FDA approves new targeted breast cancer drug


WASHINGTON (AP) — The Food and Drug Administration has approved a first-of-a-kind breast cancer medication that targets tumor cells while sparing healthy ones.


The drug Kadcyla from Roche combines the established drug Herceptin with a powerful chemotherapy drug and a third chemical linking the medicines together. The chemical keeps the cocktail intact until it binds to a cancer cell, delivering a potent dose of anti-tumor poison.


Cancer researchers say the drug is an important step forward because it delivers more medication while reducing the unpleasant side effects of chemotherapy.


"This antibody goes seeking out the tumor cells, gets internalized and then explodes them from within. So it's very kind and gentle on the patients — there's no hair loss, no nausea, no vomiting," said Dr. Melody Cobleigh of Rush University Medical Center. "It's a revolutionary way of treating cancer."


Cobleigh helped conduct the key studies of the drug at the Chicago facility.


The FDA approved the new treatment for about 20 percent of breast cancer patients with a form of the disease that is typically more aggressive and less responsive to hormone therapy. These patients have tumors that overproduce a protein known as HER-2. Breast cancer is the second most deadly form of cancer in U.S. women, and is expected to kill more than 39,000 Americans this year, according to the National Cancer Institute.


The approval will help Roche's Genentech unit build on the blockbuster success of Herceptin, which has long dominated the breast cancer marketplace. The drug had sales of roughly $6 billion last year.


Genentech said Friday that Kadcyla will cost $9,800 per month, compared to $4,500 per month for regular Herceptin. The company estimates a full course of Kadcyla, about nine months of medicine, will cost $94,000.


FDA scientists said they approved the drug based on company studies showing Kadcyla delayed the progression of breast cancer by several months. Researchers reported last year that patients treated with the drug lived 9.6 months before death or the spread of their disease, compared with a little more than six months for patients treated with two other standard drugs, Tykerb and Xeloda.


Overall, patients taking Kadcyla lived about 2.6 years, compared with 2 years for patients taking the other drugs.


FDA specifically approved the drug for patients with advanced breast cancer who have already been treated with Herceptin and taxane, a widely used chemotherapy drug. Doctors are not required to follow FDA prescribing guidelines, and cancer researchers say the drug could have great potential in patients with earlier forms of breast cancer


Kadcyla will carry a boxed warning, the most severe type, alerting doctors and patients that the drug can cause liver toxicity, heart problems and potentially death. The drug can also cause severe birth defects and should not be used by pregnant women.


Kadcyla was developed by South San Francisco-based Genentech using drug-binding technology licensed from Waltham, Mass.-based ImmunoGen. The company developed the chemical that keeps the drug cocktail together and is scheduled to receive a $10.5 million payment from Genentech on the FDA decision. The company will also receive additional royalties on the drug's sales.


Shares of ImmunoGen Inc. rose 2 cents to $14.32 in afternoon trading. The stock has ttraded in a 52-wek range of $10.85 to $18.10.


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Eric Garcetti's role in L.A. budget fixes is in dispute









Pressed in the race for mayor of Los Angeles to say how he would fix a persistent budget gap that has led to the gutting of many city services, Eric Garcetti urges voters to look at what he has done in the past.


The onetime City Council president claims credit for reforms that he said cut the City Hall shortfall to just over $200 million from more than $1 billion. He sees "tremendous progress," principally in reducing pension and healthcare costs, and asserts: "I delivered that."


But the truth is in dispute. Although there is not a singular view about any aspect of the city's troubled finances, most of those in the thick of recent budget fights depict Garcetti not as a fiscal hard-liner but as a conciliator who used his leadership position to chart a middle ground on the most significant changes.





Mayor Antonio Villaraigosa, city administrative officer Miguel Santana and one of Garcetti's rivals in the mayoral race, Councilwoman Jan Perry, were among those who pushed for bigger workforce reductions and larger employee contributions toward pensions and healthcare. Labor leaders and their champions on the City Council, including Paul Koretz and Richard Alarcon, sought to cushion the blow for workers.


Garcetti and his supporters say he moderated between those extremes. His critics said he worried too much about process and airing every viewpoint rather than focusing relentlessly on shoring up the city's bottom line.


"It was through the mayor's persistence and steadfast position that we got ongoing concessions," said Santana, the chief budget official for Los Angeles. "It was in collaboration with the council leadership that we finally reached agreements with labor."


The $1-billion-plus deficit Garcetti speaks of shrinking refers not to a single year but to the total of budget gaps that confronted Los Angeles over four years if no corrective action had been taken. The city's fiscal crisis worsened during that time because Garcetti and his fellow council members — including Perry and mayoral candidate Wendy Greuel — approved a city employee pay raise of 25% over five years just before the country stumbled into the recession. (Greuel left the council in 2009 when she was elected city controller.)


Although Garcetti focuses on his role, a portion of the financial improvements were outside his control. The state's elimination of redevelopment agencies in 2012 returned millions to L.A.'s general fund. Tax revenue also ticked upward with the economic recovery.


Garcetti's position as council president from 2006 through 2011 did put him at the center of debate about annual shortfalls that ranged to more than $400 million.


In 2009, he supported an early retirement plan that knocked 2,400 workers off the payroll. "I really pushed that through," the councilman said in an interview. Two participants in confidential contract talks at the heart of the deal had diametrically opposed views. "He made it happen, period," one said; the other offered: "I wouldn't say he was a major mover."


The plan saves the city a maximum of $230 million a year in salary and pension reductions in the short run. But Los Angeles borrowed to spread the costs of the program over 15 years, with current employees and retirees expected to shoulder the cost of the early exits.


The early retirements are expected to do nothing to resolve the long-term "structural deficit" — the $200 million to $400 million a year that Los Angeles spends above what it takes in. And early retirements could even be a net negative in the long run if, as city revenue recovers, new employees are put in those 2,400 empty positions too quickly.


In 2010 the city completed a budget fix that did attack the structural imbalance.


Garcetti's initial proposal called for upping the retirement age for new city employees to 60 from 55 and requiring workers to contribute a minimum of 2% of salary toward their retiree health care.


Budget chief Santana offered a markedly tougher plan. It required a 4% retiree health contribution, halved the health subsidy for retirees and capped pension benefits at 75% of salary instead of 100%. Santana's plan, also for new employees, became the basis of the reform.


Some who served with Garcetti on the council committee that leads employee negotiations pushed for even greater sacrifices. But Garcetti fought against ratcheting up demands on workers, saying it would be useless to approve a plan that would not survive subsequent union votes.


The councilman's greatest contribution may have come after city leaders set their position on pensions. Garcetti took the unusual step of visiting groups of workers. Some employees booed. Some asked him why city lawmakers, among the highest paid in the nation at $178,000 a year, didn't cut their own salaries.


"There was a lot of anger," said a labor leader who spoke on condition of anonymity because that union has not endorsed in the race. "But Eric talked to people as if they were adults and stayed until he answered all their questions. People appreciated him ... taking that kind of heat."


Matt Szabo, a former deputy mayor who helped negotiate with labor, said Garcetti deserved "every bit of credit" he has claimed for deficit reduction. "He knew he was running for mayor, and he was doing the right thing, but it was something that was going to cost him later" in terms of union support, said Szabo, who is running to replace Garcetti on the council.


Most of the employee groups that have endorsed thus far in the mayor's race have come out for Greuel. One political advantage for the controller: She left the council in 2009, before the city began making its toughest demands on workers.


Garcetti found himself stuck the middle again with another 2010 vote, this one over the elimination of 232 jobs — most of them in libraries and day care operations at city parks. Garcetti voted for the layoffs. Later he voted to reconsider, though he said recently that he intended only to re-air the issue, not to keep the workers on the job.


Labor leaders faulted Garcetti for giving the appearance he might be ready to save the jobs when he really wasn't. The reductions remain a sore point, because a "poison pill" in the contract required that any layoffs be accompanied by immediate pay raises for remaining city employees. Fierce disagreement remains over whether the layoffs saved the city any money.


"That became part of the negative picture" of Garcetti, said one labor leader, who asked not to be named out of concern about alienating a possible future mayor. The candidate said in an interview that he frequently found himself hewing a middle ground between some colleagues "who simply hope more revenue would come in" and others who wanted to use an "ax," making indiscriminate cuts. He added: "To me, both views were equally unacceptable."


Critics find Garcetti too malleable, ready to shift to the last argument he has heard. But others appreciate his quest for the middle, saying the fact he sometimes irritated both budget hard-liners and unions showed he had taken a reasoned approach.


"The criticism of Eric is also sort of the good news," said one of the union reps. "He has this very process-y, kumbaya, can't-we-all-get-along style. It drove us all crazy. But now I really miss it because it seems to be all politics over policy."


james.rainey@latimes.com





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The Lede: Syrian Television's Most Outraged Bystander

Last Update, 4:47 p.m. In the aftermath of a deadly bombing in Damascus on Thursday, a man emerged from a small knot of bystanders crowded around a camera crew from Syrian state television to vent his anger at the foreign Islamist fighters he held responsible. “We the Syrian people,” he said, “place the blame on the Nusra Front, the Takfiri oppressors and armed Wahhabi terrorists from Saudi Arabia that are armed and trained in Turkey.”

A report on Thursday’s bombing in Damascus from Syrian state television’s YouTube channel.

Pointing at the ruined street near the headquarters of President Bashar al-Assad’s ruling Baath Party, the man described the location as “a civilian place — a mosque, an elementary school, the homes of local families.”

Watching a copy of the report online, Rime Allaf, a Syrian writer monitoring the conflict from Vienna, noticed that this man on the street, whose views so closely echoed those of the Syrian government, had a very familiar face. That is because, as opposition activists demonstrated last June, the same man had already appeared at least 18 times in the forefront or background of such reports since the start of the uprising.

After she posted a screenshot of the man’s latest appearance, Ms. Allaf observed on Twitter that “it would be funny if there weren’t so many victims of Syria regime terrorism!”

As The Lede noted last year, the man was even featured in two reports the same day during a small pro-Assad rally in Damascus.

Two pro-Assad television channels in Syria interviewed the same man on the street at a rally in July 2012.

Mocking the dark comedy of government-run channels recycling the same die-hard Assad supporter in so many reports, activists put together several video compilations of his appearances in the state media. The most comprehensive, posted online last June, featured excerpts from 18 reports.

A compilation of Syrian state media reports featuring the same Assad supporter again and again.

Another highlight reel, uploaded to YouTube 13 months ago by a government critic, showed that after the man had spoken at least five times on state-run television, he appeared in the background of a BBC report wearing a military uniform.

A man who is frequently interviewed on Syrian state television in civilian dress appeared in the background of a BBC report wearing a military uniform.

As longtime readers of The Lede may recall, during the dispute over Iran’s 2009 presidential election, opposition bloggers noticed that one particularly die-hard supporter of Mahmoud Ahmadinejad also appeared again and again and again in photographs of pro-government rallies.

While there is no way to determine just who is responsible for Syrian television’s frequent interviews with this same man on the street, there is some evidence that Iran has advised Syria on how to report bombings on state television.

Last year, when The Guardian published a trove of hacked e-mails taken from the in-boxes of Syrian officials, one message forwarded to the president appeared to include advice from Iranian state television’s bureau chief in Damascus on what his Syrian counterparts should report after bombings. That e-mail, from Hussein Mortada, a Lebanese journalist who runs coverage of Syria for the Iranian government’s satellite news channels, complained that the government was not heeding directions he had received “from Iran and Hezbollah,” the Lebanese militant group, about who Syria should blame for bomb attacks. “It is not in our interest to say that Al Qaeda is behind” every bombing, Mr. Mortada wrote, “because such statements clear the U.S. administration and the Syrian opposition of any responsibility.”

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Do the Hemsworth Brothers Have a Type?







Style News Now





02/20/2013 at 04:30 PM ET











Miley Cyrus Liam HemsworthAKM-GSI (2)


Miley Cyrus has been very open about fiancĂ© Liam Hemsworth’s fondness for her bold new do — and he’s obviously a fan of her increasingly funky ensembles as well.


And now that we’ve spotted Hemsworth’s brother Chris out with his wife, Elsa Pataky, who’s rocking a Cyrus-esque ensemble herself, we have to wonder: do the Hemsworth boys have a type?

Both of the Aussie hotties’ significant others share an affinity for shredded denim, chunky engineer boots and choppy, super-short blonde hair.


And when we spotted the tiny girls standing next to the bulky brothers, both clad in V-necks, slouchy jeans and aviators, we admit we had to do a double take to deduce which couple was which.


Fortunately, Chris travels with the ultimate accessory — his adorable baby daughter — which makes them a bit easier to tell apart. But we still have to guess there’s a lot of confusion around the Hemsworth household at holidays.


Tell us: Do you and your siblings go for the same “type?” Are you amused that the Hemsworth boys seem to?


–Alex Apatoff


GET MORE STAR DATE STYLE INSPIRATION HERE!




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Flu shot doing a poor job of protecting elderly


ATLANTA (AP) — It turns out this year's flu shot is doing a startlingly dismal job of protecting senior citizens, the most vulnerable age group.


The vaccine is proving only 9 percent effective in people 65 and older against the harsh strain of the flu that is predominant this season, the Centers for Disease Control and Prevention said Thursday.


Health officials are baffled as to why this is so. But the findings help explain why so many older people have been hospitalized with the flu this year.


Despite the findings, the CDC stood by its recommendation that everyone over 6 months get flu shots, the elderly included, because some protection is better than none, and because those who are vaccinated and still get sick may suffer less severe symptoms.


"Year in and year out, the vaccine is the best protection we have," said CDC flu expert Dr. Joseph Bresee.


Overall, across the age groups studied, the vaccine's effectiveness was found to be a moderate 56 percent, which means those who got a shot have a 56 percent lower chance of winding up at the doctor with the flu. That is somewhat worse than what has been seen in other years.


For those 65 and older, the vaccine was only 27 percent effective against the three strains it is designed to protect against, the worst level in about a decade. It did a particularly poor job against the tough strain that is causing more than three-quarters of the illnesses this year.


It is well known that flu vaccine tends to protect younger people better than older ones. Elderly people have weaker immune systems that don't respond as well to flu shots, and they are more vulnerable to the illness and its complications, including pneumonia.


But health officials said they don't know why this year's vaccine did so poorly in that age group.


One theory, as yet unproven, is that older people's immune systems were accustomed to strains from the last two years and had more trouble switching gears to handle this year's different, harsh strain.


The preliminary data for senior citizens is less than definitive. It is based on fewer than 300 people scattered among five states.


But it will no doubt surprise many people that the effectiveness is that low, said Michael Osterholm, a University of Minnesota infectious-disease expert who has tried to draw attention to the need for a more effective flu vaccine.


Among infectious diseases, flu is considered one of the nation's leading killers. On average, about 24,000 Americans die each flu season, according to the CDC.


This flu season started in early December, a month earlier than usual, and peaked by the end of year. Hospitalization rates for people 65 and older have been some of the highest in a decade, at 146 per 100,000 people.


Flu viruses tend to mutate more quickly than others, so a new vaccine is formulated each year to target the strains expected to be the major threats. CDC officials have said that in formulating this year's vaccine, scientists accurately anticipated the strains that are circulating this season.


Because of the guesswork involved, scientists tend to set a lower bar for flu vaccine. While childhood vaccines against diseases like measles are expected to be 90 or 95 percent effective, a flu vaccine that's 60 to 70 percent effective in the U.S. is considered pretty good. By that standard, this year's vaccine is OK.


For senior citizens, a flu vaccine is considered pretty good if it's in the 30 to 40 percent range, said Dr. Arnold Monto, a University of Michigan flu expert.


A high-dose version of the flu shot was recently made available for those 65 and older, but the new study was too small to show whether that has made a difference.


The CDC estimates are based on about 2,700 people who got sick in December and January. The researchers traced back to see who had gotten shots and who hadn't. An earlier, smaller study put the vaccine's overall effectiveness at 62 percent, but other factors that might have influenced that figure weren't taken into account.


The CDC's Bresee said there is a danger in providing preliminary results because it may result in people doubting — or skipping — flu shots. But the figures were released to warn older people who got shots that they may still get sick and shouldn't ignore any serious flu-like symptoms, he said.


___


Online:


CDC report: http://www.cdc.gov/mmwr


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Doctor sexually assaulted unconscious patients, police say



Yashwant Balgiri GiriAn Orange County anesthesiologist convicted of sexually assaulting three unconscious female patients  has been sentenced to six months in jail and five years probation, despite the objections of prosecutors who wanted state prison time.


Yashwant Balgiri Giri, 60, pleaded guilty to a court offer to multiple felony counts related to the sexual battery of patients, including a 16-year-old, according to a statement from the Orange County district attorney's office.


Giri will have to register as a lifetime sex offender and will have his medical license revoked, in addition to the jail time and probation.


Prosecutors sought a state prison sentence, citing a violation of his "position of power and trust" with the women at a particularly vulnerable time.


Giri, who lives in Cypress, was working at Placentia-Linda Hospital at the time of the crimes, prosecutors said. He previously worked at several hospitals in Anaheim and Lakewood.


Through a spokeswoman, Placentia-Linda Hospital declined to comment.


Prosecutors said that in February 2009,  while a 16-year-old was unconscious from medication, Giri assaulted the girl when a scrub nurse preparing surgery tools had her back turned. The nurse witnessed the assault, prosecutors said, and reported it immediately to a hospital official.


Prosecutors allege that the hospital did not report the incident to police at the time.


In March 2011, prosecutors said, a hospital employee witnessed Giri fondling the breasts of a 36-year-old woman while she was under anesthesia for an outpatient surgery procedure.


An employee allegedly witnessed the incident  Prosecutors said the fondling continued for an extended period of time, as his actions were concealed from the surgeon and nurse.






The alleged assault was reported to a hospital official and then to Placentia police, prosecutors said.

Soon after an investigation began, Giri resigned from his duties at the hospital.


After he was arrested in May 2011, a third alleged victim stepped forward, saying she had been assaulted by Giri.


In April 2010, prosecutors said, Giri assaulted a 27-year-old woman while she was being put under anesthesia but before she was unconscious. Prosecutors said he touched the woman under the pretense of performing an examination, although it had no legitimate medical purpose.


During a sentencing hearing, a statement from the then-36-year-old woman, who was fondled, was read by prosecutors.


"His actions make me question every single doctor, nurse, medical decision and procedure I encounter within my everyday life," she said. "I not only fear for myself, I fear for my child, my friends, my family. This is a burden caused by the perverted actions of this predator."


ALSO:


 O.C. shootings: Listen to frantic 911 call


Hollywood Park Casino might lay off all 600 workers


San Diego sheriff confident 2 wounded deputies will fully recover


-- Rick Rojas


Photo: Yashwant Balgiri Giri. Credit: Orange County district attorney's office.


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IHT Special: Women Face Fight to Keep Their Rights in Tunisia







TUNIS — At the funeral this month of Chokri Belaid, the murdered secular opposition leader in Tunisia, his widow Basma Khalfaoui, a prominent feminist, stood on the ambulance carrying his casket, her head uncovered, raising her arm to wave a defiant victory sign.




“My husband was denouncing Ennahda’s double talk and we will continue his struggle,” Ms. Khalfaoui, 42, said at the funeral, referring to the moderate Islamist party that governs the country. “We will not give up the fight.”


Tunisia, perceived by the West as the most secular country in the Arab world and a staunch promoter of women’s rights, has gone through a rocky transition since the revolution two years ago that ousted President Zine el-Abidine Ben Ali. While political pluralism exists for the first time in decades, new freedoms for some are threatening long-cherished ones for others — in particular those for Tunisian women.


After Tunisia gained its independence from France in 1956, the government passed laws to expand women’s rights, including the right to education and gender equality. Over the following decades, Islamists were persecuted and exiled while the government pushed the secularization of society to such an extent that a decree in 1981 banned women from wearing a veil in public buildings and universities.


After the fall of Mr. Ben Ali’s regime, the Ennahda party won elections in October 2011 with a comfortable majority. Since then, worries have grown that one of its aims is to restrict women’s freedoms in a country where, until recently, those rights had been taken for granted for decades.


“I think it’s normal that the Islamists are so vocal — veiled women used to be harassed and the frustration came out all at once,” said Sarah Ben Hamadi, 28, a blogger and journalist. “We are simply paying today for Ben Ali’s mistakes.”


“I don’t think the country is more radical,” she added. “There is more freedom so we see more of the religious people who were hiding in the past.”


Certainly, the religious ultraconservatives known as Salafists are more visible. The University of Manouba, in suburban Tunis, experienced months of tension last year after Salafist students rioted against the ban on the niqab, the face-covering veil.


More worrying are legal overhauls, human rights officials say. As Tunisia’s Constituent Assembly writes a new constitution, there have been repeated confrontations between Islamists, who dominate the assembly and want to roll back some rights acquired by women, and secular liberals, who want an expansion of those rights to include, for example, equal inheritance rights.


“We cannot speak of an obvious rollback since the legal reality is still the same,” said Amna Guellali, the director of Human Rights Watch in Tunis. “But acquired rights are being threatened by repeated attacks by Salafist groups on those they consider infidels or on behavior they deem contrary to Islamic morality.”


When a young woman was allegedly raped by police officers in September, she was charged with indecency and risked six months in prison before the charges were dropped, after a huge uproar. Human rights organizations cite the case as an example of how rights are under threat.


“Under the old regime, there were similar cases,” Ms. Guellali acknowledged. “Now with the new freedoms in the country, the media is paying attention to these kinds of stories.” Still, she said, even allowing for the amplifying effect of the news coverage, something has changed.


Chema Gargouri, the president of the Tunisian Association for Management and Social Stability, a nongovernmental organization that provides training and microloans for women and young people in poor areas, said women were more secure under Mr. Ben Ali.


“What was really striking to me after the revolution was that women started to lose their self-esteem,” Ms. Gargouri said. “The dictatorship was pro-woman. The hatred against the dictatorship is expressed through action against women.”


The rise of social and religious repression and the loss of self-confidence “prevents any entrepreneurial initiative for women,” she added.


Ms. Gargouri, who is in her 40s, said that women of her generation had never previously had to debate or defend their rights. But recent developments had pushed her to work to raise awareness of the challenge now facing them.


“What scares me is that the Tunisian woman seems lost,” she said. “In many places I go to, people ask what the government can do for them. We try to teach them to do it on their own.”


The fact is that Tunisia has an Islamist majority, said Ms. Ben Hamadi, the blogger. “Article 1 of the Tunisian Constitution states that it is an Islamic state,” she said. “If we want real democracy, we must listen to everyone’s voice.”


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Jodi Arias Testifies: I Don't Remember Stabbing My Lover 27 Times






Update








UPDATED
02/20/2013 at 05:45 PM EST

Originally published 02/20/2013 at 05:00 PM EST







Jodi Arias


Charlie Leight/The Arizona Republic/AP


Nearly two months into her murder trial in a Phoenix courtroom, Jodi Arias told jurors Wednesday morning that she killed Travis Alexander in self-defense – but doesn't remember stabbing him nearly 30 times.

"I just remember dropping the knife and being very freaked out and screaming," Arias, 32, said after two weeks of explicit direct testimony about her sex life with Alexander, including their kinky sex shortly before his death. She says the knife was the same one Alexander had used that afternoon when he tied her up for sex.

Facing the death penalty if convicted, Arias says her memory of June 4, 2008, clears up when she put the knife in the dishwasher. Driving off barefoot, she brought with her the rope she said Alexander had used to tie her up and a gun that she pulled from the top of his walk-in closet before shooting him.

"I was very scared and very upset. ... I just wanted to die," Arias testified. "I thought, 'My life is probably done now.'"

She says she decided to bury those feelings and try to act normal as she drove north into Utah to visit another man with whom she already had plans to see.

She says she tossed the gun in the desert, dropped the rope in a Dumpster near St. George, Utah, washed the blood from her hands with a case of bottled Costco water she kept in her trunk and put on a spare pair of work shoes.

The man she met, Ryan Burns, earlier testified that Arias was frisky and affectionate when she visited on June 5. Arias testified that she kissed Burns and cuddled with him the day after killing Alexander because, "I felt safe right there and, I figured, I just wanted to seem normal, like I didn't just do what I just did."

Centerpiece of Defense

Arias's testimony was the long-anticipated centerpiece of her defense. Once that's done, prosecutors are expected to spend several days trying to pick apart her story.

Arias also talked about how she and Alexander, a charismatic Mormon motivational speaker, had an off-and-on relationship in which he sometimes become violent or sadistic.

She says she had arrived at his Mesa, Ariz. home at 5 a.m. and although they took photos and video of themselves having sex, Alexander repeatedly became enraged with her – first for giving him badly scratched CDs of photographs of their trips together, then for dropping his camera.

She says that as Alexander chased her through a walk-in closet "like a linebacker," she grabbed a gun that she knew he kept on a top shelf. She says that she held up the gun, expecting that Alexander would stop charging at her, but he didn't.

"The gun went off, I didn't even mean to shoot, I didn't know my hand was on the trigger," Arias testified. She says that, as they wrestled on the ground, she assumed that she'd shot a hole in the wall, not that she'd hit Alexander. After that, she says, "there's a lot of that day that I don't remember, there's a lot of gaps.

"I have no memory of stabbing him," Arias told jurors, who have heard graphic testimony that Alexander was shot in the head and repeatedly stabbed, and that his throat was slashed ear to ear.

Arias testified she remembers standing in his bathroom, dropping the knife on the hard floor, and thinking, "that I just couldn't believe what had just happened and I couldn't rewind the clock and take it back." She did not recall dragging him to the bathroom or placing him in the shower, she said.

Arias also testified that she still loves Alexander – "It's a different love but yes, I do."

Since the slaying, Arias has changed her story, first saying she had no connection to the crime, then saying two masked intruders killed Alexander and almost killed her. "I basically told everyone what I could remember of the day, and that the intruder story was all B.S.," Arias said Wednesday afternoon at the close of her testimony.

Prosecutors suggest Arias killed Alexander out of jealousy after he pushed her out of his life and started dating someone else, and that the gun was actually a pistol that she stole from her grandparents' home in Yreka, Calif., weeks earlier.



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Scientists use 3-D printing to help grow an ear


WASHINGTON (AP) — Printing out body parts? Cornell University researchers showed it's possible by creating a replacement ear using a 3-D printer and injections of living cells.


The work reported Wednesday is a first step toward one day growing customized new ears for children born with malformed ones, or people who lose one to accident or disease.


It's part of the hot field of tissue regeneration, trying to regrow all kinds of body parts. Scientists hope using 3-D printing technology might offer a speedier method with more lifelike results.


If it pans out, "this enables us to rapidly customize implants for whoever needs them," said Cornell biomedical engineer Lawrence Bonassar, who co-authored the research published online in the journal PLoS One.


This first-step work crafted a human-shaped ear that grew with cartilage from a cow, easier to obtain than human cartilage, especially the uniquely flexible kind that makes up ears. Study co-author Dr. Jason Spector of Weill Cornell Medical Center is working on the next step — how to cultivate enough of a child's remaining ear cartilage in the lab to grow an entirely new ear that could be implanted in the right spot.


Wednesday's report is "a nice advancement," said Dr. Anthony Atala, director of the Institute for Regenerative Medicine at Wake Forest Baptist Medical Center, who wasn't involved in the new research.


Three-dimensional printers, which gradually layer materials to form shapes, are widely used in manufacturing. For medicine, Atala said the ear work is part of broader research that shows "the technology now is at the point where we can in fact print these 3-dimensional structures and they do become functional over time."


Today, people who need a new ear often turn to prosthetics that require a rod to fasten to the head. For children, doctors sometimes fashion a new ear from the stiffer cartilage surrounding ribs, but it's a big operation. Spector said the end result seldom looks completely natural. Hence the quest to use a patient's own cells to grow a replacement ear.


The Cornell team started with a 3-D camera that rapidly rotates around a child's head for a picture of the existing ear to match. It beams the ear's geometry into a computer, without the mess of a traditional mold or the radiation if CT scans were used to measure ear anatomy.


"Kids aren't afraid of it," said Bonassar, who used his then-5-year-old twin daughters' healthy ears as models.


From that image, the 3-D printer produced a soft mold of the ear. Bonassar injected it with a special collagen gel that's full of cow cells that produce cartilage — forming a scaffolding. Over the next few weeks, cartilage grew to replace the collagen. At three months, it appeared to be a flexible and workable outer ear, the study concluded.


Now Bonassar's team can do the process even faster by using the living cells in that collagen gel as the printer's "ink." The 3-D technology directly layers the gel into just the right ear shape for cartilage to cover, without having to make a mold first.


The next step is to use a patient's own cells in the 3-D printing process. Spector, a reconstructive surgeon, is focusing on children born without a fully developed external ear, a condition called microtia. They have some ear cartilage-producing cells in that tissue, just not enough. So he's experimenting with ways to boost those cells in the lab, "so we can grow enough of them from that patient to make an ear," he explained.


That hurdle aside, cartilage may be the tissue most amenable to growing with the help of 3-D printing technology, he said. That's because cartilage doesn't need blood vessels growing inside it to survive.


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Tourist's body found stuffed in hotel water tank; guest horrified



There were few details Wednesday on how the body of a missing Canadian tourist ended up at the bottom of a water tank on the roof of a downtown hotel.


For days, residents of the Cecil Hotel thought something was amiss. At least one said there was flooding in one of the fourth-floor rooms, while others complained about weak water pressure.
One of those complaints led a hotel maintenance worker to check Tuesday on one of the large metal water cisterns on the roof, where he discovered the body of an unidentified woman in her 20s at the bottom of the tank.



Authorities said late Tuesday the body was that of Elisa Lam, 21, a Vancouver, Canada, woman last seen at the hotel Jan. 31.


"We're not ruling out foul play," said LAPD Sgt. Rudy Lopez, noting that the location of the remains "makes it suspicious."



Los Angeles police investigators searched the roof of the Cecil with the aid of dogs when Lam was reported missing about three weeks ago. Lopez said he didn't know if the tanks were examined.



"We did a very thorough search of the hotel," he said. "But we didn't search every room; we could only do that if we had probable cause" that a crime had been committed.



Once a destination for the rich and famous in the 1930s and '40s, the Cecil has gradually deteriorated, mirroring the decay of downtown Los Angeles, particularly in the skid row area. With rock-bottom rents and flexible stays, the historic 1927 building attracted those who were a step away from homelessness.



The Cecil also became a magnet for criminal activity. Most notably it was the occasional home to infamous serial killers Jack Unterweger and Richard "Night Stalker" Ramirez. Even after a multimillion-dollar makeover in 2008, police said they frequently respond to the Cecil for calls relating to domestic abuse and narcotics.



In 2010, the hotel was the scene of a bizarre incident in which a Los Angeles city firefighter who had been honored as paramedic of the year said he was stabbed while responding to a distress call. But police found inconsistencies in the story and no assailant was ever located.



On Tuesday, the Cecil grappled with a deeper mystery.
According to detectives with the LAPD's Robbery-Homicide Division, Lam came to Los Angeles from Vancouver on Jan. 26. While they did not discuss her exact movements or whether she visited anyone here, they believe her ultimate destination was Santa Cruz. Lam's reasons for visiting California were unclear, detectives said.


She was last seen Jan. 31 inside the elevator of the hotel. In surveillance footage, Lam is seen pushing buttons for multiple floors and at one point stepping out of the elevator, waving her arms.
A cause of death is still to be determined by county coroner’s officials, Lopez said.


A locked door that only employees have access to and a fire escape are the only ways to get to the roof. The door is equipped with an alarm system that notifies  hotel personnel if someone is up there, Lopez said.


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— Andrew Blankstein and Adolfo Flores



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