AP IMPACT: Big Pharma cashes in on HGH abuse

A federal crackdown on illicit foreign supplies of human growth hormone has failed to stop rampant misuse, and instead has driven record sales of the drug by some of the world's biggest pharmaceutical companies, an Associated Press investigation shows.

The crackdown, which began in 2006, reduced the illegal flow of unregulated supplies from China, India and Mexico.

But since then, Big Pharma has been satisfying the steady desires of U.S. users and abusers, including many who take the drug in the false hope of delaying the effects of aging.

From 2005 to 2011, inflation-adjusted sales of HGH were up 69 percent, according to an AP analysis of pharmaceutical company data collected by the research firm IMS Health. Sales of the average prescription drug rose just 12 percent in that same period.

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EDITOR'S NOTE — Whether for athletics or age, Americans from teenagers to baby boomers are trying to get an edge by illegally using anabolic steroids and human growth hormone, despite well-documented risks. This is the second of a two-part series.

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Unlike other prescription drugs, HGH may be prescribed only for specific uses. U.S. sales are limited by law to treat a rare growth defect in children and a handful of uncommon conditions like short bowel syndrome or Prader-Willi syndrome, a congenital disease that causes reduced muscle tone and a lack of hormones in sex glands.

The AP analysis, supplemented by interviews with experts, shows too many sales and too many prescriptions for the number of people known to be suffering from those ailments. At least half of last year's sales likely went to patients not legally allowed to get the drug. And U.S. pharmacies processed nearly double the expected number of prescriptions.

Peddled as an elixir of life capable of turning middle-aged bodies into lean machines, HGH — a synthesized form of the growth hormone made naturally by the human pituitary gland — winds up in the eager hands of affluent, aging users who hope to slow or even reverse the aging process.

Experts say these folks don't need the drug, and may be harmed by it. The supposed fountain-of-youth medicine can cause enlargement of breast tissue, carpal tunnel syndrome and swelling of hands and feet. Ironically, it also can contribute to aging ailments like heart disease and Type 2 diabetes.

Others in the medical establishment also are taking a fat piece of the profits — doctors who fudge prescriptions, as well as pharmacists and distributors who are content to look the other way. HGH also is sold directly without prescriptions, as new-age snake oil, to patients at anti-aging clinics that operate more like automated drug mills.

Years of raids, sports scandals and media attention haven't stopped major drugmakers from selling a whopping $1.4 billion worth of HGH in the U.S. last year. That's more than industry-wide annual gross sales for penicillin or prescription allergy medicine. Anti-aging HGH regimens vary greatly, with a yearly cost typically ranging from $6,000 to $12,000 for three to six self-injections per week.

Across the U.S., the medication is often dispensed through prescriptions based on improper diagnoses, carefully crafted to exploit wiggle room in the law restricting use of HGH, the AP found.

HGH is often promoted on the Internet with the same kind of before-and-after photos found in miracle diet ads, along with wildly hyped claims of rapid muscle growth, loss of fat, greater vigor, and other exaggerated benefits to adults far beyond their physical prime. Sales also are driven by the personal endorsement of celebrities such as actress Suzanne Somers.

Pharmacies that once risked prosecution for using unauthorized, foreign HGH — improperly labeled as raw pharmaceutical ingredients and smuggled across the border — now simply dispense name brands, often for the same banned uses. And usually with impunity.

Eight companies have been granted permission to market HGH by the U.S. Food and Drug Administration, which reviews the benefits and risks of new drug products. By contrast, three companies are approved for the diabetes drug insulin.

The No. 1 maker, Roche subsidiary Genentech, had nearly $400 million in HGH sales in the U.S. last year, up an inflation-adjusted two-thirds from 2005. Pfizer and Eli Lilly were second and third with $300 million and $220 million in sales, respectively, according to IMS Health. Pfizer now gets more revenue from its HGH brand, Genotropin, than from Zoloft, its well-known depression medicine that lost patent protection.

On their face, the numbers make no sense to the recognized hormone doctors known as endocrinologists who provide legitimate HGH treatment to a small number of patients.

Endocrinologists estimate there are fewer than 45,000 U.S. patients who might legitimately take HGH. They would be expected to use roughly 180,000 prescriptions or refills each year, given that typical patients get three months' worth of HGH at a time, according to doctors and distributors.

Yet U.S. pharmacies last year supplied almost twice that much HGH — 340,000 orders — according to AP's analysis of IMS Health data.

While doctors say more than 90 percent of legitimate patients are children with stunted growth, 40 percent of 442 U.S. side-effect cases tied to HGH over the last year involved people age 18 or older, according to an AP analysis of FDA data. The average adult's age in those cases was 53, far beyond the prime age for sports. The oldest patients were in their 80s.

Some of these medical records even give explicit hints of use to combat aging, justifying treatment with reasons like fatigue, bone thinning and "off-label," which means treatment of an unapproved condition

Even Medicare, the government health program for older Americans, allowed 22,169 HGH prescriptions in 2010, a five-year increase of 78 percent, according to data released by the Centers for Medicare and Medicaid Services in response to an AP public records request.

"There's no question: a lot gets out," said hormone specialist Dr. Mark Molitch of Northwestern University, who helped write medical standards meant to limit HGH treatment to legitimate patients.

And those figures don't include HGH sold directly by doctors without prescriptions at scores of anti-aging medical practices and clinics around the country. Those numbers could only be tallied by drug makers, who have declined to say how many patients they supply and for what conditions.

First marketed in 1985 for children with stunted growth, HGH was soon misappropriated by adults intent on exploiting its modest muscle- and bone-building qualities. Congress limited HGH distribution to the handful of rare conditions in an extraordinary 1990 law, overriding the generally unrestricted right of doctors to prescribe medicines as they see fit.

Despite the law, illicit HGH spread around the sports world in the 1990s, making deep inroads into bodybuilding, college athletics, and professional leagues from baseball to cycling. The even larger banned market among older adults has flourished more recently.

FDA regulations ban the sale of HGH as an anti-aging drug. In fact, since 1990, prescribing it for things like weight loss and strength conditioning has been punishable by 5 to 10 years in prison.

Steve Kleppe, of Scottsdale, Ariz., a restaurant entrepreneur who has taken HGH for almost 15 years to keep feeling young, said he noticed a price jump of about 25 percent after the block on imports. He now buys HGH directly from a doctor at an annual cost of about $8,000 for himself and the same amount for his wife.

Many older patients go for HGH treatment to scores of anti-aging practices and clinics heavily concentrated in retirement states like Florida, Nevada, Arizona and California.

These sites are affiliated with hundreds of doctors who are rarely endocrinologists. Instead, many tout certification by the American Board of Anti-Aging and Regenerative Medicine, though the medical establishment does not recognize the group's bona fides.

The clinics offer personalized programs of "age management" to business executives, affluent retirees, and other patients of means, sometimes coupled with the amenities of a vacation resort. The operations insist there are few, if any, side effects from HGH. Mainstream medical authorities say otherwise.

A 2007 review of 31 medical studies showed swelling in half of HGH patients, with joint pain or diabetes in more than a fifth. A French study of about 7,000 people who took HGH as children found a 30 percent higher risk of death from causes like bone tumors and stroke, stirring a health advisory from U.S. authorities.

For proof that the drug works, marketers turn to images like the memorable one of pot-bellied septuagenarian Dr. Jeffry Life, supposedly transformed into a ripped hulk of himself by his own program available at the upscale Las Vegas-based Cenegenics Elite Health. (He declined to be interviewed.)

These promoters of HGH say there is a connection between the drop-off in growth hormone levels through adulthood and the physical decline that begins in late middle age. Replace the hormone, they say, and the aging process slows.

"It's an easy ruse. People equate hormones with youth," said Dr. Tom Perls, a leading industry critic who does aging research at Boston University. "It's a marketing dream come true."

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Associated Press Writer David B. Caruso reported from New York and AP National Writer Jeff Donn reported from Plymouth, Mass. AP Writer Troy Thibodeaux provided data analysis assistance from New Orleans.

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AP's interactive on the HGH investigation: http://hosted.ap.org/interactives/2012/hgh

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The AP National Investigative Team can be reached at investigate(at)ap.org

EDITOR'S NOTE _ Whether for athletics or age, Americans from teenagers to baby boomers are trying to get an edge by illegally using anabolic steroids and human growth hormone, despite well-documented risks. This is the second of a two-part series.

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Obama Still an 'Optimist' on Cliff Deal

Mandel Ngan/AFP/Getty Images

WASHINGTON D.C. – Ten days remain before the mandatory spending cuts and tax increases known as the “fiscal cliff” take effect, but President Obama said he is still a “hopeless optimist” that a federal budget deal can be reached before the year-end deadline that economists agree might plunge the country back into recession.

“Even though Democrats and Republicans are arguing about whether those rates should go up for the wealthiest individuals, all of us – every single one of us -agrees that tax rates shouldn’t go up for the other 98 percent of Americans, which includes 97 percent of small businesses,” he said.

He added that there was “no reason” not to move forward on that aspect, and that it was “within our capacity” to resolve.

The question of whether to raise taxes on incomes over $250,000 remains at an impasse, but is only one element of nuanced legislative wrangling that has left the parties at odds.

For ABC News’ breakdown of the rhetoric versus the reality, click here.

At the White House news conference this evening, the president confirmed he had spoken today to Senate Majority Leader Harry Reid, D-Nev., and House Speaker John Boehner, R-Ohio, although no details of the conversations were disclosed.

The talks came the same day Speaker Boehner admitted “God only knows” the solution to the gridlock, and a day after mounting pressure from within his own Republican Party forced him to pull his alternative proposal from a prospective House vote. That proposal, ”Plan B,” called for extending current tax rates for Americans making up to $1 million a year, a far wealthier threshold than Democrats have advocated.

Boehner acknowledged that even the conservative-leaning “Plan B” did not have the support necessary to pass in the Republican-dominated House, leaving a resolution to the fiscal cliff in doubt.

“In the next few days, I’ve asked leaders of Congress to work towards a package that prevents a tax hike on middle-class Americans, protects unemployment insurance for 2 million Americans, and lays the groundwork for further work on both growth and deficit reduction,” Obama said. ”That’s an achievable goal.  That can get done in 10 days.”

Complicating matters: The halls of Congress are silent tonight. The House of Representatives began its holiday recess Thursday and Senate followed this evening.

Meanwhile, the president has his own vacation to contend with. Tonight, he was embarking for Hawaii and what is typically several weeks of Christmas vacation.

However, during the press conference the president said he would see his congressional colleagues “next week” to continue negotiations, leaving uncertain how long Obama plans to remain in the Aloha State.

The president said he hoped the time off would give leaders “some perspective.”

“Everybody can cool off; everybody can drink some eggnog, have some Christmas cookies, sing some Christmas carols, enjoy the company of loved ones,” he said. “And then I’d ask every member of Congress, while they’re back home, to think about that.  Think about the obligations we have to the people who sent us here.

“This is not simply a contest between parties in terms of who looks good and who doesn’t,” he added later. “There are real-world consequences to what we do here.”

Obama concluded by reiterating that neither side could walk away with “100 percent” of its demands, and that it negotiations couldn’t remain “a contest between parties in terms of who looks good and who doesn’t.”

Boehner’s office reacted quickly to the remarks, continuing recent Republican statements that presidential leadership was at fault for the ongoing gridlock.

“Though the president has failed to offer any solution that passes the test of balance, we remain hopeful he is finally ready to get serious about averting the fiscal cliff,” Boehner said. “The House has already acted to stop all of the looming tax hikes and replace the automatic defense cuts. It is time for the Democratic-run Senate to act, and that is what the speaker told the president tonight.”

The speaker’s office said Boehner “will return to Washington following the holiday, ready to find a solution that can pass both houses of Congress.”

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Syrian rebels fight for strategic town in Hama province

BEIRUT (Reuters) - Rebels began to push into a strategic town in Syria's central Hama province on Thursday and laid siege to at least one town dominated by President Bashar al-Assad's minority sect, activists said.

The operation risks inflaming already raw sectarian tensions as the 21-month-old revolt against four decades of Assad family rule - during which the president's Alawite sect has dominated leadership of the Sunni Muslim majority - rumbles on.

Opposition sources said rebels had won some territory in the strategic southern town of Morek and were surrounding the Alawite town of al-Tleisia.

They were also planning to take the town of Maan, arguing that the army was present there and in al-Tleisia and was hindering their advance on nearby Morek, a town on the highway that runs from Damascus north to Aleppo, Syria's largest city and another battleground in the conflict.

"The rockets are being fired from there, they are being fired from Maan and al-Tleisia, we have taken two checkpoints in the southern town of Morek. If we want to control it then we need to take Maan," said a rebel captain in Hama rural area, who asked not to be named.

Activists said heavy army shelling had targeted the town of Halfaya, captured by rebels two days earlier. Seven people were killed, 30 were wounded, and dozens of homes were destroyed, said activist Safi al-Hamawi.

Hama is home to dozens of Alawite and Christian villages among Sunni towns, and activists said it may be necessary to lay siege to many minority areas to seize Morek. Rebels want to capture Morek to cut off army supply lines into northern Idlib, a province on the northern border with Turkey where rebels hold swathes of territory.

From an offshoot of Shi'ite Islam, Alawites have largely stood behind Assad, many out of fear of revenge attacks. Christians and some other minorities have claimed neutrality, with a few joining the rebels and a more sizeable portion of them supporting the government out of fear of hardline Islamism that has taken root in some rebel groups.

Activists in Hama said rebels were also surrounding the Christian town of al-Suqeilabiya and might enter the city to take out army positions as well as those of "shabbiha" - pro-Assad militias, the bulk of whom are usually Alawite but can also include Christians and even Sunnis.

"We have been in touch with Christian opposition activists in al-Suqeilabiya and we have told them to stay downstairs or on the lowest floor of their building as possible, and not to go outside. The rebels have promised not to hurt anyone who stays at home," said activist Mousab al-Hamdee, speaking by Skype.

He said he was optimistic that potential sectarian tensions with Christians could be resolved but that Sunni-Alawite strife may be harder to suppress.

SECTARIAN FEARS

U.N. human rights investigators said on Thursday that Syria's conflict was becoming more "overtly sectarian", with more civilians seeking to arm themselves and foreign fighters - mostly Sunnis - flocking in from 29 countries.

"They come from all over, Europe and America, and especially the neighboring countries," said Karen Abuzayd, one of the U.N. investigators, told a news conference in Brussels.

Deeper sectarian divisions may diminish prospects for post-conflict reconciliation even if Assad is ousted, and the influx of foreigners raises the risk of fighting spilling into neighboring countries riven by similar communal fault lines.

Some activists privately voiced concerns of sectarian violence, but the rebel commander in Hama said fighters had been told "violations" would not be tolerated and argued that the move to attack the towns was purely strategic.

"If we are fired at from a Sunni village that is loyal to the regime we go in and we liberate it and clean it," he said. "So should we not do the same when it comes to an Alawite village just because there is a fear of an all-out sectarian war? We respond to the source of fire."

President Vladimir Putin of Russia, Assad's main ally and arms supplier, warned that any solution to the conflict must ensure government and rebel forces do not merely swap roles and fight on forever. It appeared to be his first direct comment on the possibility of a post-Assad Syria.

The West and some Arab states accuse Russia of shielding Assad after Moscow blocked three U.N. Security Council resolutions intended to increase pressure on Damascus to end the violence, which has killed more than 40,000 people. Putin said the Syrian people would ultimately decide their own fate.

Assad's forces have been hitting back at rebel advances with heavy shelling, particularly along the eastern ring of suburbs outside Damascus, where rebels are dominant.

A Syrian security source said the army was planning heavy offensives in northern and central Syria to stem rebel advances, but there was no clear sign of such operations yet.

Rebels seized the Palestinian refugee district of Yarmouk earlier this week, which put them within 3 km (2 miles) of downtown Damascus. Heavy shelling and fighting forced thousands of Palestinian and Syrian residents to flee the Yarmouk area.

Rebels said on Thursday they had negotiated to put the camp - actually a densely packed urban district - back into the hands of pro-opposition Palestinian fighters. There are some 500,000 Palestinian refugees and their descendants living in Syria, and they have been divided by the uprising.

Palestinian factions, some backed by the government and others by the rebels, had begun fighting last week, a development that allowed Syrian insurgents to take the camp.

A resident in Damascus said dozens of families were returning to the camp but that the army had erected checkpoints. Many families were still hesitant to return.

LEBANON BORDER POST TAKEN

Elsewhere, Syrian insurgents took over an isolated border post on the western frontier with Lebanon earlier this week, local residents told Reuters on Thursday.

The rebels already hold much of the terrain along Syria's northern and eastern borders with Turkey and Iraq respectively.

They said around 20 rebels from the Qadissiyah Brigade overran the post at Rankus, which is linked by road to the remote Lebanese village of Tufail.

Video footage downloaded on the Internet on Thursday, dated December 16, showed a handful of fighters dressed in khaki fatigues and wielding rifles as they kicked down a stone barricade around a small, single-storey army checkpoint.

Syrian Interior Minister Ibrahim al-Shaar arrived in Lebanon on Wednesday for treatment of wounds sustained in a bomb attack on his ministry in Damascus a week ago.

Lebanese medical sources said Shaar had shrapnel wounds in his shoulder, stomach and legs but they were not critical.

The Syrian opposition has tried to peel off defectors from the government as well as from the army, though only a handful of high-ranking officials have abandoned Assad.

The conflict has divided many Syrian families. Security forces on Thursday arrested an opposition activist who is also the relative of Vice President Farouq al-Sharaa, the Syrian Observatory said. The man was arrested along with five other activists who are considered pacifists, it said.

Sharaa, a Sunni Muslim who has few powers in Assad's Alawite-dominated power structure, said earlier this week that neither side could win the war in Syria. He called for the formation of a national unity government.

(Reporting by Erika Solomon; Editing by Andrew Osborn)

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Britain's Akram Khan's dance of creative destruction

PARIS: A year ago, Akram Khan was told his dance career was over. Now, with the Olympics ceremony under his belt, two films on the boil and three shows on tour, Britain's best-known choreographer could hardly be busier if he tried.

The 38-year-old ball of energy is in Paris this month with his most personal work to date, DESH, a full-length solo exploring his family roots in Bangladesh, through his signature fusion of contemporary dance with north Indian Kathak.

Khan's schedule for the coming months sounds like a plate-spinning act, but when he ripped his Achilles tendon during a rehearsal last January, doctors feared he would never dance again.

"It was very traumatic," he told AFP, "Ballet dancers don't come back after an Achilles tendon rupture. It's very rarely possible."

Shows were cancelled, plans cut short as Khan -- unable to walk for two months -- headed into a "humiliating" round of surgery and physiotherapy.

"I'm a dancer, so it's ego you know, somebody's telling you how to do a simple walk. I wanted to shoot them!"

"But from that it went into running, jogging, then jumping, then a little bit of confidence comes back.

"And then suddenly you're in the Olympics!" joked Khan, who choreographed and performed in a segment of the August opening ceremony.

In his solo DESH, a chameleonic Khan gives life to a dense cast of characters as the action shifts, dreamlike, from his south London birthplace to the grimy, noisy streets of Bangladesh over 80 visually-sumptuous minutes.

While he has recovered mobility, Khan has yet to get his full strength back, and had to make changes to perform the show, on world tour after premiering in London to rapturous reviews last year.

"You find other ways, and that was very valuable," he said, "I'm stronger in other ways."

Right now Khan is preparing a duet with the Flamenco dancer Izrael Galvan, in between touring with two more of his shows -- Gnosis and Sacred Monsters.

Come May he will premiere a creation called iTMOi inspired by Igor Stravinsky's "Rite of Spring" in the French city of Grenoble, before taking that show on the road as well.

Recent sideline projects have included teaming up with the artist Anish Kapoor to shoot a spoof "Gangnam Style" video in support of Chinese dissident artist Ai Wei Wei.

As if that wasn't enough, he is choreographing a film called "Desert Dancer", based on the true story of a young Iranian man persecuted for his love of dance, and is hoping to direct a film based on DESH.

In terms of juggling projects, Khan says he is busier than ever before. And in March he will become a father for the first time, when his Japanese dancer wife gives birth to a baby girl.

The story of Khan's injury and recovery loops back to an earlier one of how, as a little boy, he liked to break things to see what was inside.

"I was destructive as a child, I was fascinated to see things broken and put back together again," he told AFP, "I was very physical, I couldn't keep my hands still."

That was how Khan's mother started teaching her three-year-old son the folk dance Kathak, today the backbone of his art. To tire him out, like others might send a child to kick a ball around the yard.

Formal lessons followed aged seven, but it was long a battle of wills with a mother determined to share -- "impose", he jokes -- her culture with him.

"It was traumatic," said Khan, who talks with disarming candour, and wry humour, of his upbringing, "My mother used to bribe me, with toys, each performance I would get a little matchbox car."

While he jokes about his strong-willed mother, Khan is clear the "challenging relationship" in his life is with his father, bent on rooting out the Westerner in his son and making a true Bengali of him.

"DESH is very much about my father," he says of the piece, which opens with a scene showing him burying his father before pounding violently at the earth, as if to root out the story of their shared past.

Like a grown-up version of the creative destruction he displayed as a child.

Co-created with the poet Karthika Nair, the visual designer Tim Yip and the composer Jocelyn Pook, the work has a political dimension too, reflecting his sense that "everything is political" in Bangladesh, starting with the drinking water polluted by Western waste dumping.

"This is my story. It's part true, part lie," he says, "It needed to be epic, because it was very personal."

But for now, Khan jokes, he is done digging for his family roots: "I think I need to move on -- I need to get a life!"

-AFP/fl

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CWG scam: Delhi court orders framing of charges against Suresh Kalmadi & others

NEW DELHI: A Delhi court today ordered framing of charges against sacked CWG organising committee chairman Suresh Kalmadi and others for offences of forgery, cheating and conspiracy in a games-related graft case.

Special CBI Judge Talwant Singh passed the order on framing of charges against Kalmadi, former OC secretary general Lalit Bhanot and nine others for illegally awarding a contract to Swiss firm, Swiss Timing Omega, causing huge loss to the exchequer.

The court said "prima facie" charges of cheating, forgery, criminal conspiracy and for offences under the provisions of the Prevention of Corruption Act are made out against eight accused persons and three companies.

"Charges under section 120B (criminal conspiracy), 201 (destruction of evidence), 420 (cheating), 467, 468, 471 (relating to forgery), 506 (criminal intimidation) of the IPC and section 13(1)(d) read with section 13(2) (criminal misconduct by public servants) of the PC Act is ordered to be framed against all the accused," the court said.

"Put up for formally framing of charges on January 10 at 10.30am," the judge said.

The accused have been charge sheeted by the CBI for "illegally" awarding a contract to install Timing, Scoring and Results (TSR) system for the 2010 CWG to Swiss Timing at inflated rates causing a loss of over Rs 90 crore to the public exchequer.

Besides Kalmadi and Bhanot, the other accused in the case are OC's director general V K Verma, director general (procurement) Surjit Lal, Joint director general (sports) ASV Prasad and treasurer M Jayachandran. They are no more associated with the sporting body.

Promoters of two construction companies — P D Arya and A K Madan of Faridabad-based Gem International and A K Reddy of Hyderabad-based AKR Constructions are also accused in the case. Swiss Timing Omega is also an accused in the case.

The CBI had alleged that Kalmadi and others had rejected Spanish firm MSL's much lower bid of Rs 62 crore and awarded the contract to Swiss Timing Omega, causing a loss of over Rs 90 crore to the exchequer.

During the arguments on charges, CBI counsel V K Sharma had argued that Kalmadi and others had decided to award the contract for installing the TSR system for the CWG to Swiss Timing even before the firm had bid for it.

Sharma had also said that for TSR installation, two bids had been received - one from Swiss Timing and other from MSL Spain, and the same were opened on November 4, 2009 but Kalmadi and Verma had announced in a meeting on October 12, 2009 itself that the contract would be given to Swiss Timing.

He had also said Kalmadi had made up his mind in advance to award the contract to the Swiss firm.

Kalmadi's counsel, however, had argued that the facts given in the CBI's charge sheet were contrary to the documents which the agency had filed in the court.

Kalmadi had told the court that he was only doing the work assigned to him as the OC chairman and nothing wrong was done by him in the entire process.

The counsel appearing for other accused had also opposed the allegations levelled against them by the CBI.

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AP IMPACT: Steroids loom in major-college football

WASHINGTON (AP) — With steroids easy to buy, testing weak and punishments inconsistent, college football players are packing on significant weight — 30 pounds or more in a single year, sometimes — without drawing much attention from their schools or the NCAA in a sport that earns tens of billions of dollars for teams.

Rules vary so widely that, on any given game day, a team with a strict no-steroid policy can face a team whose players have repeatedly tested positive.

An investigation by The Associated Press — based on interviews with players, testers, dealers and experts and an analysis of weight records for more than 61,000 players — revealed that while those running the multibillion-dollar sport say they believe the problem is under control, that control is hardly evident.

The sport's near-zero rate of positive steroids tests isn't an accurate gauge among college athletes. Random tests provide weak deterrence and, by design, fail to catch every player using steroids. Colleges also are reluctant to spend money on expensive steroid testing when cheaper ones for drugs like marijuana allow them to say they're doing everything they can to keep drugs out of football.

"It's nothing like what's going on in reality," said Don Catlin, an anti-doping pioneer who spent years conducting the NCAA's laboratory tests at UCLA. He became so frustrated with the college system that it was part of the reason he left the testing industry to focus on anti-doping research.

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EDITOR'S NOTE — Whether for athletics or age, Americans from teenagers to baby boomers are trying to get an edge by illegally using anabolic steroids and human growth hormone, despite well-documented risks. This is the first of a two-part series.

___

While other major sports have been beset by revelations of steroid use, college football has operated with barely a whiff of scandal. Between 1996 and 2010 — the era of Barry Bonds, Mark McGwire, Marion Jones and Lance Armstrong — the failure rate for NCAA steroid tests fell even closer to zero from an already low rate of less than 1 percent.

The AP's investigation, drawing upon more than a decade of official rosters from all 120 Football Bowl Subdivision teams, found thousands of players quickly putting on significant weight, even more than their fellow players. The information compiled by the AP included players who appeared for multiple years on the same teams.

For decades, scientific studies have shown that anabolic steroid use leads to an increase in body weight. Weight gain alone doesn't prove steroid use, but very rapid weight gain is one factor that would be deemed suspicious, said Kathy Turpin, senior director of sport drug testing for the National Center for Drug Free Sport, which conducts tests for the NCAA and more than 300 schools.

Yet the NCAA has never studied weight gain or considered it in regard to its steroid testing policies, said Mary Wilfert, the NCAA's associate director of health and safety.

The NCAA attributes the decline in positive tests to its year-round drug testing program, combined with anti-drug education and testing conducted by schools.

The AP's analysis found that, regardless of school, conference and won-loss record, many players gained weight at exceptional rates compared with their fellow athletes and while accounting for their heights.

Adding more than 20 or 25 pounds of lean muscle in a year is nearly impossible through diet and exercise alone, said Dan Benardot, director of the Laboratory for Elite Athlete Performance at Georgia State University.

In nearly all the rarest cases of weight gain in the AP study, players were offensive or defensive linemen, hulking giants who tower above 6-foot-3 and weigh 300 pounds or more. Four of those players interviewed by the AP said that they never used steroids and gained weight through dramatic increases in eating, up to six meals a day. Two said they were aware of other players using steroids.

"I ate 5-6 times a day," said Clint Oldenburg, who played for Colorado State starting in 2002 and for five years in the NFL. Oldenburg's weight increased over four years from 212 to 290.

Oldenburg told the AP he was surprised at the scope of steroid use in college football, even in Colorado State's locker room. "There were a lot of guys even on my team that were using." He declined to identify any of them.

The AP found more than 4,700 players — or about 7 percent of all players — who gained more than 20 pounds overall in a single year. It was common for the athletes to gain 10, 15 and up to 20 pounds in their first year under a rigorous regimen of weightlifting and diet. Others gained 25, 35 and 40 pounds in a season. In roughly 100 cases, players packed on as much 80 pounds in a single year.

In at least 11 instances, players that AP identified as packing on significant weight in college went on to fail NFL drug tests. But pro football's confidentiality rules make it impossible to know for certain which drugs were used and how many others failed tests that never became public.

Even though testers consider rapid weight gain suspicious, in practice it doesn't result in testing. Ben Lamaak, who arrived at Iowa State in 2006, said he weighed 225 pounds in high school. He graduated as a 320-pound offensive lineman and said he did it all naturally.

"I was just a young kid at that time, and I was still growing into my body," he said. "It really wasn't that hard for me to gain the weight. I love to eat."

In addition to random drug testing, Iowa State is one of many schools that have "reasonable suspicion" testing. That means players can be tested when their behavior or physical symptoms suggest drug use. Despite gaining 81 pounds in a year, Lamaak said he was never singled out for testing.

The associate athletics director for athletic training at Iowa State, Mark Coberley, said coaches and trainers use body composition, strength data and other factors to spot suspected cheaters. Lamaak, he said, was not suspicious because he gained a lot of "non-lean" weight.

But looking solely at the most significant weight gainers also ignores players like Bryan Maneafaiga.

In the summer of 2004, Bryan Maneafaiga was an undersized 180-pound running back trying to make the University of Hawaii football team. Twice — once in pre-season and once in the fall — he failed school drug tests, showing up positive for marijuana use but not steroids.

He'd started injecting stanozolol, a steroid, in the summer to help bulk up to a roster weight of 200 pounds. Once on the team, he'd occasionally inject the milky liquid into his buttocks the day before games.

"Food and good training will only get you so far," he told the AP recently.

Maneafaiga's former coach, June Jones, said it was news to him that one of his players had used steroids. Jones, who now coaches at Southern Methodist University, believes the NCAA does a good job rooting out steroid use.

On paper, college football has a strong drug policy. The NCAA conducts random, unannounced drug testing and the penalties for failure are severe. Players lose an entire year of eligibility after a first positive test. A second offense means permanent ineligibility for sports.

In practice, though, the NCAA's roughly 11,000 annual tests amount to a fraction of all athletes in Division I and II schools. Exactly how many tests are conducted each year on football players is unclear because the NCAA hasn't published its data for two years. And when it did, it periodically changed the formats, making it impossible to compare one year of football to the next.

Even when players are tested by the NCAA, experts like Catlin say it's easy enough to anticipate the test and develop a doping routine that results in a clean test by the time it occurs. NCAA rules say players can be notified up to two days in advance of a test, which Catlin says is plenty of time to beat a test if players have designed the right doping regimen. By comparison, Olympic athletes are given no notice.

Most schools that use Drug Free Sport do not test for anabolic steroids, Turpin said. Some are worried about the cost. Others don't think they have a problem. And others believe that since the NCAA tests for steroids their money is best spent testing for street drugs, she said.

Doping is a bigger deal at some schools than others.

At Notre Dame and Alabama, the teams that will soon compete for the national championship, players don't automatically miss games for testing positive for steroids. At Alabama, coaches have wide discretion. Notre Dame's student-athlete handbook says a player who fails a test can return to the field once the steroids are out of his system.

The University of North Carolina kicks players off the team after a single positive test for steroids. Auburn's student-athlete handbook calls for a half-season suspension for any athlete caught using performance-enhancing drugs.

At UCLA, home of the laboratory that for years set the standard for cutting-edge steroid testing, athletes can fail three drug tests before being suspended. At Bowling Green, testing is voluntary.

At the University of Maryland, students must get counseling after testing positive, but school officials are prohibited from disciplining first-time steroid users.

Only about half the student athletes in a 2009 NCAA survey said they believed school testing deterred drug use. As an association of colleges and universities, the NCAA could not unilaterally force schools to institute uniform testing policies and sanctions, Wilfert said.

"We can't tell them what to do, but if went through a membership process where they determined that this is what should be done, then it could happen," she said.

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Associated Press writers Ryan Foley in Cedar Rapids, Iowa; David Brandt in Jackson, Miss.; David Skretta in Lawrence, Kan.; Don Thompson in Sacramento, Calif., and Alexa Olesen in Shanghai, China, and researchers Susan James in New York and Monika Mathur in Washington contributed to this report.

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Contact the Washington investigative team at DCinvestigations (at) ap.org.

Whether for athletics or age, Americans from teenagers to baby boomers are trying to get an edge by illegally using anabolic steroids and human growth hormone, despite well-documented risks. This is the first of a two-part series.

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State Department security chief leaves post over Benghazi

WASHINGTON (Reuters) - The U.S. State Department said on Wednesday its security chief had resigned from his post and three other officials had been relieved of their duties following a scathing official inquiry into the September 11 attack on the U.S. mission in Benghazi.

Eric Boswell has resigned effective immediately as assistant secretary of state for diplomatic security, State Department spokeswoman Victoria Nuland said in a terse statement. A second official, speaking on condition of anonymity, said Boswell had not left the department entirely and remained a career official.

Nuland said that Boswell, and the three other officials, had all been put on administrative leave "pending further action."

An official panel that investigated the incident concluded that the Benghazi mission was completely unprepared to deal with the attack, which killed U.S. Ambassador Christopher Stevens and three other Americans.

The unclassified version of the report, which was released on Tuesday, cited "leadership and management" deficiencies, poor coordination among officials and "real confusion" in Washington and in the field over who had the authority to make decisions on policy and security concerns.

"The ARB identified the performance of four officials, three in the Bureau of the Diplomatic Security and one in the Bureau of (Near Eastern) Affairs," Nuland said in her statement, referring to the panel known as an Accountability Review Board.

Secretary of State Hillary Clinton accepted Boswell's decision to resign effective immediately, the spokeswoman said.

Earlier, a U.S. official who spoke on condition of anonymity said Boswell, one of his deputies, Charlene Lamb, and a third unnamed official has been asked to resign. The Associated Press first reported that three officials had resigned.

PANEL STOPS SHORT OF BLAMING CLINTON

The Benghazi incident appeared likely to tarnish Clinton's four-year tenure as secretary of state but the report did not fault her specifically and the officials who led the review stopped short of blaming her.

"We did conclude that certain State Department bureau-level senior officials in critical positions of authority and responsibility in Washington demonstrated a lack of leadership and management ability appropriate for senior ranks," retired Admiral Michael Mullen, one of the leaders of the inquiry, told reporters on Wednesday.

The panel's chair, retired Ambassador Thomas Pickering, said it had determined that responsibility for security shortcomings in Benghazi belonged at levels lower than Clinton's office.

"We fixed (responsibility) at the assistant secretary level, which is, in our view, the appropriate place to look for where the decision-making in fact takes place, where - if you like - the rubber hits the road," Pickering said after closed-door meetings with congressional committees.

The panel's report and the comments by its two lead authors suggested that Clinton, who accepted responsibility for the incident in a television interview about a month after the Benghazi attack, would not be held personally culpable.

Pickering and Mullen spoke to the media after briefing members of the House of Representatives Foreign Affairs Committee and Senate Foreign Relations Committee behind closed doors on classified elements of their report.

Clinton had been expected to appear at an open hearing on Benghazi on Thursday, but is recuperating after suffering a concussion, dehydration and a stomach bug last week. She will instead be represented by her two top deputies.

Clinton, who intends to step down in January, said in a letter accompanying the review that she would adopt all of its recommendations, which include stepping up security staffing and requesting more money to fortify U.S. facilities.

The National Defense Authorization Act for 2013, which is expected to go to Congress for final approval this week, includes a measure directing the Pentagon to increase the Marine Corps presence at diplomatic facilities by up to 1,000 Marines.

Some Capitol Hill Republicans who had criticized the Obama administration's handling of the Benghazi attacks said they were impressed by the report.

"It was very thorough," said Senator Johnny Isakson. Senator John Barrasso said: "It was very, very critical of major failures at the State Department at very high levels." Both spoke after the closed-door briefing.

Others, however, took a harsher line and called for Clinton to testify as soon as she is able.

"The report makes clear the massive failure of the State Department at all levels, including senior leadership, to take action to protect our government employees abroad," Representative Mike Rogers, the Republican chairman of the House Intelligence Committee, said in a statement.

Senator Bob Corker, who will be the top Republican on the Senate Foreign Relations Committee when the new Congress is seated early next year, said Clinton should testify about Benghazi before her replacement is confirmed by the Senate.

Republicans have focused much of their firepower on U.S. Ambassador to the United Nations Susan Rice, who appeared on TV talk shows after the attack and suggested it was the result of a spontaneous protest rather than a premeditated attack.

The report concluded that there was no such protest.

Rice, widely seen as President Barack Obama's top pick to succeed Clinton, withdrew her name from consideration last week.

(Additional reporting by Tabassum Zakaria and Susan Cornwell; Editing by Christopher Wilson)

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Big-spender ex-PM to be Japan's finance chief: report

TOKYO: A former Japanese prime minister known as a big spender in his political and personal life, will likely become the country's next finance minister and deputy premier, a report said on Thursday.

The leading Nikkei business daily said incoming Prime Minister Shinzo Abe will tap 72-year-old Taro Aso as finance chief and his own deputy, in a new government set to be formed next week.

Aso's past spending habits are in line with those of Abe, whose conservative Liberal Democratic Party (LDP) swept to victory in national elections on Sunday, pledging to boost the nation's ailing economy.

Aso, a fourth-generation politician who became Japan's prime minister in 2008, served as foreign minister during Abe's 2006-2007 stint in Japan's top political job.

As prime minister, Aso launched a series of economic stimulus packages worth hundreds of billions of dollars to prop up Japan's long-struggling economy.

But his time as premier ended in less than a year as the long-ruling LDP lost a historic election to the Democratic Party of Japan (DPJ) in 2009, while Aso's own missteps dented his popularity.

The scion of a wealthy family, he faced criticism for regular outings to luxurious hotel bars and mispronouncing commonly-used Chinese characters that make up part of the Japanese writing system.

Just a week before before his party lost to the DPJ, and as the economy sputtered, Aso was quoted as saying that "if you don't have money, you'd better not get married", dealing another blow to his profile.

In 2006, while he was foreign minister, a New York Times editorial branded Aso "Japan's offensive minister" for praising aspects of his country's colonial history in Asia, a particularly sore point in China and on the Korean peninsula.

His previous spending policies, however, were similar to those pledged by Abe -- to turn on the fiscal taps.

Abe has said he will pressure the Bank of Japan into more aggressive easing to power the world's third-largest economy, which may have slipped into recession in the third quarter.

A senior LDP official said on Wednesday that the incoming government would launch a spending package worth about 10 trillion yen ($118 billion) aimed at injecting life into the nation's limp economy.

- AFP/al

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US asked to term 1984 anti-Sikh violence a genocide

WASHINGTON: A petition with more than 46,000 signatures, including 29,000 online, submitted to the Obama administration urges it to recognize the organized violence perpetrated against Sikhs during November 1984 as "genocide".

The rights group " Sikhs for Justice" (SFJ) has also announced plans to converge on Capitol Hill Feb 1, during the constituent work week of the House of Representative to lobby in support of the Sikh genocide petition, the group said.

The US department of state's Bureau of Democracy, Human Rights and Labour that deals with issues relating to the international human rights violations and crimes against humanity is expected to respond on the Sikh genocide petition, it said.

In support of the petition, the SFJ has submitted "1984 Yes it is Genocide" report to Assistant Secretary of State Michael Posner.

The 300-page report presents evidence showing that Sikhs were killed in large numbers in those 19 states of India where the Congress party was in power during November 1984 and role of Congress leaders in inciting and organising violence with intent to destroy the Sikh community.

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Experts: Kids are resilient in coping with trauma

WASHINGTON (AP) — They might not want to talk about the gunshots or the screams. But their toys might start getting into imaginary shootouts.

Last week's school shooting in Connecticut raises the question: What will be the psychological fallout for the children who survived?

For people of any age, regaining a sense of security after surviving violence can take a long time. They're at risk for lingering anxiety, depression, post-traumatic stress disorder.

But after the grief and fear fades, psychiatrists say most of Newtown's young survivors probably will cope without long-term emotional problems.

"Kids do tend to be highly resilient," said Dr. Matthew Biel, chief of child and adolescent psychiatry at MedStar Georgetown University Hospital.

And one way that younger children try to make sense of trauma is through play. Youngsters may pull out action figures or stuffed animals and re-enact what they witnessed, perhaps multiple times.

"That's the way they gain mastery over a situation that's overwhelming," Biel explained, saying it becomes a concern only if the child is clearly distressed while playing.

Nor is it unusual for children to chase each other playing cops-and-robbers, but now parents might see some also pretending they're dead, added Dr. Melissa Brymer of the UCLA-Duke National Center for Child Traumatic Stress.

Among the challenges will be spotting which children are struggling enough that they may need professional help.

Newtown's tragedy is particularly heart-wrenching because of what such young children grappled with — like the six first-graders who apparently had to run past their teacher's body to escape to safety.

There's little scientific research specifically on PTSD, post-traumatic stress disorder, in children exposed to a burst of violence, and even less to tell if a younger child will have a harder time healing than an older one.

Overall, scientists say studies of natural disasters and wars suggest most children eventually recover from traumatic experiences while a smaller proportion develop long-term disorders such as PTSD. Brymer says in her studies of school shootings, that fraction can range from 10 percent to a quarter of survivors, depending on what they actually experienced. A broader 2007 study found 13 percent of U.S. children exposed to different types of trauma reported some symptoms of PTSD, although less than 1 percent had enough for an official diagnosis.

Violence isn't all that rare in childhood. In many parts of the world — and in inner-city neighborhoods in the U.S., too — children witness it repeatedly. They don't become inured to it, Biel said, and more exposure means a greater chance of lasting psychological harm.

In Newtown, most at risk for longer-term problems are those who saw someone killed, said Dr. Carol North of the University of Texas Southwestern Medical Center, who has researched survivors of mass shootings.

Friday's shootings were mostly in two classrooms of Sandy Hook Elementary School, which has about 450 students through fourth-grade.

But those who weren't as close to the danger may be at extra risk, too, if this wasn't their first trauma or they already had problems such as anxiety disorders that increase their vulnerability, she said.

Right after a traumatic event, it's normal to have nightmares or trouble sleeping, to stick close to loved ones, and to be nervous or moody, Biel said.

To help, parents will have to follow their child's lead. Grilling a child about a traumatic experience isn't good, he stressed. Some children will ask a lot of questions, seeking reassurance, he said. Others will be quiet, thinking about the experience and maybe drawing or writing about it, or acting it out at playtime. Younger children may regress, becoming clingy or having tantrums.

Before second grade, their brains also are at a developmental stage some refer to as magical thinking, when it's difficult to distinguish reality and fantasy. Parents may have to help them understand that a friend who died isn't in pain or lonely but also isn't coming back, Brymer said.

When problem behaviors or signs of distress continue for several weeks, Brymer says it's time for an evaluation by a counselor or pediatrician.

Besides a supportive family, what helps? North advises getting children back into routines, together with their friends, and easing them back into a school setting. Studies of survivors of the Sept. 11 terrorist attacks found "the power of the support of the people who went through it with you is huge," she said.

Children as young as first-graders can benefit from cognitive-behavioral therapy, Georgetown's Biel said. They can calm themselves with breathing techniques. They also can learn to identify and label their feelings — anger, frustration, worry — and how to balance, say, a worried thought with a brave one.

Finally, avoid watching TV coverage of the shooting, as children may think it's happening all over again, Biel added. He found that children who watched the 9/11 clips of planes hitting the World Trade Center thought they were seeing dozens of separate attacks.

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EDITOR'S NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.

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