Tapping citizen-scientists for a novel gut check

WASHINGTON (AP) — The bacterial zoo inside your gut could look very different if you're a vegetarian or an Atkins dieter, a couch potato or an athlete, fat or thin.

Now for a fee — $69 and up — and a stool sample, the curious can find out just what's living in their intestines and take part in one of the hottest new fields in science.

Wait a minute: How many average Joes really want to pay for the privilege of mailing such, er, intimate samples to scientists?

A lot, hope the researchers running two novel citizen-science projects.

One, the American Gut Project, aims to enroll 10,000 people — and a bunch of their dogs and cats too — from around the country. The other, uBiome, separately aims to enroll nearly 2,000 people from anywhere in the world.

"We're finally enabling people to realize the power and value of bacteria in our lives," said microbiologist Jack Gilbert of the University of Chicago and Argonne National Laboratory. He's one of a team of well-known scientists involved with the American Gut Project.

Don't be squeamish: Yes, we share our bodies with trillions of microbes, living communities called microbiomes. Many of the bugs, especially those in the intestinal tract, play indispensable roles in keeping us healthy, from good digestion to a robust immune system.

But which combinations of bacteria seem to keep us healthy? Which ones might encourage problems like obesity, diabetes or irritable bowel syndrome?

And do diet and lifestyle affect those microbes in ways that we might control someday?

Answering those questions will require studying vast numbers of people. Getting started with a grassroots movement makes sense, said National Institutes of Health microbiologist Lita Proctor, who isn't involved with the new projects but is watching closely.

After all, there was much interest in the taxpayer-funded Human Microbiome Project, which last summer provided the first glimpse of what makes up a healthy bacterial community in a few hundred volunteers.

Proctor, who coordinated that project, had worried "there would be a real ick factor. That has not been the case," she said. Many people "want to engage in improving their health."

Scott Jackisch, a computer consultant in Oakland, Calif., ran across American Gut while exploring the science behind different diets, and signed up last week. He's read with fascination earlier microbiome research: "Most of the genetic matter in what we consider ourselves is not human, and that's crazy. I wanted to learn about that."

Testing a single stool sample costs $99 in that project, but he picked a three-sample deal for $260 to compare his own bacterial makeup after eating various foods.

"I want to be extra, extra well," said Jackisch, 42. Differing gut microbes may be the reason "there's no one magic bullet of diet that people can eat and be healthy."

It's clear that people's gut bacteria can change over time. What this new research could accomplish is a first look at how different diets may play a role, said American Gut lead researcher Rob Knight of the University of Colorado, Boulder.

One challenge is making sure participants don't expect that a map of their gut bacteria can predict their future health, or suggest lifestyle changes, anytime soon.

"I understand I'm not going to be able to say, 'Oh, my gosh, I'll be susceptible to this,'" said Bradley Heinz, 26, a financial consultant in San Francisco. He is paying uBiome $119 to analyze both his gut and mouth microbiomes; just the gut is $69.

"The more people that participate, the more information comes out and the more that everybody benefits," he added.

Participants can sign up for either project via the social fundraising site Indiegogo.com over the next month. They also can send scrapings from the skin, mouth and other sites, to analyze that bacteria. Sign up enough family members or body sites, or be tracked over time, and the price can rise into the thousands. American Gut researchers plan some free testing for those who can't afford the fees, to try to increase the experiment's diversity.

Don't forget the pets: "We sleep with them, play with them, they often eat our food," said American Gut co-founder Jeff Leach, an anthropologist. What bacteria we have in common is the next logical question.

Already, American Gut researchers are preparing to compare what they find in the typical U.S. gut with a few hundred people in rural Namibia, who eat what's described as hunter-gatherer fare. Also, Leach will spend three months living in Namibia next year, and is storing his own stool samples for before-and-after comparison.

But diet isn't the only factor. Your bacterial makeup starts at birth: Babies absorb different microbes when they're born vaginally than when they're born by C-section, a possible explanation for why cesareans raise the risk for certain infections. Taking antibiotics, especially in early childhood, can alter this teeming inner world, and it's not clear if there are lasting consequences.

Then there's your environment, such as the infections spread in hospitals. In February, a new University of Chicago hospital building opens and Gilbert will test the surfaces, the patients and their health workers to see how quickly bad bugs can move in and identify which bacteria are protective.

Whatever the findings, all the research marks "a huge teachable moment" about how we interact with microbes, Leach said.

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EDITOR'S NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.

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Online:

www.indiegogo.com/americangut

www.indiegogo.com/ubiome

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GOP senator: Boehner’s budget proposal ‘will destroy American jobs’

South Carolina Republican Sen. Jim DeMint (Win McNamee/Getty Images)

WASHINGTON—South Carolina Republican Sen. Jim DeMint just gave Democrats a shiny new talking point.

The tea party-backed senator on Tuesday slammed House Republican leaders for the fiscal cliff proposal they offered earlier this week.

"Speaker [John] Boehner's $800 billion tax hike will destroy American jobs and allow politicians in Washington to spend even more, while not reducing our $16 trillion debt by a single penny," DeMint said in a statement. "This isn't rocket science. Everyone knows that when you take money out of the economy, it destroys jobs, and everyone knows that when you give politicians more money, they spend it. This is why Republicans must oppose tax increases and insist on real spending reductions that shrink the size of government and allow Americans to keep more of their hard-earned money."

Republican House leaders on Monday sent a letter to the White House with a plan to avoid a series of automatic tax increases and spending cuts set to begin on Jan. 1, 2013. With a 10-year price tag of about $2.2 trillion, the Republican proposal would raise federal revenue by closing loopholes and capping deductions within the tax code and making changes to entitlement programs. The letter was signed by seven House leaders, including Budget Committee Chairman Paul Ryan of Wisconsin and Ways and Means Committee Chairman Dave Camp of Michigan.

Democrats dismissed it quickly, calling for a bill that would increase taxes on households earning more than $250,000 per year and more federal spending on infrastructure, which were not included in the Republican plan.

DeMint's comment may be a bit of a sideshow—he's not directly involved in the negotiations and he represents just a single vote in Congress—but it's representative of how conservatives feel about the Republican proposal, and it offers ample ammunition to President Barack Obama and Democrats in the fiscal cliff media relations war.

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Gunman severely wounds Swedish woman in Pakistan

LAHORE, Pakistan (AP) — Pakistani police say a gunman on a motorcycle has shot and critically wounded a Swedish woman in the eastern city of Lahore.

Police officer Malik Awais says the woman, Bargetta Emmi, was getting out of her car in front of her home when she was shot in the neck by an unknown assailant Monday. Her servants reported the incident to police.

Awais says Emmi was director of FGA Church (Full Gospel Assemblies of Pakistan).

The Swedish Embassy in Islamabad confirmed a Swedish woman was shot and has severe injuries but provided no other details.

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Palace says Duchess of Cambridge expecting a baby

LONDON (AP) — Get the nursery ready: Prince William and his wife Catherine are expecting their first child.

St. James's Palace announced the pregnancy Monday, saying that the Duchess of Cambridge — formerly known as Kate Middleton — has a severe form of morning sickness and is currently in a London hospital. William is at his wife's side.

The palace said that since the pregnancy is in its "very early stages," the 30-year-old duchess is expected to stay in the hospital for several days and will require a period of rest afterward.

William is second in line to the throne after his father, Prince Charles, so the couple's first child would normally become monarch in due course.

In recent days, Middleton has kept up royal appearances — recently playing field hockey with schoolchildren at her former school.

The confirmation of her pregnancy caps a jam-packed year of highs and lows for the young royals, who were married in a lavish ceremony at Westminster Abbey last year.

They have traveled the world extensively as part of Queen Elizabeth II's diamond jubilee celebrations and weathered the embarrassment of a nude photos scandal, after a tabloid snapper published topless images of the duchess.

Joe Little, managing editor of Majesty magazine, said the news bookended a year that saw the royal family riding high in popular esteem after celebrations of Queen Elizabeth II's 60 years on the throne.

"We're riding on a royal high at the moment at the end of the diamond jubilee year," he said. "People enjoyed the royal romance last year and now there's this. It's just a good news story amid all the doom and gloom."

Speculation about when William and his bride would start a family has been rife since their wedding.

William's mother — the late Princess Diana — got pregnant just four months after her wedding in 1981. Like Kate, Diana reportedly suffered from morning sickness for months and complained of constant media attention.

"The whole world is watching my stomach", Diana once said.

American tabloid speculation of the pregnancy has been rampant for months. One newspaper even cited anonymous sources talking about Kate's hormone levels. Others have focused on the first signs of the royal bump.

News of the pregnancy drew congratulations from across the U.K. establishment.

The palace said the royal family was "delighted" by the news, while Prime Minister David Cameron wrote on Twitter that the royals "will make wonderful parents."

Not only are the attractive young couple popular — with William's easy common touch reminding many of his mother, the late Princess Diana — but their child is expected to play an important role in British national life for decades to come.

Whether boy or girl, the child will be next in line behind William in the line of succession to the throne, Cabinet Office officials have said.

Leaders of Britain and the 15 former colonies that have the monarch as their head of state agreed in 2011 to new rules which give females equal status with males in the order of succession.

Although none of the nations had legislated to make the change as of September 2012, the British Cabinet Office confirmed that this is now the de-facto rule.

On the couple's tour of Malaysia, Singapore, the Solomon Islands and Tuvalu in September, William reportedly said he hoped he and Kate would have two children.

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Associated Press writers Jill Lawless and Paisley Dodds contributed to this report.

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US envoy hits China's stand in UN climate talks

DOHA, Qatar (AP) — The United States on Monday challenged China's view of how to split the burden of curbing carbon emissions, saying the rich-poor divide in past climate agreements has no place in a future pact to fight global warming.

The U.S. envoy to international climate talks in Qatar, Todd Stern, said that the next climate deal must be based on "real-world" considerations, not "an ideology that says we're going to draw a line down the middle of the world."

Beijing wants to maintain a division between developed and developing nations, setting out softer emissions-cutting requirements for poorer countries. It notes that despite its roaring growth, millions of Chinese still live in poverty, and emission limits would slow the economic expansion that would improve their lot.

The climate pact is one of the key issues under discussion at the United Nations-led talks, which have entered their second week. Last year, governments agreed it should be adopted by 2015 and take effect five years later. The U.S. didn't join the only binding emissions agreement to date, the 1997 Kyoto Protocol, because it only covered industrialized nations and not major developing countries like India and China, which is now the world's biggest carbon emitter.

"It's going to be an enormously challenging, and I think enormously important, task to get this agreement right," Stern said.

The dispute will not be resolved in Doha, where negotiators are focusing on side issues including aid to help poor countries shift to renewable energy and protect themselves from rising sea levels and other effects of global warming.

They also plan to extend the Kyoto agreement, which expires this year, until a new treaty is in place. But several nations including Japan and New Zealand don't want to be part of the extension, meaning it will only cover European countries and Australia, which account for less than 15 percent of global emissions.

Even that has been complicated by disputes over whether emissions allowances granted to Poland and other eastern European countries to offset the early economic fallout after the collapse of communism should carry over into the second phase.

U.N. climate chief Christiana Figueres told reporters that people shouldn't expect the talks to yield success overnight because they deal with "a complete transformation of the economic structure of the world" — a shift from fossil fuels to renewable energy.

"What gives me frustration is the fact that we are very far behind what science tells us we should be doing," she said. "What gives me hope is the fact that ... over the past two to three years, this process has had more progress than it did in the past 10."

EU climate commissioner Connie Hedegaard said she would raise a host of side issues at a round-table discussion with environment ministers this week, including how to reduce subsidies for fossil fuels. Even though the G-20 group of industrialized and emerging nations called for the phasing-out of such subsidies already in 2009, the International Energy Agency recently said they grew 30 percent last year to $523 billion, primarily due to increases in the Middle East and Africa.

"It has been discussed for three years or more," Hedegaard said. "Now we need to start the phasing out."

In addition to the fuel subsidies in developing countries, rich nations in 2011 gave more than $58 billion in tax breaks and other production subsidies to oil and coal companies, according to a report Monday by Oil Change International, an advocacy group for clean energy. The U.S. figure was $13 billion.

Stern said that President Barack Obama has pushed for reducing fossil fuel subsidies domestically and internationally.

"It's difficult in other countries and it's difficult at home to carry it forward because there are a lot of entrenched interests," he said.

While he highlighted U.S. initiatives undertaken during Obama's first term — such as sharply increasing fuel efficiency standards for cars and trucks and investing in green energy — Stern noted that more ambitious climate legislation had stalled in Congress and that shifts in the U.S. climate position should not be expected following Obama's re-election.

"I don't know if I would think about this in terms of a different tone here," he said. "The U.S. has done quite significant things in the president's first four years."

Climate talks are scheduled to end on Friday.

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Pacific nations alarmed by tuna overfishing

MANILA, Philippines (AP) — Pacific island nations and environmentalists raised an alarm Sunday over destructive fishing methods and overfishing that they say are threatening bigeye tuna — the fish popular among sushi lovers worldwide.

Palau fisheries official Nanette Malsol, who leads a bloc of Pacific island nations, said at the start of a weeklong tuna fisheries conference in Manila that large countries should cut back on fishing, curb the use of destructive fishing methods and respect fishing bans to allow tuna stocks to be replenished in the Pacific, which produces more than 60 percent of the world's tuna catch.

The annual meeting of the Western and Central Pacific Fisheries Commission, which regulates commercial fishing in the vast expanse of waters from Indonesia to Hawaii, is to approve steps aimed at protecting the bigeye and other threatened tuna species, along with giant whale sharks. More than 600 delegates from about 40 Asian and Western countries, along with environmental activists, are attending.

Malsol said she expects heated debate. Proponents of the multibillion-dollar fishing industry have squared off with conservationists in the past over the best ways to protect the bigeye and other species without considerably setting back the lucrative business.

Bigeye and yellowfin tuna, which can grow to 8-9 feet (2.4-2.7 meters) long and weigh more than 450 pounds (200 kilograms), are not in immediate danger of being wiped out, but have been hit hard by overfishing. The fish are used mostly for steaks, and in the case of bigeye, sushi.

The fisheries business in the western and central Pacific region, estimated to be worth about $5 billion annually, has drawn increasing numbers of industrial fishing fleets, which have caused tuna stocks to fall since the 1960s.

"This week it's up to the big fishing nations to show the world what they are going to do to cut overfishing of bigeye tuna," Malsol said.

Repeated telephone calls and messages to industry officials seeking comment Sunday were not answered.

Many fleets are using so-called "fish aggregation devices" — various types of floats which are used to lure vast numbers of tuna. When schools of tuna have massed under the devices, fishing vessels alerted by sensors approach and scoop up their catch with giant nets.

Between 47,000 and 105,000 fish aggregation devices, made from bamboo, palm fronds, plastic or old nets, have been deployed worldwide to attract a wide variety of marine life. The method is used to catch nearly half of the world's tuna and has contributed to the overfishing of bigeye tuna across the Pacific Ocean, according to the U.S.-based Pew Environment Group.

Aside from tuna, sea turtles, sharks and juvenile fish have often been caught and killed.

"The deployment of tens of thousands of drifting fish aggregating devices in the world's oceans with little to no oversight is extremely worrisome," said Amanda Nickson of the Pew Environment Group.

"The fishing industry is not currently required to account for its use of FADs. It is being allowed to gamble with the health of the ocean, and it is time for governments to require full accountability and management of this proliferating and risky fishing gear," Nickson said.

Conservation efforts, however, have been tough to implement and have sparked disagreements.

Greepeace activists said they will submit evidence to the fisheries commission detailing violations of regional tuna fishing rules by Southeast Asian countries including allowing fishing vessels to operate on the high seas without permits and required observers onboard.

A decision by the fisheries commission to exempt the Philippines from purse seine fishing — an industrial technique in which a net is used to surround and capture schools of fish — in a large swath of the Pacific has sparked complaints from other nations.

The exemption was given to discourage Philippine fleets from fishing in territorial waters off the country's eastern coast, which are known spawning grounds for tuna that later spread out to the Pacific.

Philippine Agriculture Secretary Proceso Alcala asked the fishing commission to extend the exemption, which he said started last October and would end in February next year.

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7 Quirky Christmas Gift Ideas

‘Tis the season to give…bacon-shaped Christmas tree ornaments? Stocking-stuffer candy simulating black lumps of coal? Crime scene tape for wrapping packages? How about a dreidel with Santa’s picture on it?

Yes to all these and more, say fans of quirky gifts.

Online retailers specializing in leg-lamps–the kind made famous by the movie “A Christmas Story”–and in Emergency Santa Kits say business is brisk.

Seattle novelty-seller Archie McPhee, for instance, which makes the Emergency Santa Kit, reports its business is up 20 percent from last year. Each Kit contains an inflatable white beard and red hat. “It’s in case you’re ever on an airplane flight and you suddenly have to play Santa,” explains McPhee’s spokesperson and self-styled Director of Awesomeness, David Wall.

Anything involving bacon, he says, has been selling well—so well that McPhee dedicates a portion of its website to bacon-inspired items, including candy canes, ornaments and toothpaste.

“People just naturally enjoy bacon,” he says. “At a time when everybody is so health-conscious, it’s become a kind of ‘rebel’ food. It seems naughty. To our customers, bacon has become a sign of rebellion against the status quo.”

Online retailer Perpetual Kid sells black, lump-shaped candy-coal. Says vice president Wendy Paula, “We’re definitely seeing people looking for silly products this year—things you buy for their ‘smile value.’ Candy coal has been Christmas season favorite for us for years.” She herself grew up with it. “It’s just got to be in your stocking.”

Unlike some novelty purveyors, says Paula, Perpetual Kid, shies away from anything that could be considered offensive or in bad taste. Not so Things You Never Knew Existed, a website that appears to have cornered the market on flatulent-Santa items. These include a Pull My Finger Santa’ and a spherical ornament simulating Santa’s buttocks.

For a slideshow of quirky items appropriate (or not) for holiday giving, read on.

“The world’s only beanie with a built-in beard,” trumpets website Fab.com. The tightly-knit cap and attached face-warmer is perfect for snowball fights, says the site, and will keep any chin warm on the coldest of days. “A great gift for the facial-hair challenged.” ($ 29)

Website for Perpetual Kid calls this cinnamon-flavored candy coal the perfect stocking stuffer: “You can always tell who has been naughty Christmas morning, since this candy will temporarily turn your mouth blue! Great for office parties and gift exchanges.” ($ 4.49)

The dreidel depicts Santa on one side, a Christmas tree on the other. “Don’t choose between Christmas and Hanukkah,” says Archie McPhee’s website. “Choose Chrismukkah! Imagine the fun you’ll have playing the dreidel game by the light of the menorah while waiting for Santa and his reindeer to arrive.” ($ 4.50)

“Big bacon flavor in a candy cane,” promises Archie McPhee. Canes come in both regular size and colossal. Of the collosal, the site says, “If there were a king of bacon, this would be his scepter. It’s bacon-y Christmas perfection.” For proper dental hygiene, you’ll want to brush afterwards with bacon-flavored toothpaste, also available on the website. (Colossal cane, $ 5.00)

Archie McPhee doesn’t explicitly recommend this tape for sealing up the seams of wrapping paper you have used to decorate your gifts—but just think how festive and disturbing it will look underneath the tree. Alternatively, says the website, you can use it to “mark off the scene of an itty-bitty murder.” ($ 4.50).

Christmas-in-a-tin, Archie McPhee calls its Emergency Santa Kit. “Let’s say you’re on a long flight, and everyone around you is frowning and grumpy,” says the site. Each Kit contains an inflatable white beard and jaunty Santa hat. “Just open the tin, inflate the beard, put on the hat, and shake your belly like a bowl full o’ jelly.” Before you know it, “Everyone will be sitting on your lap.” ($ 12.00)

The morning after Christmas you’ll run no risk of oversleeping if someone has been kind enough to give you this especially aggressive alarm clock. Hit its snooze button once too often, and Clocky takes matters into its own hands (or feet) by rolling away from you on powered wheels. “It will literally jump off your nightstand and scurry way, forcing you to get up out of bed and go get it to turn it off,” says a spokesperson for novelty retailer Fab.com. ($ 45.00)

Linux/Open Source News Headlines – Yahoo! News

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Letterman up for jabs with Kennedy Center Honors

WASHINGTON (AP) — David Letterman's "stupid human tricks" and Top 10 lists are being vaulted into the ranks of cultural achievements as the late night comedian receives this year's Kennedy Center Honors with six other artists.

Letterman will share the honors Sunday night with Dustin Hoffman, the rock band Led Zeppelin, Chicago bluesman Buddy Guy and ballerina Natalia Makarova.

President Barack Obama will host the honorees at the White House before they are saluted by fellow performers in a show to be broadcast Dec. 26 on CBS.

Secretary of State Hillary Rodham Clinton says she and Letterman have a history. At a dinner for the artists Saturday night, she said she's been a guest on his show several times, but if you include references to her pant suits, she's on every week.

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Asperger's dropped from revised diagnosis manual

CHICAGO (AP) — The now familiar term "Asperger's disorder" is being dropped. And abnormally bad and frequent temper tantrums will be given a scientific-sounding diagnosis called DMDD. But "dyslexia" and other learning disorders remain.

The revisions come in the first major rewrite in nearly 20 years of the diagnostic guide used by the nation's psychiatrists. Changes were approved Saturday.

Full details of all the revisions will come next May when the American Psychiatric Association's new diagnostic manual is published, but the impact will be huge, affecting millions of children and adults worldwide. The manual also is important for the insurance industry in deciding what treatment to pay for, and it helps schools decide how to allot special education.

This diagnostic guide "defines what constellations of symptoms" doctors recognize as mental disorders, said Dr. Mark Olfson, a Columbia University psychiatry professor. More important, he said, it "shapes who will receive what treatment. Even seemingly subtle changes to the criteria can have substantial effects on patterns of care."

Olfson was not involved in the revision process. The changes were approved Saturday in suburban Washington, D.C., by the psychiatric association's board of trustees.

The aim is not to expand the number of people diagnosed with mental illness, but to ensure that affected children and adults are more accurately diagnosed so they can get the most appropriate treatment, said Dr. David Kupfer. He chaired the task force in charge of revising the manual and is a psychiatry professor at the University of Pittsburgh.

One of the most hotly argued changes was how to define the various ranges of autism. Some advocates opposed the idea of dropping the specific diagnosis for Asperger's disorder. People with that disorder often have high intelligence and vast knowledge on narrow subjects but lack social skills. Some who have the condition embrace their quirkiness and vow to continue to use the label.

And some Asperger's families opposed any change, fearing their kids would lose a diagnosis and no longer be eligible for special services.

But the revision will not affect their education services, experts say.

The new manual adds the term "autism spectrum disorder," which already is used by many experts in the field. Asperger's disorder will be dropped and incorporated under that umbrella diagnosis. The new category will include kids with severe autism, who often don't talk or interact, as well as those with milder forms.

Kelli Gibson of Battle Creek, Mich., who has four sons with various forms of autism, said Saturday she welcomes the change. Her boys all had different labels in the old diagnostic manual, including a 14-year-old with Asperger's.

"To give it separate names never made sense to me," Gibson said. "To me, my children all had autism."

Three of her boys receive special education services in public school; the fourth is enrolled in a school for disabled children. The new autism diagnosis won't affect those services, Gibson said. She also has a 3-year-old daughter without autism.

People with dyslexia also were closely watching for the new updated doctors' guide. Many with the reading disorder did not want their diagnosis to be dropped. And it won't be. Instead, the new manual will have a broader learning disorder category to cover several conditions including dyslexia, which causes difficulty understanding letters and recognizing written words.

The trustees on Saturday made the final decision on what proposals made the cut; recommendations came from experts in several work groups assigned to evaluate different mental illnesses.

The revised guidebook "represents a significant step forward for the field. It will improve our ability to accurately diagnose psychiatric disorders," Dr. David Fassler, the group's treasurer and a University of Vermont psychiatry professor, said after the vote.

The shorthand name for the new edition, the organization's fifth revision of the Diagnostic and Statistical Manual, is DSM-5. Group leaders said specifics won't be disclosed until the manual is published but they confirmed some changes. A 2000 edition of the manual made minor changes but the last major edition was published in 1994.

Olfson said the manual "seeks to capture the current state of knowledge of psychiatric disorders. Since 2000 ... there have been important advances in our understanding of the nature of psychiatric disorders."

Catherine Lord, an autism expert at Weill Cornell Medical College in New York who was on the psychiatric group's autism task force, said anyone who met criteria for Asperger's in the old manual would be included in the new diagnosis.

One reason for the change is that some states and school systems don't provide services for children and adults with Asperger's, or provide fewer services than those given an autism diagnosis, she said.

Autism researcher Geraldine Dawson, chief science officer for the advocacy group Autism Speaks, said small studies have suggested the new criteria will be effective. But she said it will be crucial to monitor so that children don't lose services.

Other changes include:

—A new diagnosis for severe recurrent temper tantrums — disruptive mood dysregulation disorder. Critics say it will medicalize kids' who have normal tantrums. Supporters say it will address concerns about too many kids being misdiagnosed with bipolar disorder and treated with powerful psychiatric drugs. Bipolar disorder involves sharp mood swings and affected children are sometimes very irritable or have explosive tantrums.

—Eliminating the term "gender identity disorder." It has been used for children or adults who strongly believe that they were born the wrong gender. But many activists believe the condition isn't a disorder and say calling it one is stigmatizing. The term would be replaced with "gender dysphoria," which means emotional distress over one's gender. Supporters equated the change with removing homosexuality as a mental illness in the diagnostic manual, which happened decades ago.

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

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'Cliff' talks: Geithner invites GOP counteroffer

WASHINGTON (AP) -- President Barack Obama is ready to entertain Republican proposals for spending cuts, but GOP lawmakers must first commit to higher tax rates on the rich and specify what additional spending cuts they want in a deal to avoid the looming "fiscal cliff," Treasury Secretary Timothy Geithner said.

"The ball really is with them now," Geithner, one of the president's chief negotiators with Capitol Hill, said during appearances on five Sunday talk shows. He acknowledged that Republicans are "having a tough time trying to figure out what they can do, what they can get support from their members for." The White House "might need to give them a little more time to figure out where they go next."

Geithner presented congressional leaders Thursday with Obama's postelection blueprint for averting the combination of hundreds of billions in tax increases and spending cuts that will take effect beginning in January if Washington doesn't act to stop it.

But House Speaker John Boehner, R-Ohio, dismissed the plan as "not serious," merely a Democratic wish list that couldn't pass his chamber.

As outlined by administration officials, the plan calls for nearly $1.6 trillion in new tax revenue over the next decade, while making $600 billion in spending cuts, including $350 billion from Medicare and other health programs. But it also contains $200 billion in new spending on jobless benefits, public works and aid for struggling homeowners — and would make it virtually impossible for Congress to block Obama's ability to raise the debt ceiling.

"I was just flabbergasted," Boehner said, describing his meeting with Geithner. "I looked at him and I said, 'You can't be serious?" The speaker, noting the short time between the Nov. 6 election and the new year, said time has been lost so far "with this nonsense."

With the George W. Bush-era tax cuts expiring and across-the-board spending cuts hitting in under a month, Boehner said, "I would say we're nowhere, period." He said "there's clearly a chance" of going over the cliff.

But Geithner, also in interviews that were taped Friday, offered a somewhat rosier view. "I think we're far apart still, but I think we're moving closer together," he said.

He called the back-and-forth "normal political theater," voicing confidence a bargain can be struck in time, and said all that's blocking it is GOP acceptance of higher tax rates on the wealthy.

"It's welcome that they're recognizing that revenues are going to have to go up. But they haven't told us anything about how far rates should go up ... (and) who should pay higher taxes?" Geithner said.

He said so far, GOP proposals demonstrate "political math, not real math."

Republican leaders have said they accept higher tax revenue overall, but only through what they call tax reform — closing loopholes and limiting deductions — and only coupled with tough measures to curb the explosive growth of Medicare, Medicaid and Social Security.

But Geithner insisted that there's "no path to an agreement (without) Republicans acknowledging that rates have to go up for the wealthiest Americans." He also said the administration would only discuss changes to Social Security "in a separate process," not in talks on the fiscal cliff.

As to spending, Geithner said if Republicans don't think Obama's cutting enough spending, they should make a counter-proposal. "They might want to do some different things. But they have to tell us what those things are," he said.

Republicans have also rejected Obama's debt ceiling proposal. Geithner noted it was Senate Minority Leader Mitch McConnell who first suggested it, as a temporary measure in the summer 2011 deficit deal. The administration would make it permanent. "It was a very smart way by a senator with impeccable Republican credentials to ... lift this ... periodic threat of default," Geithner said. "And that's an essential thing for us."

Geithner voiced sympathy for Republicans leaders, saying they're caught between the voters' endorsement of higher taxes on the rich and a House GOP caucus that thinks all tax increases are job-killers.

"They really are in a difficult position," he said. "And they're going to have to figure out their politics of what they do next."

In the past week, Obama has held a series of campaign-style appearances — including one in a swing district in Pennsylvania — urging lawmakers to accept a Senate-passed measure extending tax cuts for all but the top 2 percent of wage-earners. He'll continue the effort when he meets with governors on Tuesday and speaks to the Business Roundtable on Wednesday.

GOP leaders contend letting top-end tax cuts run out would hit small businesses and cost jobs.

Still, Sen. Lamar Alexander, R-Tenn., said Republicans will "hold our nose and raise some revenues" if the result is a deal that reins in runaway debt. But he said the onus is on Obama to knuckle down to talks.

"I'm ready for the president to get off the campaign trail, and get in the White House and get a result," Alexander told reporters in Nashville on Saturday. "Right now he's got the presidential limousine headed toward the fiscal cliff with his foot on the accelerator."

Geithner appeared on CBS' "Face the Nation," NBC's "Meet the Press," CNN's "State of the Union," ABC's "This Week," and "Fox News Sunday." Boehner was on Fox, too.

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Associated Press Writer Erik Schelzig in Nashville contributed to this report.

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