Man's Body Recovery Effort Ends; Sinkhole 'Unstable'

Authorities have discontinued the rescue effort for a Florida man who was swallowed by a sinkhole when his home's foundation collapsed and said it is unlikely his body will ever be recovered.

"We feel we have done everything we can," Hillsborough County administrator Mike Merrell said at a news conference this afternoon. "At this point, it's not possible to recover the body."

Merell said officials would bring in heavy equipment to begin demolishing the home on Sunday.

"We're dealing with a very unusual sinkhole," he said. "It's very deep. It's very wide. It's very unstable."

Jeff Bush was in his bedroom when a sinkhole opened up and trapped him underneath his home at 11 p.m. Thursday.

Two homes next door to Bush's residence were evacuated today after authorities said they had been compromised by the growing sinkhole.

With the assistance of rescuers, the homeowners will be allowed to enter their home for only 30 minutes to gather valuables, authorities said.

Rescuers returned to the site in Seffner, Fla., early this morning to conduct further testing, but decided it was too dangerous for the family initially affected by the sinkhole to enter their home, which was declared condemned.

Florida Sinkhole Opens Up Beneath Man's Home Watch Video

Florida Man Believed Dead After Falling into Sinkhole Watch Video

Florida Sinkhole Swallows House, Man Trapped Inside Watch Video

While the sinkhole was initially estimated to be 15 feet deep on Thursday night, the chasm has continued to grow. Officials now estimate it measures 30 feet across and is up to 100 feet deep.

The Hillsborough County Fire Rescue has set up a relief fund for all families affected by the growing sink hole.

MORE: How Sinkholes Can Develop

Rescue operations were halted Friday night after it became too dangerous to approach the home.

Bill Bracken, an engineer with Hillsborough County Urban Search and Rescue team said the house "should have collapsed by now, so it's amazing that it hasn't."

RELATED: Florida Man Swallowed by Sinkhole: Conditions Too Unstable to Approach

Using ground penetrating radar, rescuers have found a large amount of water beneath the house, making conditions even more dangerous for them to continue the search for Bush.

Hillsborough County lies in what is known as Florida's "Sinkhole Alley." More than 500 sinkholes have been reported in the area since 1954, according to the state's environmental agency.

Meanwhile, Bush's brother, Jeremy Bush, is still reeling from Thursday night.

Jeremy Bush had to be rescued by a first responder after jumping into the hole in an attempt to rescue his brother when the home's concrete floor collapsed, but said he couldn't find him.

"I just started digging and started digging and started digging, and the cops showed up and pulled me out of the hole and told me the floor's still falling in," he said.

"These are everyday working people, they're good people," said Deputy Douglas Duvall of the Hillsborough County sheriff's office. "And this was so unexpected, and they're still, you know, probably facing the reality that this is happening."

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Herbal Viagra actually contains the real thing

IF IT looks too good to be true, it probably is. Several "herbal remedies" for erectile dysfunction sold online actually contain the active ingredient from Viagra.

Michael Lamb at Arcadia University in Glenside, Pennsylvania, and colleagues purchased 10 popular "natural" uplifting remedies on the internet and tested them for the presence of sildenafil, the active ingredient in Viagra. They found the compound, or a similar synthetic drug, in seven of the 10 products – cause for concern because it can be dangerous for people with some medical conditions.

Lamb's work was presented last week at the American Academy of Forensic Sciences meeting in Washington DC.

This article appeared in print under the headline "Herbal Viagra gets a synthetic boost"

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Obama calls for replacing sequester with balanced approach

WASHINGTON: US President Barack Obama urged Congress on Saturday to replace automatic across-the-board spending cuts known as the sequester with what he called "a balanced approach," which combines "smart" cuts with reforms.

The appeal came the day after the president, complying with the law, signed an order bringing arbitrary cuts worth US$85 billion into force as well as a report by his Office of Management and Budget detailing the cuts to each agency.

Obama has called the sweeping cuts, stemming from a 2011 debt ceiling agreement, "dumb".

The across-the-board cuts were triggered automatically following the failure of efforts to clinch a deal with Republicans on cutting the deficit.

But in his weekly radio and Internet address, he argued there was still time to find a smarter solution to the nation's debt problem.

"I still believe we can and must replace these cuts with a balanced approach - one that combines smart spending cuts with entitlement reform and changes to our tax code that make it more fair for families and businesses without raising anyone's tax rates," Obama said.

He said the budget deficit, now exceeding US$1 trillion, can be reduced without laying off workers or forcing parents and students to pay the price.

"A majority of the American people agree with me on this approach - including a majority of Republicans," the president argued. "We just need Republicans in Congress to catch up with their own party and the rest of the country."

Under the sequester, 800,000 civilian employees of the Defence Department will go on a mandatory furlough one day a week and the navy will trim voyages. The deployment of a second aircraft carrier to the Gulf has been cancelled.

Defence contractors may be forced to lay off workers and some federal health spending could be hit.

Cuts will also be made to special needs education and preschool for less well-off children. National parks could close and wait times could hit four hours at airport customs posts.

But the president insisted that despite public bickering, Republicans and Democrats actually had more in common than they were willing to let on.

"I know there are Republicans in Congress who would actually rather see tax loopholes closed than let these cuts go through," Obama said. "And I know there are Democrats who'd rather do smart entitlement reform than let these cuts go through. There's a caucus of common sense. And I'm going to keep reaching out to them to fix this for good."

- AFP/xq

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U.S. to 'rain mice' on tree snakes

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Fla. man presumed dead after sinkhole opens under his bed

SEFFNER, Fla. A man was missing and feared dead early Friday after a large sinkhole opened under the bedroom of a house near Tampa.

Jeff Bush is presumed dead after a sinkhole opened under his bed.

/

CBS

His brother says Jeff Bush screamed for help before he disappeared.

The 36-year-old man's brother, Jeremy Bush, told rescue crews he heard a loud crash around 11 p.m. Thursday, then heard his brother screaming for help.

"When he got there, there was no bedroom left," Hillsborough County Fire Rescue spokeswoman Jessica Damico said. "There was no furniture. All he saw was a piece of the mattress sticking up."

Jeremy Bush called 911 and frantically tried to help his brother Jeff. He said he jumped into the hole and dirt was quickly up to his neck.

"The floor was still giving in and the dirt was still going down, but I didn't care. I wanted to save my brother," Jeremy said. "But I just couldn't do nothing."

An arriving deputy pulled Jeremy Bush from the still-collapsing house.

28 Photos

Sinkholes

"I reached down and was able to actually able to get him by his hand and pull him out of the hole," Hillsborough County Sheriff's Deputy Douglas Duvall said. "The hole was collapsing. At that time, we left the house."

Engineers worked to determine the size of the sinkhole. At the surface, officials estimated it was about 30 feet across. Below the surface, officials believed it was 100 feet wide.

"The entire house is on the sinkhole," Damico said.

Hillsborough County Fire Chief Ron Rogers told a news briefing that extra-sensitive listening devices and cameras were inserted into the sinkhole. "They did not detect any signs of life," he said.

By early Friday, Hillsborough County Fire Rescue officials determined the home had become too unstable to continue rescue efforts.

Neighbors on both sides of the home have been evacuated.

Sinkholes are common in seaside Florida, whose underlying limestone and dolomite can be worn away by water and chemicals, then collapse.

Engineers condemned the house, reports CBS Tampa affiliate WTSP.

From the outside of the small, sky blue house, nothing appeared wrong. There wear no cracks and the only sign something was amiss was the yellow caution tape circling the house.

Hillsborough County Sheriff's Office spokesman Larry McKinnon said authorities asked sinkhole and engineering experts, and they were using equipment to see if the ground can support the weight of heavy machinery needed for the recovery effort.

Jeremy Bush stood in a neighbor's yard across the street from the house Friday and recounted the harrowing collapse.

"He was screaming my name. I could swear I heard him hollering my name to help him," he said of his brother Jeff.

Jeremy Bush's wife and his 2-year-old daughter were also inside the house. "She keeps asking where her Uncle Jeff is," he said. "I lost everything. I work so hard to support my wife and kid and I lost everything."

Janell Wheeler told the Tampa Bay Times newspaper she was inside the house with four other adults and a child when the sinkhole opened.

"It sounded like a car hit my house," she said.

The rest of the family went to a hotel but she stayed behind, sleeping in her car.

"I just want my nephew," she said through tears.

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Obama Signs Order to Begin Sequester Cuts

President Obama and congressional leaders today failed to reach a breakthrough to avert a sweeping package of automatic spending cuts, setting into motion $85 billion of across-the-board belt-tightening that neither had wanted to see.

President Obama officially initiated the cuts with an order to agencies Friday evening.

He had met for just over an hour at the White House Friday morning with Republican leaders House Speaker John Boehner and Senate Minority Leader Mitch McConnell and his Democratic allies, House Minority Leader Nancy Pelosi, Senate Majority Leader Harry Reid and Vice President Joe Biden.

But the parties emerged from their first face-to-face meeting of the year resigned to see the cuts take hold at midnight.

"This is not a win for anybody," Obama lamented in a statement to reporters after the meeting. "This is a loss for the American people."

READ MORE: 6 Questions (and Answers) About the Sequester

Officials have said the spending reductions immediately take effect Saturday but that the pain from reduced government services and furloughs of tens of thousands of federal employees would be felt gradually in the weeks ahead.

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Sequester Countdown: The Reality of Budget Cuts Watch Video

Federal agencies, including Homeland Security, the Pentagon, Internal Revenue Service and the Department of Education, have all prepared to notify employees that they will have to take one unpaid day off per week through the end of the year.

The staffing trims could slow many government services, including airport screenings, air traffic control, and law enforcement investigations and prosecutions. Spending on education programs and health services for low-income families will also get clipped.

"It is absolutely true that this is not going to precipitate the crisis" that would have been caused by the so-called fiscal cliff, Obama said. "But people are going to be hurt. The economy will not grow as quickly as it would have. Unemployment will not go down as quickly as it would have. And there are lives behind that. And it's real."

The sticking point in the debate over the automatic cuts -- known as sequester -- has remained the same between the parties for more than a year since the cuts were first proposed: whether to include more new tax revenue in a broad deficit reduction plan.

The White House insists there must be higher tax revenue, through elimination of tax loopholes and deductions that benefit wealthier Americans and corporations. Republicans seek an approach of spending cuts only, with an emphasis on entitlement programs. It's a deep divide that both sides have proven unable to bridge.

"This discussion about revenue, in my view, is over," Boehner told reporters after the meeting. "It's about taking on the spending problem here in Washington."

Boehner: No New Taxes to Avert Sequester

Boehner says any elimination of tax loopholes or deductions should be part of a broader tax code overhaul aimed at lowering rates overall, not to offset spending cuts in the sequester.

Obama countered today that he's willing to "take on the problem where it exists, on entitlements, and do some things that my own party doesn't like."

But he says Republicans must be willing to eliminate some tax loopholes as part of a deal.

"They refuse to budge on closing a single wasteful loophole to help reduce the deficit," Obama said. "We can and must replace these cuts with a more balanced approach that asks something from everybody."

Can anything more be done by either side to reach a middle ground?

The president today claimed he's done all he can. "I am not a dictator, I'm the president," Obama said.

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Smartphone projector breathes life into storybooks

Hal Hodson, technology reporter

Remember your favourite storybook from childhood? Now imagine that the characters that graced its pages didn't only appear in print, but acted out scenes right in front of you, à la magic Harry Potter paintings.

HideOut, a smartphone projector system developed by Karl Willis at Disney Research in Pittsburgh, Pennsylvania, does exactly that by using invisible-ink markers to guide the projected characters of a storybook through an entire other layer of activities.

The projector also lets the user move a digital, animated character over surfaces in the real world. By passing the camera over another of the hidden patterns - which are visible only in infrared - the character can even seem to interact with physical obstacles, as in the video above.

In a paper describing the system, presented this month at the Tangible, Embedded and Embodied Interaction conference in Barcelona, Spain, Willis laid out how projection will move past games and playing to become an important computer-human interaction technology, freeing digital content from the screens.

Willis writes that future smartphones with embedded projectors will be used to browse digital files projected on any wall or table, to augment theme parks with digital characters, or to make digital board games that jump out of the table. "Enabling projected content to be mapped onto everyday surfaces from mobile devices is an important step towards seamless interaction between the digital and physical worlds."

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Spike in dengue cases in Jan, Feb 2013

SINGAPORE: Dengue cases have spiked in the first two months of this year.

It is a cause for concern as the surge comes outside the traditional peak season.

The situation is also aggravated by more people contracting the less common dengue strains - in particular virus types 1 and 3.

The National Environment Agency is concerned that people may have less immunity to these strains, which could lead to an increase in dengue incidents.

In Singapore, the most common strain is dengue virus type 2.

Last month, the type 2 strain accounted for just under 40 per cent of all dengue cases while type 1 and type 3 made up about 30 per cent each.

It was a big drop from June 2012, when type 2 accounted for about 85 per cent of all cases. Back then, type 1 made up only about 12 per cent of cases, and type 3 cases were negligible.

- CNA/xq

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Racy mag cover features Kim, Kanye

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Two U.S. sailors convicted in Okinawa rape

Updated 4:30 a.m. EST

TOKYO Two U.S. Navy sailors were convicted and sentenced to prison on Friday for raping and robbing a woman on Okinawa in a crime that outraged many on the southern Japanese island.

Seaman Christopher Browning, of Athens, Texas, and Petty Officer 3rd Class Skyler Dozierwalker, of Muskogee, Oklahoma, were found guilty by the Naha District Court of raping and robbing a woman in her 20s in a parking lot in October. Both admitted committing the crime.

Browning, 24, was sentenced to 10 years and Dozierwalker, 23, received nine years.

The case outraged many Okinawans, who have long complained of military-related crime on their island, which hosts thousands of U.S. troops. It also sparked tougher restrictions for all 50,000 U.S. military personnel in Japan, including a curfew and drinking restrictions.

Prosecutors had sought up to 12 years in prison for Browning, who they said also robbed the woman after the rape. Both men admitted their guilt, but the defense had argued that such a long sentence would be excessive.

In handing down the verdict, presiding judge Hideyuki Suzuki said the sentences were in line with the severity of the crimes, which he called "contemptible and violent."

Tensions between U.S. troops and Okinawans are endemic because of islanders' complaints of noise, the danger of accidents and crimes committed by servicemen. The rape in October came amid large protests over the U.S. military's decision to base a new kind of aircraft at an Okinawan Marine facility.

Although most crimes committed by U.S. military personnel in Japan are handled by military courts, they can be prosecuted in Japanese courts in cases that occur off base and are deemed to be particularly serious, such as murder and rape.

The sailors were temporarily deployed to Japan with their unit, the VR-59 reserve air detachment based at Joint Naval Air Station, Fort Worth, Texas. According to police, they arrived in Okinawa two days before the crime on a brief stopover and were staying in an off-base hotel. They were reportedly drinking before the rape took place.

They will serve their sentences in a Japanese prison.

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Sequestration: Surrender is in the Air

The budget ax is about to fall, and there's little lawmakers in Washington are doing to stop it.

Despite a parade of dire warnings from the White House, an $85 billion package of deep automatic spending cuts appears poised to take effect at the stroke of midnight on Friday.

The cuts – known in Washington-speak as the sequester – will hit every federal budget, from defense to education, and even the president's own staff.

On Capitol Hill, Senate Democrats and Republicans each staged votes Thursday aimed at substituting the indiscriminate across-the-board cuts with more sensible ones. Democrats also called for including new tax revenue in the mix. Both measures failed.

Lleaders on both sides publicly conceded that the effort was largely for show, with little chance the opposing chamber would embrace the other's plan. They will discuss their differences with President Obama at the White House on Friday.

"It isn't a plan at all, it's a gimmick," Senate Minority Leader Mitch McConnell, R-Ky., said today of the Democrats' legislation.

"Republicans call the plan flexibility" in how the cuts are made, said Senate Majority Leader Harry Reid. "Let's call it what it is. It is a punt."

The budget crisis is the product of a longstanding failure of Congress and the White House to compromise on plans for deficit reduction. The sequester itself, enacted in late 2011, was intended to be so unpalatable as to help force a deal.

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Sequestration: Democrats, Republicans Play Blame Game Watch Video

Republicans and Democrats, however, remain gridlocked over the issue of taxes.

Obama has mandated that any steps to offset the automatic cuts must include new tax revenue through the elimination of loopholes and deductions. House Speaker John Boehner and the GOP insist the approach should be spending cuts-only, modifying the package to make it more reasonable.

"Do we want to close loopholes? We sure do. But if we are going to do tax reform, it should focus on creating jobs, not funding more government," House Speaker John Boehner said, explaining his opposition to Obama's plan.

Boehner, McConnell, Reid and House Minority Leader Nancy Pelosi will huddle with Obama at the White House on Friday for the first face-to-face meeting of the group this year.

"There are no preconditions to a meeting like this," White House spokesman Jay Carney said today. "The immediate purpose of the meeting is to discuss the imminent sequester deadline and to avert it."

Even if the leaders reach a deal, there's almost no chance a compromise could be enacted before the deadline. Lawmakers are expected to recess later today for a long weekend in their districts.

What will be the short-term impact of the automatic cuts?

Officials say it will be a gradual, "rolling impact" with limited visible impact across the country in the first few weeks that the cuts are allowed to stand.

Over the long term, however, the Congressional Budget Office and independent economic analysts have warned sequester could lead to economic contraction and possibly a recession.

"This is going to be a big hit on the economy," Obama said Wednesday night.

"It means that you have fewer customers with money in their pockets ready to buy your goods and services. It means that the global economy will be weaker," he said. "And the worst part of it is, it's entirely unnecessary."

Both sides say that if the cuts take effect, the next best chance for a resolution could come next month when the parties need to enact a new federal budget. Government funding runs out on March 27, raising the specter of a federal shutdown if they still can't reach a deal.

"As we anticipate an across-the-board budget cuts across our land, we still expect to see your goodness prevail, O God, " Senate Chaplain Barry Black prayed on the Senate floor this morning, "and save us from ourselves."

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Stem cells aboard SpaceX will seed mice back on Earth

Stem cell research is taking off – literally. When the SpaceX Dragon capsule sets off for the International Space Station on 1 March, its cargo will include frozen embryonic stem cells – kick-starting a clever experiment that uses short-lived mice to investigate the human health effects of long-haul space flights.

The idea is to expose mouse cells to space for stretches of time longer than a mouse's lifespan and then to use the cells to create live mice. Such experiments could represent the start of a boom in space biology enabled by commercial space firms such as SpaceX, based in Hawthorne California, that have been responsible for ferrying supplies and experiments to the space station since the NASA shuttle retired in 2011.

In May 2012, the Dragon capsule became the first commercial craft to dock with the space station. The latest launch, planned for next week, will be SpaceX's second official supply mission..

Takashi Morita of Osaka City University in Japan and colleagues are taking advantage of the trip to perform some experiments. Astronauts and animals sent to the space station have returned to Earth with damage to their immune systems, red blood cells, or reproductive systems – thought to be caused by low gravity combined with high radiation from solar particles and cosmic rays.

Morita's team is using mice to study how humans sent on much longer missions – for example, to a 501-day trip to Mars planned for 2018 and announced yesterday – might fare. It is feared that exposure to radiation in space may make them infertile or more susceptible to cancer.

Survival unknown

Mice only live for two years, so the researchers are sending frozen embryonic stem cells from the animals instead. These will stay on the space station for three years and, on return to Earth, the exposed cells will be injected into embryos, which will be implanted in female mice. The researchers will study the health of the resulting offspring – as well as mutations to their DNA.

It is not known whether the embryos will even survive, says Morita. If baby mice are born, the findings might give clues as to how space radiation affects cells in the human body. This would allow researchers to develop drugs or shielding to protect space travellers on long voyages. The researchers will also study whether the mice grown from the exposed embryonic stem cells will pass on any effects to their offspring.

This isn't the first time embryonic stem cells have travelled into space. In 2010, NASA researchers sent stem cells to the ISS on a shuttle to investigate whether damage to such cells could explain why bone and muscle breaks down in space.

Space-bio boom

Julie Robinson, chief scientist for NASA's ISS program, expects a boom in space biology research as researchers and pharmaceutical companies begin using the SpaceX program for their experiments – the ability to perform more experiments in space has been touted as a potential consequence of the nascent commercial space industry for several years.

Robinson suggests that the study of stem cells in space will also improve therapies on Earth. Low gravity appears to allow stem cells to grow faster and prevents them from differentiating.

A team led byLouis Yuge of Hiroshima University in Japan is about to begin a clinical trial in which people with osteoarthritis are treated with bone and muscle stem cells grown in low-gravity environments on Earth. If they remain as stem cells for a longer period, he says, they may be better at spreading in the wounded area and turning into the correct type of tissue.

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Motor Racing: Pedrosa tops final Sepang MotoGP test

SEPANG, Malaysia: Honda's Dani Pedrosa set the pace on Thursday, the final day of the second MotoGP test at Sepang in Malaysia, while his new teammate Marc Marquez took second on a slippery circuit.

The gap between the two Spanish riders was just 0.081 seconds and the pair edged out their traditional Yamaha rivals, Jorge Lorenzo and Valentino Rossi.

After heavy overnight downpours, top riders including Lorenzo, Pedrosa, Marquez and Rossi earlier in the day had a chance to test their bikes' handling on a damp track on wet-weather tyres.

Conditions vastly improved in the afternoon, and Pedrosa took advantage by pushing his bike hard for a total of 57 laps to notch the fastest time of two minutes 00.562 second.

Lorenzo, a double MotoGP champion, came in third 0.430 of a second off the pace.

Marquez has been consistently fast since the first pre-season test sessions at Sepang three weeks ago. The MotoGP rookie continued to make impressive progress despite crashing twice in the day. He was unhurt.

Lorenzo's team-mate, nine-times world champion Valentino Rossi, was fourth at two minutes 01.062 seconds.

Spain's Alvaro Bautista on a Honda was fifth, while British Yamaha rider Cal Crutchlow took sixth.

Pedrosa, 27, who is in top form and hungry for a MotoGP title, topped the timesheets during both test sessions this month, apart from on Wednesday when Lorenzo took the honours.

While track conditions this week were a little worse than early this month, he said they allowed him to learn more about the bike's performance.

"We did a good test overall. The basics of the bike is quite good," Pedrosa said.

Pedrosa made his debut in 2006 but has never won a world championship for Honda, largely due to injuries. He has been runner-up for the MotoGP title on three occasions.

Lorenzo acknowledged he needed to improve his performance. "We had a problem in the front tyre. I had to slow down a bit my pace," he said.

He said the slippery track also hampered his attempt to set a faster pace than Wednesday, when he topped the timesheet. "If it had not rained last night, I am sure I could have improved the lap time from yesterday."

Italy's Andrea Dovizioso on a Ducati came in eighth, just behind Honda's Stefan Bradl of Germany.

"We are slow in the middle of the corner. At this moment we do not have the capacity to fight Honda and Yamaha but I am really happy with how much we have improved with the bike," Dovizioso told reporters.

A third session will be held in Jerez from March 23 to 25 before the opening round of the MotoGP world championship in Qatar under floodlights on April 7.

Malaysia will host round 15 on October 13.

- AFP/al

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Woman: I was fired for having sex

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Medicare paid billions to sub-par nursing homes: HHS

SAN FRANCISCO Medicare paid billions in taxpayer dollars to nursing homes nationwide that were not meeting basic requirements to look after their residents, government investigators have found.

The report, released Thursday by the Department of Health and Human Services' inspector general, said Medicare paid about $5.1 billion for patients to stay in skilled nursing facilities that failed to meet federal quality of care rules in 2009, in some cases resulting in dangerous and neglectful conditions.

One out of every three times patients wound up in nursing homes that year, they landed in facilities that failed to follow basic care requirements laid out by the federal agency that administers Medicare, investigators estimated.

By law, nursing homes need to write up care plans specially tailored for each resident, so doctors, nurses, therapists and all other caregivers are on the same page about how to help residents reach the highest possible levels of physical, mental and psychological well-being.

Not only are residents often going without the crucial help they need, but the government could be spending taxpayer money on facilities that could endanger people's health, the report concluded. The findings come as concerns about health care quality and costs are garnering heightened attention as the Obama administration implements the nation's sweeping health care overhaul.

"These findings raise concerns about what Medicare is paying for," the report said.

Investigators estimate that in one out of five stays, patients' health problems weren't addressed in the care plans, falling far short of government directives. For example, one home made no plans to monitor a patient's use of two anti-psychotic drugs and one depression medication, even though the drugs could have serious side effects.

In other cases, residents got therapy they didn't need, which the report said was in the nursing homes' financial interest because they would be reimbursed at a higher rate by Medicare.

In one example, a patient kept getting physical and occupational therapy even though the care plan said all the health goals had been met, the report said.

The Office of Inspector General's report was based on medical records from 190 patient visits to nursing homes in 42 states that lasted at least three weeks, which investigators said gave them a statistically valid sample of Medicare beneficiaries' experiences in skilled nursing facilities.

That sample represents about 1.1 million patient visits to nursing homes nationwide in 2009, the most recent year for which data was available, according to the review.

Overall, the review raises questions about whether the system is allowing homes to get paid for poor quality services that may be harming residents, investigators said, and recommended that the Centers for Medicare & Medicaid Services tie payments to homes' abilities to meet basic care requirements. The report also recommended that the agency strengthen its regulations and ramp up its oversight. The review did not name individual homes, nor did it estimate the number of patients who had been mistreated, but instead looked at the overall number of stays in which problems arose.

In response, the agency agreed that it should consider tying Medicare reimbursements to homes' provision of good care. CMS also said in written comments that it is reviewing its own regulations to improve enforcement at the homes.

"Medicare has made significant changes to the way we pay providers thanks to the health care law, to reward better quality care," Medicare spokesman Brian Cook said in a statement to The Associated Press. "We are taking steps to make sure these facilities have the resources to improve the quality of their care, and make sure Medicare is paying for the quality of care that beneficiaries are entitled to."

CMS hires state-level agencies to survey the homes and make sure they are complying with federal law, and can require correction plans, deny payment or end a contract with a home if major deficiencies come to light. The agency also said it would follow up on potential enforcement at the homes featured in the report.

Greg Crist, a Washington-based spokeswoman for the American Health Care Association, which represents the largest share of skilled nursing facilities nationwide, said overall, nursing home operators are well regulated and follow federal guidelines, but added that he could not fully comment on the report's conclusions without having had the chance to read it.

"Our members begin every treatment with the individual's personal health needs at the forefront. This is a hands-on process, involving doctors and even family members in an effort to enhance the health outcome of the patient," Crist said.

Virginia Fichera, who has relatives in two nursing homes in New York, said she would welcome a greater push for accountability at skilled nursing facilities.

"Once you're in a nursing home, if things don't go right, you're really a prisoner," said Fichera, a retired professor in Sterling, N.Y. "As a concerned relative, you just want to know the care is good, and if there are problems, why they are happening and when they'll be fixed."

Once residents are ready to go back home or transfer to another facility, federal law also requires that the homes write special plans to make sure patients are safely discharged.

Investigators found the homes didn't always do what was needed to ensure a smooth transition.

In nearly one-third of cases, facilities also did not provide enough information when the patient moved to another setting, the report found.

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Arias Prosecutor Too Combative, Experts Say

He has barked, yelled, been sarcastic and demanded answers from accused murderer Jodi Arias this week.

And in doing so, prosecutor Juan Martinez and his aggressive antics may be turning off the jury he is hoping to convince that Arias killed her ex-boyfriend Travis Alexander in June 2008, experts told ABCNews.com today.

"Martinez is his own worst enemy," Mel McDonald, a prominent Phoenix defense attorney and former judge, told ABC News. "He takes it to the point where it's ad nauseam. You have difficulty recognizing when he's driving the point home because he's always angry and pushy and pacing around the courtroom. He loses the effectiveness, rather than build it up."

"He's like a rabid dog and believes you've got to go to everybody's throat," he said.

"If they convict her and give her death, they do it in spite of Juan, not because of him," McDonald added.

Martinez's needling style was on display again today as he pestered Arias to admit that she willingly participated in kinky sex with Alexander, though she previously testified that she only succumbed to his erotic fantasies to please him.

Arias, now 32, and Alexander, who was 27 at the time of his death, dated for a year and continued to sleep together for another year following their break-up.

Arias drove to his house in Mesa, Ariz., in June 2008, had sex with him, they took nude photos together and she killed him in his shower. She claims it was in self-defense. If convicted, Arias could face the death penalty.

Jodi Arias, Prosecutor Butt Heads in Cross-Examination Watch Video

Jodi Arias Maintains She 'Felt Like a Prostitute' Watch Video

Jodi Arias Admits to Killing Man, Lying to Police Watch Video

Martinez also attempted to point out inconsistencies in her story of the killing, bickering with her over details about her journey from Yreka, Calif., to Mesa, Ariz., including why she borrowed gas cans from an ex-boyfriend, when she allegedly took naps and got lost while driving, and why she spontaneously decided to visit Alexander at his home in Mesa for a sexual liaison.

"I want to know what you're talking about," Arias said to Martinez at one point.

"No, I'm asking you," he yelled.

Later, he bellowed, "Am I asking you if you're telling the truth?"

"I don't know," Arias said, firing back at him. "Are you?"

During three days of cross examining Arias this week, Martinez has spent hours going back and forth with the defendant over word choice, her memory, and her answers to his questions.

"Everyone who takes witness stand for defense is an enemy," McDonald said. "He prides himself on being able to work by rarely referring to his notes, but what he's giving up in that is that there's so much time he wastes on stupid comments. A lot of what I've heard is utterly objectionable."

Martinez's behavior has spurred frequent objections of "witness badgering" from Arias' attorney Kirk Nurmi, who at one point Tuesday stood up in court and appealed to the judge to have a conference with all of the attorneys before questioning continued. Judge Sherry Stephens at one point admonished Martinez and Arias for speaking over one another.

Andy Hill, a former spokesperson for the Phoenix police department, and Steven Pitt, a forensic psychiatrist who has testified as an expert witness at many trials in the Phoenix area, both said that despite his aggressive style, Martinez would likely succeed in obtaining a guilty verdict.

"When it comes to cross examination, one size does not fit all," said Pitt. "But if you set aside the incessant sparring, what the prosecutor I believe is effectively doing is pointing out the various inconsistencies in the defendant's version of events."

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US nuclear dump is leaking toxic waste

Waste from the production of US nukes is on the loose. Toxic cargo is escaping from six of the 177 ageing tanks at the Hanford site in Washington state where the nation stores two-thirds of its high-level nuclear waste, most of it from the production of nuclear bombs.

The site houses 200 million litres of radioactive and hazardous waste, and 67 tanks have leaked waste before. The new leaks undermine recent reassurances that the dump is now secure.

The biggest worry is that highly radioactive sludges containing heat-generating isotopes are corroding the bottoms of the tanks, following work to drain off most of the liquid waste which allowed the isotopes to collect there, says Bob Alvarez of the Institute of Policy Studies in Washington DC.

"There is no immediate public health risk," said Lindsey Geisler, a spokesperson for the Department of Energy. However, much of the waste has already contaminated groundwater, says Tom Carpenter of Hanford Challenge, an environmental watchdog in Seattle, Washington.

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Rehabilitative care innovation can alleviate manpower crunch: govt

SINGAPORE: The government said the use of technology not only accelerates the rehabilitation process of patients, but also helps ease manpower shortages in healthcare.

The latest in "rehab innovations" for those with disabilities are on display at the inaugural Rehab Tech Asia exhibition in Singapore.

The showcase includes a robot arm which allows users who are paralysed in their upper bodies to do daily functions, such as drinking a glass of water.

Laurie Piquet, director of rehabilitation development at KINOVA, said: "When we demonstrate this to users, often the first comments that we have are, 'that's the first time I'm drinking a glass of water by myself'."

The innovation from Canada is compatible with any powered wheelchair and can be controlled by a joystick or through neck movements.

A special wheelchair also improves mobility by making it easier for users to climb stairs and cross pavements.

Other than technology for patients to use, there are also devices for caregivers.

"The Body Up", distributed by Lifeline, is a transfer assist device for bed-ridden patients. The contraption can be used to lift a patient who weighs less than 120kg.

With a growing demand for special needs care, those in the field of rehabilitation said such technology can alleviate problems of manpower shortage.

Dr Kong Keng He, senior consultant at department of rehabilitation medicine at Tan Tock Seng Hospital, said: "It is still very hospital-centric. The patient goes to the hospital to get treatment. I think it will be better off to make it more patient-centric. Deploy this treatment, whether it is rehabilitation, back to the community. And it's always possible for community centres, day rehabilitation centres to acquire these equipment and to have patients to receive their therapy there."

Minister of State for Health Dr Amy Khor agreed, saying the high cost of some technology may be offset by productivity gains in the long run.

She said: "Where it is viable and applicable, I think we should adopt them because it's helpful in terms of improving, accelerating the rehabilitation experience as well as in terms of better use of manpower, improving productivity, and this is something we need to look at. Where it is still costly, I think technology will develop and we will have to continue to monitor this."

With the recent enhancements made to the Senior's Mobility and Enabling Fund, Dr Khor said the subsides should encourage the elderly to go for rehabilitation services within the community.

On how the fund will be disbursed to help home care patients, especially those who are not in touch with intermediate- and long-term care providers, Dr Khor said the Agency for Integrated Care will work with the operators to help spread awareness of the fund. The agency will also work with the grassroots organisations and Community Development Councils to publicise the fund among needy residents.

- CNA/xq

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Peru: 'Missing' U.S. couple found, but family wants proof

STORY HIGHLIGHTS

• Peru's tourism minister say Jamie Neal and Garrett Hand were found in the Amazon


• Hand's mother says she won't believe the news until she hears directly from her son


• Family and friends have not been able to reach the couple since January


• Some areas they planned to visit are out of cell phone and Internet reach

(CNN) -- An American couple that went missing on a bike trek through Peru has been spotted "safe and sound," the South American country's top tourism official said Tuesday.

Jamie Neal and Garrett Hand are heading upstream in a small boat on a jungle river, said Jose Luis Silva, Peru's minister of tourism and commerce.

"They're currently in a remote, paradise-like region of the Peruvian Amazon, which is difficult to access," he told CNN.

But even as authorities trumpeted the news, Hand's mother said in a statement that she won't believe it until she hears directly from her son.

"We have not heard from them since January 25, nor have they accessed bank accounts since that time," mother Francine Fitzgerald said. "We have only the worst to consider as to why."

The couple, who hail from the San Francisco area, left last November and began a series of social media posts chronicling the trip of their dreams -- a four-month bike adventure through South America.

"Will be riding my bike in other countries and out of contact for 4 months!" Neal wrote in a November Facebook post before flying with Hand to Buenos Aires, Argentina.

But for weeks, the couple shared photos online from their trek through Argentina, Chile and Peru, showing themselves posing beside their bikes on remote mountain roads, camping out in tents and smiling at the beach.

In late January, however, their Internet postings stopped and calls to their cell phones went unanswered. Family members say no one has been able to get in touch with them since then.

Fitzgerald said both the U.S. Embassy in Peru and the country's interior ministry have called to say that Neal and Hand were spotted.

But that's not enough, she said.

"Let me reiterate, until we have PROOF OF LIFE, we cannot celebrate these rumors and sightings," she wrote on a Facebook page set up to facilitate a search for the couple. "Proof of life is my son's voice on the phone and a picture of him holding the missing poster."

Silva told CNN that the tourism ministry learned of the couple's location from police, who received a report from a clinic in the town of Angoteros after sending out a nationwide alert about the missing couple.

The ministry will send a hydroplane tomorrow to shoot video of the couple and provide proof they're doing OK, he said.

"They have no idea of the commotion they have caused in the media," he said, "because they simply can't communicate with family from where they currently are."

Neal and Hand, both 25, according to a family flyer, were last seen in Lima, the Peruvian capital. But some of the areas they planned to visit are out of cell phone and Internet reach.

The Peruvian National Police earlier told CNN that the manager of a hostel in Pucallpa, where the couple stayed, confirmed to a police investigator they reached the jungle city in early February.

The manager of Arco Iris Amazonica, a small hotel in the rain forest city of Iquitos, told police the couple stayed there on February 16 and told him they planned to travel to the town of Naplo, a 15-day trek.

Peru is known for the Inca ruins of Machu Picchu, located in the Cusco region, which attract hundreds of thousands of international travelers each year.

Two weeks ago, the U.S. Embassy in Lima issued a security message warning Americans of "a potential kidnapping threat in the Cusco area."

"The Embassy has received information that members of a criminal organization may be planning to kidnap U.S. citizen tourists in the Cusco and Machu Picchu area," the message said.

But it also clarified that "thousands of U.S. citizens routinely travel to the Cusco region without undue incident. The U.S. Embassy remains confident of the Peruvian government's efforts to ensure the safety of all tourists in the region."

Peru's tourism minister said Tuesday that he was "deeply concerned" about the negative impact of reports of the missing American couple.

The reason the couple has been out of touch for so long has nothing to do with any crime, he said.

"These two young people have fallen in love with Peru," Silva said. "They have visited off-the-beaten-path places and it seems like they're having a blast -- so much so that they have forgotten to communicate with their families."

CNN's Catherine E. Shoichet and Tom Watkins contributed to this report.

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Two cops, suspect dead in Calif. shootings

Updated 1:50 a.m. EST

SANTA CRUZ, Calif. Two police officers were shot and killed Tuesday while investigating a sexual assault, and a suspect was also fatally shot, authorities said.

Santa Cruz police Chief Kevin Vogel says Sgt. Loren Butch Baker and Detective Elizabeth Butler were gunned down in mid-afternoon Tuesday as they followed up on a sexual assault investigation. He says Baker was a 28-year veteran of the department and Butler had been with the department 10 years. Vogel says Baker was married and the father of two daughters, while Butler leaves behind two young sons.

A suspect, identified as 35-year-old Jeremy Goulet, was shot and killed a short time later while authorities were pursuing the gunman, the Santa Cruz County sheriff's office said.

Residents on the adjoining streets where the shootings occurred received an automatic police call warning them to stay locked inside. About half an hour later, more than a dozen semi-automatic shots echoed down the streets in a brief shootout that killed the suspect.

Witnesses described hearing a "multitude of gunfire" - with 20 or more shots fired during that gun battle between the suspect and law enforcement, reports CBS San Francisco station station KPIX-TV.

Police were going door-to-door in the neighborhood, searching homes, garages, even closets, although the sheriff said authorities didn't know if another suspect remained at large.

Police, sheriff's deputies and FBI agents filled intersections, some with guns drawn, in what is ordinarily a quiet, residential neighborhood in the community about 60 miles south of San Francisco.

A store clerk a few buildings away from the shooting said the barrage of gunfire was "terrifying."

"We ducked. We have big desks, so under the desks we went," said the clerk, who spoke on condition of anonymity and asked that her store not be identified because she feared for her safety.

She said she remained locked in her store hours after the shooting and was still scared.

Two schools were locked down during the shooting. The students were later evacuated by bus to the County Government Center about half a mile away.

As darkness fell, helicopters and light aircraft patrolled above the neighborhood, which is about a mile from downtown Santa Cruz and the Santa Cruz Beach Boardwalk. The campus of University of California, Santa Cruz, is about five miles away.

The city's mayor, Hilary Bryant, said in a statement that the city was shocked over the shootings.

"Tonight we are heartbroken at the loss of two of our finest police officers who were killed in the line of duty, protecting the community we love," the statement said. "This is an exceptionally shocking and sad day for Santa Cruz and our Police Department."

Santa Cruz has faced a recent spate of violence, and community leaders had scheduled a downtown rally Tuesday to speak out against shootings. That and a city council meeting were canceled after teary-eyed city leaders learned of the deaths.

Those shootings include the killing of Pauly Silva, a 32-year-old martial arts instructor who was shot outside a popular downtown bar and restaurant on Feb. 9.

Two days later, a UC Santa Cruz student waiting at a bus stop was shot in the head during a robbery. She is recovering from her injuries.

Then on Feb. 17, a 21-year-old woman was raped and beaten on the UC Santa Cruz campus. Four days later, a Santa Cruz couple fought off two men who came in their home before dawn and threatened them with a sword.

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