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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U.S., Japan agree on approach to Trans-Pacific Partnership talks

WASHINGTON (Reuters) - The United States and Japan on Friday agreed on language aimed at giving Japanese Prime Minister Shinzo Abe political cover to bring the world's third-largest economy into negotiations on a U.S.-led free trade agreement in the Asia Pacific region.

In a carefully worded statement following Abe's meeting with President Barack Obama, the two countries reaffirmed that "all goods would subject to negotiation" if Japan joins the talks with the United States and 10 other countries.

At the same time, the statement leaves open a possible outcome to the Trans-Pacific Partnership, or TPP, talks where the Japan could still protect its rice sector and the United States could keep duties on Japanese autos.

"Recognizing that both countries have bilateral trade sensitivities, such as certain agricultural products for Japan and certain manufactured products for the United States, the two governments confirm that, as the final outcome will be determined during the negotiations, it is not required to make a prior commitment to unilaterally eliminate all tariffs upon joining the TPP negotiations," the statement said.

Jeffrey Schott, a senior fellow at the Peterson Institute for International Economics, called the joint statement "a big step forward" in the process of determining whether Japan will join TPP talks, which members hope to finish this year.

"The United States and Japan agreed that the deal has to be comprehensive, but you don't commit to the final terms before you even get into the negotiations," Schott said.

But Representative Sander Levin, the top Democrat on the powerful House of Representatives Ways and Means Committee, called the statement "worrisome" and warned any agreement that includes Japan would not pass Congress unless it truly pries open that country's farm and automotive markets.

Abe, who is on his first trip to Washington since taking office in December, has vowed to revive Japan's economy with an expansive monetary policy, big spending and structural reform.

Joining the TPP talks could help with the third task by exposing Japanese companies and farmers to more competition.

But Japanese rice and other farmers who have long enjoyed high tariff protections are opposed to Tokyo entering the talks, and Abe curried their favor during his campaign last year by promising not to unilaterally agree to eliminate tariffs on certain sensitive products.

The current TPP members - United States, Canada, Mexico, Australia, New Zealand, Chile, Peru, Singapore, Malaysia, Vietnam and Brunei - have pledged to negotiate an agreement that eliminates tariffs in as many areas as possible.

To accomplish that goal they have agreed not to exclude any sectors or products from the negotiations.

That stance also worries Ford Motor Co and the United Auto Workers, which have pressured the Obama administration not to allow Japan into the talks until Tokyo makes reforms to open its market to more auto imports.

Although Japan already has no auto tariffs, Ford and the UAW argue that the country relies on regulatory and other non-tariff barriers to keep out auto imports.

The U.S.-Japan joint statement said the two governments would continue their discussions on the possibility of Japan joining the TPP talks.

"While progress has been made in these consultations, more work remains to be done," in areas such as autos and insurance, the joint statement said.

A final decision to allow Japan into the negotiations would have to be made by all the current TPP members.

Additionally, the White House would have to give Congress 90 days notice before starting talks with Japan.

(Additional reporting by Mark Felsenthal; Editing by David Brunnstrom and Eric Walsh)

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Cirque Du Soleil Announces New Michael Jackson-Themed Show in Las Vegas

By Mark Gray

02/21/2013 at 09:15 PM EST

The logo

Courtesy Cirque du Soleil

The King of Pop will live in Vegas!

The long-rumored Cirque Du Soleil show based on the music of Michael Jackson was formally announced Thursday afternoon.

Premiering June 29 at Las Vegas's Mandalay Bay, the show, Michael Jackson ONE, will run 90 minutes and will feature more than 60 dancers and aerialists performing to Jackson's best known music.

Executives say the show will be different from the current Cirque Du Soleil show Immortal, which features Jackson's music.

Jackson friend and choreographer Jamie King said, "Everything [Jackson] does is with a childlike heart. For Michael, every day was fresh, every day was new, every day had to be bigger and better than the last one."

Tickets for the general public go on sale March 7.

Which Jackson song are you most excited to see performed in the show? Sound off in the comments below!

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APNewsBreak: Govs to hear Oregon health care plan

SALEM, Ore. (AP) — Oregon Gov. John Kitzhaber will brief other state leaders this weekend on his plan to lower Medicaid costs, touting an overhaul that President Barack Obama highlighted in his State of the Union address for its potential to lower the deficit even as health care expenses climb.

The Oregon Democrat leaves for Washington, D.C., on Friday to pitch his plan that changes the way doctors and hospitals are paid and improves health care coordination for low income residents so that treatable medical problems don't grow in severity or expense.

Kitzhaber says his goal is to win over a handful of other governors from each party.

"I think the politics have been dialed down a couple of notches, and now people are willing to sit down and talk about how we can solve the problem" of rising health care costs, Kitzhaber told The Associated Press in a recent interview.

Kitzhaber introduced the plan in 2011 in the face of a severe state budget deficit, and he's been talking for two years about expanding the initiative beyond his state. Now, it seems he's found people ready to listen.

Hospital executives from Alabama visited Oregon last month to learn about the effort. And the U.S. Department of Health and Human Services announced Thursday that it's giving Oregon a $45 million grant to help spread the changes beyond the Medicaid population and share information with other states, making it one of only six states to earn a State Innovation Model grant.

Kitzhaber will address his counterparts at a meeting of the National Governors Association. His talk isn't scheduled on the official agenda, but a spokeswoman confirmed that Kitzhaber is expected to present.

"The governors love what they call stealing from one another — taking the good ideas and the successes of their colleagues and trying to figure out how to apply that in their home state," said Matt Salo, director of the National Association of Medicaid Directors.

There's been "huge interest" among other states in Oregon's health overhaul, Salo said, not because the concepts are brand new, but because the state managed to avoid pitfalls that often block health system changes.

Kitzhaber persuaded state lawmakers to redesign the system of delivering and paying for health care under Medicaid, creating incentives for providers to coordinate patient care and prevent avoidable emergency room visits. He has long complained that the current financial incentives encourage volume over quality, driving costs up without making people healthier.

Obama, in his State of the Union address this month, suggested that changes such as Oregon's could be part of a long-term strategy to lower the federal debt by reigning in the growing cost of federally funded health care.

"We'll bring down costs by changing the way our government pays for Medicare, because our medical bills shouldn't be based on the number of tests ordered or days spent in the hospital — they should be based on the quality of care that our seniors receive," Obama said.

The Obama administration has invested in the program, putting up $1.9 billion to keep Oregon's Medicaid program afloat over the next five years while providers make the transition to new business models and incorporate new staff and technology.

In exchange, though, the state has agreed to lower per-capita health care cost inflation by 2 percentage points without affecting quality.

The Medicaid system is unique in each state, and Kitzhaber isn't suggesting that other states should adopt Oregon's specific approach, said Mike Bonetto, Kitzhaber's health care policy adviser. Rather, he wants governors to buy into the broad concept that the delivery system and payment models need to change.

That's not a new theory. But Oregon has shown that under the right circumstances massive changes to deeply entrenched business models can gain wide support.

What Oregon can't yet show is proof the idea is working — that it's lowering costs without squeezing on the quality or availability of care. The state is just finishing compiling baseline data that will be used as a basis of comparison.

One factor driving the Obama administration's interest in Oregon's success is the president's health care overhaul. Under the Affordable Care Act, millions more Americans will join the Medicaid rolls after Jan. 1, and the health care system will have to be able to absorb the influx of patients in a logistically and financially sustainable way.

The federal government will pay 100 percent of the costs for those additional patients in the first three years before scaling back to 90 percent in 2020 and beyond.

"There are a lot of governors who are facing the same challenges we're facing in Oregon," Kitzhaber said. "They recognize that the cost of health care is something they're going to have to get their arms around."

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Wall Street ends lower on growth worries

NEW YORK (Reuters) - U.S. stocks fell for a second straight day on Thursday and the S&P 500 posted its worst two-day loss since November after reports cast doubt over the health of the U.S. and euro-zone economies.

But a late-day rally helped stocks erase some of their losses with most of the pullback concentrated in the technology- heavy Nasdaq. The move suggested investors were still willing to buy on dips even after the sharp losses in the last session.

In Europe, business activity indexes dealt a blow to hopes that the euro zone might emerge from recession soon, showing the downturn across the region's businesses unexpectedly grew worse this month.

"The PMI numbers out of Europe were really a blow to the market," said Jack De Gan, chief investment officer at Harbor Advisory in Portsmouth, New Hampshire. "The market was expecting signs that recovery is still there, but the numbers just highlighted that the euro-zone problem is still persistent."

U.S. initial claims for unemployment benefits rose more than expected last week while the Federal Reserve Bank of Philadelphia said its index of business conditions in the U.S. mid-Atlantic region fell in February to the lowest in eight months.

Gains in Wal-Mart Stores Inc shares helped cushion the Dow. The shares gained 1.5 percent to $70.26 after the world's largest retailer reported earnings that beat expectations, though early February sales were sluggish.

The Dow Jones industrial average <.dji> fell 46.92 points, or 0.34 percent, to 13,880.62 at the close. The Standard & Poor's 500 Index <.spx> lost 9.53 points, or 0.63 percent, to 1,502.42. The Nasdaq Composite Index <.ixic> dropped 32.92 points, or 1.04 percent, to close at 3,131.49.

The two-day decline marked the U.S. stock market's first sustained pullback this year. The Standard & Poor's 500 has fallen 1.8 percent over the period and just managed to hold the 1,500 level on Thursday. Still, the index is up 5.3 percent so far this year.

The abrupt reversal in markets, which started on Wednesday after minutes from the Federal Reserve's January meeting suggested stimulus measures may end earlier than thought, looks set to halt a seven-week winning streak for stocks that had lifted the Dow and the S&P 500 close to all-time highs.

Wall Street will soon face another test with the upcoming debate in Washington over the automatic across-the-board spending cuts put in place as part of a larger congressional budget fight. Those cuts, set to kick in on March 1 unless lawmakers agree on an alternative, could depress the economy.

Semiconductor stocks ranked among the weakest of the day, pressuring the Nasdaq as the Philadelphia Semiconductor Index <.sox> fell 1.8 percent. Intel Corp fell 2.3 percent to $20.25 while Advanced Micro Devices lost 3.7 percent to $2.60 as the S&P 500's biggest percentage decliner.

The Dow also got a helping hand from personal computer maker Hewlett-Packard Co , which rose 2.3 percent to end the regular session at $17.10. The company was scheduled due to report first-quarter results after the closing bell.

Shares of Boeing Co rose 1.6 percent to $76.01 as a senior executive was set to meet with the head of the U.S. Federal Aviation Administration on Friday and present a series of measures to prevent battery failures that grounded its 787 Dreamliner fleet, according to a source familiar with the plans.

In other company news, shares of supermarket operator Safeway Inc jumped 14.1 percent to $22.97 after the company reported earnings that beat expectations.

Shares of VeriFone Systems Inc tumbled nearly 43 percent to $18.24 after the credit-card swipe machine maker forecast first- and second-quarter profits well below expectations.

Of the 427 companies in the S&P 500 that have reported results so far, 69.3 percent have exceeded analysts' expectations, compared with a 62 percent average since 1994 and 65 percent over the past four quarters, according to Thomson Reuters data through Thursday morning.

Fourth-quarter earnings for S&P 500 companies are estimated to have risen 5.9 percent, according to the data, above a 1.9 percent forecast at the start of the earnings season.

Berry Petroleum Co jumped 19.3 percent to $46.02 after oil and gas producer Linn Energy LLC said it would buy the company in an all-stock deal valued at $4.3 billion, including debt. Linn Energy shares advanced 2.8 percent to $37.68.

About two stocks fell for everyone that rose on the New York Stock Exchange and Nasdaq. About 7.64 billion shares changed hands on the New York Stock Exchange, the Nasdaq and NYSE MKT, well above the 20-day moving average of around 6.6 billion shares.

(Editing by Jan Paschal)

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French general urges EU to equip "impoverished" Mali army

BAMAKO, Mali (Reuters) - The European Union should complement a mission to train Mali's army, routed by rebels last year, by providing equipment from uniforms to vehicles and communications technology, a French general said on Wednesday.

General Francois Lecointre, appointed to head the EU training mission to Mali (EUTM) that was formally launched this week, said in Bamako equipping the "very impoverished" and disorganized Malian army was as important as training it.

Europe, along with the United States, has backed the French-led military intervention in Mali which since January 11 has driven al Qaeda-allied Islamist insurgents out of the main northern towns into remote mountains near Algeria's border.

European governments have ruled out sending combat troops to join French and African soldiers pursuing the Islamist rebels.

But the EU is providing a 500-strong multinational training force that will give military instruction to Malian soldiers for an initial period of 15 months at an estimated cost of 12.3 million euros ($16.45 million).

While hailing what he called the EU's "courageous, novel, historic" decision to support Mali, Lecointre told a news conference the Malian army's lack of equipment was a problem.

"I know the Malian state is poor, but the Malian army is more than poor," the French general told a news conference, adding that it urgently needed everything from uniforms and weapons to vehicles and communications equipment.

Last year, when Tuareg separatist forces swelled by weapons and fighters from the Libyan conflict swept out of the northern deserts, a demoralized and poorly-led Malian army collapsed and fled before them, abandoning arms and vehicles.

Mali's military was further shaken by a March 22 coup by junior officers who toppled President Amadou Toumani Toure, sowing division among rival army factions. Islamist radicals allied to al Qaeda later hijacked the victorious Tuareg rebellion to occupy the northern half of the country.

In a fast-charging military campaign led by Paris, French and African troops have driven the jihadists out of principal northern towns like Gao and Timbuktu, and are fighting the rebels in the Adrar des Ifoghas mountains.

HUMAN RIGHTS INSTRUCTION

Flanked by Mali's armed forces chief, General Ibrahima Dembele, Lecointre said he was disappointed that a meeting of international donors last month pledged funds for an African military force, known as AFISMA, being deployed in Mali, but included "very few" contributions for the Malian army itself.

"The European Union needs to invest today in the equipping of the Malian army and not just in its training," the general said, adding he would make this point strongly in a report to EU member state representatives early next month.

Asked how much re-equipping the army would cost, he said it would be "much more" than the 12 million euros of EU financing for the training mission, but could not give a precise estimate.

Starting early in April, the EU mission will start instructing Malian soldiers with a plan to train four new battalions of 600-700 members each, formed from existing enlisted men and new recruits.

Lecointre said the EU training would include instruction in human rights. Demands for this increased after allegations by Malian civilians and international human rights groups that Malian soldiers were executing Tuaregs and Arabs accused of collaborating with Islamist rebels.

The European training contingent is drawn from a range of European countries, but the main contributors would be France, Germany, Italy, Spain and Britain, EUTM officers said.

Mali's army has received foreign training before - several battalions that fled before the rebels last year were trained by the U.S. military and the leader of the March 22 coup, Captain Amadou Sanogo, attended training courses in the United States.

Dembele said U.S. training failed to forge cohesion among Malian units and he hoped the EU training would achieve this.

The United States, which halted direct support for the Malian military after last year's coup, could eventually resume aid if planned national elections in July fully restore democracy to the West African country.

Washington is providing airlift, refuelling and intelligence support to the French-led military intervention in Mali. ($1 = 0.7479 euros)

(Reporting by Pascal Fletcher; Editing by Jason Webb)

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Baby Girl on the Way for Big Brother's Britney Haynes

Mom & Babies
Celebrity Baby Blog

02/20/2013 at 08:45 PM ET

Britney Haynes is expecting a little houseguest of her own!

“Halfway there and it’s definitely a GIRL!! She arrives in July; couldn’t be happier,” the Big Brother star Tweeted Wednesday.

Along with her tweet, Haynes, 25, posted a photo of herself holding sonogram photos of her baby girl.

The outspoken player competed as a houseguest on season 12 of the CBS reality show where she placed fourth before returning as a “coach” and eventually a player during season 14, where she placed eighth.

During season 14, Haynes often discussed missing her husband — high school sweetheart Nathan ‘Ryan’ Godwin, whom she married in between seasons in March 2012 — and expressed her desire to become a mother to fellow coach and new mom Janelle Pierzina, who’s currently expecting her second child in August.

Courtesy Britney Haynes

– Patrick Gomez

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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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Syria "Scud-type" missile said to kill 20 in Aleppo

AMMAN (Reuters) - A Syrian missile killed at least 20 people in a rebel-held district of Aleppo on Tuesday, opposition activists said, as the army turns to longer-range weapons after losing bases in the country's second-largest city.

The use of what opposition activists said was a large missile of the same type as Russian-made Scuds against an Aleppo residential district came after rebels overran army bases over the past two months from which troops had fired artillery.

As the uprising against President Bashar al-Assad, now a civil war, nears its two-year mark, rebels also landed three mortar bombs in the rarely-used presidential palace compound in the capital Damascus, opposition activists said on Tuesday.

The United Nations estimates 70,000 people have been killed in the conflict between largely Sunni Muslim rebels and Assad's supporters among his minority Alawite sect. An international diplomatic deadlock has prevented intervention, as the war worsens sectarian tensions throughout the Middle East.

A Russian official said on Tuesday that Moscow, which is a long-time ally of Damascus, would not immediately back U.N. investigators' calls for some Syrian leaders to face the International Criminal Court for war crimes.

Moscow has blocked three U.N. Security Council resolutions that would have increased pressure on Assad.

Casualties are not only being caused directly by fighting, but also by disruption to infrastructure and Syria's economy.

An estimated 2,500 people in a rebel-held area of northeastern Deir al-Zor province have been infected with typhoid, which causes diarrhea and can be fatal, due to drinking contaminated water from the Euphrates River, the World Health Organization (WHO) said on Tuesday.

"There is not enough fuel or electricity to run the pumps so people drink water from the Euphrates which is contaminated, probably with sewage," the WHO representative in Syria, Elisabeth Hoff, told Reuters by telephone.

The WHO had no confirmed reports of deaths so far.

BURIED UNDER RUBBLE

In northern Aleppo, opposition activists said 25 people were missing under rubble of three buildings hit by a several-meter-long missile. They said remains of the weapon showed it to be a Scud-type missile of the type government forces increasingly use in Aleppo and in Deir a-Zor.

NATO said in December Assad's forces fired Scud-type missiles. It did not specify where they landed but said their deployment was an act of desperation.

Bodies were being gradually dug up, Mohammad Nour, an activist, said by phone from Aleppo.

"Some, including children, have died in hospitals," he said.

Video footage showed dozens of people scouring for victims and inspecting damage. A body was pulled from under collapsed concrete. At a nearby hospital, a baby said to have been dug out from wreckage was shown dying in the hands of doctors.

Reuters could not independently verify the reports.

Opposition activists also reported fighting near the town of Nabak on the Damascus-Homs highway, another route vital for supplying forces in the capital loyal to Assad, whose family has ruled Syria since the 1960s.

Rebels moved anti-aircraft guns into the eastern Damascus district of Jobar, adjacent to the city centre, as they seek to secure recent gains, an activist said.

"The rebels moved truck-mounted anti-aircraft guns to Jobar and are now firing at warplanes rocketing the district," said Damascus activist Moaz al-Shami.

Russian Deputy Foreign Minister Gennady Gatilov told a news conference a U.N. war crimes report, which accuses military leaders and rebels of terrorizing civilians, was "not the path we should follow ... at this stage it would be untimely and unconstructive."

Syria is not party to the Rome Statute that established the ICC and the only way the court can investigate the situation is if it receives a referral from the Security Council, where Moscow is a permanent member.

(Writing by Oliver Holmes; Editing by Jason Webb)

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What's Next for Mindy McCready's Two Young Boys?

By Steve Helling

02/19/2013 at 07:00 PM EST

Mindy McCready's apparent suicide on Sunday has left her two young sons in custodial limbo.

The boys – Zander, 6, and Zayne, 10 months – had been in state custody since Feb. 7, when McCready called police to ask for help in making her father and stepmother leave her home. When police arrived, McCready appeared to be intoxicated, according to a Department of Human Services report.

In a subsequent petition, the singer's father, Tim McCready, asked the court to order her to undergo mental health and substance abuse evaluation and treatment, alleging that his daughter, who had recently lost her boyfriend, "hasn't had a bath in a week ... screams about everything ... [is] very verbally abusive to Zander."

After a judge granted the petition, the children were quickly removed and placed into foster care. Although McCready was released from treatment, the boys remained in state custody.

At the time, Zander's father, Billy McKnight, requested custody of his son. "My son needs me," he told PEOPLE on Feb. 8. "I'm married, working and successful. I'm on the right track and proud of it. I've been sober for years. I just want my son."

But McCready's mother and stepfather, Gayle and Michael Inge, also want custody of the children – and authorities seem to agree.

In a proposed order sent to Circuit Judge Lee Harrod, the Department of Human Services proposed that the Inges might be a better fit for the children, claiming that they have "a substantial relationship." The Inges had custody of Zander for much the past few years, during McCready’s rehab and jail stints.

With McCready's death, the judge will have to determine what is in the children's best interest. A custody hearing has been scheduled for April 5.

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