Gunman kills 2, then self at Oregon mall

A masked gunman who opened fire in the crowded Clackamas Town Center mall in suburban Portland, Ore., killing two individuals and seriously injuring a third before killing himself, has been "tentatively" identified by police, though they have not yet released his name.

The shooter, wearing a white hockey mask, black clothing, and a bullet proof vest, tore through the mall around 3:30 p.m. Tuesday, entering through a Macy's store and proceeding to the food court and public areas spraying bullets, according to witness reports.

Police have not released the names of the deceased. Clackamas County Sheriff's Department Lt. James Rhodes said authorities are in the process of notifying victims' families.

The injured victim has been transported to a local hospital, according to Clackamas County Sheriff Craig Roberts.

PHOTOS: Oregon Mall Shooting

Nadia Telguz, who said she was a friend of the injured victim, told ABC News affiliate KATU-TV in Portland that the woman was expected to recover.

"My friend's sister got shot," Teleguz told KATU. "She's on her way to (Oregon Health and Science University hospital). They're saying she got shot in her side and so it's not life-threatening, so she'll be OK."

Witnesses from the shooting rampage said that a young man who appeared to be a teenager ran through the upper level of Macy's to the mall food court, firing multiple shots, one right after the other, with what is believed to be a black, semi-automatic rifle.

More than 10,000 shoppers were at the mall during the day, police said. Roberts said that officers responded to the scene of the shooting within minutes, and four SWAT teams swept the 1.4 million-square-foot building searching for the shooter. He was eventually found dead, an apparent suicide.

"I can confirm the shooter is dead of an apparent self-inflicted gunshot wound," Rhodes said. "By all accounts there were no rounds fired by law enforcement today in the mall."

Roberts said more than 100 law enforcement officers responded to the shooting, and at least four local agencies were working on the investigation, including the FBI and Bureau of Alcohol, Tobacco and Firearms, which is working to trace the shooter's weapon.

READ: Guns in America: A Statistical Look

"For all of us, the mall is supposed to be a place where we can take our families, especially during the holiday season," Roberts said. "Things like this are not supposed to happen."

Roberts also said that shoppers, including two emergency room nurses and one physician who happened to be at the mall, provided medical assistance to victims who had been shot. Other shoppers helped escort individuals out of the mall and out of harm's way, he said.

"There were a huge amount of people running in different directions, and it was chaos for a lot of citizens, but true heroes were stepping up in this time of high stress," Roberts said. "E.R. nurses on the scene were providing medical care to those injured, a physician on the scene was helping provide care to the wounded."

Mall shopper Daniel Martinez told KATU that he had just sat down at a Jamba Juice inside the mall when he heard rapid gunfire. He turned and saw the masked gunman, dressed in all black, about 10 feet away from him.

"I just saw him (the gunman) and thought, 'I need to go somewhere,'" Martinez said. "It was so fast, and at that time, everyone was moving around."

Martinez said he ran to the nearest clothing store. As he ran, he motioned for another woman to follow; several others ran to the store as well, hiding in a fitting room. They stayed there for an hour and a half until SWAT teams told them it was safe to leave the mall.

Witness Amber Tate said she was in the parking lot of the mall when she saw the shooter run by, wearing a mask and carrying a machine gun, headed for the Macy's.

"He looked like a teenager wearing a gun, like a bullet proof vest and he had a machine, like an assault rifle and a white mask and he looked at me," she said.

Other witnesses described the shooter as being on a mission and determined, looking straight ahead. He then seemed to walk through the mall toward the other end of the building, shooting along the way, according to witness reports.

Witnesses told KATU they heard "pops" and then saw the mall Santa fall to the ground. The man dressed as Santa, who did not give his name, told KATU that he wasn't concerned at first by what sounded like balloons popping.

"Then when I heard about 18 more shots, I decided it was a semi-automatic and I hit the floor and my employees must have just scattered and got out of there because when I got up there was nobody there but me," he said.

Others interviewed said that Macy's shoppers and store employees huddled in a dressing room to avoid being found.

"I was helping a customer in the middle of the store, her and her granddaughter and while we were looking at sweatshirts we heard five to seven shots from a machine gun fire just outside my store," Jacob Rogers, a store clerk, told KATU.

"We moved everyone into the back room where there's no access to outside but where there's a camera so we can monitor what's going on out front," Rogers said.

Evan Walters, an employee of a store in the mall, told ABC News Radio that he was locked in a store for his safety and he saw two people shot and heard multiple gunshots.

"It was over 20, and it was kind of surreal because we hear pops and loud noises," he said. "We're next to the food court here and we hear pops and loud noises all the time, but we don't -- nothing like that. It was very definite gunshots."

Former FBI agent and ABC News contributor Brad Garrett said the shooter's mask is typical for mass shooters, who often dress up in costume or wear something other than their regular clothes when they open fire in public.

"The biggest thing for a mass shooter is the control and empowerment for the shooting," he said. "It isn't uncommon for shooter to wear a costume, or sometimes simply to dress in black. In this case, apparently, he wore a hockey mask. He went there being someone other than who he is in reality because it gives him power."

Garrett called the shooting today one of the worst scenarios for law enforcement, as malls are more crowded than ever during the holiday shopping season.

"The thing about mass shooters is that they almost always are premeditated. They are planned," Garrett said. "This shooter I'm sure went through some period of steps before he actually reached going to mall, and there'll be signs or systems either through friends, online, through relatives that will play into understanding why he committed this act."

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Australian prank call radio to donate profits to nurse’s family

CANBERRA (Reuters) – The Australian radio station behind a prank call to a British hospital will donate its advertising revenue until the end of the year to a fund for the family of the nurse who apparently took her own life after the stunt, the company said on Tuesday.

Southern Cross Austereo, parent company of Sydney radio station 2Day FM, said it would donate all advertising revenue, with a minimum contribution of A$ 500,000 ($ 525,000), to a memorial fund for the nurse, Jacintha Saldanha, who answered the telephone at the hospital treating Prince William’s pregnant wife, Kate.

The company has suspended the Sydney-based announcers, Mel Greig and Michael Christian, scrapped their “Hot 30″ programme and suspended advertising on the station in the wake of the Saldanha’s death. Southern Cross said it would resume advertising on its station from Thursday.

“It is a terrible tragedy and our thoughts continue to be with the family,” Southern Cross Chief Executive Officer Rhys Holleran said in a statement.

“We hope that by contributing to a memorial fund we can help to provide the Saldanha family with the support they need at this very difficult time.”

(Reporting by James Grubel; Editing by Robert Birsel)

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Recent hacking of U.N. nuclear agency not first attempt: IAEA

WASHINGTON (Reuters) – A recently announced hacking of the U.N. nuclear agency’s computer servers was not the first time an attempt had been made to break into the organization’s computer system, the head of the agency said on Thursday.

Yukiya Amano, director general of the International Atomic Energy Agency, said that a few months ago a group broke into the agency’s computer system and stole personal information of scientists working on peaceful uses of nuclear energy.

In response to questions at a Council on Foreign Relations event in Washington, Amano repeated what he said last week after the hacking was revealed: no sensitive information about the IAEA‘s nuclear inspections had been stolen.

The IAEA has shut down the server that had been hacked and is continuing an investigation, Amano said. But he also said it wasn’t the first attempt to break into the system.

“If you ask if this is the only case? I would say there have been some other tries but we are doing our best to protect our system,” Amano said.

The hackers – a group using an Iranian-sounding name – have posted scores of email addresses of experts who have been working with the U.N. agency on a website, and have urged the IAEA to investigate Israel’s nuclear activity.

Israel, which has an undeclared nuclear arsenal, and the United States accuse Iran of seeking to develop a nuclear weapons capability. Tehran denies such ambitions.

Amano would not say if he believed Iran was behind the attacks on the IAEA, whose missions include preventing the spread of nuclear weapons and which is investigating Iran’s disputed nuclear activities.

“The group … they have what looks like an Iranian name. But that does not mean that the origin is Iran,” he said.

There has been an increase in suspected Iranian cyber attacks this year, coinciding with a deepening standoff with the West over Tehran’s nuclear program.

(Reporting by Deborah Charles. Editing by Warren Strobel and Doina Chiacu)

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Elijah Wood, Aaron Paul rally fans to save north Hollywood taco joint

LOS ANGELES (TheWrap.com) – Elijah Wood and Aaron Paul are on a mission to save a North Hollywood taco stand.

The actors are rallying fans around Henry‘s Tacos, which has been on the corner of Tujunga and Moorpark for 51 years and is closing December 31 due to a conflict with the building’s landlord.

In an announcement posted on Facebook, the stand’s owner, Janis Hood, said that running the restaurant is too much of a burden for her – but the landlord, Mehran Ebrahimpour, isn’t allowing “prospective buyers committed to continuing the tradition” to take over the lease.

The reason, Hood believes, is because she “unwittingly” angered him by nominating Henry’s to become for a Historic Cultural Monument a year ago. Ultimately, the city council never voted on her request, but the damage was done.

Once loyal customer Wood heard the news, he immediately took to Twitter: “Los Angeles institution, Henry’s Tacos to shut,” Wood tweeted. “Please retweet. Very sad situation.”

Over 250 followers and counting have heard his cry, including a few famous friends like Aaron Paul, Colin Hanks and “Bridesmaids” director Paul Feig.

“This can’t happen. Save LA history,” Feig added, after retweeting Wood’s words.

But instead of just wishing for a Christmas miracle, Paul has a plan – not to mention a cool opportunity for his fans. The “Breaking Bad” star is asking “the masses” to join him for lunch this coming Sunday.

“We must save @HenrysTacos from closing,” he tweeted. “Come join me for lunch this Sunday at 2pm!! Join the masses and eat some tacos!! Tell your friends.”

While he may bring Henry’s some extra business before serving its last burrito, owner Hood makes it seem like the chances of changing Henry’s fate are slim.

“The current prospective buyers have agreed to all the landlord’s terms, but he has ceased communicating with them,” she wrote. “Therefore, I have given my notice and it has been accepted by the landlord.”

Neither Hood nor Ebrahimpour immediately responded to TheWrap’s request for comment.

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New tests could hamper food outbreak detection

WASHINGTON (AP) — It’s about to get faster and easier to diagnose food poisoning, but that progress for individual patients comes with a downside: It could hurt the nation’s ability to spot and solve dangerous outbreaks.

Next-generation tests that promise to shave a few days off the time needed to tell whether E. coli, salmonella or other foodborne bacteria caused a patient’s illness could reach medical laboratories as early as next year. That could allow doctors to treat sometimes deadly diseases much more quickly — an exciting development.

The problem: These new tests can’t detect crucial differences between different subtypes of bacteria, as current tests can. And that fingerprint is what states and the federal government use to match sick people to a contaminated food. The older tests might be replaced by the new, more efficient ones.

“It’s like a forensics lab. If somebody says a shot was fired, without the bullet you don’t know where it came from,” explained E. coli expert Dr. Phillip Tarr of Washington University School of Medicine in St. Louis.

The federal Centers for Disease Control and Prevention warns that losing the ability to literally take a germ’s fingerprint could hamper efforts to keep food safe, and the agency is searching for solutions. According to CDC estimates, 1 in 6 Americans gets sick from foodborne illnesses each year, and 3,000 die.

“These improved tests for diagnosing patients could have the unintended consequence of reducing our ability to detect and investigate outbreaks, ultimately causing more people to become sick,” said Dr. John Besser of the CDC.

That means outbreaks like the salmonella illnesses linked this fall to a variety of Trader Joe’s peanut butter might not be identified that quickly — or at all.

It all comes down to what’s called a bacterial culture — whether labs grow a sample of a patient’s bacteria in an old-fashioned petri dish, or skip that step because the new tests don’t require it.

Here’s the way it works now: Someone with serious diarrhea visits the doctor, who gets a stool sample and sends it to a private testing laboratory. The lab cultures the sample, growing larger batches of any lurking bacteria to identify what’s there. If disease-causing germs such as E. coli O157 or salmonella are found, they may be sent on to a public health laboratory for more sophisticated analysis to uncover their unique DNA patterns — their fingerprints.

Those fingerprints are posted to a national database, called PulseNet, that the CDC and state health officials use to look for food poisoning trends.

There are lots of garden-variety cases of salmonella every year, from runny eggs to a picnic lunch that sat out too long. But if a few people in, say, Baltimore have salmonella with the same molecular signature as some sick people in Cleveland, it’s time to investigate, because scientists might be able narrow the outbreak to a particular food or company.

But culture-based testing takes time — as long as two to four days after the sample reaches the lab, which makes for a long wait if you’re a sick patient.

What’s in the pipeline? Tests that could detect many kinds of germs simultaneously instead of hunting one at a time — and within hours of reaching the lab — without first having to grow a culture. Those tests are expected to be approved as early as next year.

This isn’t just a science debate, said Shari Shea, food safety director at the Association of Public Health Laboratories.

If you were the patient, “you’d want to know how you got sick,” she said.

PulseNet has greatly improved the ability of regulators and the food industry to solve those mysteries since it was launched in the mid-1990s, helping to spot major outbreaks in ground beef, spinach, eggs and cantaloupe in recent years. Just this fall, PulseNet matched 42 different salmonella illnesses in 20 different states that were eventually traced to a variety of Trader Joe’s peanut butter.

Food and Drug Administration officials who visited the plant where the peanut butter was made found salmonella contamination all over the facility, with several of the plant samples matching the fingerprint of the salmonella that made people sick. A New Mexico-based company, Sunland Inc., recalled hundreds of products that were shipped to large retailers all over the country, including Target, Safeway and other large grocery chains.

The source of those illnesses probably would have remained a mystery without the national database, since there weren’t very many illnesses in any individual state.

To ensure that kind of crucial detective work isn’t lost, the CDC is asking the medical community to send samples to labs to be cultured even when they perform a new, non-culture test.

But it’s not clear who would pay for that extra step. Private labs only can perform the tests that a doctor orders, noted Dr. Jay M. Lieberman of Quest Diagnostics, one of the country’s largest testing labs.

A few first-generation non-culture tests are already available. When private labs in Wisconsin use them, they frequently ship leftover samples to the state lab, which grows the bacteria itself. But as more private labs switch over after the next-generation rapid tests arrive, the Wisconsin State Laboratory of Hygiene will be hard-pressed to keep up with that extra work before it can do its main job — fingerprinting the bugs, said deputy director Dr. Dave Warshauer.

Stay tuned: Research is beginning to look for solutions that one day might allow rapid and in-depth looks at food poisoning causes in the same test.

“As molecular techniques evolve, you may be able to get the information you want from non-culture techniques,” Lieberman said.

___

Follow Mary Clare Jalonick on Twitter at http://twitter.com/mcjalonick

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Can Obama avoid the 'second-term curse'?

By Jeff Greenfield

Poor Barack Obama. After fighting and spending his way to a close but clear re-election, he’s doomed to four years of agony thanks to that “second-term” curse, which afflicts just about every president who has had the misfortune to win another four years.

The litany appears compelling: the martyred Lincoln; Grant mired in scandal; FDR suffering big political setbacks; Nixon’s disgrace; Reagan’s Iran-Contra scandal; Clinton’s impeachment; George W. Bush’s collapsing popularity. A second term sounds so unappealing, it’s almost surprising Obama didn’t ask for a recount.

Except…there are two things worth remembering about this “curse.” First, it doesn’t really afflict every second-term president. Second, for many presidents, the woes are rooted in actions and decisions taken during the first term—which raises a dicey question about what might come to afflict this president.

Theodore Roosevelt was enormously popular throughout his “second” term (his “first” term was finishing the assassinated William McKinley’s second). The only reason he did not win an actual second term was that, just after his 1904 landslide, he’d declared he would not run again—a decision he regretted almost immediately. (He ran again in 1912 as a third-party candidate, finishing second.)

Calvin Coolidge, elected in a landslide after assuming the presidency when Warren Harding died, presided over four years of peace and prosperity. He stepped down after, declaring, “I do not choose to run for president in 1928.”

Dwight Eisenhower’s Republican Party did suffer serious election reversals in the 1958 mid-terms, but Ike’s personal popularity remained very high in his second term; he left with a 59 percent job approval rating, and his vice president came within a whisker of succeeding him.

What about more recent examples? Reagan’s popularity took a hit when the Iran-Contra story surfaced at the end of 1986, but by the time he left office, he had a robust 63 percent job approval rating, and his vice president won a solid popular vote victory and an electoral college landslide.

And the disgraced Clinton? It’s certainly plausible that his year-long fight to survive scandal and impeachment seriously weakened him. His dependence on his base may have made it impossible for him to reach across the aisle on entitlement reform. But he left office with a 66 percent job approval, and his vice president did win the popular vote.

It’s often said that a second-term victory gives a president an exaggerated sense of his own power, leading him to commit the sin of “hubris” that is always the precursor to tragedy. And history offers examples, from FDR’s attempt to pack the Supreme Court, to George W. Bush’s attempt to partially privatize Social Security.

But take a step back and you’ll find a surprisingly neglected aspect of this history: In many cases, it was what a president did before re-election that planted the seeds of disaster.

Look at Vietnam. The escalation of that conflict began early in 1965, with the bombing of the North and the infusion of large numbers of U.S. troops. But the foundation of that escalation came in the summer of 1964, in the Gulf of Tonkin, when an (almost certainly phantom) attack on U.S. ships led LBJ to win, from a credulous Congress, the Gulf of Tonkin Resolution, authorizing the president to use “all necessary force”—which Johnson interpreted as a virtual blank check.

Watergate? The story exploded early in Nixon’s second term, in the courtroom of Judge John Sirica. But the Watergate break-in and the allied sins of the White House “plumbers’ unit” all took place in the president’s first term—in large measure, to ensure that he’d win again.

The Clinton impeachment? Monica Lewinsky came to the White House as an intern pressed into service because of the government shutdown of 1995. Her affair with the president ended before his second inauguration.

For Bush, the central disaster of his second term was the descent of Iraq into civil war and chaos, and the collapse of the rationale for going into Iraq in the first place—those non-existent weapons of mass destruction. That invasion and the breathtaking failures of intelligence and strategy were rooted in the decisions made in 2002-03.

So, if we’re wise to look at first-term decisions that may come to haunt a second term, what’s the most likely source of future Obama nightmares?

They come, I think, mostly from abroad, where the potential for instability, violence and anti-American hostility could make presidential decisions look very bad. Imagine Egypt turning increasingly Islamist, with a besieged President Morsi—or a successor—repudiating the peace treaty with Israel that has kept the region free of all-out war for 40 years.

Imagine Iraq exploding into a new civil war, or aligning itself with a still-governing Assad in Syria, or with Iran. How would that make Obama’s decision to withdraw from the country look? Pakistan—America’s permanent “frenemy”—is always a step away from turning into a hostile, terrorist-friendly, nuclear power. That step would throw a harsh light on U.S. policy toward that nation.

Should any of those events transpire, expect to hear renewed cries that “the curse of the second term” has struck again. But before joining the chorus, take a hard look at where the trouble really began.

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McAfee wants to return to US, ‘normal life’

BACALAR, Mexico (AP) — Software company founder John McAfee said Sunday he wants to return to the United States and “settle down to whatever normal life” he can.

In a live-stream Internet broadcast from the Guatemalan detention center where he is fighting a government order that he be returned to Belize, the 67-year-old said “I simply would like to live comfortably day by day, fish, swim, enjoy my declining years.”

Police in neighboring Belize want to question McAfee in the fatal shooting of a U.S. expatriate who lived near his home on a Belizean island in November.

The creator of the McAfee antivirus program again denied involvement in the killing during the Sunday Internet video hook-up, during which he answered what he said were reporters’ questions.

His comments were sometimes contradictory. McAfee is an acknowledged practical joker who has dabbled in yoga, ultra-light aircraft and the production of herbal medications.

The British-born McAfee first said that returning to the United States “is my only hope now.” But he later added, “I would be happy to go to England, I have dual citizenship.”

He was emphatic that “I cannot ever return to Belize …. there is no hope for my life if I am ever returned to Belize.”

“If I am returned,” he said, “bad things will clearly happen to me.”

He descibed the health problems that had him briefly hospitalized earlier this week after Guatemalan authorities detained him for entering the country illegally. He apparently snuck in across a rural, unguarded spot along the border.

“I did not eat for two days, I drank very little liquids, and for the first time in many years I’ve been smoking almost non-stop,” he said. “I stood up, passed out hit my head on the wall, came to,” though he now said he was feeling better.

McAfee praised the role his 20-year-old Belizean girlfriend, Samantha Vanegas, played in his escape from Belize, where he claims he is being persecuted by corrupt politicians. Authorities in Belize deny that they are persecuting him and have questioned his mental state.

“Sam saved the day many times” during their escape, he said, and suggested he would take her with him to the United States if he is allowed to go there.

He confirmed that journalists from Vice magazine who accompanied him on his escape after weeks of hiding in Belize had unwittingly posted photos with embedded data that revealed his exact location.

“It was an error anyone could make,” he said, noting they were under a lot of pressure at the time.

McAfee has led an eccentric life since he sold his stake in the anti-virus software company named after him in the early 1990s and moved to Belize about three years ago to lower his taxes.

He told The New York Times in 2009 that he had lost all but $ 4 million of his $ 100 million fortune in the U.S. financial crisis. However, a story on the Gizmodo website quoted him as describing that claim as “not very accurate at all.”

McAfee’s Guatemalan attorney, Telesforo Guerra, says that he has filed three separate legal appeals in the hope that his client can stay in Guatemala, where his political asylum request was rejected.

Guerra said he filed an appeal for a judge to make sure McAfee’s physical integrity is protected, an appeal against the asylum denial and a petition with immigration officials to allow his client to stay in this Central American country indefinitely.

The appeals could take several days to resolve, Guerra said. He added that he could still use several other legal resources but wouldn’t give any other details.

Fredy Viana, a spokesman for the Immigration Department, said that before the agency looks into the request to allow McAfee to stay in Guatemala, a judge must first deal with the appeal asking that authorities make sure McAfee’s physical integrity is protected.

“We won’t look into (allowing him to stay) until the other appeal is resolved,” Viana said. “The law gives me 30 days to resolve the issue.”

McAfee went on the run last month after Belizean officials tried to question him about the killing of Gregory Viant Faull, who was shot to death in early November.

McAfee acknowledges that his dogs were bothersome and that Faull had complained about them, but denies killing Faull. Faull’s home was a couple of houses down from McAfee’s compound in Ambergris Caye, off Belize’s Caribbean coast.

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Syrian Rebels Now Have a Tank Powered by a Playstation Controller

As Syria‘s rebels work to overthrow the tank-equipped Assad regime, they’ve learned that it helps to have tanks of their own. They deserve bonus points for integrating video game technology. This is no exaggeration. Have a look at the opposition forces’ “100 percent made in Syria” armored vehicle, the Sham II.

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Named for ancient Syria and assembled out of spare parts over the course of a month, the Sham II sort of rough around the edges, but it’s got impressive guts. It rides on the chassis of an old diesel car and is fully encased in light steel that’s rusted from the elements. Five cameras are mounted around the tanks outside, and there’s a machine gun mounted on a turning turret. Inside, it kind of looks like a man cave. A couple of flat screen TVs are mounted on opposite walls. The driver sits in front of one, controlling the vehicle with a steering wheel, and the gunner sits at the other, aiming the machine gun with a Playstation controller.

RELATED: It’s Never a Good Idea to Put Your Torture Victims on YouTube

Sham II is heading up to the devastated city of Aleppo to join the combat forces there. Meanwhile, rebel forces continue to close in on Damascus and Assad’s shrinking regime. Diplomats have already begun to speculate about what the Syrian president’s next move would be. We do know that Assad has been exploring the option of seeking political asylum in the Middle East or in Latin American. However, it looks more likely that Assad and his cronies will retreat to the Alawite-controlled mountains on Syria’s Mediterranean coast. The only other alternative — chemical weapons attack notwithstanding — would be for Assad to stay in the palace and fight to the end. And can you imagine standing helpless as a fierce machine like Sham II roared up the palace steps? Run, Bashar. Run.

RELATED: The CIA Is Guiding Weapons into Syria

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Gabrielle Aplin tops UK charts with Power of Love

LONDON (Reuters) – English singer Gabrielle Aplin scored her first British number one on Sunday with a cover of the Frankie Goes To Hollywood hit “The Power of Love”, the Official Charts Company said.

Aplin climbed to number one from sixth place with the song, which first entered the charts in 1984 and is the theme for a Christmas television advert for British retailer John Lewis.

In the album charts, Olly Murs, a former runner-up in television’s X-Factor talent contest, held on to the top spot with his release “Right Place Right Time”, but saw his “Troublemaker” slip to third place in the singles ranks.

American singer Pink was the week’s highest climber in the singles top ten, jumping to eighth place from number 26 with “Try”.

(Reporting by Tim Castle; editing by Jason Webb)

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Iron may prevent behavioral issues in small babies

NEW YORK (Reuters Health) – Iron supplements may help boost brain development and ward off behavioral problems in babies who are born a bit on the small side, a new study from Sweden suggests.

Low birth-weight babies are more likely to end up iron deficient, researchers said. They need more of the nutrient for catch-up growth and haven’t stored as much as other babies if they’re also born premature.

For that reason, very early-term and very small babies are often put on iron – but less research has looked at babies born just shy of normal weight, to see if they are also at risk.

“I think this further solidifies the evidence that it’s a very good idea to give these (marginally low birth-weight) children iron supplements,” said Dr. Magnus Domellof, from Umea University, who worked on the study.

The research was led by his colleague, Dr. Staffan Berglund. Their team followed 285 infants born between 4 pounds, 7 ounces and 5 pounds, 8 ounces.

When the babies were six weeks old, the researchers randomly assigned them to get iron drops – either one or two milligrams per kilogram of body weight – or iron-free placebo drops each day until their six-month birthday.

Then at age three and a half, Domellof’s team brought the kids back for IQ tests and surveyed parents about their behavioral issues. The researchers compared kids in the iron- and placebo-drop study groups with another 95 children who were born at normal weight.

There were no IQ differences based on whether the smaller-than-average babies had been put on an iron regimen. All three low birth-weight groups had average scores between 104 and 105. (“Cognitive impairment” in this study was considered an IQ under 85.)

However, significantly more babies given placebo drops had behavioral problems, as reported by their parents. The issues included problems managing emotional reactions, anxiety and depression, as well as sleep and attention problems.

Almost 13 percent of the placebo-group babies scored above the cutoff for clinical behavior problems, versus about 3 percent of kids who’d taken iron drops and kids from the normal-weight comparison group.

That suggests iron deficiency in infancy may be a direct cause of behavioral problems later in childhood, the researchers wrote Monday in the journal Pediatrics.

They are continuing to monitor the same group of kids as they get older, to see if new cognitive or behavioral problems develop or old ones get better as the children head into grade school.

Domellof said he and his colleagues didn’t see any extra stomach problems in kids or delayed growth linked to the use of iron drops. Some research has suggested giving excessive iron to young kids who aren’t deficient may stunt their development.

But, “I would not be afraid of recommending this to all children (born) below 2,500 grams (5 pounds, 8 ounces) at this dose,” Domellof told Reuters Health.

“Here’s where an ounce of prevention is worth a pound of cure,” said Dr. Michael Georgieff, a child development researcher at the University of Minnesota in Minneapolis who had reviewed the study as part of Berglund’s dissertation committee.

He told Reuters Health that it’s important for all parents to know their baby’s iron requirements when they leave the hospital.

“The issue with these marginally low birth-weight infants is, people really haven’t paid a lot of attention to them, but the evidence is accumulating that they are at risk for behavioral problems and less than ideal cognitive function,” said Dr. Betsy Lozoff, who studies the effects of iron deficiency in infants at the University of Michigan in Ann Arbor.

For most babies in the United States, extra iron is recommended starting at four to six months, either through supplements if the mother is breastfeeding or through formula. Very small or premature babies typically have their iron monitored from birth.

But Lozoff, who wasn’t involved in the new research, said that in many places, there are no recommendations for how to treat babies who are just below a normal birth weight.

“This would suggest that it should just be a routine supplementation, and it can be at a low level of iron,” she told Reuters Health.

SOURCE: http://bit.ly/cxXOG Pediatrics, online December 10, 2012.

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