construct a nuclear bomb.

"VICIOUS CYCLE"

When Kim Jong-un, who is 30, took power after his father's death in December 2011, there were hopes that he would bring reforms and end Kim Jong-il's "military first" policies.

Instead, North Korea, whose economy is smaller than it was 20 years ago and where a third of children are believed to be malnourished, appears to be trapped in a cycle of sanctions followed by further provocations.

"The more North Korea shoots missiles, launches satellites or conducts nuclear tests, the more the U.N. Security Council will impose new and more severe sanctions," said Shen Dingli, a professor at Shanghai's Fudan University. "It is an endless, vicious cycle."

Options for the international community appear to be in short supply. Diplomats at the United Nations said negotiations on new sanctions could take weeks since China is likely to resist tough new measures for fear they could lead to further retaliation by the North Korean leadership.

Beijing has also been concerned that tougher sanctions could further weaken North Korea's economy and prompt a flood of refugees into China.

Tuesday's action appeared to have been timed for the run-up to February 16 anniversary celebrations of Kim Jong-il's birthday, as well as to achieve maximum international attention.

Significantly, the test comes at a time of political transition in China, Japan and South Korea, and as Obama begins his second term. The U.S. president will likely have to tweak his State of the Union address due to be given on Tuesday.

Japanese Prime Minister Shinzo Abe is bedding down a new government and South Korea's new president, Park Geun-hye, is preparing to take office on February 25.

China too is in the midst of a once-in-a-decade leadership transition to Xi Jinping, who takes office in March. Both Abe and Xi are staunch nationalists.

The longer-term game plan from Pyongyang may be to restart international talks aimed at winning food and financial aid. China urged it to return to the stalled "six-party" talks on its nuclear program, hosted by China and including the two Koreas, the United States, Japan and Russia.

Its puny economy and small diplomatic reach mean that North Korea struggles to win attention on the global stage - other than through nuclear tests and attacks on South Korea, the last of which was made in 2010.

"Now the next step for North Korea will be to offer talks... - any form to start up discussion again to bring things to their advantage," predicted Jeung Young-tae, senior research fellow at the Korea Institute for National Unification in Seoul.

(Additional reporting by Jack Kim, Christine Kim and Jumin Park in SEOUL; Linda Sieg in TOKYO; Louis Charbonneau and Michelle Nichols at the UNITED NATIONS; Fredrik Dahl in VIENNA; Michael Martina and Chen Aizhu in BEIJING; Mette Fraende in COPENHAGEN; Adrian Croft, Charlie Dunmore and Justyna Pawlak in BRUSSELS; Mark Hosenball, Paul Eckert, Roberta Rampton, Tabassum Zakaria and Jeff Mason in WASHINGTON; Editing by Nick Macfie, Claudia Parsons and David Brunnstrom)

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Pre-pregnancy folic acid linked to lower autism risk

WASHINGTON: Children born to women who started taking folic acid supplements four to eight weeks before pregnancy appear to be at a lower risk of autism, a study showed on Tuesday.

Pal Suren of the Norwegian Institute of Public Health and colleagues looked into the use of folic acid supplements before and during early pregnancy, and any impact on the later risk of various disorders on the autism spectrum.

"Our main finding was that maternal use of folic acid supplements around the time of conception was associated with a lower risk of autistic disorder," the authors wrote in the Journal of the American Medical Association.

The journal recalled that many countries recommend flour be enriched with folic acid to lower the risk of birth defects, and that women are often advised to take folic acid supplements before and during pregnancy.

Despite the practice, European and North American studies have found that many pregnant women take less folate in their diet than is necessary to prevent neural tube defects.

Suren's research appears to confirm that the advice to take folic acid supplements is well-founded.

The 85,176 Norwegian children who took part in the study were born between 2002 and 2008.

Among the sample, 270 children, or 0.32 percent, were diagnosed with autism spectrum disorders, and researchers found that there was an inverse association between folic acid use and subsequent autism risks.

About 1 in 88 children, or 1.14 percent, in the United States have been identified with an autism spectrum disorder, according to the US Centres for Disease Control and Prevention.

Mothers who took folic acid supplements in early pregnancy had a 40 percent lower risk of having children with autistic disorder compared with mothers who did not take folic acid, the researchers found.

Folic acid is found in naturally high levels in foods such as dark leafy greens, asparagus and broccoli, as well as citrus fruits.

- AFP/de

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India bought helicopters Obama rejected as ‘costly’

NEW DELHI: US president Barack Obama had found a variant of the AW-101 helicopters too exorbitant to pass muster in 2009. But the Indian government had no such qualms while inking the Rs 3,546-crore deal for 12 plush AW-101 helicopters just a year later in 2010.

The American "Marine One", the call sign of the US Marine Corps helicopter which ferries the US President, would of course have been much more high-tech and "souped-up" helicopter compared to the Indian variant.

Obama had shot down the Marine One project, under which the US Navy was to have acquired 28 helicopters, after cost escalations had taken the overall cost to over $13 billion in June 2009, as per some estimates.

Money, instead, was invested to upgrade the existing US Presidential helicopter fleet. Last heard, another AW-101 variant was again in contention to bag the US Navy's latest programme to develop the "Marine One Presidential Helicopter".

Three of the 12 AW-101choppers contracted by India — eight in VVIP configuration and four in non-VVIP - have already been inducted in the IAF's elite Communication Squadron, which ferries around the President, PM and other VVIPs, at the Palam airbase. They are slated to replace the ageing Russian-origin Mi-8s and Mi-17s being currently used to fly VVIPs within the country.

Indian VVIPs have been getting plush new aircraft and helicopters to travel in style and security over the last decade. The AW-101s, for instance, have robust self-defence systems like missile-approach warners, chaff and flare dispensers and directed infra-red electronic counter-measures to protect VVIPs on board. In the VVIP configuration, they ferry only 10 passengers instead of the usual 40.

Another concern of the Special Protection Group (SPG), which provides proximate security to the PM, was the helicopters have "a high tail boom" to allow cars to come right next to the rear exit staircase without "exposing" VVIPs to a threat from anyone in the vicinity.

Earlier, India had inducted five mid-sized Embraer 135BJ Legacy jets, under a Rs 727-crore deal in September 2003, and three Business Boeing Jets (BBJs), under a Rs 937-crore contract in October 2005, for the travel of VVIPs. The BBJs also have advanced self-protection suites to guard against missiles and other threats. While the Legacy jets replaced old HS-748 Avros with the Communication Squadron, the BBJs substituted the two 737-200 aircraft bought in 1983.

Major defence scams

Jeep Scandal: One of the first scandals to hit independent India, and definitely the country's first brush with allegations of impropriety in defence procurement. In 1948, Indian high commissioner in Britain V K Krishna Menon was accused of bypassing procurement protocols to sign a deal worth Rs 80 lakh to buy 155 jeeps from the UK. Many also alleged they were second-hand jeeps. Government did not permit a judicial inquiry. Menon went on to become India's defence minister.

Bofors Scandal: The most infamous of all defence scandals the country has seen. Allegations emerged in the late 1980s that there were kickbacks in the purchase of Bofors guns from Sweden. Several high profile individuals figured among the accused, the investigations went on for many years and finally ended in a whimper. It brought down the fortunes of the young Rajiv
HDW Scandal: Allegations emerged in 1987 that the German defence firm had paid a commission for the purchase of submarines by India, in the early 80s. Former Navy chief and one of the architects of the 1971 war, Admiral S M Nanda, was among those raided. The CBI closed its investigations, failing to find any evidence of the alleged payment of bribes.

Tehelka Tapes: Two reporters who went around as representatives of a fake defence firm recorded many key political leaders, military officers and civil servants talking in detail about how bribes were paid in defence deals. Defence minister George Fernandes had to resign after his party's treasurer boasted in the tapes about collecting bribes along with Jaya Jaitly from arms dealers. Specific evidence emerged of paybacks in purchase of Barak missiles from Israel, upgunning of artillery guns etc. No major breakthrough in CBI investigations until today. It has closed at least one of the cases without any evidence.

Denel Scandal: Allegations emerged in South Africa that Denel, a government-controlled firm which had supplied anti-material rifle to Indian Army, had paid bribes to middlemen for the Indian contract. Chargesheet yet to be filed.

Sudipto Ghosh Scandal: In 2009, the CBI arrested the just-retired chief of Ordnance Factory Board Sudipto Ghosh and several of his associates for fixing contracts of OFB. After CBI found evidence of bribery, the government in March 2012 blacklisted six companies for 10 years -- Singapore Technologies, Israeli Military Industries, Germany's Rheinmetall Air Defence, Russian firm Corporation Defence, Indian firms T S Kisan & Company and R K Machine Tool.

Abhishek Verma Scandal: The son of former members of Parliament is in jail, and he and his wife are accused of stealing defence secrets and accepting bribes from defence firms. Investigations are continuing into the affairs of Verma, who may have also had a role in the VVIP helicopter deal.

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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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Benedict's Legacy Marred by Sex Abuse Scandal

When Pope Benedict XVI resigns at the end of this month, he leaves behind a Church grappling with a global fallout from sex abuse and a personal legacy marred by allegations that he was instrumental in covering up that abuse.

As the sex abuse scandal spread from North America to Europe, Benedict became the first pope to meet personally with victims, and offered repeated public apologies for the Vatican's decades of inaction against priests who abused their congregants.

"No words of mine could describe the pain and harm inflicted by such abuse," the pope said in a 2008 homily in Washington, D.C., before meeting with victims of abuse for the first time. "It is important that those who have suffered be given loving pastoral attention." During the same trip to the U.S., he met with victims for the first time.

For some of the victims, however, Benedict's actions were "lip service and a public relations campaign," said Jeff Anderson, a Minnesota lawyer who represents victims of sex abuse. For 25 years, Benedict, then known as Cardinal Joseph Ratzinger, headed the Vatican office responsible for investigating claims of sex abuse, but he did not act until he received an explicit order from Pope John Paul II.

In 1980, as Archbishop of Munich, Ratzinger approved plans for a priest to move to a different German parish and return to pastoral work only days after the priest began therapy for pedophilia. The priest was later convicted of sexually abusing boys.

Vincenzo Pinto/AFP/Getty Images

PHOTOS: Church Sex Scandals

In 1981, Cardinal Ratzinger became head of the Vatican's Congregation for the Doctrine of the Faith – the office once known as the Inquisition -- making him responsible for upholding church doctrine, and for investigating claims of sexual abuse against clergy. Thousands of letters detailing allegations of abuse were forwarded to Ratzinger's office.

A lawsuit filed by the Center for Constitutional Rights on behalf of the Survivors' Network of Those Abused by Priests (SNAP), a victims' rights group, charges that as head of the church body Ratzinger participated in a cover-up of abuse. In an 84-page complaint, the suit alleges that investigators of sex abuse cases in several countries found "intentional cover-ups and affirmative steps taken that serve to perpetuate the violence and exacerbate the harm."

"Ratzinger, now Pope Benedict XVI, either knew and/or some cases consciously disregarded information that showed subordinates were committing or about to commit such crimes," the complaint says.

Jeffrey Lena, the Vatican's lawyer in the U.S., told the AP the complaint was a "ludicrous publicity stunt and a misuse of international judicial processes."

In the 1990s, former members of the Legion of Christ sent a letter to Ratzinger alleging that the founder and head of the Catholic order, Father Marcial Maciel, had molested them while they were teen seminarians. Maciel was allowed to continue as head of the order.

In 1996, Ratzinger didn't respond to letters from Milwaukee's archbishop about a priest accused of abusing students at a Wisconsin school for the deaf. An assistant to Ratzinger began a secret trial of the priest, Father Lawrence Murphy, but halted the process after Murphy wrote a personal appeal to Ratzinger complaining of ill health.

In 2001, Pope John Paul II issued a letter urging the Congregation of the Doctrine of the Faith to pursue allegations of child abuse in response to calls from bishops around the world.

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Pope's sudden resignation sends shockwaves through Church

VATICAN CITY (Reuters) - Pope Benedict stunned the Roman Catholic Church on Monday when he announced he would stand down, the first pope to do so in 700 years, saying he no longer had the mental and physical strength to carry on.

Church officials tried to relay a climate of calm confidence in the running of a 2,000-year-old institution, but the decision could lead to uncertainty in a Church already besieged by scandal for covering up sexual abuse of children by priests.

The soft-spoken German, who always maintained that he never wanted to be pope, was an uncompromising conservative on social and theological issues, fighting what he regarded as the increasing secularization of society.

It remains to be seen whether his successor will continue such battles or do more to bend with the times.

Despite his firm opposition to tolerance of homosexual acts, his eight year reign saw gay marriage accepted in many countries. He has staunchly resisted allowing women to be ordained as priests, and opposed embryonic stem cell research, although he retreated slightly from the position that condoms could never be used to fight AIDS.

He repeatedly apologized for the Church's failure to root out child abuse by priests, but critics said he did too little and the efforts failed to stop a rapid decline in Church attendance in the West, especially in his native Europe.

In addition to child sexual abuse crises, his papacy saw the Church rocked by Muslim anger after he compared Islam to violence. Jews were upset over rehabilitation of a Holocaust denier. During a scandal over the Church's business dealings, his butler was accused of leaking his private papers.

In an announcement read to cardinals in Latin, the universal language of the Church, the 85-year-old said: "Well aware of the seriousness of this act, with full freedom I declare that I renounce the ministry of Bishop of Rome, Successor of St Peter ...

"As from 28 February 2013, at 20:00 hours (1900 GMT) the See of Rome, the See of St. Peter will be vacant and a conclave to elect the new Supreme Pontiff will have to be convoked by those whose competence it is."

POPE DOESN'T FEAR SCHISM

Benedict is expected to go into isolation for at least a while after his resignation. Vatican spokesman Father Federico Lombardi said Benedict did not intend to influence the decision of the cardinals in a secret conclave to elect a successor.

A new leader of the world's 1.2 billion Roman Catholics could be elected as soon as Palm Sunday, on March 24, and be ready to take over by Easter a week later, Lombardi said.

Several popes in the past, including Benedict's predecessor John Paul, have refrained from stepping down over their health, because of the division that could be caused by having an "ex-pope" and a reigning pope alive at the same time.

Lombardi said the pope did not fear a possible "schism", with Catholics owing allegiances to a past and present pope in case of differences on Church teachings.

He indicated the complex machinery of the process to elect a new pope would move quickly because the Vatican would not have to wait until after the elaborate funeral services for a pope.

It is not clear if Benedict will have a public life after he resigns. Lombardi said Benedict would first go to the papal summer residence south of Rome and then move into a cloistered convent inside the Vatican walls.

The resignation means that cardinals from around the world will begin arriving in Rome in March and after preliminary meetings, lock themselves in a secret conclave and elect the new pope from among themselves in votes in the Sistine Chapel.

There has been growing pressure on the Church for it to choose a pope from the developing world to better reflect where most Catholics live and where the Church is growing.

"It could be time for a black pope, or a yellow one, or a red one, or a Latin American," said Guatemala's Archbishop Oscar Julio Vian Morales.

The cardinals may also want a younger man. John Paul was 58 when he was elected in 1978. Benedict was 20 years older.

"We have had two intellectuals in a row, two academics, perhaps it is time for a diplomat," said Father Tom Reese, senior fellow at the Woodstock Theological Center at Georgetown University. "Rather than electing the smartest man in the room, they should elect the man who will listen to all the other smart people in the Church."

Liberals have already begun calling for a pope that would be more open to reform.

"The current system remains an 'old boy's club' and does not allow for women's voices to participate in the decision of the next leader of our Church," said the Women's Ordination Conference, a group that wants women to be able to be priests.

"GREAT COURAGE"

The last pope to resign willingly was Celestine V in 1294 after reigning for only five months, his resignation was known as "the great refusal" and was condemned by the poet Dante in the "Divine Comedy". Gregory XII reluctantly abdicated in 1415 to end a dispute with a rival claimant to the papacy.

Lombardi said Benedict's stepping aside showed "great courage". He ruled out any specific illness or depression and said the decision was made in the last few months "without outside pressure". But the decision was not without controversy.

"This is disconcerting, he is leaving his flock," said Alessandra Mussolini, a parliamentarian who is granddaughter of Italy's wartime dictator. "The pope is not any man. He is the vicar of Christ. He should stay on to the end, go ahead and bear his cross to the end. This is a huge sign of world destabilization that will weaken the Church."

Cardinal Stanislaw Dziwisz, secretary to the late Pope John Paul, said the former pope had stayed on despite failing health for the last decade of his life as he believed "you cannot come down from the cross."

While the pope had slowed down recently - he started using a cane and a wheeled platform to take him up the long aisle in St Peter's Square - he had given no hint recently that he was considering such a dramatic decision.

Elected in 2005 to succeed the enormously popular John Paul, Benedict never appeared to feel comfortable in the job.

"MIND AND BODY"

In his announcement, the pope told the cardinals that in order to govern "... both strength of mind and body are necessary, strength which in the last few months, has deteriorated in me to the extent that I have had to recognize my incapacity to adequately fulfill the ministry entrusted to me."

Before he was elected pope, the former Cardinal Joseph Ratzinger was known as "God's rottweiler" for his stern stand on theological issues. After a few months, he showed a milder side but he never drew the kind of adulation that had marked the 27-year papacy of his predecessor John Paul.

U.S. President Barack Obama extended prayers to Benedict and best wishes to those who would choose his successor.

German Chancellor Angela Merkel said the pope's decision must be respected if he feels he is too weak to carry out his duties. British Prime Minister David Cameron said: "He will be missed as a spiritual leader to millions."

The Archbishop of Canterbury, leader of the worldwide Anglican communion, said he had learned of the pope's decision with a heavy heart but complete understanding.

CHEERS AND SCANDAL

Elected to the papacy on April 19, 2005, Benedict ruled over a slower-paced, more cerebral and less impulsive Vatican.

But while conservatives cheered him for trying to reaffirm traditional Catholic identity, his critics accused him of turning back the clock on reforms by nearly half a century and hurting dialogue with Muslims, Jews and other Christians.

After appearing uncomfortable in the limelight at the start, he began feeling at home with his new job and showed that he intended to be pope in his way.

Despite great reverence for his charismatic, globe-trotting predecessor -- whom he put on the fast track to sainthood and whom he beatified in 2011 -- aides said he was determined not to change his quiet manner to imitate John Paul's style.

A quiet, professorial type who relaxed by playing the piano, he showed the gentle side of a man who was the Vatican's chief doctrinal enforcer for nearly a quarter of a century.

The first German pope for some 1,000 years and the second non-Italian in a row, he traveled regularly, making about four foreign trips a year, but never managed to draw the oceanic crowds of his predecessor.

The child abuse scandals hounded most of his papacy. He ordered an official inquiry into abuse in Ireland, which led to the resignation of several bishops.

Scandal from a source much closer to home hit in 2012 when the pontiff's butler, responsible for dressing him and bringing him meals, was found to be the source of leaked documents alleging corruption in the Vatican's business dealings.

Benedict confronted his own country's past when he visited the Nazi death camp at Auschwitz. Calling himself "a son of Germany", he prayed and asked why God was silent when 1.5 million victims, most of them Jews, were killed there.

Ratzinger served in the Hitler Youth during World War Two when membership was compulsory. He was never a member of the Nazi party and his family opposed Adolf Hitler's regime.

(Additional reporting by James Mackenzie, Barry Moody, Cristiano Corvino, Alexandra Hudson in Berlin, and Dagamara Leszkowixa in Poland; Editing by Peter Graff)

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US urges G20 to avoid competitive devaluation

WASHINGTON: The United States on Monday urged the Group of 20 economic powers, which holds a meeting later this week, to avoid competitive currency devaluation that would threaten economic growth.

"To ensure growth strategies in the world's largest economies are mutually compatible and promote global growth, the G20 needs to deliver on the commitment to move to market-determined exchange rates and refrain from competitive devaluation," said Lael Brainard, the Treasury official who will lead the US delegation to the meeting.

Japan's recent monetary easing has stoked fears, especially in Europe, of a currency war between the major economies as policymakers seek to devalue their currencies to make exports more competitive.

Brainard, the Treasury under secretary for international affairs, notably called on China to do more to let the yuan float more freely in the market.

"It will be important that China... reinvigorate the move to a market-determined exchange rate and interest rates," she said.

Brainard was speaking at a news conference focused on the G20 finance chiefs meeting that opens Friday in Moscow.

She underscored that some emerging-market economies have tightly run exchange-rate regimes with extensive capital controls.

"The asymmetry in exchange rate policy creates the potential for conflict" and "generates protectionist measures," she noted.

She also called on Beijing to improve its adherence to international trade rules.

The United States regularly accuses China, which had a record US$315 billion trade surplus with the US in 2012, of favouring its state-controlled businesses and subsidizing exports.

Saying that global growth was still weak after the 2007-2009 financial crisis, Brainard warned against complacency and recommended avoiding any severe budget adjustments.

"We must avoid jeopardising the recovery with a premature shift to restraint," she said.

One-third of the G20 advanced and emerging-market economies, which represent almost 90 per cent of the global economy, were in recession, she said.

Brainard said that the International Monetary Fund's recent admission that it had underestimated the impact of austerity plans on growth should raise a red flag when policymakers look at making budget cuts.

"The G20 has to do a better job balancing medium-term fiscal consolidation with the imperative of supporting near-term growth," she said.

"We need to do more to get people back to work."

As for the United States, Brainard said that big across-the-board spending cuts due to take effect March 1, known as sequestration, pose a serious threat to the country. Without an agreement in Congress to avert the cuts, the Defense Department budget will be cut by up to 10 per cent.

"It's important to avoid sequestration, which is a blunt and indiscriminate instrument that poses a serious threat to national security, domestic priorities and the economy, she said.

- AFP/jc

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Punjab cop among 2 held for minor's rape

FARIDKOT: Police on Monday arrested two persons, including a Punjab Police constable, for allegedly abducting and gang raping a minor girl in a Faridkot village.

The accused have been identified as Kulwinder Singh, 25, a constable posted with the Faridkot police, and Kuldeep Singh, 24. Both the accused, who belong to the victim's village, were produced in the local court on Monday which remanded them in police custody of four days.

According to police complaint, the 14-year-old girl was abducted by the duo on Sunday evening and allegedly raped. The complaint was filed by the girl's grandfather after she did not return home till late Sunday evening.

Police have registered a case of abduction on Sunday night and arrested the accused and recovered the girl on Monday morning from near Hariwala village and added the charges of rape after medical examination confirmed the crime.

Sadar police station SHO Pratap Singh said the car used for abducting the minor girl has also been recovered. The car is registered in the name of Kulwinder's father, the SHO added.

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