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.


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 co-developed by South San Francisco-based Genentech and ImmunoGen Inc., of Waltham, Mass. ImmunoGen developed the technology that binds the drug ingredients 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. slipped 8 cents to $14.22 in afternoon trading. They have traded 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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Deadly Bombings Hit Southern India City


Mahesh Kumar A/Associated Press


A member of the bomb squad with a sniffer dog arrived at a blast site in Hyderabad on Thursday.







NEW DELHI — Two bombs planted on bicycles killed at least 13 people and wounded some 70 in a busy shopping district in the southern India city of Hyderabad at the height of Thursday’s evening rush hour, the largest terrorist bombing in the country since September 2011.




Sushil Kumar Shinde, India’s home affairs minister, said the central government had warned state governments that such an attack was planned. “We have had some information for the last two days of such an incident,” he said.


Hyderabad, one of India’s largest cities and a leading center of the country’s burgeoning pharmaceutical and biotechnology industries, has suffered other such attacks in recent years, usually linked to sectarian friction. The blast sites on Thursday — in the Dilsukh Nagar neighborhood, packed with shops, restaurants, theaters and a huge produce market — were quickly mobbed by protesters, reporters, the curious, and politicians and their large security contingents. Television news footage in the hours afterward showed chaotic scenes, with some investigators trying to find the remains of explosive devices while huge numbers of people jostled for space around them.


Mr. Shinde, speaking to journalists in New Delhi, said that the bicycles were 150 meters away from each other and the bombs detonated about 10 minutes apart , killing eight at one site and three at the other. But he forewarned that the toll could rise, and it did so, with 13 reported dead by midnight.


In a Twitter message, Prime Minister Manmohan Singh said. “This is a dastardly attack, the guilty will not go unpunished.”


They and other officials sought to diminish the chances of the kind of sectarian rioting that has long plagued the country.


Asked in a news conference if he believed that Muslim extremists were to blame for the bicycle blasts, Mr. Shinde said: “We have to investigate. We should not come to conclusion immediately.”


Mr. Singh, said in another Twitter message, said: “I appeal to the public to remain calm and maintain peace.”


Asaduddin Owaisi, a Muslim member of Parliament from Hyderabad, called the blasts “cowardly.”


“I feel that the priority is to maintain peace,” he said. “Let us not fall pray to rumors.” The crush of government officials at the blast sites, along with their with enormous entourages and their own police squads, was portrayed by NDTV-News as particularly unhelpful. The money and resources spent on protecting bureaucrats and politicians has become a source of increasing controversy in India, especially in the wake of a highly publicized gang-rape case in December in New Delhi. But Indian politicians, like those elsewhere, often compete with each other to show who is tougher on acts of terrorism and other crimes.


“We’ve seen political leaders come into the area and hold press conferences,” the anchor on NDTV said. “That’s the last thing they should be doing.”


Kiran Kumar Reddy, the chief minister of Andhra Pradesh, held a news conference away from the scene late Thursday night and asked people to stay away from the blast areas. Renuka Chowdhury, a leader of the Indian National Congress Party, pleaded with other politicians to stay away as well.


“I really wish politicians would recognize this,” Ms. Chowdhury said.


The bombings in recent years in Hyderabad have often used homemade explosives.


In May 2007, 13 people died after a bomb went off at the Mecca Masjid, including some who were killed in clashes between the police and Muslim protesters afterward. In August 2007, a pair of synchronized explosions tore through two popular gathering spots in Hyderabad, killing at least 42 and wounding dozens. Police found and defused 19 more bombs in the hours after the blasts, left at bus stops, theaters, pedestrian bridges and intersections.


In New Delhi in September 2011, a briefcase exploded near the high court, killing at least 12 people and injuring scores.


Hari Kumar contributed reporting.



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Diane Lane and Josh Brolin Split















02/21/2013 at 02:25 PM EST







Josh Brolin and Diane Lane


Frank Micelotta/PictureGroup


After eight years of marriage, Josh Brolin and Diane Lane are splitting, their reps confirm to PEOPLE.

The pair, who married in a 2004 ceremony at Brolin's central California ranch, were first introduced by the actor's stepmother, Barbra Streisand, at a party in 2002.

Brolin, 45, was recently arrested and held for public intoxication just before midnight on New Year's Eve 2013, but he was released without charge.

Spotted without his wedding ring the following day, Brolin, donning sunglasses, seemed unfazed by the trouble as he ate with a male friend at Sauce on Hampton in Venice, Calif.

A few days later, Lane, 48, headed to the Palm Springs Film Festival – without her husband – where she presented an award to her former Unfaithful costar, Richard Gere.

Brolin was previously married to Alice Adair, with whom he had two children. Lane previously wed Christopher Lambert, and they had one child together.

Reporting by JENNIFER GARCIA

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Flu shot did poor job against worst bug in seniors


ATLANTA (AP) — For those 65 and older, this season's flu shot is only 9 percent effective against the most common and dangerous flu bug, according to a startling new government report.


Flu vaccine tends to protect younger people better than older ones and never works as well as other kinds of vaccines. But experts say the preliminary results for seniors are disappointing and highlight the need for a better vaccine.


For all age groups, the vaccine's effectiveness is moderate at 56 percent, which is nearly as well as other flu seasons, the Centers for Disease Control and Prevention said Thursday.


For those 65 and older, it is 27 percent effective against the three strains in the vaccine, the lowest in about a decade but not far below from what's expected. But the vaccine did a particularly poor job of protecting older people against the harshest flu strain, which is causing most of the illnesses this year. CDC officials say it's not clear why.


Vaccinations are now recommended for anyone over 6 months, and health officials stress that some vaccine protection is better than none at all. While it's likely that older people who were vaccinated are still getting sick, many of them may be getting less severe symptoms.


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


To be sure, the preliminary data for seniors 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. Older people are most vulnerable to flu and its complications, and the nation has seen some of the highest hospitalization rates for people 65 and older in a decade.


Flu viruses tend to mutate more quickly than others, and it's not unusual for multiple strains to be spreading at the same time. A new vaccine is formulated each year targeting the three strains expected to be the major threats. But that involves guesswork.


Because of these challenges, 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. The 56 percent effectiveness figure means people have a 56 percent lower chance of winding up at the doctor for treatment of flu symptoms.


For seniors, 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.


Older people have weaker immune systems that don't respond as well to flu shots. That's why a high-dose version was recently made available for those 65 and older. The new study was too small to show whether that made a difference this year.


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 flu shots and who hadn't. An earlier study put the vaccine's overall effectiveness slightly higher, at 62 percent.


The CDC's Bresee said there's a danger in providing preliminary results because it may result in people doubting — or skipping — flu shots. But the data was 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.


The new data highlights an evolution in how experts are evaluating flu vaccine effectiveness. For years, it was believed that if the viruses in the vaccine matched the ones spreading around the country, then the vaccine would be effective. This year's shot was a good match to the bugs going around this winter, including the harsher H3N2 that tends to make people sicker.


But the season proved to be a moderately severe one, with many illnesses occurring in people who'd been vaccinated.


____


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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Boiko Borisov, Prime Minister of Bulgaria, Submits Resignation





Prime Minister Boiko Borisov of Bulgaria submitted his government’s resignation on Wednesday after a tumultuous week of public anger over rising electricity prices, corruption and worsening living standards that ignited mass protests nationwide and led to bloody clashes with the police on Tuesday night.




“The people gave us power, and today we are returning it,” Mr. Borisov said on Wednesday morning in Parliament, according to local news reports.


The speaker of Parliament, Tsetska Tsacheva, said the resignation of the prime minister and his cabinet would not be effective until Parliament put it to a vote on Thursday. Since Mr. Borisov controls Parliament, acceptance would seem sure.


The protests — the biggest in at least 15 years — were triggered by electricity price increases and corruption scandals, including one over the nominee to head the state electricity regulatory commission, which sets rates. She was accused of selling cigarettes illegally online and her nomination was later withdrawn.


Tempers were inflamed further when Bulgaria’s finance minister Simeon Djankov, the architect of painful fiscal probity, stepped down on Monday. Rather than allaying anger, analysts said the resignation was greeted by the public as an admission that the government’s economic policies, had not worked.


Tens of thousands of Bulgarians took to the streets across the country to protest. Some yelled “Mafia!” Others burned their utility bills.


While the country’s fiscal prudence has helped it to avoid having to seek an international bailout like Hungary or Romania, analysts said that rising unemployment and weak growth, coupled with wage and pension freezes and tax increases, had mobilized the country’s increasingly disgruntled middle class, who felt themselves squeezed during the financial crisis.


Opposition political parties had been trying to exploit public anger over the government’s austerity measures as general elections planned for July approached. Elections are now expected in April or May, and analysts said the opposition Socialist party was expected to benefit from the turmoil.


Daniel Smilov, program director at the Center for Liberal Strategies, a political research organization, in the Bulgarian capital, Sofia, said that Bulgarians were disillusioned that the overthrow of Communism in 1989 and the country’s subsequent democratization had not delivered the expected prosperity.


Bulgaria has struggled to shed a reputation for lawlessness and corruption. It remains poor, with an average monthly wage of just $480, the lowest in the European Union.


“What we are seeing is the result of a general distrust in government and the political system,” Mr. Smilov said, noting than protests had engulfed wealthy as well as poorer regions of the country. “These are not the bottom layers of society, but people in the middle strata who been hit hardest by the financial crisis. They fear they are losing their status, and they might become poor very fast.”


Trying to appease the protesters, the prime minister said on Tuesday that the license of the Czech utility CEZ, which provides power to many residential customers in Bulgaria, would be withdrawn. Mr. Borisov cited beatings of protesters Tuesday by the police as one reason.


“Every drop of blood for us is a stain,” he said. “I can’t look at a Parliament surrounded by barricades, that’s not our goal, neither our approach, if we have to protect ourselves from the people.”


Mr. Smilov said that after the Parliament accepted the government’s resignation, President Rosen Plevneliev would then appoint a caretaker government. Mr. Borisov said his party would not participate in an interim government.


Mr. Borisov’s resignation could signal the political demise of one of the country’s most colorful political figures. A former karate instructor, bodyguard, fireman and mayor of Sofia with a shaved head and a talk-tough approach, Mr. Borisov was once viewed as being so invincible that Bulgarians called him “Batman.”


As the owner of a private security company, he provided security services for Todor Zhivkov, the former Communist leader of Bulgaria. Mr. Borisov was then the personal bodyguard for Simeon Saxe-Coburg-Gotha, the child czar who returned to be elected prime minister in 2001.


Mr. Borisov rose to oversee the police at the Interior Ministry, before being elected mayor of Sofia and then becoming prime minister in 2009.


“Mr. Borisov is a typical populist leader who came to power promising to take revenge against the transition on behalf of the poor,” says Andrei Raichev, a political analyst at Gallup International in Sofia. “Now the people realize that they were lied to.”


Mr. Raichev said that no one could predict how the public will react to the resignation. “We could even reach the absurd situation that the protests continue against no one,” he said. “Which means that they are against everyone.”


This article has been revised to reflect the following correction:

Correction: February 20, 2013

An earlier version of this article and an accompanying photo caption misspelled the given name of Bulgaria’s prime minister. He is Boiko Borisov, not Boyko.



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Amy Poehler Is the Latest Star to Get Bangs - Who Should Be Next?




Style News Now





02/20/2013 at 01:30 PM ET



BangsLandov, AKM-GSI, BEImages, Wireimage


We’ve filled out our Oscar ballots and predicted the gowns, now the PEOPLE StyleWatch team is ready to talk hair.


Bold bangs are sizzling hot in Hollywood right now: Amy Poehler’s just the latest star to step out with fringe, which is why we’re hoping for a big bang debut at the Oscars. Now we just have to decide who will follow in the footsteps of Michelle Obama, LeAnn Rimes and Poehler, all who have gotten sassy chops in the last month. Here are our front runners:


Amanda Seyfried: The actress has had these long, layered golden locks since her Mean Girls days, so we’re ready for her to spice it up a bit. Seyfried, call your stylist and request some side-swept bangs. They’re flattering, flirty and not-too-frightening for a first-timer … and let’s be honest, you wouldn’t mind stealing some of that Les Mis spotlight from Anne Hathaway come Sunday night.



Jessica Chastain: Chastain already gives us major mane envy, which is why the star is a prime candidate for a blunt bangs cut à la Jessica Biel. Just think how chic she’d look if she wore her tresses straight with serious statement stunners — and since she’s been sporting dramatic hairstyles throughout awards season, we bet she’d dare to try something similar at the Oscars.


Bradley Cooper: Given that he’s one of the sexiest men alive, we’re not telling him to change much, but a little cleanup to his already face-framing locks could do wonders for Cooper‘s floppy hairdo.


Who do you think should try bangs at the Oscars? Vote below and sound off in the comments!






–Jennifer Cress


PHOTOS: SEE MORE STAR HAIRSTYLES!


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Obama admin. tackles colonoscopy confusion


WASHINGTON (AP) — The new health law requires that most insurance plans cover all costs for preventive care, including colon cancer screening.


But it didn't turn out to be that simple.


Many patients ended up with a bill when the doctor performing the colonoscopy removed precancerous growths known as polyps. Why the bill? Because a preventive screening had turned into a procedure.


Now the Obama administration is trying to straighten out the confusion: Polyp removal is part of preventive care, and therefore free of charge to the patient.


Health plans also must cover an expensive genetic test for breast cancer if a woman's doctor orders it. And the lowly aspirin for heart trouble is covered too, if prescribed.


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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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O.C. shootings: Killings occurred during morning routines


Body found in hotel water tank identified as Canadian tourist


Woman who ran surrogate parenting firm pleads guilty in fraud case


— Andrew Blankstein and Adolfo Flores



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