U.S. News: Suicides are surging among US troops

UPDATES CHART WITH JUNE 3 NUMBERS: Chart shows suicides across the military since 2008;

WASHINGTON (AP) -- Suicides are surging among America's troops, averaging nearly one a day this year - the fastest pace in the nation's decade of war.

The 154 suicides for active-duty troops in the first 155 days of the year far outdistance the U.S. forces killed in action in Afghanistan - about 50 percent more - according to Pentagon statistics obtained by The Associated Press.

The numbers reflect a military burdened with wartime demands from Iraq and Afghanistan that have taken a greater toll than foreseen a decade ago. The military also is struggling with increased sexual assaults, alcohol abuse, domestic violence and other misbehavior.

Because suicides had leveled off in 2010 and 2011, this year's upswing has caught some officials by surprise.

The reasons for the increase are not fully understood. Among explanations, studies have pointed to combat exposure, post-traumatic stress, misuse of prescription medications and personal financial problems. Army data suggest soldiers with multiple combat tours are at greater risk of committing suicide, although a substantial proportion of Army suicides are committed by soldiers who never deployed.

The unpopular war in Afghanistan is winding down with the last combat troops scheduled to leave at the end of 2014. But this year has seen record numbers of soldiers being killed by Afghan troops, and there also have been several scandals involving U.S. troop misconduct.

The 2012 active-duty suicide total of 154 through June 3 compares to 130 in the same period last year, an 18 percent increase. And it's more than the 136.2 suicides that the Pentagon had projected for this period based on the trend from 2001-2011. This year's January-May total is up 25 percent from two years ago, and it is 16 percent ahead of the pace for 2009, which ended with the highest yearly total thus far.

Suicide totals have exceeded U.S. combat deaths in Afghanistan in earlier periods, including for the full years 2008 and 2009.

The suicide pattern varies over the course of a year, but in each of the past five years the trend through May was a reliable predictor for the full year, according to a chart based on figures provided by the Armed Forces Medical Examiner.

The numbers are rising among the 1.4 million active-duty military personnel despite years of effort to encourage troops to seek help with mental health problems. Many in the military believe that going for help is seen as a sign of weakness and thus a potential threat to advancement.

Kim Ruocco, widow of Marine Maj. John Ruocco, a helicopter pilot who hanged himself in 2005 between Iraq deployments, said he was unable to bring himself to go for help.

"He was so afraid of how people would view him once he went for help," she said in an interview at her home in suburban Boston. "He thought that people would think he was weak, that people would think he was just trying to get out of redeploying or trying to get out of service, or that he just couldn't hack it - when, in reality, he was sick. He had suffered injury in combat and he had also suffered from depression and let it go untreated for years. And because of that, he's dead today."

Ruocco is currently director of suicide prevention programs for the military support organization Tragedy Assistance Programs, or TAPS. She joined the group after her husband's suicide, and she organized its first program focused on support for families of suicide victims.

Jackie Garrick, head of a newly established Defense Suicide Prevention Office at the Pentagon, said in an interview Thursday that the suicide numbers this year are troubling.

"We are very concerned at this point that we are seeing a high number of suicides at a point in time where we were expecting to see a lower number of suicides," she said, adding that the weak U.S. economy may be confounding preventive efforts even as the pace of military deployments eases.

Garrick said experts are still struggling to understand suicidal behavior.

"What makes one person become suicidal and another not is truly an unknown," she said.

Dr. Stephen N. Xenakis, a retired Army brigadier general and a practicing psychiatrist, said the suicides reflect the level of tension as the U.S. eases out of Afghanistan though violence continues.

"It's a sign in general of the stress the Army has been under over the 10 years of war," he said in an interview. "We've seen before that these signs show up even more dramatically when the fighting seems to go down and the Army is returning to garrison."

But Xenakis said he worries that many senior military officers do not grasp the nature of the suicide problem.

A glaring example of that became public when a senior Army general recently told soldiers considering suicide to "act like an adult."

Maj. Gen. Dana Pittard, commander of the 1st Armored Division, last month retracted - but did not apologize for - a statement in his Army blog in January. He had written, "I have now come to the conclusion that suicide is an absolutely selfish act." He also wrote, ""I am personally fed up with soldiers who are choosing to take their own lives so that others can clean up their mess. Be an adult, act like an adult, and deal with your real-life problems like the rest of us." He did also counsel soldiers to seek help.

His remarks drew a public rebuke from the Army, which has the highest number of suicides and called his assertions "clearly wrong." Last week the chairman of the Joint Chiefs of Staff, Army Gen. Martin Dempsey, said he disagrees with Pittard "in the strongest possible terms."

The military services have set up confidential telephone hotlines, placed more mental health specialists on the battlefield, added training in stress management, invested more in research on mental health risk and taken other measures.

The Marines established a counseling service dubbed "DStress line," a toll-free number that troubled Marines can call anonymously. They also can use a Marine website to chat online anonymously with a counselor.

The Marines arguably have had the most success recently in lowering their suicide numbers, which are up slightly this year but are roughly in line with levels of the past four years. The Army's numbers also are up slightly. The Air Force has seen a spike, to 32 through June 3 compared to 23 at the same point last year. The Navy is slightly above its 10-year trend line but down a bit from 2011.

As part of its prevention strategy, the Navy has published a list of "truths" about suicide.

"Most suicidal people are not psychotic or insane," it says. "They might be upset, grief-stricken, depressed or despairing."

In a report published in January the Army said the true impact of its prevention programs is unknown.

"What is known is that all Army populations ... are under increased stress after a decade of war," it said, adding that if not for prevention efforts the Army's suicide totals might have been as much as four times as high.

Marine Sgt. Maj. Bryan Battaglia, the senior enlisted adviser to the chairman of the Joint Chiefs of Staff, recently issued a video message to all military members in which he noted that suicides "are sadly on the rise."

"From private to general, we shoulder an obligation to look and listen for signs and we stand ready to intervene and assist our follow service member or battle buddy in time of need," Battaglia said.

The suicide numbers began surging in 2006. They soared in 2009 and then leveled off before climbing again this year. The statistics include only active-duty troops, not veterans who returned to civilian life after fighting in Iraq or Afghanistan. Nor does the Pentagon's tally include non-mobilized National Guard or Reserve members.

The renewed surge in suicides has caught the attention of Defense Secretary Leon Panetta. Last month he sent an internal memo to the Pentagon's top civilian and military leaders in which he called suicide "one of the most complex and urgent problems" facing the Defense Department, according to a copy provided to the AP.

Panetta touched on one of the most sensitive aspects of the problem: the stigma associated seeking help for mental distress. This is particularly acute in the military.

"We must continue to fight to eliminate the stigma from those with post-traumatic stress and other mental health issues," Panetta wrote, adding that commanders "cannot tolerate any actions that belittle, haze, humiliate or ostracize any individual, especially those who require or are responsibly seeking professional services."

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Pakistan blocks Twitter over contentious tweets

 Pakistan blocks Twitter

ISLAMABAD (AP) -- Pakistan blocked the social networking website Twitter for several hours because it refused to remove tweets considered offensive to Islam, said one of the country's top telecommunications officials.

The tweets were promoting a competition on Facebook to post images of Islam's Prophet Muhammad, said Mohammad Yaseen, chairman of the Pakistan Telecommunication's Authority. Many Muslims regard depictions of the prophet, even favorable ones, as blasphemous.

The government restored access to Twitter before midnight Sunday, about eight hours after it initially blocked access, possibly because of public criticism it received for its censorship.

Twitter spokesman Gabriel Stricker said the company had not taken down any tweets or made any other changes before Pakistan stopped blocking the site.

Yaseen said Sunday afternoon that Pakistan's Ministry of Information Technology had ordered the telecommunications authority to block Twitter because the company refused to remove the offending tweets.

The ministry informed Yaseen to restore access to Twitter Sunday evening, but he did not know what led to the decision.

Yaseen said Facebook had agreed to address Pakistan's concern about the competition.

Facebook confirmed in a written statement that it blocked access to the content in Pakistan. The site noted that it occasionally restricts content when it is illegal or offensive out of respect for local laws and culture.

A top court in Pakistan ordered a ban on Facebook in 2010 amid anger over a similar competition. The ban was lifted about two weeks later, after Facebook blocked the particular page in Pakistan. The Pakistani government said at the time that it would continue to monitor other major websites for anti-Islamic links and content.

Even when Twitter was blocked Sunday, many people based in Pakistan continued to use the website by employing programs that disguise the user's location. There was widespread criticism of the government's action by those on Twitter, who tend to be more liberal than average Pakistanis.

"Another cheap moral stunt by Pakistan," tweeted liberal Pakistani columnist Nadeem Paracha.

The 2010 Facebook controversy sparked many in Pakistan's liberal elite to question why Pakistanis could not be entrusted to decide for themselves whether or not to look at a website. Some observers noted that Pakistan had gone further than several other Muslim countries by banning Facebook, and said it showed the rise of conservative Islam in the country.

There were a handful of protests against Facebook back in 2010, often organized by student members of radical Islamic groups. Some of the protesters carried signs advocating holy war against the website for allowing the competition page to be posted in the first place.

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Ex-tabloid editor faces phone hacking charges

Rebekah Brooks, former chief executive of News International

LONDON (AP) -- Ex-News of the World editor Rebekah Brooks, her husband and four others were charged Tuesday over alleged attempts to conceal evidence of Britain's tabloid phone hacking scandal, prosecutors said.

The criminal charges are the first to be filed since police launched a new inquiry into phone hacking in January 2011. Previously, two people were jailed in 2007 for hacking the phones of members of the royal household.

Brooks, 43, who quit as News International chief executive in July, faces three separate allegations of conspiracy to pervert the course of justice - an offense that carries a maximum sentence of life imprisonment.

Alison Levitt, the principal legal advisor to Britain's Director of Public Prosecutions, said that Brooks is alleged to have concealed material from police - including computers and other electronic devices - and is accused of removing seven boxes of material from News International archives.

Brooks' husband Charlie Brooks, a racehorse trainer; Brooks' former personal assistant Cheryl Carter; the ex-head of security at News International Mark Hanna; Brooks' ex-chauffeur Paul Edwards; and Daryl Jorsling, a member of the firm's security staff, also face allegations of obstruction of justice.

Levitt confirmed that a seventh person, who was also a member of News International security staff, would not face any charges.

"All these matters relate to the ongoing police investigation into allegations of phone hacking and corruption of public officials in relation to the News of the World and The Sun newspapers," Levitt said.

The offenses are all alleged to have taken place in the frantic days last July when Rupert Murdoch closed down the 168-year-old News of The World amid widespread public disgust over revelations that it had hacked the cell phone of a missing schoolgirl who was later found dead.

Murdoch announced his decision on July 7, 2011. Levitt said the alleged offenses took place between July 6 and July 19.

In a statement, Brooks and her husband said the decision by the Crown Prosecution Service to file charges was unjust.

"We deplore this weak and unjust decision. After the further unprecedented posturing of the CPS we will respond later today after our return from the police station," the couple said in a statement.

Levitt said that all six would appear for hearings at Westminster Magistrates' Court. No dates have been set for the hearings.

Carter's lawyer Henri Bradman said in a statement that Brooks' former assistant "vigorously denies the commission" of any offense. He said that the ex-aide was suffering the "most unhappy period of her life."

Brooks, who spent more than 20 years working in the News Corp. empire - rising from a junior employee to chief executive - remains on police bail over separate allegations related to illegal eavesdropping, and will face more questions from detectives on that issue in the coming months.

Last week, she was questioned by Britain's media ethics inquiry over her close links to leading politicians - including Prime Minister David Cameron, a neighbor and longtime friend of her husband.

She acknowledged that while serving as a news executive she had frequently traded text messages with Cameron, and that he had sent her a message of support as she stepped down amid the scandal.

Separately, police said Tuesday that two people had been arrested in their investigation into the alleged bribery of public officials by tabloid reporters seeking scoops.

A 50-year-old man who works for Britain's Revenue and Customs department, which handles taxes and welfare payments, was detained on suspicion of misconduct in a public office. A 43-year-old woman was arrested over an allegation of assisting misconduct in a public office and money laundering offenses.

Detectives said that both arrests were the result of information supplied by News Corp.'s management standards committee, which has turned over evidence of alleged wrongdoing.

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A black mark for survivor of financial crisis

JPMorgan Chase & Co. Chief Executive Officer Jamie Dimon, center

NEW YORK (AP) -- The reputation that Jamie Dimon honed for decades on Wall Street has been severely damaged in a matter of days.

In the 1980s and 1990s, he was the protege of banking industry legend Sanford Weill. In the early 2000s, he took over Bank One, an institution few believed was fixable, and restored it to a profit.

And in 2008 and 2009, at JPMorgan Chase, Dimon built a fortress strong enough to stay profitable during the financial crisis.

His zeal for cost-cutting and perceived mastery of risk did more than keep JPMorgan strong enough to bail out two failing competitors, Bear Stearns and Washington Mutual. It gave him a kind of street cred during the post-crisis years, when he lashed out at regulators who sought to rein in banks, and Occupy Wall Street protesters who raged against them.

Now all that is on the line.

Dimon had to face stock analysts and reporters on Thursday and confess to a "flawed, complex, poorly reviewed, poorly executed and poorly monitored" trading strategy that lost a surprise $2 billion.

The revelation caused traders to shave almost 10 percent off JPMorgan's stock price the following day and brought a shower of complaints from industry observers and lawmakers who said banks needed tighter scrutiny.

Making the black eye worse for Dimon, the loss came in derivatives trading, the complex financial maneuvering that - on a much greater scale - led to large losses and dissolved banks during the financial crisis.

Dimon "staked so much of his reputation on creating this perception of being the ultimate, infallible risk manager," said Simon Johnson, a former chief economist of the International Monetary Fund who is now a professor at MIT. "And along comes this huge mistake."

Dimon, 56, grew up in the Queens borough of New York City, the grandson of a Greek immigrant. His father was a stockbroker who worked for many years at Merrill Lynch.

After college and business school, Dimon turned down an offer from the venerable investment bank Goldman Sachs. Weill had been Dimon's father's boss at a previous job and recruited the younger Dimon to American Express.

Weill became Dimon's mentor. When Weill left American Express in 1986, Dimon followed him to Commercial Credit Co., a sleepy finance firm that catered to middle-class clients.

Weill went on to buy a host of companies, including Smith Barney and Travelers, and Dimon led some of those divisions. The empire-building culminated when Travelers merged with Citicorp to form Citigroup in 1998, the largest U.S. bank at that time.

Dimon was the heir apparent but had started to clash with Weill. Weill was insecure about Dimon's growing assertiveness, and Dimon often showed his temper in meetings. Weill fired Dimon in 1998.

Dimon spent time reading biographies of statesmen and took up boxing lessons to let off steam. In 2000, he became CEO of Bank One, a Chicago bank that was losing money. By 2003, he had turned the bank around, and in 2004 it merged with JPMorgan Chase. Dimon became CEO of JPMorgan in 2006.

By that time, Dimon had lived through several industry crises, including the savings and loan meltdown of the late 1980s, a Russian debt default in 1998 and the dot-com stock bust of the early 2000s.

Dimon was not the man responsible for any of those, of course, as he is for the $2 billion error.

His admission of the mistake this week left some analysts asking whether his grip is slipping, and the bank's more than $2 trillion in assets have become too big for him to manage.

More likely, some other analysts said, it is a statement about how, three and a half years after the crisis, banks still conduct impossibly complex trades that are difficult to track.

"If even Jamie gets it wrong managing a $2 trillion bank, what does it say about banks where management is far inferior?" said Mike Mayo, a bank analyst at the brokerage CLSA and author of the book "Exile on Wall Street."

Just a few weeks ago, while answering questions from stock analysts, Dimon dismissed media reports of big market-moving trades by JPMorgan as a "complete tempest in a teapot."

He admitted Thursday that he should have been paying better attention. Asked to what, he first said trading losses then said, "There was some stuff in the newspaper and a bunch of other stuff."

Dimon's signature trait has been cost-cutting, an attribute that helped the banks he led squirrel cash away. At Bank One, after finding out how many newspaper subscriptions the bank paid for, he is reported to have told an executive: "You're a businessman; pay for your own Wall Street Journal."

That low tolerance for profligacy kept the banks he managed strong enough to weather any crisis. Now, Dimon says the trade that was conducted is so complex that the losses could easily get worse.

JPMorgan's $2 billion loss was caused by trades that were meant to hedge, or protect, the bank from trading losses that could occur in the investments of the bank's corporate treasury.

The amount of the loss was small for an institution of JPMorgan's size - it cleared $19 billion in profit last year - but will hurt its second-quarter earnings and was an embarrassment. It rattled the industry, too. Other bank stocks fell as much as 4 percent Friday.

"It puts egg on our face, and we deserve any criticism we get," Dimon said at a hastily convened conference call with investors to reveal the losses.

During the crisis in 2008, Dimon drew wide praise for keeping his bank healthy, including from President Barack Obama and billionaire investor Warren Buffett. One biographical book that was released soon after the financial crisis was titled "Last Man Standing."

In the years since, other Wall Street bankers and CEOs have cowered as the public backlash against bankers and their bonuses has grown. But Dimon, who made $23 million last year, according to an Associated Press calculation, used his stature to become the most outspoken banking CEO.

He attacked any obstacle that came in his way or his company's - especially regulations aimed at stopping banks from taking the kinds of risks that precipitated the financial crisis. Dimon viewed them as impediments to the bank's ability to make a profit.

He did not even spare the Federal Reserve chairman, Ben Bernanke, or one of his iconic predecessors, Paul Volcker. At times, his outspokenness took on a swagger that raised eyebrows.

At a public forum last year, Dimon pointedly challenged Bernanke to defend his regulatory drive, which he said was going to slow down the U.S. economic recovery.

Earlier this year, Dimon said in a Fox Business Network interview: "Paul Volcker, by his own admission, has said he doesn't understand capital markets. ... He has proven that to me."

One of the most respected Fed chiefs, Volcker has championed a law that restricts banks from trading with their own money.

Since Thursday, Dimon has contended the trades in question were meant to manage the bank's financial risk, not turn a profit, and thus would not be subject to the so-called Volcker rule.

Outside analysts have been more skeptical, and the mistake has breathed energy into the push to toughen financial regulations. Dimon did say that he should have been paying closer attention.

"We know we were sloppy. We know we were stupid. We know there was bad judgment," he told NBC News on Friday in an interview to air Sunday on "Meet the Press."

He said he did not know whether laws had been broken and invited regulators to look into the matter. "But we intend to fix it and learn from it and be a better company when it's done," he added.

Most analysts gave Dimon kudos for coming clean on the trading loss, but few disagreed that his reputation had taken a severe hit.

Said Nancy Bush, longtime bank analyst at NAB research, and contributing editor at SNL Financial: "Jamie certainly cannot be standard-bearer for the banking industry anymore."

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French Election: Hollande defeats Sarkozy 51.62 pct to 48.38 pct

French president-elect Francois Hollande wave to supporters with his companion

PARIS (AP) -- France has awoken to a new era after electing Socialist Francois Hollande as president, a leftist pledging to buck Europe's austerity trend and NATO's timetable for Afghanistan.

After an appearance before thronging crowds on Paris' Place de la Bastille in the early morning hours Monday at which he pledged "to finish with austerity," Hollande was back at work, arriving at his campaign headquarters around 10:30 a.m. local time.

Hollande has his work cut out to fulfill the hopes his victory has stirred on France's Left, overjoyed to have one of their own in power for the first time since Socialist Francois Mitterrand was president from 1981 to 1995.

Sarkozy is now the latest victim of a wave of voter anger over spending cuts in Europe that has ousted governments and leaders in the past couple of years.

Final results from France's presidential election show Hollande narrowly defeated Sarkozy with 51.62 percent of the vote, or 1.13 million of the 37 million votes cast in Sunday's election.

Sarkozy, who finished the first round about half-a-million votes behind Hollande, failed in his bid to attract sufficient votes from supporters of far-right leader Marine Le Pen.

The head of the National Front party refused to endorse either candidate and said she would cast a blank vote. In that, she was followed by more than 2 million others, a total far higher than in previous elections.

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Thousands march as Japan shuts off nuclear power

Participants raise banners with a slogan, "Good bye, nuclear power station"

TOKYO (AP) -- Thousands of Japanese marched to celebrate the switching off of the last of their nation's 50 nuclear reactors Saturday, waving banners shaped as giant fish that have become a potent anti-nuclear symbol.

Japan was without electricity from nuclear power for the first time in four decades when the reactor at Tomari nuclear plant on the northern island of Hokkaido went offline for mandatory routine maintenance.

After last year's March 11 quake and tsunami set off meltdowns at the Fukushima Dai-ichi plant, no reactor halted for checkups has been restarted amid public worries about the safety of nuclear technology.

"Today is a historic day," Masashi Ishikawa shouted to a crowd gathered at a Tokyo park, some holding traditional "koinobori" carp-shaped banners for Children's Day that have become a symbol of the anti-nuclear movement.

"There are so many nuclear plants, but not a single one will be up and running today, and that's because of our efforts," Ishikawa said.

The activists said it is fitting that the day Japan stopped nuclear power coincides with Children's Day because of their concerns about protecting children from radiation, which Fukushima Dai-ichi is still spewing into the air and water.

The government has been eager to restart nuclear reactors, warning about blackouts and rising carbon emissions as Japan is forced to turn to oil and gas for energy.

Japan now requires reactors to pass new tests to withstand quakes and tsunami and to gain local residents' approval before restarting.

The response from people living near nuclear plants has been mixed, with some wanting them back in operation because of jobs, subsidies and other benefits to the local economy.

The mayor of Tomari city, Hiroomi Makino, is among those who support nuclear power.

"There may be various ways of thinking but it's extremely regrettable," he said of the shutdown.

Major protests, like the one Saturday, have been generally limited to urban areas like Tokyo, which had received electricity from faraway nuclear plants, including Fukushima Dai-ichi.

Before the nuclear crisis, Japan relied on nuclear power for a third of its electricity.

The crowd at the anti-nuclear rally, estimated at 5,500 by organizers, shrugged off government warnings about a power shortage. If anything, they said, with the reactors going offline one by one, it was clear the nation didn't really need nuclear power.

Whether Japan will suffer a sharp power crunch is still unclear.

Electricity shortages are expected only at peak periods, such as the middle of the day in hot weather, and critics of nuclear power say proponents are exaggerating the consequences to win public approval to restart reactors.

Hokkaido Electric Power Co. spokesman Hisatoshi Kibayashi said the shutdown was completed late Saturday.

The Hokkaido Tomari plant has three reactors, but the other two had been halted earlier. Before March 11 last year, the nation had 54 nuclear reactors, but four of the six reactors at Fukushima Dai-ichi are being decommissioned because of the disaster.

Yoko Kataoka, a retired baker who was dancing to the music at the rally waving a small paper carp, said she was happy the reactor was being turned off.

"Let's leave an Earth where our children and grandchildren can all play without worries," she said, wearing a shirt that had, "No thank you, nukes," handwritten on the back.

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Breast cancer is rare in men, but they fare worse

A surgery scar is seen on breast cancer survivor Robert Kaitz's left breast

CHICAGO (AP) -- Men rarely get breast cancer, but those who do often don't survive as long as women, largely because they don't even realize they can get it and are slow to recognize the warning signs, researchers say.

On average, women with breast cancer lived two years longer than men in the biggest study yet of the disease in males.

The study found that men's breast tumors were larger at diagnosis, more advanced and more likely to have spread to other parts of the body. Men were also diagnosed later in life; in the study, they were 63 on average, versus 59 for women.

Many men have no idea that they can get breast cancer, and some doctors are in the dark, too, dismissing symptoms that would be an automatic red flag in women, said study leader Dr. Jon Greif, a breast cancer surgeon in Oakland, Calif.

The American Cancer Society estimates 1 in 1,000 men will get breast cancer, versus 1 in 8 women. By comparison, 1 in 6 men will get prostate cancer, the most common cancer in men.

"It's not really been on the radar screen to think about breast cancer in men," said Dr. David Winchester, a breast cancer surgeon in NorthShore University HealthSystem in suburban Chicago who was not involved in the study. Winchester treats only a few men with breast cancer each year, compared with at least 100 women.

The researchers analyzed 10 years of national data on breast cancer cases, from 1998 to 2007. A total of 13,457 male patients diagnosed during those years were included, versus 1.4 million women. The database contains about 75 percent of all U.S. breast cancer cases.

The men who were studied lived an average of about eight years after being diagnosed, compared with more than 10 years for women. The study doesn't indicate whether patients died of breast cancer or something else.

Greif prepared a summary of his study for presentation Friday at a meeting of American Society of Breast Surgeons in Phoenix.

Dr. Akkamma Ravi, a breast cancer specialist at Weill Cornell Medical College in New York, said the research bolsters results in smaller studies and may help raise awareness. Because the disease is so rare in men, research is pretty scant, and doctors are left to treat it the same way they manage the disease in women, she said.

Some doctors said one finding in the study suggests men's breast tumors might be biologically different from women's: Men with early-stage disease had worse survival rates than women with early-stage cancer. But men's older age at diagnosis also might explain that result, Greif said.

The causes of breast cancer in men are not well-studied, but some of the same things that increase women's chances for developing it also affect men, including older age, cancer-linked gene mutations, a family history of the disease, and heavy drinking.

There are no formal guidelines for detecting breast cancer in men. The American Cancer Society says routine, across-the-board screening of men is unlikely to be beneficial because the disease is so rare.

For men at high risk because of a strong family history or genetic mutations, mammograms and breast exams may be helpful, but men should discuss this with their doctors, the group says.

Men's breast cancer usually shows up as a lump under or near a nipple. Nipple discharge and breasts that are misshapen or don't match are also possible signs that should be checked out.

Tom More, 67, of Custer, Wash., was showering when he felt a pea-size lump last year near his right nipple. Because a golfing buddy had breast cancer, More didn't put off seeing his doctor. The doctor told More that he was his first male breast cancer patient.

Robert Kaitz, a computer business owner in Severna Park, Md., thought the small growth under his left nipple was just a harmless cyst, like ones that had been removed from his back. By the time he had it checked out in 2006, almost two years later, the lump had started to hurt.

The diagnosis was a shock.

"I had no idea in the world that men could even get breast cancer," Kaitz said. He had a mastectomy, and 25 nearby lymph nodes were removed, some with cancer. Chemotherapy and radiation followed.

Tests showed Kaitz, 52, had a BRCA genetic mutation that has been linked to breast and ovarian cancer in women. He may have gotten the mutation from his mother, who is also a breast cancer survivor. It has also been linked to prostate cancer, which Kaitz was treated for in 2009.

A powerboater and motorcycle buff, Kaitz jokes about being a man with a woman's disease but said he is not embarrassed and doesn't mind showing his breast surgery scar.

The one thing he couldn't tolerate was tamoxifen, a hormone treatment commonly used to help prevent breast cancer from returning in women. It can cause menopausal symptoms, so he stopped taking it.

"It killed me. I tell you what - night sweats, hot flashes, mood swings, depression. I'd be sitting in front of the TV watching a drama and the tears wouldn't stop pouring," he said.

Doctors sometimes prescribe antidepressants or other medication to control those symptoms.

Now Kaitz gets mammograms every year. Men need to know that "we're not immune," he said. "We have the same plumbing."

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Another finalist takes a bow on 'American Idol'

Skylar Laine performs on the singing competition series "American Idol," 

LOS ANGELES (AP) -- It was an unfortunate night for Skylar Laine on "American Idol."

The 18-year-old country rocker from Brandon, Miss., who imbued Creedence Clearwater Revival's "Fortunate Son" and Dusty Springfield's "Say You Love Me" with her twangy sensibilities on Wednesday's show was revealed to have received the fewest viewer votes Thursday on the Fox singing contest.

Laine was joined at the bottom by Hollie Cavanagh, the 18-year-old balladeer from McKinney, Texas, who opened Wednesday's installment with a pop-infused take on Ike and Tina Turner's "River Deep Mountain High," and later dialed it down with the Leona Lewis hit "Bleeding Love."

"They both sang their faces off last night," said "Idol" judge Randy Jackson.

The other singers remaining in the competition are booming 20-year-old gospel singer Joshua Ledet of Westlake, La.; bluesy 21-year-old pawn shop worker Phillip Phillips of Leesburg, Ga.; and budding 16-year-old pop diva Jessica Sanchez of San Diego.

The four remaining finalists will return to the stage next week.

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15 million of world's babies are born prematurely

A mother carrying her unnamed twin baby, 11 days old, in a Care center

WASHINGTON (AP) -- About 15 million premature babies are born every year - more than 1 in 10 of the world's births and a bigger problem than previously believed, according to the first country-by-country estimates of this obstetric epidemic.

The startling toll: 1.1 million of these fragile newborns die as a result, and even those who survive can suffer lifelong disabilities.

Most of the world's preemies are born in Africa and Asia, says the report released Wednesday.

It's a problem for the U.S., too, where half a million babies are born too soon. That's about 1 in 8 U.S. births, a higher rate than in Europe, Canada, Australia or Japan - and even worse than rates in a number of less developed countries, too, the report found.

But the starkest difference between rich and poorer countries: Survival.

"Being born too soon is an unrecognized killer," said Dr. Joy Lawn of Save the Children, who co-authored the report with the March of Dimes, World Health Organization and a coalition of international health experts. "And it's unrecognized in the countries where you could have a massive effect in reducing these deaths."

Sophisticated and expensive intensive care saves the majority of preterm babies in the U.S. and other developed nations, even the tiniest, most premature ones. The risk of death from prematurity is at least 12 times higher for an African newborn than for a European baby, the report found.

Globally, prematurity is not only the leading killer of newborns but the second-leading cause of death in children under 5.

"These facts should be a call to action," United Nations Secretary-General Ban Ki-moon wrote in an introduction to the report.

Three-quarters of the deaths could be prevented by spreading some simple, inexpensive treatments to the neediest countries, the report concludes. For example, providing $1 steroid shots during preterm labor hastens development of immature fetal lungs. They're standard in developed countries; wider use in low-income countries could save nearly 400,000 babies a year.

Even more lives could be saved by teaching "kangaroo care," in which moms carry their tiny babies nestled skin-to-skin on their bare chests for warmth when there are no incubators.

"To see babies who are 900 grams (about 2 pounds) survive without any technology, it's fantastic," says Lawn, who has watched kangaroo care save lives in countries like Malawi, with the highest preterm birth rate - 18.1 percent.

Also needed: Antibiotics to fight the infections that often kill newborns, and antiseptic cream to prevent umbilical cord infection.

Survival isn't the only hurdle. No one knows how many preemies suffer disabilities including cerebral palsy, blindness or learning disorders.

That's why preventing preterm births in the first place is the ultimate goal, one reason for comparing countries - to learn why some do better and some worse. Previously, the groups had estimated that 13 million babies were born prematurely each year, based on regional data.

About 12 percent of U.S. births are preterm, about the same as Wednesday's report estimates in Thailand, Turkey and Somalia. In contrast, just 5.9 percent of births in Japan and Sweden are premature.

Experts can't fully explain why the U.S. preemie rate is so much worse than similar high-income countries. But part of the reason must be poorer access to prenatal care for uninsured U.S. women, especially minority mothers-to-be, said March of Dimes epidemiologist Christopher Howson. African-American women are nearly twice as likely as white women to receive late or no prenatal care, and they have higher rates of preterm birth as well, he said.

More disturbing, the report ranks the U.S. with a worse preterm birth rate than 58 of the 65 countries that best track the problem, including much of Latin America. Add dozens of poor countries where the counts are less certain, and the report estimates that 127 other nations may have lower rates.

Whatever the precise numbers, "we have a shared problem among all countries and we need a shared solution," Howson said.

One key: Not just early prenatal care but more preconception care, he said. Given that in the U.S. alone, nearly half of pregnancies are unplanned, health providers should use any encounter with a woman of childbearing age to check for factors that could imperil a pregnancy.

"Ensure that mom goes into her pregnancy as healthy as possible," Howson said.

Scientists don't know what causes all preterm birth, and having one preemie greatly increases the risk for another. But among the risk factors:

-Diabetes, high blood pressure, infections and smoking.

-Being underweight or overweight, and spacing pregnancies less than two years apart.

-Pregnancy before age 17 or over 40.

-Carrying twins or more.

-In wealthier countries, early elective inductions and C-sections.

"A healthy baby is worth the wait," Howson said, noting that being even a few weeks early can increase the risk of respiratory problems, jaundice, even death.

The WHO defines a preterm birth as before completion of the 37th week of pregnancy. Most preemies fall in the "late preterm" category, born between 32 and 37 weeks. Extreme preemies are born before 28 weeks. So-called "very preterm" babies fall in between.

Lawn's biggest frustration is how often later preemies die in low-income countries because even the health providers may not know simple steps that might save them - and the fatalism around those deaths.

"If you're in the States and have a preterm baby now, even at 25 weeks you've got a 50 percent chance of survival and people expect that. Whereas in Ghana, if a baby's born 2 months early, people kind of expect the baby to die," she said.

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Junior Seau found dead at California home, U.S.

Luisa Seau, mother of Junior Seau (inset), grieves in the driveway of the home

OCEANSIDE, Calif. (AP) -- Junior Seau, a homegrown superstar who was the fist-pumping, emotional leader of the San Diego Chargers for 13 years, was found shot to death at his home Wednesday morning in what police said appeared to be a suicide. He was 43.

Police Chief Frank McCoy said Seau's girlfriend reported finding him unconscious with a gunshot wound to the chest and lifesaving efforts were unsuccessful. A gun was found near him, McCoy said. Police said no suicide note was found and they didn't immediately know who the gun was registered to.

Seau's death in Oceanside, in northern San Diego County, stunned the region he represented with almost reckless abandon. The same intensity that got the star linebacker ejected for fighting in his first exhibition game helped carry the Chargers to their only Super Bowl, following the 1994 season. A ferocious tackler, he'd leap up, pump a fist and kick out a leg after dropping a ball carrier or quarterback.

"It's a sad thing. It's hard to understand," said Bobby Beathard, who as Chargers general manager took Seau out of Southern California with the fifth pick overall in the 1990 draft. "He was really just a great guy. If you drew up a player you'd love to have the opportunity to draft and have on the team and as a teammate, Junior and Rodney (Harrison), they'd be the kind of guys you'd like to have."

Quarterback Stan Humphries recalled that Seau did everything at the same speed, whether it was practicing, lifting weights or harassing John Elway.

"The intensity, the smile, the infectious attitude, it carried over to all the other guys," said Humphries, who was shocked that Seau is now the eighth player from the '94 Super Bowl team to die.

Seau's mother appeared before reporters outside the former player's house, weeping uncontrollably.

"I don't understand ... I'm shocked," Luisa Seau cried out.

Her son gave no indication of a problem when she spoke to him by phone earlier this week, she said.

"He's joking to me, he called me a `homegirl,'" she said.

Seau's death follows the suicide last year of former Chicago Bears player Dave Duerson, who also shot himself in the chest.

In October 2010, Seau survived a 100-foot plunge down a seaside cliff in his SUV, hours after he was arrested for investigation of domestic violence at the Oceanside home he shared with his girlfriend. The woman had told authorities that Seau assaulted her during an argument.

There was no evidence of drugs or alcohol involved in the crash and Seau told authorities he fell asleep while driving. He sustained minor injuries.

"I just can't imagine this, because I've never seen Junior in a down frame of mind," Beathard said. "He was always so upbeat and he would keep people up. He practiced the way he played. He made practice fun. He was a coach's dream. He was an amazing guy as well as a player and a person. This is hard to believe."

Seau's ex-wife, Gina, told the Union-Tribune San Diego that he texted her and each of their three children separate messages: "I love you."

Seau, who played in the NFL for parts of 20 seasons, is the eighth member of San Diego's lone Super Bowl team who has died, all before the age of 45. Lew Bush, Shawn Lee, David Griggs, Rodney Culver, Doug Miller, Curtis Whitley and Chris Mims are the others. Causes of death ranged from heart attacks to a plane crash to a lightning strike.

Seau's also is among a few recent, unexpected deaths of NFL veterans.

Duerson's family has filed a wrongful death suit against the NFL, claiming the league didn't do enough to prevent or treat concussions that severely damaged Duerson's brain before he died in in February 2011.

Former Atlanta Falcons safety Ray Easterling, who had joined in a concussion-related lawsuit against the league - one of dozens filed in the last year - died last month at age 62. His wife has said he suffered from depression and dementia after taking years of hits.

Seau is not known to have been a plaintiff in the concussion litigation.

However, his ex-wife told The Associated Press that Seau sustained concussions during his career.

"Of course he had. He always bounced back and kept on playing," she said. "He's a warrior. That didn't stop him. I don't know what football player hasn't. It's not ballet. It's part of the game."

Gina Seau said she didn't know if the effects of concussions contributed to Seau's death.

"We have no clues whatsoever. We're as stunned and shocked as anyone else. We're horribly saddened. We miss him and we'll always love him."

When Humphries joined the Chargers in a 1992 trade, he said it was obvious Seau was "the person who had the most energy, the most excited, the guy who tried to rally everybody." Humphries said Seau "brought out a lot of youngness" in older players.

He also helped younger players.

"So sad to hear about Jr Seau," tweeted New Orleans Saints quarterback Drew Brees, who was with San Diego from 2001-05. "Junebug. Buddy. The greatest teammate a young guy could ask for. This is a sad day. He will be missed greatly."

Seau called many of those around him "Buddy." He often referred to teammates as "my players."

Seau was voted to a Chargers-record 12 straight Pro Bowls and was an All-Pro six times.

"We all lost a friend today," Chargers President Dean Spanos said in a statement. "This is just such a tragic loss. One of the worst things I could ever imagine."

Seau's greatest game may have been in the 17-13 victory at Pittsburgh in the AFC championship game in January 1995 that sent the Chargers to the Super Bowl. Playing through the pain of a pinched nerve in his neck, he spread out his 16 tackles from the first play to the second-to-last. San Diego was routed 49-26 in the Super Bowl by San Francisco.

Humphries also recalled Seau recovering Elway's fumble to seal a come-from-behind victory in the 1994 opener at Denver.

Seau left the Chargers after the 2002 season when the team unceremoniously told him he was free to pursue a trade. He held a farewell news conference at the restaurant he owned in Mission Valley, and later was traded to Miami.

Seau retired a few times, the first in August 2006, when he said, "I'm not retiring. I am graduating."

Four days later, he signed with the New England Patriots. He was with the Patriots when they lost to the New York Giants in the Super Bowl following the 2007 season, which ended New England's quest for a perfect season.

Last fall, finally retired for good, Seau was inducted into the San Diego Chargers Hall of Fame.

His last season was 2009.

"Twenty years, to be part of this kind of fraternity, to be able to go out and play the game that you love, and all the lessons and the friends and acquaintances which you meet along the way, you can't be in a better arena," Seau said in August.

The Patriots issued a statement expressing grief over Seau's death. "This is a sad day for the entire Patriots organization, our coaches and his many Patriots teammates," the statement said.

More than 100 people gathered outside of Seau's home, only hours after he was found dead. Families showed up with flowers and fans wearing Chargers jerseys waited to get news.

Several hours after Seau was found, his body was loaded onto a medical examiner's van and taken away as fans snapped pictures and raised their hands in the air as if in prayer.

Family friend Priscilla Sanga said about 50 friends and family members gathered in the garage where Seau's body lay on a gurney and they had the opportunity to say goodbye.

"Everybody got to see Junior before they took him away," Sanga said. "He looked so peaceful and cold. It was disbelief. We all touched him and kissed him."

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Taliban kill 7 in Afghan capital after Obama visit

A French soldier part of the NATO forces walks on debris

KABUL, Afghanistan (AP) -- The Taliban struck back less than two hours after President Barack Obama left Afghanistan on Wednesday, targeting a foreigners' housing compound with a suicide car bomb and militants disguised as women in an assault that killed at least seven people.

It was the second major assault in Kabul in less than three weeks and highlighted the Taliban's continued ability to strike in the heavily guarded capital even when security had been tightened for Obama's visit and Wednesday's anniversary of the killing of al-Qaida leader Osama bin Laden in neighboring Pakistan.

Obama arrived at Bagram Air Field late Tuesday, then traveled to Kabul by helicopter for a meeting with President Hamid Karzai in which they signed an agreement governing the U.S. presence after combat troops withdraw in 2014. Later, back at the base, he was surrounded by U.S. troops, shaking every hand. He then gave a speech broadcast to Americans back home, before ending his lightning visit just before 4:30 a.m.

The U.S. president, who is in the midst of a re-election campaign, touted the Navy SEAL raid that killed bin Laden a year ago Wednesday, noting that the operation was launched from a base in Afghanistan.

He also said that "the tide has turned" over the last three years.

"We broke the Taliban's momentum. We've built strong Afghan security forces. We devastated al-Qaida's leadership, taking out over 20 of their top 30 leaders," he said.

But the violence that erupted about 90 minutes after his departure was a stark reminder of the difficult task still ahead for Afghan troops as they work to secure their country after U.S. and other foreign troops end their combat mission following nearly a decade at war.

The deal signed with Karzai does not commit the United States to any specific troop presence or spending. But it does allow the U.S. to potentially keep troops in Afghanistan through 2024 for two specific purposes: continued training of Afghan forces and targeted operations against al-Qaida.

The United States also promises to seek money from Congress every year to support Afghanistan.

The attack began with a suicide car bomb near the gate of the privately guarded compound, which sits off Jalalabad road - one of the main thoroughfares out of the city, Interior Ministry spokesman Sediq Sediqi said.

Kabul Deputy Police Chief Daoud Amin said those killed in the blast included four people in a station wagon that was driving past the area, a passer-by and a Nepalese security guard. He didn't have the identity of the seventh person killed. The Interior Ministry said 17 other people were wounded, most Afghan children on their way to school.

A local witness said a separate group of attackers disguised in burqas - the head-to-toe robes worn by conservative Afghan women - then tried to storm the compound.

"A vehicle stopped here and six people wearing burqas entered the alley carrying black bags in their hands. When they entered the alley, there was an explosion," said Abdul Manan.

Explosions and gunfire shook the city for hours as Afghan soldiers rushed to the scene and battled the attackers.

A Western official who had been briefed on the assault said the attackers had breached the perimeter defense, around the compound's parking areas, but had not gotten past a secondary security gate that protects the actual living areas. He spoke on condition of anonymity because he was not authorized to release the information.

The area appeared to have calmed down by about 10 a.m. NATO said all the attackers had been killed. It did not give a number, but the Taliban said it had deployed four fighters as it claimed responsibility for the attack.

The compound, which is known as Green Village, houses hundreds of international contractors, diplomats and aid workers in eastern Kabul. It also was the target of anti-foreigner protests following the burning of Qurans at a U.S. base in February. At that time, violent protests raged outside, but the angry crowds did not breach the compound's defenses.

The compound's main gate was destroyed, with the wreckage of the suicide bomber's car sitting in front, and the road running past it was littered with shoes, books, school supplies and the bloody ID card of a student from a nearby school.

A young man who saw the explosion said the dead pedestrian was one of his fellow classmates.

"I was walking to school when I saw a very big explosion. A car exploded and flames went very high into the air," said 21-year-old Mohammad Wali. "Then I saw a body of one of my classmates lying on the street. I knew it was a suicide attack and ran away. I was so afraid."

Taliban spokesman Zabiullah Mujahid claimed responsibility for the attack.

"This was a message to Obama that those are not real Afghans that are signing documents about this country," Mujahid said. "The real Afghan nation are those people that are not letting foreign invaders stay in this country or disrespect the dignity of our country."

He said the target of Wednesday's attack was a "foreign military base." A spokesman for the alliance, Capt. Justin Brockhoff, said no NATO bases came under attack.

The Green Village complex, with its towering blast walls and heavily armed security force, is very similar in appearance to NATO bases in the city. An Associated Press reporter at the scene saw a group of Afghan soldiers enter the compound, after which heavy shooting could be heard coming from inside.

Elsewhere, NATO said that two coalition service members were killed Wednesday in a bomb blast in the country's east. The alliance did not give the nationality of the troops or provide other details.

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Add kidneys to list of things that can be recycled

Kidney (inner view)

CHICAGO (AP) -- It turns out you can recycle just about anything these days - even kidneys and other organs donated for transplants.

Recently in Chicago, in what is believed to be the first documented case of its kind in the U.S., a transplanted kidney that was failing was removed from a patient while he was still alive and given to somebody else.

There have been other cases since the 1980s of transplant organs being used more than once, but they were rare and involved instances in which the first recipient died.

Typically when transplanted organs fail in living patients, doctors throw them away. But with more than 73,000 people awaiting transplants nationwide, some specialists say doctors should consider trying to reuse more organs to ease the severe shortage.

"The need for kidney transplantation doesn't match our capacity," said Dr. Lorenzo Gallon, a Northwestern University transplant specialist who oversaw the kidney recycling operation in Chicago. "People die on dialysis" while awaiting kidneys.

That was the possible fate awaiting two strangers. A research letter describing the unusual case was published in Thursday's New England Journal of Medicine.

The donated kidney lasted just two weeks in the first patient, a 27-year-old Illinois man. The same disease that ruined his kidneys started to damage the new kidney, given to him by his sister. He was getting sicker, and doctors needed to act fast if they were going to save the organ. With permission from the man and his sister, they removed it last July and retransplanted it into a 67-year-old Indiana man.

The Illinois man is back on dialysis and will probably get another transplant eventually.

Still, reusing a transplanted organ can be tricky - and riskier - because surgeons have to deal with scar tissue that typically forms around an organ as the body heals from the operation.

Also, Wayne Shelton, a bioethicist at Albany Medical College in New York, said the practice may raise ethical questions. He said doctors need to make sure patients who are offered reused parts understand all the risks and are not made to feel coerced into accepting such organs. And because these cases are so rare, there is little data on how patients with recycled parts fare, Shelton noted.

Dr. Jonathan Bromberg, director of transplantation at the University of Maryland Medical Center, praised the Northwestern doctors but said organ recycling is unlikely to become commonplace because it would be rare for an already transplanted organ to be healthy enough to be reused.

In Boston in 2009, a man died shortly after a getting a new heart, and the organ was in good enough shape to be transplanted into someone else. A 2005 medical journal report detailed three U.S. cases involving donor livers reused after the initial recipients died, and said they were among 11 similar cases between 1987 and 2005. Medical literature also includes reports from the 1990s about a kidney retransplant in Spain and a heart retransplant in Switzerland.

In the Chicago case, Ray Fearing of Arlington Heights, Ill., received a new kidney that was later reused by Erwin Gomez of Valparaiso, Ind., a surgeon familiar with the medical complexities involved.

Joel Newman, a spokesman for the United Network for Organ Sharing, said previous retransplants in the U.S. "have occurred when the original recipient has died soon after a transplant but the organ is still able to function. To our knowledge, this is the first publicly reported instance where a kidney has been removed from a living person due to the risk of organ failure and retransplanted."

Fearing had a disease that caused scarring that prevented the kidneys from filtering waste from blood. He had to quit his industrial machinery job and went on dialysis a year ago. His sister donated a kidney last June in what was "probably the happiest moment of my life," Fearing said. The worst, he said, was a few days later, when doctors told him the kidney was damaged and had to be removed.

Gallon, medical director of Northwestern's kidney transplant program, thought the kidney could be reused in somebody else if it was removed quickly, before it became irreversibly damaged.

Gallon needed Fearing's permission, and also asked the young man's sister, Cera Fearing.

Fearing said he was heartbroken and reluctant to abandon an organ that had been his only hope for a normal life. But he decided it was the only option that made sense. His sister, too, was crushed but said she didn't hesitate when told her kidney might help someone else.

"I just assumed it's damaged, it's garbage," she said. "The fact that they were able to give it to someone that somehow was able to benefit from it was great."

Gomez was selected because he was a good match. But Gallon said doctors also thought Gomez's medical background would help him understand the complexities. Gomez said he had never heard of reusing transplant organs, and he worried about taking what seemed like damaged goods. But he agreed after the Northwestern team explained the risks and possible benefits.

The removal and retransplant operations took place July 1. Within two days, the transplanted kidney had regained function. Gallon said he is convinced the damage is reversed.

Gomez is taking anti-rejection drugs and is off dialysis. "I finally feel normal," he said. Fearing is back on dialysis and said he is doing OK.

Gallon said it is not uncommon for patients with Fearing's disease to go through more than one transplanted kidney, and he expects Fearing will eventually get another one.

Despite his own misfortune, Fearing said he is "extremely happy about being a part of this medical breakthrough" that might end up helping others.

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3-D release steers 'Titanic' past $2 billion mark

Scene from 'Titanic'

LOS ANGELES (AP) — James Cameron has shored up his position as king of the worldwide box office.

Cameron's 1997 blockbuster "Titanic" sailed beyond the $2 billion mark in lifetime ticket sales, thanks to a 3-D re-release of the film that was timed to the centennial of the ship's sinking.

Only one other movie has topped $2 billion, and it's also Cameron's. His 2009 sci-fi smash "Avatar" earned $2.8 billion worldwide.

The "Titanic" reissue took in about $100 million this weekend — $11.6 million domestically and a whopping $88.2 million in 69 overseas markets. That included a $58 million debut in China and put the re-release total worldwide at $190.8 million.

Added to the film's $1.84 billion haul in its original release, "Titanic" now stands at $2.03 billion worldwide.

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Prominent Pakistani acid victim commits suicide

People carry the body of a Pakistani acid attack victim Fakhra Younnus

ISLAMABAD (AP) — Pakistani acid attack victim Fakhra Younus had endured more than three dozen surgeries over more than a decade to repair her severely damaged face and body when she finally decided life was no longer worth living.

The 33-year-old former dancing girl — who was allegedly attacked by her then-husband, an ex-lawmaker and son of a political powerhouse — jumped from the sixth floor of a building in Rome, where she had been living and receiving treatment.

Her March 17 suicide and the return of her body to Pakistan on Sunday reignited furor over the case, which received significant international attention at the time of the attack. Her death came less than a month after a Pakistani filmmaker won the country's first Oscar for a documentary about acid attack victims.

Younus' story highlights the horrible mistreatment many women face in Pakistan's conservative, male-dominated culture and is a reminder that the country's rich and powerful often appear to operate with impunity. Younus' ex-husband, Bilal Khar, was eventually acquitted, but many believe he used his connections to escape the law's grip — a common occurrence in Pakistan.

More than 8,500 acid attacks, forced marriages and other forms of violence against women were reported in Pakistan in 2011, according to The Aurat Foundation, a women's rights organization. Because the group relied mostly on media reports, the figure is likely an undercount.

"The saddest part is that she realized that the system in Pakistan was never going to provide her with relief or remedy," Nayyar Shabana Kiyani, an activist at The Aurat Foundation, said of Younus. "She was totally disappointed that there was no justice available to her."

Younus was a teenage dancing girl working in the red light district of the southern city of Karachi when she met her future husband, the son of Ghulam Mustafa Khar, a former governor of Pakistan's largest province, Punjab. The unusual pairing was the younger Khar's third marriage. He was in his mid-30s at the time.

The couple was married for three years, but Younus eventually left him because he allegedly physically and verbally abused her. She claimed that he came to her mother's house while she was sleeping in May 2000 and poured acid all over her in the presence of her 5-year-old son from a different man.

Tehmina Durrani, Ghulam Mustafa Khar's ex-wife and his son's stepmother, became an advocate for Younus after the attack, drawing international attention to the case. She said that Younus' injuries were the worst she had ever seen on an acid attack victim.

"So many times we thought she would die in the night because her nose was melted and she couldn't breathe," said Durrani, who wrote a book about her own allegedly abusive relationship with the elder Khar. "We used to put a straw in the little bit of her mouth that was left because the rest was all melted together."

She said Younus, whose life had always been hard, became a liability to her family, for whom she was once a source of income.

Fakhra Younnus before (L) and after (R)

"Her life was a parched stretch of hard rock on which nothing bloomed," Durrani wrote in a column in The News after Younus' suicide.

Younus' ex-husband grew up in starkly different circumstances, amid the wealth and power of the country's feudal elite, and counts Pakistani Foreign Minister Hina Rabbani Khar as a cousin.

Bilal Khar once again denied carrying out the acid attack in a TV interview following her suicide, suggesting a different man with the same name committed the crime. He claimed Younus killed herself because she didn't have enough money, not because of her horrific injuries, and criticized the media for hounding him about the issue.

"You people should be a little considerate," said Khar. "I have three daughters and when they go to school people tease them."

In February, Younus said in one of her last interviews that powerful Pakistanis brutally treat ordinary citizens and "don't know how painful they make others' lives."

"I want such people to be treated in the same way" as they treat people whose lives they ruin, she told Geo TV over the telephone from Rome.

Younus was energized when the Pakistani government enacted a new set of laws last year that explicitly criminalized acid attacks and mandated that convicted attackers would serve a minimum sentence of 14 years, said Durrani. She hoped to return someday to get justice once her health stabilized.

"She said, 'When I come back, I will reopen the case, and I'll fight myself,' and she was a fighter," Durrani said.

Durrani had to battle with both Younus' ex-husband and the government to send her to Italy, where the Italian government paid for her treatment and provided her money to live on and send her child to school. Pakistani officials argued that sending Younus to Italy would give the country a bad name, Durrani said.

Younus was happy when Sharmeen Obaid-Chinoy won an Oscar for her documentary about acid attack victims in February, but was worried about being forgotten since she wasn't profiled in the film, said Durrani.

Durrani said Younus' case should be a reminder that the Pakistani government needs to do much more to prevent acid attacks and other forms of violence against women, and also help the victims.

"I think this whole country should be extremely embarrassed that a foreign country took responsibility for a Pakistani citizen for 13 years because we could give her nothing, not justice, not security," said Durrani.

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