As Syria's rebels close in, Assad has three options

The magnificent views across Damascus from the presidential palace on Mount Qassioun are unlikely to provide much comfort these days for Bashar al-Assad, Syria’s beleaguered head of state.

For several weeks, the skyline to the north, east, and south has been stained by black columns of smoke from artillery explosions and air strikes as Syrian government forces struggle to prevent the Free Syrian Army (FSA) rebels from inching ever closer to their goal of unseating Mr. Assad’s regime.

After 20 months of confrontation, Assad’s hold on power is looking increasingly frail, leaving him and his regime with few remaining options.

“There is no doubt that the regime’s capacity is declining and that the FSA continues to become ever stronger and better armed,” says a European diplomat closely following developments in Syria.

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The current status of the regime is uncertain and it is not even clear if Assad is still in charge. The diplomat says that Assad appears to have become a “prisoner of his own system,” no longer playing an active leadership role and confined to his palace. Instead, there are indications that an informal "security council” has emerged consisting of between 50 to 100 top regime and military figures drawn from the minority Alawite community which is handling the daily confrontation against the armed opposition.

THREE OPTIONS

Either way, the regime is steadily losing ground as the rebels attempt to encircle Damascus for an apparent final push into the city center, leaving Assad with three possible choices. The first – although least likely – option is to remain in the presidential palace to the bitter – and probably bloody – end, fulfilling a promise he made last month in an interview with Russian television to “live and die in Syria”.

A second possibility is to escape Damascus with his family and seek asylum in a third country, perhaps Iran or Venezuela, the governments of which openly support the Syrian regime. Faisal Miqdad, Syria’s deputy foreign minister, was reported to have visited Venezuela, Cuba, and Ecuador recently. Ecuador subsequently announced that it was not entertaining the idea of granting asylum to Assad.

The most likely option, however, and one that appears already to be under way, is for the regime and the core of the army and security forces to retreat to the Alawite-populated mountains on the Mediterranean coast. Diplomatic sources say that there are unconfirmed reports that the regime is planning to register all Sunnis who live in the coastal cities of Tartous, Banias, and Latakia which could potentially form part of an Alawite-dominated enclave. The coastal cities are predominantly Sunni-populated while the mountain hinterland is mainly Alawite.

EXODUS TO THE MOUNTAINS

Furthermore, there appears to be a steady and discreet trickle of families of pro-regime Alawite army officers leaving the upmarket Mezzeh neighborhood of Damascus for the coastal mountains.

“More and more regime supporters and, or their families are moving up the coast, and there are persistent rumors that at least part of the government now sits in Tartous,” the European diplomat says. “All indications are that the regime's fallback position is to retreat to the coastal area of ​​Tartous and Latakia.”

Significantly, units of the rebel Free Syrian Army operating north of Damascus appear to be limiting ambushes to south-bound military traffic heading to the capital along the main highway, the sources say. Vehicles heading north are left unmolested, raising the possibility that the highway, which leads to Tartous, is being offered as an escape route for the regime to prevent a protracted and bloody last stand in Damascus.

INCREMENTAL RETREAT

Still, there might not be a mad dash for the mountains as Damascus falls but more of an incremental retreat.

“I think that the Assad regime will go in stages,” says Andrew Tabler, Syria expert at the Washington Institute for Near East Policy. “You have the north and east go and then after that there will be a real effort to hold on to Damascus as long as possible. But in the end I don't see that as viable.”

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Mr. Tabler says he envisages a staged pullback from Damascus first to the area west of Homs, Syria’s third largest city which lies two-thirds of the way along the Damascus-Tartous highway, and then to the mountains.

“Those areas are viable, I think, in the short- to medium-term,” he says.

A fallback to Homs would explain the fierce fighting that erupted in September and October in a string of villages between Homs and the border with Lebanon, 20 miles to the south. Syrian troops assisted by pro-regime Shabiha militiamen and combatants from Hezbollah, the Lebanese militant Shia group, fought rebel forces to maintain control of the villages which flank the vital Damascus-Tartous highway.

ALAWITE STATELET?

While there appears to be consensus among analysts that the regime will eventually decamp to the coastal region, what remains unclear is the nature of the enclave – if any – that would be established there. The prospect of creating a mini Alawite state along the lines of the French-engineered statelet between 1920 and 1937 appears improbable under current circumstances. It would require the suppression of hostile Sunnis in the coastal cities and would be internationally ostracized and subject to attack by the FSA.

The chief motivation for retreating to the mountains in the first place is self-preservation rather than state-building (Alawites represent about 12 percent of Syria’s 23 million, while Sunnis comprise about 70 percent).

“The Alawite community … is counting on [Assad’s] army to protect them from possible retribution from the rebel militias,” writes Joshua Landis, professor of Middle East history at the University of Oklahoma and author of the influential Syria Comment blog. “Sectarian hatred has been driven to a fever pitch by the brutality of the regime. Syrians have been putting hate into their hearts over the past two years, making the likelihood of some sort of retribution ever more likely and the ethnic cleansing a possibility, even if a small one at the time.”

A rump regime well-entrenched into the mountain villages defended by the Alawite core of the army and security services equipped with armor, artillery, air power and possibly even chemical and biological weapons could buy the Assads some breathing space during a likely period of chaos caused by a sudden leadership vacuum in Damascus. But it is questionable whether it would provide a long-term solution for the Assad clan’s survival.

ALAWITE DIVISIONS

Also working against a more formally established enclave is the fact that not all Alawites support the Assad regime. Some may prefer to cut a deal with the opposition rather than link the fate of the community to that of the Assads. Even Assad’s home town of Qordaha, 15 miles south east of Latakia, has reportedly seen some intra-Alawite unrest between supporters and opponents of the Assad clan.

The Assad family, under Bashar’s 12-year rule, has “all but seceded socially and economically” from its roots and has done “precious little” for the Alawites which remains one of the poorest communities in Syria, says Fred Hof, a senior fellow at the Atlantic Council’s Rafik Hariri Center for the Middle East and former special adviser for transition in Syria at the State Department.

“On top of that, they have placed this community in grave jeopardy by recklessly pursuing a sectarian strategy to save their skins and preserve their ability to acquire material wealth,” he says. “In sum, I think it would be inadvisable for the [Assads] and their chief enablers to try and set up shop in Latakia and vicinity. If they have to escape in that direction because of a closed Damascus airport, they’d do well to keep moving. Where to? I don’t know who would have them at this point.”

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Peru’s capital highly vulnerable to major quake

LIMA, Peru (AP) — The earthquake all but flattened colonial Lima, the shaking so violent that people tossed to the ground couldn’t get back up. Minutes later, a 50-foot (15-meter) wall of Pacific Ocean crashed into the adjacent port of Callao, killing all but 200 of its 5,000 inhabitants. Bodies washed ashore for weeks.

Plenty of earthquakes have shaken Peru‘s capital in the 266 years since that fateful night of Oct. 28, 1746, though none with anything near the violence.

The relatively long “seismic silence” means that Lima, set astride one of the most volatile ruptures in the Earth’s crust, is increasingly at risk of being hammered by a one-two, quake-tsunami punch as calamitous as what devastated Japan last year and traumatized Santiago, Chile, and its nearby coast a year earlier, seismologists say.

Yet this city of 9 million people is sorely unprepared. Its acute vulnerability, from densely clustered, unstable housing to a dearth of first-responders, is unmatched regionally. Peru’s National Civil Defense Institute forecasts up to 50,000 dead, 686,000 injured and 200,000 homes destroyed if Lima is hit by a magnitude-8.0 quake.

“In South America, it is the most at risk,” said architect Jose Sato, director of the Center for Disaster Study and Prevention, or PREDES, a non-governmental group financed by the charity Oxfam that is working on reducing Lima’s quake vulnerability.

Lima is home to a third of Peru’s population, 70 percent of its industry, 85 percent of its financial sector, its entire central government and the bulk of international commerce.

“A quake similar to what happened in Santiago would break the country economically,” said Gabriel Prado, Lima’s top official for quake preparedness. That quake had a magnitude of 8.8.

Quakes are frequent in Peru, with about 170 felt by people annually, said Hernando Tavera, director of seismology at the country’s Geophysical Institute. A big one is due, and the chances of it striking increase daily, he said. The same collision of tectonic plates responsible for the most powerful quake ever recorded, a magnitude-9.5 quake that hit Chile in 1960, occurs just off Lima’s coast, where about 3 inches of oceanic crust slides annually beneath the continent.

A 7.5-magnitude quake in 1974 a day’s drive from Lima in the Cordillera Blanca range killed about 70,000 people as landslides buried villages. Seventy-eight people died in the capital. In 2007, a 7.9-magnitude quake struck even closer, killing 596 people in the south-central coastal city of Pisco.

A shallow, direct hit is the big danger.

More than two in five Lima residents live either in rickety structures on unstable, sandy soil and wetlands that amplify a quake’s destructive power or in hillside settlements that sprang up over a generation as people fled conflict and poverty in Peru’s interior. Thousands are built of colonial-era adobe.

Most quake-prone countries have rigorous building codes to resist seismic events. In Chile, if engineers and builders don’t adhere to them they can face prison. Not so in Peru.

“People are building with adobe just as they did in the 17th century,” said Carlos Zavala, director of Lima’s Japanese-Peruvian Center for Seismic Investigation and Disaster Mitigation.

Environmental and human-made perils compound the danger.

Situated in a coastal desert, Lima gets its water from a single river, the Rimac, which a landslide could easily block. That risk is compounded by a containment pond full of toxic heavy metals from an old mine that could rupture and contaminate the Rimac, said Agustin Gonzalez, a PREDES official advising Lima’s government.

Most of Lima’s food supply arrives via a two-lane highway that parallels the river, another potential chokepoint.

Lima’s airport and seaport, the key entry points for international aid, are also vulnerable. Both are in Callao, which seismologists expect to be scoured by a 20-foot (6-meter) tsunami if a big quake is centered offshore, the most likely scenario.

Mayor Susana Villaran’s administration is Lima’s first to organize a quake-response and disaster mitigation plan. A February 2011 law obliged Peru’s municipalities to do so. Yet Lima’s remains incipient.

“How are the injured going to be attended to? What is the ability of hospitals to respond? Of basic services? Water, energy, food reserves? I don’t think this is being addressed with enough responsibility,” said Tavera of the Geophysical Institute.

By necessity, most injured will be treated where they fall, but Peru’s police have no comprehensive first-aid training. Only Lima’s 4,000 firefighters, all volunteers, have such training, as does a 1,000-officer police emergency squadron.

But because the firefighters are volunteers, a quake’s timing could influence rescue efforts.

“If you go to a fire station at 10 in the morning there’s hardly anyone there,” said Gonzalez, who advocates a full-time professional force.

In the next two months, Lima will spend nearly $ 2 million on the three fire companies that cover downtown Lima, its first direct investment in firefighters in 25 years, Prado said. The national government is spending $ 18 million citywide for 50 new fire trucks and ambulances.

But where would the ambulances go?

A 1997 study by the Pan American Health Organization found that three of Lima’s principal public hospitals would likely collapse in a major quake, but nothing has been done to reinforce them.

And there are no free beds. One public hospital, Maria Auxiliadora, serves more than 1.2 million people in Lima’s south but has just 400 beds, and they are always full.

Contingency plans call for setting up mobile hospitals in tents in city parks. But Gonzalez said only about 10,000 injured could be treated.

Water is also a worry. The fire threat to Lima is severe — from refineries to densely-backed neighborhoods honeycombed with colonial-era wood and adobe. Lima’s firefighters often can’t get enough water pressure to douse a blaze.

“We should have places where we can store water not just to put out fires but also to distribute water to the population,” said Sato, former head of the disaster mitigation department at Peru’s National Engineering University.

The city’s lone water-and-sewer utility can barely provide water to one-tenth of Lima in the best of times.

Another big concern: Lima has no emergency operations center and the radio networks of the police, firefighters and the Health Ministry, which runs city hospitals, use different frequencies, hindering effective communication.

Nearly half of the city’s schools require a detailed evaluation to determine how to reinforce them against collapse, Sato said.

A recent media blitz, along with three nationwide quake-tsunami drills this year, helped raise consciousness. The city has spent more than $ 77 million for retention walls and concrete stairs to aid evacuation in hillside neighborhoods, Prado said, but much more is needed.

At the biggest risk, apart from tsunami-vulnerable Callao, are places like Nueva Rinconada.

A treeless moonscape in the southern hills, it is a haven for economic refugees who arrive daily from Peru’s countryside and cobble together precarious homes on lots they scored into steep hillsides with pickaxes.

Engineers who have surveyed Nueva Rinconada call its upper reaches a death trap. Most residents understand this but say they have nowhere else to go.

Water arrives in tanker trucks at $ 1 per 200 liters (52 gallons) but is unsafe to drink unless boiled. There is no sanitation; people dig their own latrines. There are no streetlamps, and visibility is erased at night as Lima’s bone-chilling fog settles into the hills.

Homes of wood, adobe and straw matting rest on piled-rock foundations that engineers say will crumble and rain down on people below in a major quake.

A recently built concrete retaining wall at the valley’s head lies a block beneath the thin-walled wood home of Hilarion Lopez, a 55-year-old janitor and community leader. It might keep his house from sliding downhill, but boulders resting on uphill slopes could shake loose and crush him and his neighbors.

“We’ve made holes and poured concrete around some of the more unstable boulders,” he says, squinting uphill in a strong late morning sun.

He’s not so worried if a quake strikes during daylight.

“But if I get caught at night? How do I see a rock?”

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Associated Press writer Franklin Briceno contributed to this report.

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Frank Bajak on Twitter: http://twitter.com/fbajak

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Kevin Smith: “Clerks III” will be my last writing/directing effort

LOS ANGELES (TheWrap.com) – “Clerks III” will be Kevin Smith‘s last writing/directing effort, the filmmaker tweeted on Friday morning:

“So with the ‘HIT SOMEBODY‘ shift, the minute Jeff Anderson signs on, my last cinematic effort as a writer/director will be ‘CLERKS III’”

Referring to the ice-hockey comedy he’s writing that takes place over the course of 30 years, the “shift” means now it will be not a theatrical release but a television mini-series.

“Since ‘HIT SOMEBODY’ is now gonna be a mini-series,” the 42-year-old wrote. “Yes – that leaves room for a new final flick before I retire from directing feature films.”

So pending the participation of Anderson, the actor who played Randal Graves in the first two “Clerks” films, Smith’s fans will get the ultimate goodbye gift – a complete trilogy for the convenient store comedy franchise.

The first installment was the director’s mirco-budgeted breakthrough independent film, which launched characters Jay and Silent Bob into pop culture and led to four more spinoffs.

Minimum-wage earners Randal and Dante (Brian O’Halloran) were featured in a series of “Clerks” comics in the late ’90s before becoming the focus of a short-lived animated television series in 2000 (and eventually making it back to the big screen for a quick cameo in 2001′s “Jay and Silent Bob Strike Back”). Smith finally finished their story in 2006′s “Clerks II.”

Or so we thought. Apparently, he wants to end his film-directing career with the characters and actors that helped it begin. However, the tweet heard around the world of cinema suggests it may be somewhat of a challenge to persuade at least one half of the “Clerks” duo to come aboard.

Beyond “Hit Somebody” and “Clerks III,” Smith will keep himself busy with “SModcast,” a weekly podcast, and AMC’s “Comic Book Men,” which has been renewed for a second season.

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Health workers march in Spain’s capital against cuts, reforms

MADRID (Reuters) – Thousands of health workers, on strike since last month, marched on Sunday in Madrid to protest against budget cuts and plans from the Spanish capital’s regional government to privatize the management of public hospitals and medical centers.

It was the third time doctors, nurses and health workers have rallied since the local authorities put forward a plan in October to place six hospitals and dozens of medical practices under private management. The plan also calls for patients to be charged a fee of 1 euro for prescriptions.

Workers launched an indefinite strike last month against the plan, which has not been endorsed by the centre-right government of Prime Minister Mariano Rajoy. Health workers in the capital are striking Monday-Thursday each week and seeing patients only on Fridays, while also responding to emergencies.

Spain’s 17 autonomous regions control health and education policies and spending. They have all had to implement steep cuts this year as the country struggles to meet tough European Union-agreed deficit targets.

Dressed in white scrubs, the protesters shouted slogans such as “Health is not for sale” and “Health 100 percent public, no to privatizations”.

“Of course, privatization can be reversed. Actually the question is not if it can be reversed, because privatization should never have a future,” said Luis Alvarez, an unemployed man from Madrid attending the demonstration.

Belen Padilla, a doctor at Madrid’s hospital Gregorio Maranon, said one million citizens had already signed a petition rejecting the plan.

(Reporting by Reuters Television; Writing by Julien Toyer; Editing by Peter Graff)

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Software guru McAfee did not have heart attack: lawyer

GUATEMALA CITY (Reuters) – Software pioneer John McAfee did not have a heart attack in Guatemala as originally thought, but is suffering from stress and hypertension, his lawyer Telesforo Guerra said on Thursday.

“He never had a heart attack. Nothing like that,” Guerra said in Guatemala City. “I’m not a doctor. I’m just telling you what the doctors told me. He was suffering from stress, hypertension and tachycardia (an abnormally rapid heartbeat).”

After being rushed to a hospital in an ambulance on Thursday, McAfee, 67, was later spirited out of the building out of sight of reporters and into a police patrol car, Guerra said.

McAfee, who is fighting deportation from Guatemala, was detained on Wednesday after crossing illegally into the country from neighboring Belize. Police in Belize want to question McAfee in connection with his neighbor’s murder.

Earlier, Guerra said McAfee had suffered two mild heart attacks in the morning.

(Reporting by Lomi Kriel; Editing by Stacey Joyce)

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Anger at Australian radio station over royal hoax

LONDON (AP) — It started out as a joke, but ended in tragedy.

The sudden death of a nurse who unwittingly accepted a prank call to a London hospital about Prince William‘s pregnant wife Kate has shocked Britain and Australia, and sparked an angry backlash Saturday from some who argue the DJs who carried out the hoax should be held responsible.

At first, the call by two irreverent Australian DJs posing as royals was picked up by news outlets around the world as an amusing anecdote about the royal pregnancy. Some complained about the invasion of privacy, the hospital was embarrassed, and the radio presenters sheepishly apologized.

But the prank took a dark twist Friday with the death of nurse Jacintha Saldanha, a 46-year-old mother of two, three days after she took the hoax call. Police have not yet determined Saldanha‘s cause of death, but people from London to Sydney have been making the assumption that she died because of stress from the call.

King Edward VII’s Hospital, where the former Kate Middleton was being treated for acute morning sickness this week, wrote a strongly-worded letter to the 2DayFM radio station’s parent company Southern Cross Austereo, condemning the “truly appalling” hoax and urging it to take steps to ensure such an incident would never happen again.

“The immediate consequence of these premeditated and ill-considered actions was the humiliation of two dedicated and caring nurses who were simply doing their job tending to their patients,” the letter read. “The longer term consequence has been reported around the world and is, frankly, tragic beyond words.”

The hospital did not comment when asked whether it believed the prank call had directly caused Saldanha’s death, only saying that the protest letter spoke for itself.

DJs Mel Grieg and Michael Christian, who apologized for the prank on Tuesday, took down their Twitter accounts after they were bombarded by thousands of abusive comments. Rhys Holleran, CEO of Southern Cross Austereo, said the pair have been offered counseling and were taken off the air indefinitely.

No one could have foreseen the tragic consequences of the prank, he stressed.

“I spoke to both presenters early this morning and it’s fair to say they’re completely shattered,” Holleran told reporters on Saturday.

“These people aren’t machines, they’re human beings,” he said. “We’re all affected by this.”

Details about Saldanha have been trickling out since the duty nurse’s body was found at apartments provided by the private hospital, which has treated a line of royals before, including Prince Philip, who was hospitalized there for a bladder infection in June.

The nurse, who was originally from India, had lived with her partner Benedict Barboza and a teenage son and daughter in Bristol, in southwestern England, for the past nine years. The hospital praised her as a “first-class nurse” who was well-respected and popular among colleagues during her four years working there.

Just before dawn on Tuesday, Saldanha was looking after her patients when the phone rang. A woman pretending to be Queen Elizabeth II asked to speak to the duchess, and, believing the caller, Saldanha transferred the call to a fellow nurse caring for the duchess, who spoke to the two DJs about Kate’s condition live on air.

During the call — which was put online and later broadcast on news channels worldwide — Grieg mimicked the Britain’s monarch’s voice and asked about the duchess’ health. She was told Kate “hasn’t had any retching with me and she’s been sleeping on and off.” Grieg and Christian, who pretended to be Prince Charles, also discussed with the nurse when they could travel to the hospital to check in on Kate.

Three days later, officers responding to reports that a woman was found unconscious discovered Saldanha, who was pronounced dead at the scene. Police didn’t release a cause of death, but said they didn’t find anything suspicious. A coroner will make a determination on the cause.

In the aftermath of Saldanha’s death, some speculated about whether the nurse was subject to pressure to resign or about to be punished for the mistake. Royal officials said Prince William and Kate were “deeply saddened,” but insisted that the palace had not complained about the hoax. King Edward VII’s Hospital also maintained that it did not reprimand Saldanha.

“We did not discipline the nurse in question. There were no plans to discipline her,” a hospital spokesman said. He declined to provide further details, and did not respond to questions about the second nurse’s condition.

The Australian Communications and Media Authority, which regulates radio broadcasting, said it has received complaints about the prank and is discussing the matter with the Sydney-based station, which yanked its Facebook page after it received thousands of angry comments.

Holleran, the radio executive, would not say who came up with the idea for the call. He only said that “these things are often done collaboratively.” He said 2DayFM would work with authorities, but was confident the station hadn’t broken any laws, noting that prank calls in radio have been happening “for decades.”

The station has a history of controversy, including a series of “Heartless Hotline” shows in which disadvantage people were offered a prize that could be taken away from them by listeners.

Saldanha’s family asked for privacy in a brief statement issued through London police.

Flowers were left outside the hospital’s nurse’s apartments, with one note reading: “Dear Jacintha, our thoughts are with you and your family. From all your fellow nurses, we bless your soul. God bless.”

Officials from St. James’s Palace have said the duchess is not yet 12 weeks pregnant. The child would be the first for her and William.

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Google launches Snapseed photo editor on Android, makes iOS version free

After acquiring the makers of Snapseed in September, Google (GOOG) on Thursday released the popular photo application for Android smartphones and tablets. Google also updated the iOS version of the app to add Google+ integration and some new filters, and it cut the price of the original app from $ 4.99 to free. Snapseed is a simple yet powerful photo editor from Nik Software that allows users to enhance images with various tweaks and gesture-based touch ups, along Instagram-like filters. Snapseed is available now for the iPhone, iPad and Android smartphones and tablets.

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Rolling Stones hit NY for 50th anniversary gig

NEW YORK (AP) — “Time Waits for No One,” the Rolling Stones sang in 1974, but lately it’s seemed like that grizzled quartet does indeed have some sort of exemption from the ravages of time.

At an average age of 68-plus years, the British rockers are clearly in fighting form, sounding tight, focused and truly ready for the spotlight at a rapturously received pair of London concerts last month.

On Saturday, Mick Jagger, Keith Richards, Ronnie Wood and Charlie Watts hit New York for the first of three U.S. shows on their “50 and Counting” mini-tour, marking a mind-boggling half-century since the band first began playing its unique brand of blues-tinged rock.

And the three shows — Saturday’s at the new Barclays Center in Brooklyn, then two in Newark, N.J., on Dec. 13 and 15 — aren’t the only big dates on the agenda. Next week the Stones join a veritable who’s who of British rock royalty and U.S. superstars at the blockbuster 12-12-12 Sandy benefit concert at Madison Square Garden. Also scheduled to perform: Paul McCartney, the Who, Eric Clapton, Bruce Springsteen & The E Street Band, Alicia Keys, Kanye West, Eddie Vedder, Billy Joel, Roger Waters and Chris Martin.

The Stones‘ three U.S. shows promise to have their own special guests, too. Mary J. Blige will be at the Brooklyn gig, as well as guitarist Gary Clark Jr., the band has announced. (Blige performed a searing “Gimme Shelter” with frontman Jagger in London.) Rumors are swirling of huge names at the Dec. 15 show, which also will be on pay-per-view.

In a flurry of anniversary activity, the band also released a hits compilation last month with two new songs, “Doom and Gloom” and “One More Shot,” and HBO premiered a new documentary on their formative years, “Crossfire Hurricane.”

The Stones formed in London in 1962 to play Chicago blues, led at the time by the late Brian Jones and pianist Ian Stewart, along with Jagger and Richards, who’d met on a train platform a year earlier. Bassist Bill Wyman and drummer Charlie Watts were quick additions.

Wyman, who left the band in 1992, was a guest at the London shows last month, as was Mick Taylor, the celebrated former Stones guitarist who left in 1974 — to be replaced by Wood, the newest Stone and the youngster at 65.

The inevitable questions have been swirling about the next step for the Stones: another huge global tour, on the scale of their last one, “A Bigger Bang,” which earned more than $ 550 million between 2005 and 2007? Something a bit smaller? Or is this mini-tour, in the words of their new song, really “One Last Shot”?

The Stones won’t say. But in an interview last month, they made clear they felt the 50th anniversary was something to be marked.

“I thought it would be kind of churlish not to do something,” Jagger told The Associated Press. “Otherwise, the BBC would have done a rather dull film about the Rolling Stones.”

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Associated Press writer David Bauder contributed to this report.

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Pfizer/Bristol drug cuts recurrence of blood clots – study

(Reuters) – A new blood clot preventer from Pfizer Inc and Bristol-Myers Squibb Co reduced the risk of recurrence of clots in veins and lungs and death by 80 percent with no increase in major bleeding in a study testing extended use of the drug.

In the year-long trial of 2,486 patients who had been previously treated for the condition known as venous thromboembolism (VTE) the drug, apixaban, met the combined primary goal by significantly reducing the recurrence of blood clots and death from any cause compared with a placebo, according to data presented at the American Society of Hematology (ASH) meeting in Atlanta, Georgia.

The rate of recurrence or death was 11.6 percent in the placebo group compared with 3.8 percent for those who got 2.5 milligrams of apixaban and 4.2 percent for the 5 mg dose of the drug. The results were also published in the New England Journal of Medicine.

The incidence of major bleeding, always a concern with blood thinners, was extremely low in all three arms of the trial, researchers said – 0.5 percent for placebo, 0.2 percent for the low dose of apixaban and 0.1 percent for the higher dose.

“Usually when you have an effective antithrombotic you have to pay a price in terms of bleeding. This was not the case in this study,” Dr. Giancarlo Agnelli, the study’s principal investigator, said in a telephone interview.

“There was no evidence at all of increased major bleeding and this is extremely important because you are comparing an active drug with placebo,” he said.

There was a slightly higher rate of clinically relevant nonmajor bleeding, such as nose bleeds that required medical attention, observed in patients taking the higher dose of apixaban at 4.2 percent compared with the low dose and placebo, researchers said.

Apixaban belongs to a new class of blood thinners that aim to replace decades old and difficult to use warfarin. The drug, which will be sold under the brand name Eliquis, is widely considered to be one of the most important new medicines for Pfizer and Bristol-Myers, both of which saw their top selling products lose patent protection in the past year.

AWAITING U.S. APPROVAL

It is approved in Europe and awaiting a U.S. approval decision for preventing blood clots and strokes in patients with atrial fibrillation – a type of irregular heart beat – and is also being tested against warfarin as a primary treatment for VTE with data expected next year.

A rival drug from Bayer and Johnson & Johnson called Xarelto is already approved for both conditions, but based on clinical data analysts have said they believe Eliquis is the best class.

An approval for extended use in VTE patients, during which they would take the drug for at least a year after initial treatment, could significantly boost future sales.

“The evidence is for one year. The next step would be to see whether this clinical benefit is extended after one year,” Agnelli said.

VTE consists of deep vein thrombosis, typically blood clots in the legs, and pulmonary embolism, which are dangerous clots in the lungs. Clots that begin in the extremities can travel to the heart and lungs and can be fatal. VTE is typically treated with warfarin for three to six months.

After that, “there is quite a remarkable level of uncertainty about whether to extend or not,” explained Agnelli, professor of internal medicine at the University of Perugia in Italy, who presented the data at the ASH meeting.

“Extended treatment might be clinically relevant because the recurrence rate after stopping treatment can be 10 percent in the first year,” Agnelli said. “Reducing the recurrence of VTE means reduced hospitalization costs and in some cases fewer fatal events.”

Physicians have been looking for alternatives to warfarin, which must be closely monitored to keep levels therapeutic but not toxic. The new drugs do not require monitoring or the dietary and lifestyle changes necessary with warfarin. But they still face an uphill battle as warfarin is far less expensive, and doctors have a comfort level using a drug that has been around for more than half a century despite the challenges.

Patients in the study had received treatment with warfarin for six to 12 months before starting the one-year extension trial that aimed to show further treatment could reduce recurrence rates and to see if the lower dose of apixaban was a viable option.

“It is quite clear that the lower dose is as effective as the higher. For the first time we showed that by reducing the dose of an antithrombotic agent in this clinical setting we can have the same efficacy with no major bleeding,” Agnelli said.

“This is actually something that could change clinical practice,” he added.

(Reporting by Bill Berkrot; Editing by Jilian Mincer, Berard Orr)

Health News Headlines – Yahoo! News

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Egypt terror leader possibly linked to Benghazi attack arrested

Dec 8, 2012 2:16pm

Mohammad Hannon/AP Photo

The leader of an Egyptian terrorist cell that planned attacks in Egypt and may be linked with the storming of the U.S. consulate in Benghazi, Libya on Sept. 11 has been arrested by Egyptian intelligence officers, according to an official close to Egypt’s intelligence agency and a senior U.S. official.

Mohammad Jamal Abdo Ahmed had become one of Egypt’s most dangerous terrorists and led a small cell of Egyptians that collected suicide vests, bombs and grenades before their Cairo safe house was raided by intelligence officials in late October, according to the U.S. official.

PHOTOS: Benghazi: US Consulate Attack Aftermath

Most of the cell’s targets were Egyptian, but both the U.S. and Egyptian officials said Ahmed admitted to traveling to Libya and assisting Ansar al Sharia, which U.S. officials suspect organized the attack on the consulate that killed U.S. Ambassador to Libya Chris Stevens.

READ: More on the Political Fallout From the Benghazi Attack

Until now, neither the United States nor Egypt has determined exactly what role Ahmed played in the attack in eastern Libya, according to both officials.

Ahmed may have also been planning attacks on U.S. targets in Egypt and neighboring countries, the U.S. official said, and had aspirations to join al Qaeda.

Ahmed, who is Egyptian, was arrested two weeks ago in eastern Egypt in the Sharqiyah province, the Egyptian official said.

Egyptian officials continue to question him and he will remain in custody for another 15 days, according to the Egyptian official.

His arrest was first reported by the Wall Street Journal.

READ: Four Americans Slain in Libya ‘Come Home’

SHOWS: World News

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