Bombing at political rally kills 9 in Pakistan


PESHAWAR, Pakistan (AP) — A suicide bomber in Pakistan killed nine people including a provincial government official at a political rally held Saturday by a party that has opposed the Taliban, officials said.


The rally in Peshawar, the capital of northwestern Khyber Pakhtunkhwa province, was held by the Awami National Party, whose members have been repeatedly targeted by the Taliban.


Among the dead was Bashir Bilour, the second most senior member of the provincial Cabinet, said Ghulam Ahmed Bilour, the politician's brother and federal railways minister.


Over 20 others were wounded by the blast, said local police officer Sabir Khan.


Bilour was leaving the rally after delivering the keynote speech when the attack occurred, said Nazir Khan, a local Awami National Party leader.


"There was smoke and dust all around, and dead and wounded people were lying on the ground," he said.


The suicide bomber was on foot, said another police officer, Imtiaz Khan.


Mian Iftikhar Hussain, the Khyber Pakhtunkhwa information minister and a member of the Awami National Party, said both he and Bilour had repeatedly received threats from militants. He condemned the attack and said the government needed to intensify its battle against the Taliban.


"Terrorism has engulfed our whole society," said Hussain. "They are targeting our bases, our mosques, our bazars, public meetings and our security checkpoints."


Ten Taliban militants attacked the military area of an international airport in Peshawar with rockets and car bombs a week ago, killing four people and wounding over 40 others. Five of the militants were killed during the attack, and five others died the next day in a gunbattle with security forces.


Also Saturday, police said a mob in southern Pakistan stormed a police station to seize a mentally unstable Muslim man accused of burning a copy of Islam's holy book. The crowd beat him to death, and then set fire to his body.


The case is likely to raise further concerns about the country's harsh blasphemy laws, which can result in a death sentence or life in prison to anyone found guilty. An accusation or investigation alone can lead to deaths, as people take the law into their own hands and kill those accused of violating it. Police stations and even courts have been attacked by mobs.


Police arrested the man on Friday after being informed by residents that he had burned a Quran inside a mosque where he had been staying for a night, said local police official Biharud Deen.


An angry mob of more than 200 people then broke into the police station in the southern town of Dadu and took the accused man, who they say was under questioning. Deen said police tried their best to save the man's life but were unable to stop the furious crowd.


Police have arrested 30 people for suspected involvement in the attack, said Deen. The head of the local police station and seven officers had been suspended, he said.


Past attempts by governments in predominantly Muslim Pakistan to review these laws have met with violent opposition from hardline Islamist parties.


In southwestern Pakistan, gunmen late Friday killed 11 Pakistanis and Afghans who were trying to cross into neighboring Iran to travel on to Europe as illegal immigrants, said local government official Zubair Ahmed. The shooting took place in Sunsar town in Baluchistan province, he said.


It was not immediately clear who was behind the attack, but hundreds of Pakistanis and Afghans are captured by Iranian border guards every year for illegally trying to travel to Europe to find better jobs.


_____


Associated Press writers Abdul Sattar in Quetta, Pakistan, and Adil Jawad in Karachi, Pakistan, contributed to this report.


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Vatican says pope beats Justin Bieber on re-tweets






VATICAN CITY (Reuters) – Pope Benedict, white-haired, 85, and a neophyte to social media site Twitter, has beaten out 18-year old heartthrob Justin Bieber to set a percentage record for re-tweeting by his followers, the Vatican said on Thursday.


The Vatican newspaper said that as of noon Italian time on Thursday the pope had 2.1 million followers on Twitter, eight days after his first tweet was sent.






While Canadian singer-songwriter Bieber has roughly 15 times as many followers – 31.7 million – the Vatican newspaper said Benedict had beaten Bieber on re-tweets.


It said about 50 percent of the pope’s followers had re-tweeted his first tweet on December 12 while only 0.7 percent of Bieber’s followers had re-tweeted one of the singer’s most popular tweets on September 26, when he commented on the death by cancer of a six-year-old fan.


The Vatican said this was part of a wider trend in which people were looking for more spiritual content.


The pope already tweets in English, German, Italian, French, Spanish, Portuguese, Polish and Arabic. The newspaper said he will start tweeting in Latin and Chinese soon.


(Reporting By Philip Pullella, editing by Paul Casciato)


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Ashton Kutcher files for divorce from Demi Moore


LOS ANGELES (AP) — Ashton Kutcher filed court papers Friday to end his seven-year marriage to actress Demi Moore.


The actor's divorce petition cites irreconcilable differences and does not list a date that the couple separated. Moore announced last year that she was ending her marriage to the actor 15 years her junior, but she never filed a petition.


Kutcher's filing does not indicate that the couple has a prenuptial agreement. The filing states Kutcher signed the document Friday, hours before it was filed in Los Angeles Superior Court.


Kutcher and Moore married in September 2005 and until recently kept their relationship very public, communicating with each other and fans on the social networking site Twitter. After their breakup, Moore changed her name on the site from (at)mrskutcher to (at)justdemi.


Kutcher currently stars on CBS' "Two and a Half Men."


Messages sent to Kutcher's and Moore's publicists were not immediately returned Friday.


Moore, 50, and Kutcher, 34, created the DNA Foundation, also known as the Demi and Ashton Foundation, in 2010 to combat the organized sexual exploitation of girls around the globe. They later lent their support to the United Nations' efforts to fight human trafficking, a scourge the international organization estimates affects about 2.5 million people worldwide.


Moore was previously married to actor Bruce Willis for 13 years. They had three daughters together — Rumer, Scout and Tallulah Belle — before divorcing in 2000. Willis later married model-actress Emma Heming in an intimate 2009 ceremony at his home in Parrot Cay in the Turks and Caicos Islands that attended by their children, as well as Moore and Kutcher.


Kutcher has been dating former "That '70s Show" co-star Mila Kunis.


The divorce filing was first reported Friday by People magazine.


___


Anthony McCartney can be reached at http://twitter.com/mccartneyAP.


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Predicting who's at risk for violence isn't easy


CHICAGO (AP) — It happened after Columbine, Virginia Tech, Aurora, Colo., and now Sandy Hook: People figure there surely were signs of impending violence. But experts say predicting who will be the next mass shooter is virtually impossible — partly because as commonplace as these calamities seem, they are relatively rare crimes.


Still, a combination of risk factors in troubled kids or adults including drug use and easy access to guns can increase the likelihood of violence, experts say.


But warning signs "only become crystal clear in the aftermath, said James Alan Fox, a Northeastern University criminology professor who has studied and written about mass killings.


"They're yellow flags. They only become red flags once the blood is spilled," he said.


Whether 20-year-old Adam Lanza, who used his mother's guns to kill her and then 20 children and six adults at their Connecticut school, made any hints about his plans isn't publicly known.


Fox said that sometimes, in the days, weeks or months preceding their crimes, mass murderers voice threats, or hints, either verbally or in writing, things like "'don't come to school tomorrow,'" or "'they're going to be sorry for mistreating me.'" Some prepare by target practicing, and plan their clothing "as well as their arsenal." (Police said Lanza went to shooting ranges with his mother in the past but not in the last six months.)


Although words might indicate a grudge, they don't necessarily mean violence will follow. And, of course, most who threaten never act, Fox said.


Even so, experts say threats of violence from troubled teens and young adults should be taken seriously and parents should attempt to get them a mental health evaluation and treatment if needed.


"In general, the police are unlikely to be able to do anything unless and until a crime has been committed," said Dr. Paul Appelbaum, a Columbia University professor of psychiatry, medicine and law. "Calling the police to confront a troubled teen has often led to tragedy."


The American Academy of Child & Adolescent Psychiatry says violent behavior should not be dismissed as "just a phase they're going through."


In a guidelines for families, the academy lists several risk factors for violence, including:


—Previous violent or aggressive behavior


—Being a victim of physical or sexual abuse


—Guns in the home


—Use of drugs or alcohol


—Brain damage from a head injury


Those with several of these risk factors should be evaluated by a mental health expert if they also show certain behaviors, including intense anger, frequent temper outbursts, extreme irritability or impulsiveness, the academy says. They may be more likely than others to become violent, although that doesn't mean they're at risk for the kind of violence that happened in Newtown, Conn.


Lanza, the Connecticut shooter, was socially withdrawn and awkward, and has been said to have had Asperger's disorder, a mild form of autism that has no clear connection with violence.


Autism experts and advocacy groups have complained that Asperger's is being unfairly blamed for the shootings, and say people with the disorder are much more likely to be victims of bullying and violence by others.


According to a research review published this year in Annals of General Psychiatry, most people with Asperger's who commit violent crimes have serious, often undiagnosed mental problems. That includes bipolar disorder, depression and personality disorders. It's not publicly known if Lanza had any of these, which in severe cases can include delusions and other psychotic symptoms.


Young adulthood is when psychotic illnesses typically emerge, and Appelbaum said there are several signs that a troubled teen or young adult might be heading in that direction: isolating themselves from friends and peers, spending long periods alone in their rooms, plummeting grades if they're still in school and expressing disturbing thoughts or fears that others are trying to hurt them.


Appelbaum said the most agonizing calls he gets are from parents whose children are descending into severe mental illness but who deny they are sick and refuse to go for treatment.


And in the case of adults, forcing them into treatment is difficult and dependent on laws that vary by state.


All states have laws that allow some form of court-ordered treatment, typically in a hospital for people considered a danger to themselves or others. Connecticut is among a handful with no option for court-ordered treatment in a less restrictive community setting, said Kristina Ragosta, an attorney with the Treatment Advocacy Center, a national group that advocates better access to mental health treatment.


Lanza's medical records haven't been publicly disclosed and authorities haven't said if it is known what type of treatment his family may have sought for him. Lanza killed himself at the school.


Jennifer Hoff of Mission Viejo, Calif. has a 19-year-old bipolar son who has had hallucinations, delusions and violent behavior for years. When he was younger and threatened to harm himself, she'd call 911 and leave the door unlocked for paramedics, who'd take him to a hospital for inpatient mental care.


Now that he's an adult, she said he has refused medication, left home, and authorities have indicated he can't be forced into treatment unless he harms himself — or commits a violent crime and is imprisoned. Hoff thinks prison is where he's headed — he's in jail, charged in an unarmed bank robbery.


___


Online:


American Academy of Child & Adolescent Psychiatry: http://www.aacap.org


___


AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner


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Predicting who's at risk for violence isn't easy


CHICAGO (AP) — It happened after Columbine, Virginia Tech, Aurora, Colo., and now Sandy Hook: People figure there surely were signs of impending violence. But experts say predicting who will be the next mass shooter is virtually impossible — partly because as commonplace as these calamities seem, they are relatively rare crimes.


Still, a combination of risk factors in troubled kids or adults including drug use and easy access to guns can increase the likelihood of violence, experts say.


But warning signs "only become crystal clear in the aftermath, said James Alan Fox, a Northeastern University criminology professor who has studied and written about mass killings.


"They're yellow flags. They only become red flags once the blood is spilled," he said.


Whether 20-year-old Adam Lanza, who used his mother's guns to kill her and then 20 children and six adults at their Connecticut school, made any hints about his plans isn't publicly known.


Fox said that sometimes, in the days, weeks or months preceding their crimes, mass murderers voice threats, or hints, either verbally or in writing, things like "'don't come to school tomorrow,'" or "'they're going to be sorry for mistreating me.'" Some prepare by target practicing, and plan their clothing "as well as their arsenal." (Police said Lanza went to shooting ranges with his mother in the past but not in the last six months.)


Although words might indicate a grudge, they don't necessarily mean violence will follow. And, of course, most who threaten never act, Fox said.


Even so, experts say threats of violence from troubled teens and young adults should be taken seriously and parents should attempt to get them a mental health evaluation and treatment if needed.


"In general, the police are unlikely to be able to do anything unless and until a crime has been committed," said Dr. Paul Appelbaum, a Columbia University professor of psychiatry, medicine and law. "Calling the police to confront a troubled teen has often led to tragedy."


The American Academy of Child & Adolescent Psychiatry says violent behavior should not be dismissed as "just a phase they're going through."


In a guidelines for families, the academy lists several risk factors for violence, including:


—Previous violent or aggressive behavior


—Being a victim of physical or sexual abuse


—Guns in the home


—Use of drugs or alcohol


—Brain damage from a head injury


Those with several of these risk factors should be evaluated by a mental health expert if they also show certain behaviors, including intense anger, frequent temper outbursts, extreme irritability or impulsiveness, the academy says. They may be more likely than others to become violent, although that doesn't mean they're at risk for the kind of violence that happened in Newtown, Conn.


Lanza, the Connecticut shooter, was socially withdrawn and awkward, and has been said to have had Asperger's disorder, a mild form of autism that has no clear connection with violence.


Autism experts and advocacy groups have complained that Asperger's is being unfairly blamed for the shootings, and say people with the disorder are much more likely to be victims of bullying and violence by others.


According to a research review published this year in Annals of General Psychiatry, most people with Asperger's who commit violent crimes have serious, often undiagnosed mental problems. That includes bipolar disorder, depression and personality disorders. It's not publicly known if Lanza had any of these, which in severe cases can include delusions and other psychotic symptoms.


Young adulthood is when psychotic illnesses typically emerge, and Appelbaum said there are several signs that a troubled teen or young adult might be heading in that direction: isolating themselves from friends and peers, spending long periods alone in their rooms, plummeting grades if they're still in school and expressing disturbing thoughts or fears that others are trying to hurt them.


Appelbaum said the most agonizing calls he gets are from parents whose children are descending into severe mental illness but who deny they are sick and refuse to go for treatment.


And in the case of adults, forcing them into treatment is difficult and dependent on laws that vary by state.


All states have laws that allow some form of court-ordered treatment, typically in a hospital for people considered a danger to themselves or others. Connecticut is among a handful with no option for court-ordered treatment in a less restrictive community setting, said Kristina Ragosta, an attorney with the Treatment Advocacy Center, a national group that advocates better access to mental health treatment.


Lanza's medical records haven't been publicly disclosed and authorities haven't said if it is known what type of treatment his family may have sought for him. Lanza killed himself at the school.


Jennifer Hoff of Mission Viejo, Calif. has a 19-year-old bipolar son who has had hallucinations, delusions and violent behavior for years. When he was younger and threatened to harm himself, she'd call 911 and leave the door unlocked for paramedics, who'd take him to a hospital for inpatient mental care.


Now that he's an adult, she said he has refused medication, left home, and authorities have indicated he can't be forced into treatment unless he harms himself — or commits a violent crime and is imprisoned. Hoff thinks prison is where he's headed — he's in jail, charged in an unarmed bank robbery.


___


Online:


American Academy of Child & Adolescent Psychiatry: http://www.aacap.org


___


AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner


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NKorea says it has detained a US citizen


PYONGYANG, North Korea (AP) — North Korea said Friday that an American citizen has been detained after confessing to unspecified crimes, confirming news reports about his arrest at a time when Pyongyang is facing criticism from Washington for launching a long-range rocket last week.


The American was identified as Pae Jun Ho in a brief dispatch issued by the state-run Korean Central News Agency in Pyongyang. News reports in the U.S. and South Korea said Pae is known in his home state of Washington as Kenneth Bae, a 44-year-old tour operator of Korean descent.


An expert said he is likely to become a bargaining chip for the North, an attempt to draw the U.S. into talks. Five other Americans known to have been detained in North Korea since 2009 were all eventually released.


North Korean state media said Pae arrived in the far northeastern city of Rajin on Nov. 3 as part of a tour.


Rajin is part of a special economic zone not far from Yanji, China, that has sought to draw foreign investors and tourists over the past year. Yanji, home to many ethnic Korean Chinese, also serves as a base for Christian groups that shelter North Korean defectors.


"In the process of investigation, evidence proving that he committed a crime against (North Korea) was revealed. He admitted his crime," the KCNA dispatch said.


The North said the crimes were "proven through evidence" but did not elaborate.


KCNA said consular officials from the Swedish Embassy in Pyongyang visited Pae on Friday. Sweden represents the United States in diplomatic affairs in North Korea since Washington and Pyongyang do not have diplomatic relations.


Karl-Olof Andersson, Sweden's ambassador to North Korea, told The Associated Press he could not comment on the case and referred the matter to the U.S. State Department.


The State Department was not immediately able to provide any additional information about the report.


The operator of a Korean language website for the Korean community in the Northwest, Chong Tae Kim of JoySeattle.com, said the detainee's father lives in Korea and his mother lives in Lynnwood, Washington.


"She hopes the State Department and Swedish Embassy help with his release," he said Friday. "She's trying not to speak to reporters, fearing that could affect her son's release."


The office of U.S. Rep. Suzan DelBene says it has reached out to the mother and is pressing the State Department for information.


"We are very concerned about it and seeing what can be done on our end to help with this," said spokesman Viet Shelton.


State Department spokesperson Victoria Nuland said on Dec. 11 that Washington was "obviously aware" of reports that a U.S. citizen was detained in North Korea. She didn't confirm the reports.


In Seoul, the Segye Ilbo newspaper reported last week that Bae had been taking tourists on a five-day trip to the North when he was arrested. The newspaper cited unidentified sources.


News of the arrest comes as North Korea is celebrating the launch of a satellite into space on Dec. 12, in defiance of calls by the U.S. and others to cancel a liftoff widely seen as an illicit test of ballistic missile technology.


The announcement of the American's detainment could be a signal from the North that it wants dialogue with the United States, said Cheong Seong-chang, an analyst at the private Sejong Institute in South Korea. He said trips by former U.S. Presidents Bill Clinton and Jimmy Carter to North Korea to secure the release of other detained Americans created a mood for U.S.-North Korea talks.


"North Korea knows sanctions will follow its rocket launch. But in the long run, it needs an excuse to reopen talks after the political atmosphere moves past sanctions," Cheong said.


Cheong said he expects that the American will be tried and convicted in coming months. North Korean leader Kim Jong Un has the power to grant amnesty and will exercise it as a bargaining chip, Cheong said.


Nuland said earlier this week that Washington had been trying to reach out to Kim.


"Instead, that was met not only with an abrogation of agreements that had been made by the previous North Korean regime, but by missile activity both in April and in December," she told reporters.


She said Washington had no choice but to put pressure on Pyongyang, and was discussing with its allies how to "further isolate" the regime.


In April 2009, a North Korean rocket launch took place while two American journalists, Laura Ling and Euna Lee, were in North Korean custody after allegedly trying to sneak into the country across the Tumen River dividing the North from China.


They were sentenced to 12 years of hard labor before being released on humanitarian grounds after Clinton flew to Pyongyang to negotiate their release.


Subsequently, three other Americans were arrested and eventually released by North Korea. All three are believed to have been accused of illegally spreading Christianity.


North Korea has several sanctioned churches in Pyongyang but frowns on the distribution of Bibles and other religious materials by foreigners. Interaction between North Koreans and foreigners is strictly regulated.


___


AP writers Foster Klug and Sam Kim in Seoul, South Korea, and Doug Esser in Seattle contributed to this report.


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Investors shed shares of Blackberry maker






NEW YORK (AP) — Shares of Blackberry maker Research in Motion slumped more than 16 percent Friday with future revenue coming into question and a declining number of subscribers.


RIM’s stock jumped initially Thursday when the Canadian company released better-than-expected third-quarter results and a stronger cash position.






Shares reversed course during a conference call later, when executives said that the company won’t generate as much revenue from telecommunications carriers once it releases the new BlackBerry 10.


RIM’s stock had been on a three-month rally in which the stock more than doubled from levels not previously seen since 2003.


“Despite a solid quarter, the stock is trading down due to the introduction of a lower enterprise service tier and fears that RIM will not receive monthly services revenues for consumer BB10 subscribers,” said Jefferies analyst Peter Misek. He thinks RIM has offered carriers a lower-priced option in exchange for a bigger purchase commitment for the new device. He kept his “Hold” rating.


Sterne Agee analyst Shaw Wu kept maintained a “Neutral” rating on the stock, but lowered his earnings estimates, saying he continued to be concerned about RIM’s ability to compete with Apple and Google.


Shares of Research in Motion Ltd. fell $ 2.29 to $ 11.83 in morning trading.


Wireless News Headlines – Yahoo! News





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UK man jailed over forged Churchill signatures


LONDON (AP) — A British antiques dealer has been jailed for 10 months for forging the signatures of Winston Churchill and other famous figures in books he sold as collector items.


Prosecutors say Allan Formhals bought books at recycling centers and junk sales and made thousands of pounds selling them on eBay after adding the bogus autographs.


Judge Peter Henry said police who searched the 66-year-old's home in Milford-on-Sea in southern England found "an Aladdin's Cave" of forged signatures from Oliver Cromwell, Queen Elizabeth I, Marie Antoinette and others.


Formhals was convicted in October of 10 counts of fraud and sentenced Friday.


Ian Lawson of the Metropolitan Police economic crimes unit said police had recovered more than 100 forged volumes, but many more are believed still to be on the market.


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AP IMPACT: Big Pharma cashes in on HGH abuse


A federal crackdown on illicit foreign supplies of human growth hormone has failed to stop rampant misuse, and instead has driven record sales of the drug by some of the world's biggest pharmaceutical companies, an Associated Press investigation shows.


The crackdown, which began in 2006, reduced the illegal flow of unregulated supplies from China, India and Mexico.


But since then, Big Pharma has been satisfying the steady desires of U.S. users and abusers, including many who take the drug in the false hope of delaying the effects of aging.


From 2005 to 2011, inflation-adjusted sales of HGH were up 69 percent, according to an AP analysis of pharmaceutical company data collected by the research firm IMS Health. Sales of the average prescription drug rose just 12 percent in that same period.


___


EDITOR'S NOTE — Whether for athletics or age, Americans from teenagers to baby boomers are trying to get an edge by illegally using anabolic steroids and human growth hormone, despite well-documented risks. This is the second of a two-part series.


___


Unlike other prescription drugs, HGH may be prescribed only for specific uses. U.S. sales are limited by law to treat a rare growth defect in children and a handful of uncommon conditions like short bowel syndrome or Prader-Willi syndrome, a congenital disease that causes reduced muscle tone and a lack of hormones in sex glands.


The AP analysis, supplemented by interviews with experts, shows too many sales and too many prescriptions for the number of people known to be suffering from those ailments. At least half of last year's sales likely went to patients not legally allowed to get the drug. And U.S. pharmacies processed nearly double the expected number of prescriptions.


Peddled as an elixir of life capable of turning middle-aged bodies into lean machines, HGH — a synthesized form of the growth hormone made naturally by the human pituitary gland — winds up in the eager hands of affluent, aging users who hope to slow or even reverse the aging process.


Experts say these folks don't need the drug, and may be harmed by it. The supposed fountain-of-youth medicine can cause enlargement of breast tissue, carpal tunnel syndrome and swelling of hands and feet. Ironically, it also can contribute to aging ailments like heart disease and Type 2 diabetes.


Others in the medical establishment also are taking a fat piece of the profits — doctors who fudge prescriptions, as well as pharmacists and distributors who are content to look the other way. HGH also is sold directly without prescriptions, as new-age snake oil, to patients at anti-aging clinics that operate more like automated drug mills.


Years of raids, sports scandals and media attention haven't stopped major drugmakers from selling a whopping $1.4 billion worth of HGH in the U.S. last year. That's more than industry-wide annual gross sales for penicillin or prescription allergy medicine. Anti-aging HGH regimens vary greatly, with a yearly cost typically ranging from $6,000 to $12,000 for three to six self-injections per week.


Across the U.S., the medication is often dispensed through prescriptions based on improper diagnoses, carefully crafted to exploit wiggle room in the law restricting use of HGH, the AP found.


HGH is often promoted on the Internet with the same kind of before-and-after photos found in miracle diet ads, along with wildly hyped claims of rapid muscle growth, loss of fat, greater vigor, and other exaggerated benefits to adults far beyond their physical prime. Sales also are driven by the personal endorsement of celebrities such as actress Suzanne Somers.


Pharmacies that once risked prosecution for using unauthorized, foreign HGH — improperly labeled as raw pharmaceutical ingredients and smuggled across the border — now simply dispense name brands, often for the same banned uses. And usually with impunity.


Eight companies have been granted permission to market HGH by the U.S. Food and Drug Administration, which reviews the benefits and risks of new drug products. By contrast, three companies are approved for the diabetes drug insulin.


The No. 1 maker, Roche subsidiary Genentech, had nearly $400 million in HGH sales in the U.S. last year, up an inflation-adjusted two-thirds from 2005. Pfizer and Eli Lilly were second and third with $300 million and $220 million in sales, respectively, according to IMS Health. Pfizer now gets more revenue from its HGH brand, Genotropin, than from Zoloft, its well-known depression medicine that lost patent protection.


On their face, the numbers make no sense to the recognized hormone doctors known as endocrinologists who provide legitimate HGH treatment to a small number of patients.


Endocrinologists estimate there are fewer than 45,000 U.S. patients who might legitimately take HGH. They would be expected to use roughly 180,000 prescriptions or refills each year, given that typical patients get three months' worth of HGH at a time, according to doctors and distributors.


Yet U.S. pharmacies last year supplied almost twice that much HGH — 340,000 orders — according to AP's analysis of IMS Health data.


While doctors say more than 90 percent of legitimate patients are children with stunted growth, 40 percent of 442 U.S. side-effect cases tied to HGH over the last year involved people age 18 or older, according to an AP analysis of FDA data. The average adult's age in those cases was 53, far beyond the prime age for sports. The oldest patients were in their 80s.


Some of these medical records even give explicit hints of use to combat aging, justifying treatment with reasons like fatigue, bone thinning and "off-label," which means treatment of an unapproved condition. In other cases, the drug was used "for an unknown indication," meaning that the reason for treatment wasn't clear.


Even Medicare, the government health program for older Americans, allowed 22,169 HGH prescriptions in 2010, a five-year increase of 78 percent, according to data released by the Centers for Medicare and Medicaid Services in response to an AP public records request. And nearly half the increase came in one year: 2007.


"There's no question: a lot gets out," said hormone specialist Dr. Mark Molitch of Northwestern University, who helped write medical standards meant to limit HGH treatment to legitimate patients.


And those figures don't include HGH sold directly by doctors without prescriptions at scores of anti-aging medical practices and clinics around the country. Those numbers could only be tallied by drug makers, who have declined to say how many patients they supply and for what conditions.


The AP approached every U.S.-authorized manufacturer to ask what efforts they make to market responsibly and prevent abuse. Only one HGH supplier, Novo Nordisk, agreed to an interview.


"We're doing our level best to make sure that the right patients are getting the right medicine at the right time," said company spokesman Ken Inchausti.


He said the company is aware of the abuse issue. He said if patients apply for assistance from the company's patient-support hub, prescriptions will be flagged for review if they are missing the most rigorous test or an endocrinologist's signature. He said the company won't sell HGH directly to doctors accused of bad practices and does not deal with anti-aging clinics.


Representatives of other FDA-approved HGH makers insist they do not encourage use by bodybuilders or athletes or wealthy baby boomers trying to recapture their youth. But some said they are largely powerless to control who uses their medications or why.


"Lilly cannot restrict the actions of distributors, pharmacies or doctors," Eli Lilly spokeswoman Kelley Murphy said in a written statement.


That argument doesn't fly for critics like Dr. Peter Rost, a retired Pfizer executive who filed a whistleblower lawsuit over the HGH marketing practices of Pharmacia, which later merged with Pfizer. He said drug companies are simply looking the other way and betting that their profits will eclipse the cost of any fines.


They view it as "good business," he said.


___


PEDDLED ON INTERNET


Type "human growth hormone" into any Internet search engine, and it will spit back countless websites with overblown promises of smoother skin, better sex, weight loss and even renewed body organs.


Any doctor who actually prescribes the drug for those purposes is taking a legal risk.


FDA regulations ban the sale of HGH as an anti-aging drug. In fact, since 1990, prescribing it for things like weight loss and strength conditioning has been punishable by 5 to 10 years in prison.


Such marketing claims are routinely made at hormone clinics like Palm Beach Life Extension, whose owners are among 13 people now awaiting trial on federal charges in Florida in a steroids and HGH distribution case brought last year.


"Grow YOUNG with Us!" screamed a banner on the company's now-defunct website, which advertised that HGH can reduce body fat, improve vision, strengthen the immune system, aid kidney function, lower blood pressure and enhance memory and mood.


The clinic arranged to have its clients' prescriptions filled at Treasure Coast Pharmacy, in Jensen Beach, Fla.


In 2009, the FBI recorded a phone call between the pharmacy's owner, Peter Del Toro, and a doctor in Elkton, Md., who was cooperating with agents after being implicated in a related steroid-distribution case.


Their talk, documented in a court filing, illustrates how things often work in the networks of pharmacies and clinics that drive HGH sales.


Patients submitted a medical history form by mail and took a blood test. But in most instances, the indictment said, the evaluation was a sham: One doctor was charged with giving a clinic a pad of blank, signed prescriptions to save him the chore of signing off on each diagnosis. He got $50 for every drug order bearing his name, the indictment said.


Dr. Rodney Baltazar, the Maryland physician cooperating with the FBI, sometimes consulted briefly with patients via webcam. But he made it clear in the call that those evaluations were perfunctory at best.


Baltazar was a gynecologist, not an endocrinologist. He said he knew "a little bit" about HGH and testosterone, which are often prescribed in tandem, but he relied largely on clinic salespeople to set doses.


The pharmacist coached the doctor: Keep detailed medical charts documenting that patients are taking the drug for at least some kind of health problem, just in case the U.S. Drug Enforcement Administration ever came calling.


"Because somebody questions you, you want to be able to say, 'Here, look at his chart. You know, he's got fatigue. He's got, you know, a decreased sex drive. He's got increased body fat. He has some -- some slight depression, probably.' Whatever his signs and symptoms are."


None of these conditions is a legal reason to prescribe HGH. But the pharmacist said that most investigators will be satisfied and move on "because there's guys that are just selling stuff basically like a boiler room."


Del Toro was arrested along with 12 other people in September 2011 on charges that they distributed steroids and human growth hormone to people who had no legitimate medical need. He is awaiting trial. His lawyer declined to comment. Baltazar was sentenced to six months in prison for involvement in steroid distribution schemes.


At the height of the crackdown in 2007, the federal government went after Pfizer in a case involving anti-aging clinics. The company paid $34.7 million in fines to settle the case — 11 percent of the company's annual revenue from the drug.


___


TROUBLED HISTORY


Blockbuster U.S. sales of HGH represent the latest frustration in 25 years of government efforts to control abuse of the growth drug made infamous by sports scandals.


First marketed in 1985 for children with stunted growth, HGH was soon misappropriated by adults intent on exploiting its modest muscle- and bone-building qualities. Congress limited HGH distribution to the handful of rare conditions in an extraordinary 1990 law, overriding the generally unrestricted right of doctors to prescribe medicines as they see fit.


Despite the law, illicit HGH spread around the sports world in the 1990s, making deep inroads into bodybuilding, college athletics, and professional leagues from baseball to cycling. The even larger banned market among older adults has flourished more recently.


For years, cheaper supplies from unauthorized foreign factories, particularly in China, fed the market via direct and Internet sales that sidestepped the medical establishment.


Though such shipments were banned under other law, the imports initially attracted little attention because they were usually labeled as raw pharmaceutical ingredients, which compounding pharmacies are allowed to bring into the country.


That flow began to be curtailed in 2006, when U.S. drug authorities stepped up efforts to block shipments at the border.


A handful of pharmacies across the country were hit with criminal charges over their handling of HGH. Federal prosecutors charged China's biggest HGH maker, GeneScience Pharmaceutical, with illegally distributing its Jintropin brand in the U.S. The company's CEO pleaded guilty in 2010.


With illicit supplies crimped, many pharmacies stopped selling unauthorized HGH. But tens of thousands of adult abusers began buying pricey U.S.-approved HGH that remained available in abundant supply, the AP found in its analysis of sales data.


Thus, pushed by a powerful demand, sales of U.S.-approved brands have swelled far beyond expected levels for a drug approved in just a handful of rare conditions.


Dr. Robert Marcus, a retired hormone specialist who left HGH manufacturer Eli Lilly and Co. in 2008, said that company was bent on stopping foreign counterfeits, not on cutting off abusers. "That's where their major level of frustration was — pharmaceutical fraud — rather than focusing on people who were using growth hormone illegitimately," he said.


Dr. Jim Meehan, of Tulsa, Okla., who has used HGH to treat aging problems and sports injuries, said the federal clampdown "never seemed to affect my patients and their ability to get Omnitrope, Tev-Tropin" and other government-approved brands.


The big drug companies have applauded the foreign crackdown and urged the government to do even more to combat sales of fake or fraudulently labeled HGH. In 2004, Bruce Kuhlik, speaking for the Pharmaceutical Research and Manufacturers of America, told a federal task force that unauthorized drug importation "is inherently unsafe" and industry representatives used Chinese HGH imports as their poster child.


In 2007, as the HGH embargo gained momentum, authorized makers picked up 41 percent more HGH orders, raising their annual total from 245,000 to 345,000, according to the analysis of the IMS Health data. Similarly, most of the drug's sales boom happened in the first two years of the crackdown, with 46 percent inflation-adjusted growth in yearly sales to $1.1 billion.


Steve Kleppe, of Scottsdale, Ariz., a restaurant entrepreneur who has taken HGH for almost 15 years to keep feeling young, said he noticed a price jump of about 25 percent after the block on imports. He now buys HGH directly from a doctor at an annual cost of about $8,000 for himself and the same amount for his wife.


Despite higher prices, the business has expanded in recent years largely on the strength of sales to healthy adults who can afford to indulge their hope of retaining youthful vigor.


___


GROWING OLD


Many older patients go for HGH treatment to scores of anti-aging practices and clinics heavily concentrated in retirement states like Florida, Nevada, Arizona and California.


These sites are affiliated with hundreds of doctors who are rarely endocrinologists. Instead, many tout certification by the American Board of Anti-Aging and Regenerative Medicine, though the medical establishment does not recognize the group's bona fides.


The clinics offer personalized programs of "age management" to business executives, affluent retirees, and other patients of means, sometimes coupled with the amenities of a vacation resort.


The clinics insist there are few, if any, side effects from HGH. Mainstream medical authorities say otherwise.


A 2007 review of 31 medical studies showed swelling in half of HGH patients, with joint pain or diabetes in more than a fifth. A French study of about 7,000 people who took HGH as children found a 30 percent higher risk of death from causes like bone tumors and stroke, stirring a health advisory from U.S. authorities.


For proof that the drug works, marketers turn to images like the memorable one of pot-bellied septuagenarian Dr. Jeffry Life, supposedly transformed into a ripped hulk of himself by his own program available at the upscale Las Vegas-based Cenegenics Elite Health. (He declined to be interviewed.)


These promoters of HGH say there is a connection between the drop-off in growth hormone levels through adulthood and the physical decline that begins in late middle age. Replace the hormone, they say, and the aging process slows.


"It's an easy ruse. People equate hormones with youth," said Dr. Tom Perls, a leading industry critic who does aging research at Boston University. "It's a marketing dream come true."


Some scientific studies of HGH have found modest benefits: some muscle and bone building, as well as limited fat loss, but nothing like the claims of the anti-aging industry. And some of the value credited to HGH may instead come from testosterone, which is routinely provided with HGH by anti-aging doctors and sports suppliers.


Endocrinologists say it's natural for the body to produce less growth hormone as people age beyond their early 20s, because they aren't growing anymore. Only a tiny number of adults with extraordinarily low HGH levels — perhaps several thousand of them — are believed to suffer real deficiencies that can properly be treated with the hormone.


Still, anti-aging doctors routinely diagnose otherwise healthy middle-aged people with an HGH deficiency, simply because their levels are lower than in young adults. "Basically anyone going through midlife," can benefit from the drug, declared one prescriber, Dr. Howard Elkin, of Whittier, Calif., who has himself competed as a bodybuilder.


Dr. Kenneth Knott, of Marietta, Ga., said HGH helps his older patients feel "more vibrant" and look "more alive."


Like many anti-aging doctors, he diagnoses patients by testing for a blood component called insulin growth factor, which is indirectly tied to HGH. Endocrinologists use a more authoritative test that stimulates the pituitary gland to make HGH itself. Nearly all insurers insist on this stimulation testing, and that's why clinic patients almost always pay for HGH out of their own pockets.


Bob Vitols, a 50-year-old lab assistant at a veterinary medicine company in Lincoln, Neb., is a rare exception. His unusually generous health plan isn't allowed to challenge a doctor's prescription.


Four years ago, Vitols began feeling run down. So he Googled his symptoms on the Internet, decided he had a hormone deficiency, and sought out a clinic.


One doctor put him on testosterone replacement therapy. A second clinic added HGH after diagnosing him with osteopenia, a mild bone thinning common in aging adults. It is not, however, a condition that can properly be treated with HGH.


Despite the diagnosis, the treatments — which can cost $10,000 per year — have been covered by his health insurance, he said. He takes Genotropin, the HGH made by Pfizer. His prescriptions are filled via mail order by CVS Caremark Corp., one of the largest dispensers of prescription drugs in the U.S.


Vitols said the drug changed his life: his mood is better, and he isn't burning out every day at 2 p.m. "I feel like I could walk outside and just walk through a fence — and come out fine on the other side," he said.


His experiences with the drug haven't all been positive, though. Vitols said he initially developed elevated liver enzymes and went to a specialist, who told him to stop taking hormones immediately.


Instead, Vitols said, he adjusted his dosage, and the problem disappeared.


He also dumped the specialist:


"I could tell he was against hormones right at the start," Vitols said.


___


Associated Press Writer David Caruso reported from New York and AP National Writer Jeff Donn reported from Plymouth, Mass. AP Writer Troy Thibodeaux provided data analysis assistance from New Orleans.


___


AP's interactive on the HGH investigation: http://hosted.ap.org/interactives/2012/hgh


___


The AP National Investigative Team can be reached at investigate(at)ap.org


EDITOR'S NOTE _ Whether for athletics or age, Americans from teenagers to baby boomers are trying to get an edge by illegally using anabolic steroids and human growth hormone, despite well-documented risks. This is the second of a two-part series.


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A somber moment for 26 victims of Sandy Hook school massacre


NEWTOWN, Conn. (AP) — The chiming of bells reverberated throughout Newtown on Friday, commemorating one week since the crackle of gunfire in a schoolhouse killed 20 children and six adults in a massacre that has shaken the community — and the nation — to its core.


Gov. Dannel P. Malloy gathered with other officials in rain and wind on the steps of the Edmond Town Hall as the bell rang 26 times in memory of each life lost at Sandy Hook Elementary School. The gunman also killed his mother before the massacre, and himself afterward.


Officials didn't plan any formal remarks Friday morning, and similar commemorations took place throughout the country.


Though the massacre does not rank as the deadliest school shooting in U.S. history — that happened at Virginia Tech — the tender age of the victims and the absence of any apparent motive has struck at Americans' hearts and minds. The gunman used a military-style assault rifle loaded with ammunition intended to inflict maximum damage, officials have said.


The White House said President Barack Obama privately observed the moment of silence.


Just a week after the attack, gun control has taken a front burner in Congress, where previous mass shootings produced only minimal legislative reaction. Vice President Joe Biden said Thursday that the Obama administration would push to tighten gun laws.


The National Rifle Association, at its first public event since the shootings, called Friday for armed police officers to be posted in American school to stop the next killer "waiting in the wings."


Wayne LaPierre, CEO of the nation's largest gun-rights lobby with 4.3 million members, said at the Washington news conference that, "The only thing that stops a bad guy with a gun is a good guy with a gun."


The briefing was interrupted twice by people carrying signs protesting the organization. The protesters were taken from the room.


Traffic stopped in the streets outside the town hall in Newtown as bells rang out to honor the dead.


Malloy, taking deep breaths with his hands folded in front of him, was joined by the Newtown superintendent of schools, lawmakers and other officials as bells rang out at the nearby Trinity Episcopal Church.


Firefighters bowed their heads around a memorial filled with teddy bears, other stuffed animals and a New York Giants pillow. Some hugged and onlookers shook their hands afterward.


"When I heard the 26 bells ring it just melted my soul," said Kerrie Glassman, of Sandy Hook, who said she knew seven of the victims. "It's just overwhelming. You just can't believe this happened in our town."


Milysa Musiel, 21, came from neighboring Monroe and said she felt helpless.


"Everybody wants to do something," she said. "It shook that false sense of security that we had. This is my backyard."


Chip Carpenter, a volunteer with the police and fire department, said he was upset to see the wind knocking down tents for memorials.


"I was so distraught this morning," he said. "I just cried for the longest time. Just seeing everything falling apart. We suffered enough here."


The chiming of bells reverberated throughout the nation.


In New York City, bells at the historic Trinity Church near the World Trade Center tolled 28 times, and in Massachusetts, bells in churches around the state, including Boston's historic Old North Church, rang in honor of those killed in the attack.


When the bells tolled mournfully to honor the victims of last week's shooting rampage, they did so 26 times, for each child and staff member killed.


Rarely do residents mention the first person police said Adam Lanza killed that morning: his mother, Nancy, who was shot in the head four times while she lay in bed.


That makes 27.


A private funeral was held Thursday in New Hampshire for Nancy Lanza, according to Donald Briggs, the police chief in Kingston, N.H., where her funeral was held. About 25 family members attended the ceremony.


Newtown and environs weathered a fourth day of funerals Thursday, and five more funerals or memorials were scheduled for Friday.


Biden, who is overseeing the administration's response to last week's shooting, said he and Obama are "absolutely committed" to curbing gun violence in the United States.


"Even if we can only save one life, we have to take action," he said.


Gun-control measures have faced fierce resistance in Congress for years, but that may be changing because of the events in Connecticut, which shocked the nation.


After the shooting, Obama signaled for the first time that he's willing to spend significant political capital on the issue. Some prominent gun-rights advocates on Capitol Hill — Democrats and Republicans alike — have expressed willingness to consider new measures.


Investigators have said that Nancy Lanza, a gun enthusiast, visited shooting ranges several times and that her son also visited an area range.


Authorities say Adam Lanza shot his mother at their home and then took her car and some of her guns to the school, where he broke in and opened fire. A Connecticut official said Nancy Lanza was shot four times in the head with a .22-caliber rifle.


Adam Lanza was wearing all black, with an olive-drab utility vest, during the school attack. Investigators have found no letters or diaries that could explain the rampage.


Friends and acquaintances have described him as intelligent, but odd and quiet.


Friends said he would stare down at the floor and not speak when she brought him into a local pizzeria. They knew that he'd switched schools more than once and that she'd tried home schooling him. But while she occasionally expressed concern about his future during evenings at the bar, she never complained.


"I heard her as a parent. I always said that I wouldn't want to be in her shoes. But I thought, 'Wow. She holds it well,'" said Jon Tambascio, son of the pizzeria operator.


___


Contributing to this report were Associated Press writers Michael Melia, John Christoffersen and David Klepper in Newtown; Jim Fitzgerald in Katonah, N.Y.; and Frederic J. Frommer in Washington.


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Indian women live in fear of violence


NEW DELHI (AP) — It is almost every Indian woman's nightmare, lived daily when in public — a stream of obscene comments, unwanted hands being placed on them and then being blamed for causing the sexual violence.


The gang-rape and beating of a 23-year-old student by six men on a bus in New Delhi may have sparked days of protests and demands for authorities to take tougher action, but for women in India it is just an extreme example of what they have to live with.


Many in India's capital and across the country say they are constantly on guard, fearing everything from the routine gropings they suffer on public buses to far more violent assaults. Some say they have structured their entire lives around protecting themselves and their children.


Here are the stories of three women:


Gita Ganeshan, a 52-year-old bank worker, moved to New Delhi with her husband four years ago from the central city of Bhopal to protect their oldest daughter after she was attacked in the Indian capital, where she was studying.


The young woman had been out for a morning walk in a park near her house when four men surrounded her and began tormenting her, Ganeshan said.


"One of the men squeezed her breast. She screamed and kept screaming and running till she came home," she said.


She said she and her daughter would go to the park when she visited the city.


"This was a park where we would walk every day. The girls would jog or run and we would walk along," she said. "Just that one day, she went alone and this happened and it changed our outlook as far the safety of our girls was concerned."


Her daughter gave up jogging and wouldn't leave the house alone for months. Her parents got themselves transferred to the city to look after her.


"That was when we decided that protecting our children had to be our first priority. We've given them a good education. We cannot now tell them now not to pursue their careers because it is not safe to be out working late," she said.


She has trained the young woman to be alert: "Never let your guard down."


Now, Ganeshan is thinking of moving to the central city of Indore to protect her younger daughter, who got a job there.


But for now, she has arranged a special plan to watch over her from far away.


Every evening, her daughter calls as soon as she gets off the bus on her way home from work. The two talk for the next 15 minutes while the young woman walks the kilometer to her home, Ganeshan said.


"Every day, I wake up and my first thought is of my daughters and their safety. I call them up, or they call me," she said. "It is a real fear we confront when, even for a few hours, we are not in touch over the telephone."


Sandhya Jadon, 26, a lawyer from the northern town of Agra, said the harassment starts as soon as she leaves her home.


"For most men, any woman who is out of the four walls of her house is fair game," she said.


Last week, she was repeatedly groped on a public minibus.


"It was broad daylight. I was heading to court, and this man kept trying to touch my thigh. I shouted at him and he had the gall to ask me, 'So what can you do to stop me?'" she said.


She shouted, made the driver stop and got off. But the man continued sitting in the bus and grinning at his audacity. Not one of the 10 other passengers came to her help. Most looked away, she said.


"All day that day I was disturbed. I was shaking inside but also angry. Why do we women have to suffer this?" she asked.


For the next few days, she avoided public buses for fear she would run into the man again.


She feels relatively safe at court, in her lawyer's robes. But she still doesn't stay late at work and asks her parents to meet her at the bus stop to walk her home.


"But the fear — that something bad will happen if you are not careful — is always with you. It hangs over your work; it hangs over everything you do — what you wear, or don't wear; how you talk or how you walk. It is like this big suffocating cloud hanging over you every single day of your life," she said.


Priyanka Khatri, a 21-year-old college student, said fear of attack has forced her to limit her world.


There are no movies in the evening, no late-night parties, no outside activity at all after sundown. College events are cut short because she has to get home.


"Whatever happens, I have to be home before dark. Otherwise, my parents get so worried and they will keep calling me on my cell phone till they know I'm safe," she said.


Khatri said she will only go out in the evening accompanied by her parents to a nearby temple or a family wedding.


She is shadowed by fear when she gets dressed in the morning.


"I wouldn't dream of wearing shorts or skirts in public," she said.


She is petrified by her daily commute to school on public buses.


"Usually I carry a safety pin with me, because in buses there are always men who will try to touch you," Khatri said. "Some men are so brazen, you tick them off and they will persist on groping you. Then you feel you have to do something. So I stick my pin into them, or I use my elbow, and just jab them with my elbow. But that too makes you afraid."


And she has tempered her dreams to fit the reality of life in Delhi. The outgoing badminton enthusiast longed to be an event planner. Instead, she is looking for teaching jobs, "because then I can be home before dark."


If her precautions fail and she is attacked, Khatri has a backup plan, she said.


"I will scream. I always have a scream."


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Halle Berry, Chaka Khan among 2013 BET Honorees


NEW YORK (AP) — Actress Halle Berry and musician Chaka Khan will be honored at the 2013 BET Honors.


The network announced Thursday that basketball star Lisa Leslie, music executive Clarence Avant and religious leader T.D. Jakes will also be celebrated at the Jan. 12 event in Washington at the Warner Theatre. The special airs Feb. 11.


BET Honors highlights African Americans performing at top levels in the areas of music, literature, entertainment, education and more.


Maya Angelou was among the honorees at this year's BET Honors. First Lady Michelle Obama presented her award.


Actress Gabrielle Union will host the special. Performers will be announced at a later date.


___


Online:


http://www.bet.com


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AP IMPACT: Steroids loom in major-college football


WASHINGTON (AP) — With steroids easy to buy, testing weak and punishments inconsistent, college football players are packing on significant weight — 30 pounds or more in a single year, sometimes — without drawing much attention from their schools or the NCAA in a sport that earns tens of billions of dollars for teams.


Rules vary so widely that, on any given game day, a team with a strict no-steroid policy can face a team whose players have repeatedly tested positive.


An investigation by The Associated Press — based on dozens of interviews with players, testers, dealers and experts and an analysis of weight records for more than 61,000 players — revealed that while those running the multibillion-dollar sport believe the problem is under control, that is hardly the case.


The sport's near-zero rate of positive steroids tests isn't an accurate gauge among college athletes. Random tests provide weak deterrence and, by design, fail to catch every player using steroids. Colleges also are reluctant to spend money on expensive steroid testing when cheaper ones for drugs like marijuana allow them to say they're doing everything they can to keep drugs out of football.


"It's nothing like what's going on in reality," said Don Catlin, an anti-doping pioneer who spent years conducting the NCAA's laboratory tests at UCLA. He became so frustrated with the college system that it drove him in part to leave the testing industry to focus on anti-doping research.


Catlin said the collegiate system, in which players often are notified days before a test and many schools don't even test for steroids, is designed to not catch dopers. That artificially reduces the numbers of positive tests and keeps schools safe from embarrassing drug scandals.


While other major sports have been beset by revelations of steroid use, college football has operated with barely a whiff of scandal. Between 1996 and 2010 — the era of Barry Bonds, Mark McGwire, Marion Jones and Lance Armstrong — the failure rate for NCAA steroid tests fell even closer to zero from an already low rate of less than 1 percent.


The AP's investigation, drawing upon more than a decade of official rosters from all 120 Football Bowl Subdivision teams, found thousands of players quickly putting on significant weight, even more than their fellow players. The information compiled by the AP included players who appeared for multiple years on the same teams, making it the most comprehensive data available.


For decades, scientific studies have shown that anabolic steroid use leads to an increase in body weight. Weight gain alone doesn't prove steroid use, but very rapid weight gain is one factor that would be deemed suspicious, said Kathy Turpin, senior director of sport drug testing for the National Center for Drug Free Sport, which conducts tests for the NCAA and more than 300 schools.


Yet the NCAA has never studied weight gain or considered it in regard to its steroid testing policies, said Mary Wilfert, the NCAA's associate director of health and safety. She would not speculate on the cause of such rapid weight gain.


The NCAA attributes the decline in positive tests to its year-round drug testing program, combined with anti-drug education and testing conducted by schools.


"The effort has been increasing, and we believe it has driven down use," Wilfert said.


Big gains, data show


The AP's analysis found that, regardless of school, conference and won-loss record, many players gained weight at exceptional rates compared with their fellow athletes and while accounting for their heights. The documented weight gains could not be explained by the amount of money schools spent on weight rooms, trainers and other football expenses.


Adding more than 20 or 25 pounds of lean muscle in a year is nearly impossible through diet and exercise alone, said Dan Benardot, director of the Laboratory for Elite Athlete Performance at Georgia State University.


The AP's analysis corrected for the fact that players in different positions have different body types, so speedy wide receivers weren't compared to bulkier offensive tackles. It could not assess each player's physical makeup, such as how much weight gain was muscle versus fat, one indicator of steroid use. In the most extreme case in the AP analysis, the probability that a player put on so much weight compared with other players was so rare that the odds statistically were roughly the same as an NFL quarterback throwing 12 passing touchdowns or an NFL running back rushing for 600 yards in one game.


In nearly all the rarest cases of weight gain in the AP study, players were offensive or defensive linemen, hulking giants who tower above 6-foot-3 and weigh 300 pounds or more. Four of those players interviewed by the AP said that they never used steroids and gained weight through dramatic increases in eating, up to six meals a day. Two said they were aware of other players using steroids.


"I just ate. I ate 5-6 times a day," said Clint Oldenburg, who played for Colorado State starting in 2002 and for five years in the NFL. Oldenburg's weight increased over four years from 212 to 290, including a one-year gain of 53 pounds, which he attributed to diet and two hours of weight lifting daily. "It wasn't as difficult as you think. I just ate anything."


Oldenburg told the AP he was surprised at the scope of steroid use in college football, even in Colorado State's locker room. "College performance enhancers were more prevalent than I thought," he said. "There were a lot of guys even on my team that were using." He declined to identify any of them.


The AP found more than 4,700 players — or about 7 percent of all players — who gained more than 20 pounds overall in a single year. It was common for the athletes to gain 10, 15 and up to 20 pounds in their first year under a rigorous regimen of weightlifting and diet. Others gained 25, 35 and 40 pounds in a season. In roughly 100 cases, players packed on as much 80 pounds in a single year.


In at least 11 instances, players that AP identified as packing on significant weight in college went on to fail NFL drug tests. But pro football's confidentiality rules make it impossible to know for certain which drugs were used and how many others failed tests that never became public.


What is bubbling under the surface in college football, which helps elite athletes gain unusual amounts of weight? Without access to detailed information about each player's body composition, drug testing and workout regimen, which schools do not release, it's impossible to say with certainty what's behind the trend. But Catlin has little doubt: It is steroids.


"It's not brain surgery to figure out what's going on," he said. "To me, it's very clear."


Football's most infamous steroid user was Lyle Alzado, who became a star NFL defensive end in the 1970s and '80s before he admitted to juicing his entire career. He started in college, where the 190-pound freshman gained 40 pounds in one year. It was a 21 percent jump in body mass, a tremendous gain that far exceeded what researchers have seen in controlled, short-term studies of steroid use by athletes. Alzado died of brain cancer in 1992.


The AP found more than 130 big-time college football players who showed comparable one-year gains in the past decade. Students posted such extraordinary weight gains across the country, in every conference, in nearly every school. Many of them eclipsed Alzado and gained 25, 35, even 40 percent of their body mass.


Even though testers consider rapid weight gain suspicious, in practice it doesn't result in testing. Ben Lamaak, who arrived at Iowa State in 2006, said he weighed 225 pounds in high school and 262 pounds in the summer of his freshman year on the Cyclones football team. A year later, official rosters showed the former basketball player from Cedar Rapids weighed 306, a gain of 81 pounds since high school. He graduated as a 320-pound offensive lineman and said he did it all naturally.


"I was just a young kid at that time, and I was still growing into my body," he said. "It really wasn't that hard for me to gain the weight. I had fun doing it. I love to eat. It wasn't a problem."


In addition to random drug testing, Iowa State is one of many schools that have "reasonable suspicion" testing. That means players can be tested when their behavior or physical symptoms suggest drug use.


Despite gaining 81 pounds in a year, Lamaak said he was never singled out for testing.


The associate athletics director for athletic training at Iowa State, Mark Coberley, said coaches and trainers use body composition, strength data and other factors to spot suspected cheaters. Lamaak, he said, was not suspicious because he gained a lot of "non-lean" weight.


"There are a lot of things that go into trying to identify whether guys are using performance-enhancing drugs," Coberley said. "If anybody had the answer, they'd be spotting people that do it. We keep our radar up and watch for things that are suspicious and try to protect the kids from making stupid decisions."


There's no evidence that Lamaak's weight gain was anything but natural. Gaining fat is much easier than gaining muscle. But colleges don't routinely release information on how much of the weight their players gain is muscle, as opposed to fat. Without knowing more, said Benardot, the expert at Georgia State, it's impossible to say whether large athletes were putting on suspicious amounts of muscle or simply obese, which is defined as a body mass index greater than 30.


Looking solely at the most significant weight gainers also ignores players like Bryan Maneafaiga.


In the summer of 2004, Maneafaiga was an undersized 180-pound running back trying to make the University of Hawaii football team. Twice — once in pre-season and once in the fall — he failed school drug tests, showing up positive for marijuana use. What surprised him was that the same tests turned up negative for steroids.


He'd started injecting stanozolol, a steroid, in the summer to help bulk up to a roster weight of 200 pounds. Once on the team, where he saw only limited playing time, he'd occasionally inject the milky liquid into his buttocks the day before games.


"Food and good training will only get you so far," he told the AP recently.


Maneafaiga's coach, June Jones, meanwhile, said none of his players had tested positive for doping since he took over the team in 1999. He also said publicly that steroids had been eliminated in college football: "I would say 100 percent," he told The Honolulu Advertiser in 2006.


Jones said it was news to him that one of his players had used steroids. Jones, who now coaches at Southern Methodist University, said many of his former players put on bulk working hard in the weight room. For instance, adding 70 pounds over a three- to four-year period isn't unusual, he said.


Jones said a big jump in muscle year-over-year — say 40 pounds — would be a "red light that something is not right."


Jones, a former NFL head coach, said he is unaware of any steroid use at SMU and believes the NCAA is doing a good job testing players. "I just think because the way the NCAA regulates it now that it's very hard to get around those tests," he said.


The cost of testing


While the use of drugs in professional sports is a question of fairness, use among college athletes is also important as a public policy issue. That's because most top-tier football teams are from public schools that benefit from millions of dollars each year in taxpayer subsidies. Their athletes are essentially wards of the state. Coaches and trainers — the ones who tell players how to behave, how to exercise and what to eat — are government employees.


Then there are the health risks, which include heart and liver problems and cancer.


On paper, college football has a strong drug policy. The NCAA conducts random, unannounced drug testing and the penalties for failure are severe. Players lose an entire year of eligibility after a first positive test. A second offense means permanent ineligibility from sports.


In practice, though, the NCAA's roughly 11,000 annual tests amount to just a fraction of all athletes in Division I and II schools. Exactly how many tests are conducted each year on football players is unclear because the NCAA hasn't published its data for two years. And when it did, it periodically changed the formats, making it impossible to compare one year of football to the next.


Even when players are tested by the NCAA, people involved in the process say it's easy enough to anticipate the test and develop a doping routine that results in a clean test by the time it occurs. NCAA rules say players can be notified up to two days in advance of a test, which Catlin says is plenty of time to beat a test if players have designed the right doping regimen. By comparison, Olympic athletes are given no notice.


"Everybody knows when testing is coming. They all know. And they know how to beat the test," Catlin said, adding, "Only the really dumb ones are getting caught."


Players are far more likely to be tested for drugs by their schools than by the NCAA. But while many schools have policies that give them the right to test for steroids, they often opt not to. Schools are much more focused on street drugs like cocaine and marijuana. Depending on how many tests a school orders, each steroid test can cost $100 to $200, while a simple test for street drugs might cost as little as $25.


When schools call and ask about drug testing, the first question is usually, "How much will it cost," Turpin said.


Most schools that use Drug Free Sport do not test for anabolic steroids, Turpin said. Some are worried about the cost. Others don't think they have a problem. And others believe that since the NCAA tests for steroids their money is best spent testing for street drugs, she said.


Wilfert, the NCAA official, said the possibility of steroid testing is still a deterrent, even at schools where it isn't conducted.


"Even though perhaps those institutional programs are not including steroids in all their tests, they could, and they do from time to time," she said. "So, it is a kind of deterrence."


For Catlin, one of the most frustrating things about running the UCLA testing lab was getting urine samples from schools around the country and only being asked to test for cocaine, marijuana and the like.


"Schools are very good at saying, 'Man, we're really strong on drug testing,'" he said. "And that's all they really want to be able to say and to do and to promote."


That helps explain how two school drug tests could miss Maneafaiga's steroid use. It's also possible that the random test came at an ideal time in Maneafaiga's steroid cycle.


Enforcement varies


The top steroid investigator at the U.S. Drug Enforcement Administration, Joe Rannazzisi, said he doesn't understand why schools don't invest in the same kind of testing, with the same penalties, as the NFL. The NFL has a thorough testing program for most drugs, though the league has yet to resolve a long-simmering feud with its players union about how to test for human growth hormone.


"Is it expensive? Of course, but college football makes a lot of money," he said. "Invest in the integrity of your program."


For a school to test all 85 scholarship football players for steroids twice a season would cost up to $34,000, Catlin said, plus the cost of collecting and handling the urine samples. That's about 0.2 percent of the average big-time school football budget of about $14 million. Testing all athletes in all sports would make the school's costs higher.


When schools ask Drug Free Sport for advice on their drug policies, Turpin said she recommends an immediate suspension after the first positive drug test. Otherwise, she said, "student athletes will roll the dice."


But drug use is a bigger deal at some schools than others.


At Notre Dame and Alabama, the teams that will soon compete for the national championship, players don't automatically miss games for testing positive for steroids. At Alabama, coaches have wide discretion. Notre Dame's student-athlete handbook says a player who fails a test can return to the field once the steroids are out of his system.


"If you're a strength-and-conditioning coach, if you see your kids making gains that seem a little out of line, are you going to say, 'I'm going to investigate further? I want to catch someone?'" said Anthony Roberts, an author of a book on steroids who says he has helped college football players design steroid regimens to beat drug tests.


There are schools with tough policies. The University of North Carolina kicks players off the team after a single positive test for steroids. Auburn's student-athlete handbook calls for a half-season suspension for any athlete caught using performance-enhancing drugs.


Wilfert said it's not up to the NCAA to determine whether that's fair.


"Obviously if it was our testing program, we believe that everybody should be under the same protocol and the same sanction," she said.


Fans typically have no idea that such discrepancies exist and players are left to suspect who might be cheating.


"You see a lot of guys and you know they're possibly on something because they just don't gain weight but get stronger real fast," said Orrin Thompson, a former defensive lineman at Duke. "You know they could be doing something but you really don't know for sure."


Thompson gained 85 pounds between 2001 and 2004, according to Duke rosters and Thompson himself. He said he did not use steroids and was subjected to several tests while at Duke, a school where a single positive steroid test results in a yearlong suspension.


Meanwhile at UCLA, home of the laboratory that for years set the standard for cutting-edge steroid testing, athletes can fail three drug tests before being suspended. At Bowling Green, testing is voluntary.


At the University of Maryland, students must get counseling after testing positive, but school officials are prohibited from disciplining first-time steroid users. Athletic department spokesman Matt Taylor denied that was the case and sent the AP a copy of the policy. But the policy Taylor sent included this provision: "The athletic department/coaching staff may not discipline a student-athlete for a first drug offense."


By comparison, in Kentucky and Maryland, racehorses face tougher testing and sanctions than football players at Louisville or the University of Maryland.


"If you're trying to keep a level playing field, that seems nonsensical," said Rannazzisi at the DEA. He said he was surprised to learn that what gets a free pass at one school gets players immediately suspended at another. "What message does that send? It's OK to cheat once or twice?"


Only about half the student athletes in a 2009 NCAA survey said they believed school testing deterred drug use.


As an association of colleges and universities, the NCAA could not unilaterally force schools to institute uniform testing policies and sanctions, Wilfert said.


"We can't tell them what to do, but if went through a membership process where they determined that this is what should be done, then it could happen," she said.


'Everybody around me was doing it'


Steroids are a controlled substance under federal law, but players who use them need not worry too much about prosecution. The DEA focuses on criminal operations, not individual users. When players are caught with steroids, it's often as part of a traffic stop or a local police investigation.


Jared Foster, 24, a quarterback recruited to play at the University of Mississippi, was kicked off the team in 2008 after local authorities arrested him for giving a man nandrolone, an anabolic steroid, according to court documents. Foster pleaded guilty and served jail time.


He told the AP that he doped in high school to impress college recruiters. He said he put on enough lean muscle to go from 185 pounds to 210 in about two months.


"Everybody around me was doing it," he said.


Steroids are not hard to find. A simple Internet search turns up countless online sources for performance-enhancing drugs, mostly from overseas companies.


College athletes freely post messages on steroid websites, seeking advice to beat tests and design the right schedule of administering steroids.


And steroids are still a mainstay in private, local gyms. Before the DEA shut down Alabama-based Applied Pharmacy Services as a major nationwide steroid supplier, sales records obtained by the AP show steroid shipments to bodybuilders, trainers and gym owners around the country.


Because users are rarely prosecuted, the demand is left in place after the distributor is gone.


When Joshua Hodnik was making and wholesaling illegal steroids, he had found a good retail salesman in a college quarterback named Vinnie Miroth. Miroth was playing at Saginaw Valley State, a Division II school in central Michigan, and was buying enough steroids for 25 people each month, Hodnik said.


"That's why I hired him," Hodnik said. "He bought large amounts and knew how to move it."


Miroth, who pleaded no contest in 2007 and admitted selling steroids, helped authorities build their case against Hodnik, according to court records. Now playing football in France, Miroth declined repeated AP requests for an interview.


Hodnik was released from prison this year and says he is out of the steroid business for good. He said there's no doubt that steroid use is widespread in college football.


"These guys don't start using performance-enhancing drugs when they hit the professional level," the Oklahoma City man said. "Obviously it starts well before that. And you can go back to some of the professional players who tested positive and compare their numbers to college and there is virtually no change."


Maneafaiga, the former Hawaii running back, said his steroids came from Mexico. A friend in California, who was a coach at a junior college, sent them through the mail. But Maneafaiga believes the consequences were nagging injuries. He found religion, quit the drugs and became the team's chaplain.


"God gave you everything you need," he said. "It gets in your mind. It will make you grow unnaturally. Eventually, you'll break down. It happened to me every time."


At the DEA, Rannazzisi said he has met with and conducted training for investigators and top officials in every professional sport. He's talked to Major League Baseball about the patterns his agents are seeing. He's discussed warning signs with the NFL.


He said he's offered similar training to the NCAA but never heard back. Wilfert said the NCAA staff has discussed it and hasn't decided what to do.


"We have very little communication with the NCAA or individual schools," Rannazzisi said. "They've got my card. What they've done with it? I don't know."


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Associated Press writers Ryan Foley in Cedar Rapids, Iowa; David Brandt in Jackson, Miss.; David Skretta in Lawrence, Kan.; Don Thompson in Sacramento, Calif.;and Alexa Olesen in Shanghai, China; and researchers Susan James in New York and Monika Mathur in Washington contributed to this report.


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Contact the Washington investigative team at DCinvestigations (at) ap.org.


Whether for athletics or age, Americans from teenagers to baby boomers are trying to get an edge by illegally using anabolic steroids and human growth hormone, despite well-documented risks. This is the first of a two-part series.


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Daily funerals now routine in Newtown


NEWTOWN, Conn. (AP) — A season that should be a time of joy has been marked by heart-wrenching loss in Newtown, as more victims from the massacre of 20 children and six adults are laid to rest.


At least nine funerals and wakes were held Wednesday for those who died when gunman Adam Lanza, armed with a military-style assault rifle, broke into Sandy Hook Elementary School Friday and opened fire. Lanza killed his mother at her home before the attack and committed suicide at the school as police closed in.


On Thursday, five funerals and six wakes were planned, and more tributes were scheduled for Friday and Saturday.


"The first few days, all you heard were helicopters," said Dr. Joseph Young, an optometrist who attended one funeral and would go to several more. "Now at my office all I hear is the rumble of motorcycle escorts and funeral processions going back and forth throughout the day."


At St. Rose of Lima Catholic Church on Wednesday, mourners arrived for Caroline Previdi, an auburn-haired 6-year-old with an impish smile, before the service had even ended for Daniel Barden, a 7-year-old who dreamed of being a firefighter.


"It's sad to see the little coffins," said the Rev. John Inserra, a Catholic priest who worked at St. Rose for years before transferring to a church in Greenwich.


"It's always hard to bury a child," Inserra said of the seemingly unrelenting cycle of sorrow and loss. "God didn't do this. God didn't allow this. We allowed it. He said, 'Send the little children to me.' But he didn't mean it this way."


Hundreds of firefighters formed a long blue line outside the church for Daniel's funeral. Two of his relatives work at the Fire Department of New York, and the gap-toothed redhead had wanted to join their ranks one day.


At Caroline's funeral, mourners wore pink ties and scarves — her favorite color — and remembered her as a New York Yankees fan who liked to kid around. "Silly Caroline" was how she was known to neighbor Karen Dryer.


"She's just a girl that was always smiling, always wanting others to smile," Dryer said.


Across town, at Christ the King Lutheran Church, hundreds gathered for the funeral of Charlotte Helen Bacon, many wearing buttons picturing the 6-year-old redhead. Speakers, including her grandfather, told of her love of wild animals, the family's golden retriever and the color pink.


She was "a beautiful little girl who could be a bit stubborn at times, just like all children," said Danbury resident Linda Clark as she left the service.


And in nearby Stratford, family and friends gathered to say goodbye to Victoria Soto, a first-grade teacher hailed as a hero for trying to shield her students, some of whom escaped. Musician Paul Simon, a family friend, performed "The Sound of Silence" at the service.


"She had the perfect job. She loved her job," said Vicky Ruiz, a friend since first grade.


In Woodbury, a line of colleagues, students and friends of slain Sandy Hook Principal Dawn Hochsprung, 47, wrapped around the block to pay their respects to the administrator, who rushed the gunman in an effort to stop him and paid with her life. U.S. Secretary of Education Arne Duncan attended the service.


"She loved kids. She'd do anything to help them and protect them," said Joann Opulski, of Roxbury.


The symbol of Christmas took on a new meaning in Newtown, where one memorial featured 26 Christmas trees — one for each victim at the school.


Edward Kish said he bought a Christmas tree two days before the shooting but hasn't had the heart to put it up or decorate it.


"I'll still put it up, probably," he said. "It doesn't seem right, and it doesn't seem like Christmas."


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Contributing to this report were Associated Press writers Allen G. Breed, Helen O'Neill, John Christoffersen, Katie Zezima and Pat Eaton-Robb in Newtown; Michael Melia in Hartford; and Larry Margasak in Washington and AP Business Writer Joshua Freed in Minneapolis.


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Park Geun-hye elected SKorea's 1st woman leader


SEOUL, South Korea (AP) — Conservative ruling party candidate Park Geun-hye was elected South Korea's first female president Wednesday, a historic win that came despite her past as the daughter of a divisive military strongman.


After five years of high tension under unpopular incumbent Lee Myung-bak, Park's win could also mean a new drive to start talks with rival North Korea, which launched a widely condemned long-range rocket last week. Pyongyang's state media, however, has repeatedly questioned the sincerity of her North Korea policy, which calls for greater engagement than her fellow party member, the hard-line Lee Myung-bak.


Her win is also history-making in Northeast Asia. No Korean woman is believed to have ruled since the ninth century. Park becomes the most powerful figure in a country where women are often paid less than men, are often trapped in low-paying jobs, despite first-class educations, and often struggle to raise families and pursue careers.


Analysts said her victory shows women can thrive in South Korea's tough political world.


After liberal candidate Moon Jae-in (Moon Jay-in) conceded defeat in a close race, Park said that she would dedicate herself to improving public livelihood and achieving national unity.


"I really thank you. This election is the people's victory," Park told a crowd of people packing a Seoul plaza.


With about 92 percent of votes counted, Park had won 51.6 percent to Moon's 47.9 percent, according to the state-run National Election Commission. Park is to take office in February when Lee ends his single five-year term.


Huge crowds lined up throughout the day, braving frigid weather to choose between Park and Moon, the son of North Korean refugees. Both candidates steered away from Lee's unpopular policies, including, most strikingly, his hard-line stance on North Korea.


Turnout was the highest in 15 years, and some analysts thought that might lift Moon, who is more popular with younger voters. Despite moving to the center, however, Park was carried by her conservative base of mainly older voters who remember with fondness what they see as the firm economic and security guidance of her father, the late President Park Chung-hee, who ruled South Korea as dictator for 18 years until his intelligence chief killed him during a drinking party in 1979.


Park says she is open to dialogue with North Korea but calls on Pyongyang to show progress in nuclear dismantlement for better relations with Seoul. North Korea described Park's stance as "deceptive," saying her North Korea policy is the same as Lee's.


Ties between the Koreas plummeted during Lee's term. Many voters blame the tension over the last five years for encouraging North Korea to conduct nuclear and missile tests — including a rocket launch last week by Pyongyang that outsiders call a cover for a banned long-range missile test. Some also say ragged North-South relations led to two attacks blamed on Pyongyang that killed 50 South Koreans in 2010.


Park will govern under the shadow of her father, who is both an asset and a soft spot. Many older South Koreans revere his strict economic policies and tough line against North Korea. But he's also loathed for his odious treatment of opponents, including claims of torture and snap executions.


Park's win means that South Korean voters believe she would evoke her father's strong charisma as president and settle the country's economic and security woes, according to Chung Jin-young, a political scientist at Kyung Hee University in South Korea.


"Park is good-hearted, calm and trustworthy," 50-year-old housewife Lee Hye-Young said at a polling station at a Seoul elementary school. "Also, I think Park would handle North Korea better. Moon would want to make too many concessions to North Korea."


North Korea forced itself as an issue in the closing days of campaigning with last week's rocket launch, which put a satellite into orbit but was condemned by the United Nations and others as a cover for testing long-range missile technology.


Park has raised the possibility of a meeting with North Korean leader Kim Jong Un, but only if it's "an honest dialogue on issues of mutual concern."


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Associated Press writers Youkyung Lee and Sam Kim contributed to this story.


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