Soldier with new arms determined to be independent

BALTIMORE (AP) — After weeks of round-the-clock medical care, Brendan Marrocco insisted on rolling his own wheelchair into a news conference using his new transplanted arms. Then he brushed his hair to one side.

Such simple tasks would go unnoticed in most patients. But for Marrocco, who lost all four limbs while serving in Iraq, these little actions demonstrate how far he's come only six weeks after getting a double-arm transplant.

Wounded by a roadside bomb in 2009, the former soldier said he could get by without legs, but he hated living without arms.

"Not having arms takes so much away from you. Even your personality, you know. You talk with your hands. You do everything with your hands, and when you don't have that, you're kind of lost for a while," the 26-year-old New Yorker told reporters Tuesday at Johns Hopkins Hospital.

Doctors don't want him using his new arms too much yet, but his gritty determination to regain independence was one of the chief reasons he was chosen to receive the surgery, which has been performed in the U.S. only seven times.

That's the message Marrocco said he has for other wounded soldiers.

"Just not to give up hope. You know, life always gets better, and you're still alive," he said. "And to be stubborn. There's a lot of people who will say you can't do something. Just be stubborn and do it anyway. Work your ass off and do it."

Dr. W.P. Andrew Lee, head of the team that conducted the surgery, said the new arms could eventually provide much of the same function as his original arms and hands. Another double-arm transplant patient can now use chopsticks and tie his shoes.

Lee said Marrocco's recovery has been remarkable, and the transplant is helping to "restore physical and psychological well-being."

Tuesday's news conference was held to mark a milestone in his recovery — the day he was to be discharged from the hospital.

Next comes several years of rehabilitation, including physical therapy that is going to become more difficult as feeling returns to the arms.

Before the surgery, he had been living with his older brother in a specially equipped home on New York's Staten Island that had been built with the help of several charities. Shortly after moving in, he said it was "a relief to not have to rely on other people so much."

The home was heavily damaged by Superstorm Sandy last fall.

"We'll get it back together. We've been through a lot worse than that," his father, Alex Marrocco, said.

For the next few months, Marrocco plans to live with his brother in an apartment near the hospital.

The former infantryman said he can already move the elbow on his left arm and rotate it a little bit, but there hasn't been much movement yet for his right arm, which was transplanted higher up.

Marrocco's mother, Michelle Marrocco, said he can't hug her yet, so he brushes his left arm against her face.

The first time he moved his left arm was a complete surprise, an involuntary motion while friends were visiting him in the hospital, he said.

"I had no idea what was going through my mind. I was with my friends, and it happened by accident," he recalled. "One of my friends said 'Did you do that on purpose?' And I didn't know I did it."

Marrocco's operation also involved a technical feat not tried in previous cases, Lee said in an interview after the news conference.

A small part of Marrocco's left forearm remained just below his elbow, and doctors transplanted a whole new forearm around and on top of it, then rewired nerves to serve the old and new muscles in that arm.

"We wanted to save his joint. In the unlucky event we would lose the transplant, we still wanted him to have the elbow joint," Lee said.

He also explained why leg transplants are not done for people missing those limbs — "it's not very practical." That's because nerves regrow at best about an inch a month, so it would be many years before a transplanted leg was useful.

Even if movement returned, a patient might lack sensation on the soles of the feet, which would be unsafe if the person stepped on sharp objects and couldn't feel the pain.

And unlike prosthetic arms and hands, which many patients find frustrating, the ones for legs are good. That makes the risks of a transplant not worth taking.

"It's premature" until there are better ways to help nerves regrow, Lee said.

Now Marrocco, who was the first soldier to survive losing all four limbs in the Iraq War, is looking forward to getting behind the wheel of his black 2006 Dodge Charger and hand-cycling a marathon.

Asked if he could one day throw a football, Dr. Jaimie Shores said sure, but maybe not like Baltimore Ravens quarterback Joe Flacco.

"Thanks for having faith in me," Marrocco interjected, drawing laughter from the crowd.

His mother said Marrocco has always been "a tough cookie."

"He's not changed that, and he's just taken it and made it an art form," Michelle Marrocco said. "He's never going to stop. He's going to be that boy I knew was going to be a pain in my butt forever. And he's going to show people how to live their lives."

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Associated Press Chief Medical Writer Marilynn Marchione in Milwaukee and AP writer David Dishneau in Hagerstown, Md., contributed to this report.

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Slain doctor remembered for faith and zest for life

He was remembered by patients and colleagues as a caring and talented physician, one who followed his father's footsteps into medicine. And his friends spoke of how devout he was in his Jewish faith as well as of his kindness and his zest for life.

"He was just a good soul," one colleague and friend said.

Now police are trying to determine why someone would walk into the urologist's Newport Beach offices and shoot him to death.

Dr. Ronald Gilbert was killed Monday in an exam room of his practice in the heart of a bustling medical community, allegedly gunned down by a 75-year-old retired barber who recently told a neighbor that he had cancer and didn't expect to live much longer.

Stanwood Fred Elkus of Lake Elsinore was arrested within seven minutes of the first call from the medical offices next to Hoag Memorial Hospital, authorities said. Elkus, who is being held on $1-million bail and is expected to be in court Wednesday, was described by neighbors as having problems with his prostate and undergoing surgeries. He recently told a neighbor that he believed he would soon be dead.

One neighbor, Sherry Martin, said that Elkus would always ride through his Riverside County neighborhood on his bike, wearing a baseball cap. Sometimes, he offered to give haircuts to neighbors.

But Elkus had run-ins with other neighbors in the past, including a dispute over bushes in a woman's backyard that was exacerbated into more than a year of Elkus allegedly taunting her family. Melissa Evans, 36, said that he would pass by on his bike or in his car, staring them down, or would harass their dog late at night.

"He just couldn't let it go," she said. "He couldn't let go of something so small."

Evans said the erratic behavior was so unsettling that she, her husband and three sons moved to a community 10 miles away. But even after they moved to Wildomar, she said, he was spotted driving by their new home about three months ago.

Gilbert's death, however, has prompted a different sort of reaction: an outpouring of warm memories and shock at his violent death.

Colleagues said Gilbert, 52, had an "impeccable" reputation, having worked as the chief of urology at Hoag Hospital from 1998 to 2002 and as a volunteer faculty member at UC Irvine's Medical School, from which he graduated in 1987. His research interests included sexual dysfunction and bladder and prostate cancer.

He had also developed a spray designed to treat premature ejaculation. Dr. Eugene Rhee, president of the California Urological Assn., said Gilbert was especially proud of that work. "It was a much-needed medication," Rhee said.

Bruce Sechler, 61, had been Gilbert's patient for about seven years. "Right off the bat," the Huntington Beach resident said, "he could put you at ease and make you feel like he was genuinely concerned about you as a person and your needs."

Gerry Crews, a close friend who had known Gilbert since their high school days in Whittier, said that he knew how to have fun too, and loved classic rock. He sang in a garage band with Crews' older brother in high school. But he also had a laser focus during his undergraduate years at UC Santa Barbara so that he could achieve his ambition of becoming a doctor like his father.

"I was not a hard worker in college; he was," Crews, 51, said. "From the start, he planned to go to medical school and he worked very hard to get into medical school."

Even with his focus on medicine, friends recalled that he had a unique ability to keep an open and balanced life. He held on to a deep appreciation for music, and would have jam sessions with his sons, who played guitar and drums. He also traveled and snow-skied.

Faith had also been a pillar in his life, friends say, influencing his choices and how he approached the world.

Crews said he moved from Tustin — where his old friends lived nearby — to Huntington Harbour so that he could be closer to his synagogue and walk there on the Sabbath. He had also retrofitted his kitchen to prepare kosher meals. And his oldest son had recently been living in Israel.

"On Saturdays," Gilbert's neighbor Betty Combs recalled, "they dressed to the nines and walked to synagogue."

Those who knew him also said he had built up a stable of friends over the years because he was willing to share his time and knowledge. Crews remembered him being a source of support on the two times his wife had breast cancer.

"He was generous of himself," said Tom Mayer, a longtime friend and a registered nurse who once worked at Hoag Hospital. "He gave you everything."

When he heard of a shooting at the Newport Beach medical campus, Mayer, 49, drove straight there from work in Mission Viejo, still dressed in his scrubs. He had called and texted Gilbert, but there was no reply. The next day, he recalled the impact Gilbert's unconditional friendship had on his life.

"He was a light," Mayer said. "He was someone who could be turned to, just to talk.... My life wouldn't be the same if I never met Ron."

nicole.santacruz@latimes.com

rick.rojas@latimes.com

Times Community News staff writers Jill Cowan and Lauren Williams contributed to this report.

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The Female Factor: Chinese Courts Turn a Blind Eye to Abuse

BEIJING — Before they married in 2009, Tan Yong admitted to Li Yan that he had beaten his three previous wives. He promised to change.

The promises didn’t last, said Li Dehuai, Ms. Li’s brother. Soon after the wedding, Mr. Tan began abusing his wife.

“He stubbed out cigarettes on her face and legs. He would take her hair and hit her head against the wall. He locked her on the balcony for hours in the winter,” said Mr. Li, speaking by telephone from Chongqing in southwestern China. The abuse went on for more than a year.

Today, Mr. Tan is dead, beaten to death by Ms. Li with the barrel of his air gun during an argument in November 2010, and Mr. Li is trying to save his sister’s life as she sits in a jail in Sichuan Province awaiting execution for murder. The case has caused an outcry among Chinese legal experts and feminists, who say it underscores the severe sentences often imposed on women who fight back, injuring or killing abusive husbands.

“Li Yan’s case tells people that extreme tragedy will happen if an abused woman cannot get effective help from the neighborhood committee, the women’s federation, the police,” said Feng Yuan, of the Anti-Domestic Violence Network, based in Beijing.

“When power cannot deliver justice, abused women will find their own way of achieving justice, sadly and wrongly,” Ms. Feng said.

Chinese law requires that a history of domestic abuse be considered in such cases. Ms. Li’s was especially gruesome: After killing her husband (which she confessed to early, asking a neighbor to call the police), she cut him up and boiled some of the parts. If that is hard to excuse, consider this, said Ms. Feng: She wasn’t in her right mind.

“There’s something called abused women’s syndrome, and she had it. A woman like that may lose her reason and lose control,” said Ms. Feng, one of hundreds of people petitioning the courts to retry Ms. Li, this time taking the abuse into proper consideration. This was not done the first time, making Ms. Li’s case a miscarriage of justice, they say.

Others who have joined the appeal include lawyers, deputies to the National People’s Congress and Amnesty International, which last week issued an urgent action call for the Chinese authorities not to execute Ms. Li. The sentence could be carried out any day now, activists say, probably before the Lunar New Year’s Eve on Feb. 9.

Women’s jails are filled with women who have injured or killed abusive husbands, according to the Anti-Domestic Violence Network, citing studies by local women’s federations and scholars. They account for 60 percent of inmates in one jail in Anshan, in Liaoning Province, and 80 percent of women serving heavy sentences in a jail in Fuzhou, in Fujian Province.

In a study by Xing Hongmei of China Women’s University, of 121 female inmates in a Sichuan jail who were serving time for attacking or killing abusive partners, 71 were originally sentenced to life in prison or to death (sometimes commuted, delayed or overturned on appeal), and 28 more were sentenced to at least 10 years. This means more than 80 percent received the heaviest possible sentences for murder or bodily harm, the study said.

For months before she killed Mr. Tan, Ms. Li sought help from the authorities in Anyue County, in Sichuan Province, where they lived, her brother said.

“She telephoned the police in, I think, May 2010, after a beating, but they said it was an affair between married people and hung up,” he said.

She went to her neighborhood committee. “They told her to go to the women’s association. The women’s association told her to go to the police. The police told her to go to the neighborhood committee,” and so it continued, he said. “She was sent from place to place and didn’t know what to do.”

Officials at the local justice department whom she asked about divorce told her that unless Mr. Tan agreed, she could be left destitute. She was better off tolerating the abuse, they advised.

There was some documentation of the abuse, including police photographs of injuries and a medical report after hospital treatment, said Mr. Li. But both the Sichuan court that sentenced her and the Supreme Court in Beijing, which reviews all death sentences — Mr. Li and activists say it upheld his sister’s sentence last week — failed to take this into account when sentencing her, Mr. Li said.

“We all hoped the court would recognize the torture she’d suffered in those years,” he said. “But it didn’t.”

“I know what my sister did was wrong, but since this happened, I have studied many cases of domestic abuse, and I know her situation is not uncommon,” he said.

He has not yet been able to tell their mother, or Ms. Li’s 18-year-old daughter from a previous marriage, that Ms. Li faces imminent execution.

“I think my niece knows, somehow,” he said. “But my mother couldn’t take it.”

Their father, who died last year, had worked in the same silk factory as Ms. Li and Mr. Tan, and had disliked the man from the start, Mr. Li said.

“He was so depressed at her situation,” he said. “I think he died of grief.”

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Troubled smartphone pioneer RIM prepares to raise the curtain on BlackBerry 10

NEW YORK, N.Y. – After several technical blunders, two unexpected delays and one major shakeup in its leadership, BlackBerry-maker Research In Motion is about to raise the curtain for its new smartphone devices in hopes that consumers share the excitement.

The unveiling of the phones and operating system on Wednesday marks the start of an advertising blitz that will stretch to social media, the Super Bowl and beyond as RIM tries to regain the cool factor that was once firmly in its grasp.

If all goes according to plan, the event will also mark the end of a troublesome 12 months that has seen RIM try to stay afloat while its future was constantly in question by outsiders, and its stock price tumbled to the lowest level in about a decade.

While the first hurdles to overcome on Wednesday are the opinions of tech analysts and investor reaction, the true measure of success — actual sales of the phones — is still weeks away.

As a crowd of thousands gathers Wednesday at Pier 36, a massive entertainment venue on the shores of Manhattan, chief executive Thorsten Heins will step onto the stage holding the BlackBerry that has been at once considered the company’s last hope, but also its biggest hurdle.

Just over a year ago, when Heins took over the top spot at RIM, the smartphone maker was in a state of flux as its marketshare tumbled in North America against growing competition from Apple’s iPhone and various devices on the Android operating system.

Analysts had widely blamed the lack of leadership from former co-CEOs Jim Balsillie and Mike Lazaridis as the reasons that RIM failed to innovate its way out of trouble, but they also said that Heins had much to prove in hardly any time.

The company was in a bubble, insisting that it hadn’t lost its footing in the smartphone industry, even though from the outside their downfall was indisputable.

But as the dust settled from Balsillie’s exit in March 2012, Heins began to face the realities of RIM’s problems and launched a major overhaul of its middle management and deep cuts to its operations.

While Heins preferred to call it removing a “little fat on the hips,” the changes at RIM were a far more strategic and complex surgery.

The company closed some of its manufacturing facilities and announced plans to lay off about 5,000 workers, as it aimed to save $ 1 billion across RIM’s operations by February 2013. Heins reached that savings goal, and he did it three months ahead of schedule.

“He is probably one of the least dogmatic people at RIM,” said Carl Howe, vice-president of consumer research at Yankee Group.

“I think he learned from his predecessors.”

Despite all of the changes, Heins was still up against the fact that development of the BlackBerry 10 operating system was woefully behind schedule. Already delayed from a launch in 2011, the CEO was forced in June to further push the debut into 2013, missing crucial sales periods like the back-to-school and Christmas holiday shopping seasons.

While analysts hated the idea of another delay, it also bought the company some extra time to tweak the software to capitalize on the weaknesses of competitors’ smartphones.

One of those features is the BlackBerry Balance technology, which allows one phone to operate as both a business and personal device entirely separate from each other. Another one lets users seamlessly shift between the phone’s applications like they’re flipping between pages on a desk.

The BlackBerry Messenger chat program will also get an update that includes video chat and screen sharing options.

RIM’s executives also began an aggressive campaign last year to win the developer community. Under its previous leadership, the BlackBerry had practically ignored the growing popularity of smartphone applications for services like Netflix, Skype and Instagram.

A sea of change was coming under its new leaders, and Heins had managed to at least steady a company that was swaying on its pillars by coming up with unconventional ideas.

As the BlackBerry lost steam in North America and Europe, he turned to developing countries like Indonesia and Nigeria to keep revenues flowing in the near term. In those places, consumers were hungry for low-cost smartphones and the BlackBerry was still considered a status symbol.

The decision helped RIM keep its subscriber base steady, and maintain its $ 2-billion cash reserve, which was set aside for emergencies. It will use some of that money to promote the new phones.

“Up until now I think everything (Heins) laid out in terms of his plan … he’s shown that he’s executed on it,” said Richard Tse, an analyst at Cormark Securities Inc.

“In terms of what they’ve done on the development side, in terms of streamlining the operations and preserving the cash, I think he’s done a very good job to date.”

Investors aren’t satisfied with all of his decisions, however, especially when Heins unveiled a rough plan in December that will likely eat into the lucrative service fees charged to BlackBerry subscribers.

Heins told analysts on its most recent earnings conference call that RIM plans to launch an a la carte menu of services where both enterprise customers and casual smartphone users can pick their packages. The change would likely mean reduced revenues in one of the most lucrative areas of its business.

Even on the dawn of the new BlackBerry unveiling, there are still questions about whether RIM will exist in its current form this time next year. Some analysts have said the company will eventually be forced to sell off at least its hardware division, if not more.

“They’re in such a difficult position that I can’t think of a management change that would help them get out of it,” Tim Long of BMO Capital Markets.

“Clearly there are people out there that think the BlackBerry 10 is going to be something that gets them back on the map. We don’t think so.”

Long said his checks within the mobile phone industry have shown that carriers aren’t particularly interested in RIM’s touchscreen smartphone, but they’re more anxious for the keypad version, or QWERTY phone, due sometime after the initial launch.

“We think that’s an issue,” he said.

If the stock price is any sign, RIM’s investors are at least more confident this month then they’ve been in a long time. As of Monday’s closing price, RIM’s shares have risen 167 per cent from its lowest level in about a decade, reached in September, on the Toronto Stock Exchange.

Several analysts have boosted their target prices for the company’s stock in the past two weeks.

Whatever happens after the new BlackBerrys are unveiled, it’s certain that RIM isn’t in the clear yet.

“Product transitions are always pretty ugly,” said Howe.

“The good news is if you can get yourself through to the other side … you have an opportunity to disrupt the market yourself.”

Wireless News Headlines – Yahoo! News

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Anne Hathaway Says She 'Met A Lot of Bad Ones' Before Meeting Her Husband

Caught in the Act

01/29/2013 at 06:00 AM EST

Adam Shulman and Anne Hathaway

Christopher Polk/WireImage

Following the Screen Actors Guild Awards on Sunday, Anne Hathaway was feeling the love at an after party at the Four Seasons in Beverly Hills.

Hathaway – who won an Actor for her role in Les Misérables – was overheard saying, "I'm in a celebratory mood."

With a drink in her hand, Hathaway told friends that her engagement ring from husband Adam Shulman is her "prized possession" and that her wedding band "isn't bad either," an onlooker tells PEOPLE.

Hathaway – who, according to a source "was playing matchmaker all night" – was later overheard telling her friends that she "met a lot of bad ones" before meeting Shulman.

– Patrick Gomez

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Soldier talks about his new arms after transplant

BALTIMORE (AP) — A soldier who lost all four limbs in an Iraq roadside bombing has two new arms following a double transplant at Johns Hopkins Hospital.

Twenty-six-year-old Brendan Marrocco along with the surgeons who treated him will be at the Baltimore hospital on Tuesday to discuss the new limbs.

The transplants are only the seventh double-hand or double-arm transplant ever conducted in the United States.

The infantryman was injured by a roadside bomb in 2009. The New York City man also received bone marrow from the same dead donor. The approach is aimed at helping his body accept the new arms with minimal medication to prevent rejection.

The military is sponsoring operations like these to help wounded troops. About 300 have lost arms or hands in the wars.

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Legislation proposed to help California launch healthcare overhaul

SACRAMENTO — The state Legislature gaveled in a special session on healthcare Monday, pushing forward with sweeping proposals to help California implement President Obama's healthcare overhaul.

The measures, including a major expansion of Medi-Cal, the state's public insurance program for the poor, would cement the state's status as the nation's earliest and most aggressive adopter of the federal Affordable Care Act. Beginning in January 2014, the law requires most Americans to buy health insurance or pay a penalty.

Gov. Jerry Brown called the special session so healthcare bills that he signs can take effect within 90 days rather than next year.

State lawmakers are racing to pass rules for enrollment in a new state-run insurance market in October. They include a requirement for insurers to cover consumers who have preexisting medical conditions.

Legislative leaders in both houses sponsored bills that would dramatically expand Medi-Cal. Under the proposals, individuals earning up to 138% of the federal poverty level — or $15,415 a year — would be covered, potentially adding more than 1 million Californians to the rolls.

The federal government would subsidize costs for the first three years, phasing down to 90% afterward.

"Ensuring that every Californian has access to quality, affordable healthcare is one of the most important public policy challenges we face," said Assembly Speaker John A. Pérez (D-Los Angeles) at a Capitol news conference. "No Californian should ever face bankruptcy or severe financial setbacks due to illness and injury."

Brown, in his State of the State speech last week, sounded a note of caution even as he embraced the federal law. The long-term costs are unknown, he said, and hold the potential to undermine California's precariously balanced budget.

He called the Medi-Cal expansion "incredibly complex," adding that "it will take more time" to achieve than other parts of the healthcare overhaul. Brown has said the change could allow the state to reduce the roughly $2 billion it gives to counties to care for the uninsured, but county officials and healthcare advocates say that such a move could hurt their ability to help the millions of Californians who will still lack coverage.

The special-session legislation would also streamline the Medi-Cal enrollment process to help sign up hundreds of thousands of Californians who are currently eligible but not enrolled. According to a recent study by the UC Berkeley Center for Labor Research and the UCLA Center for Health Policy Research, that change could add 240,000 to 510,000 people to the Medi-Cal rolls by 2019.

Brown has earmarked $350 million in his budget proposal to pay for the increased participation. Costs for the currently eligible group would be split evenly between the state and federal governments.

For all their enthusiasm, legislative leaders also said they were working within fiscal constraints. Pérez defended the state's moves, for instance, to slash Medi-Cal reimbursement rates two years ago. Healthcare providers have appealed a federal court's decision allowing the cuts, arguing that the reductions would cause community clinics to close and prompt doctors to turn away Medi-Cal patients.

California, Pérez said, lacks the resources to better compensate doctors, hospitals and pharmacists.

"I don't think we're in a situation to make fundamental changes to that," he said.

michael.mishak@latimes.com

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India Ink: One Delhi Gang Rape Suspect Is Ruled a Minor

NEW DELHI

The Indian Juvenile Justice Board ruled Monday that one suspect in the recent fatal gang rape of a young woman on a moving bus is officially a juvenile, which could result in a lenient sentence if he is found guilty of the crime.

The teenager, who school records show is 17 years old, could receive a maximum sentence of three years in a detention facility if found guilty. Five other men accused of the premeditated rape and killing of a 23-year old physiotherapy student on Dec. 16 could face life imprisonment or the death penalty if found guilty.

The December gang rape and the victim’s subsequent death of injuries sustained during the rape prompted widespread protests in India over the lack of safety and justice for women, and calls for the rapists to be executed.

Some criminal and legal experts expected the juvenile to be forced to undergo a bone ossification test, which is sometimes used to determine age in India where birth records are not always accurate. But the juvenile board’s ruling Monday makes that unlikely.

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Jennifer Lawrence Feeling Better Thanks to a 'Lot of Medication'

By Dahvi Shira

01/28/2013 at 07:00 AM EST

Jennifer Lawrence is on the mend.

The ailing Silver Linings Playbook starlet is finally feeling fine after a reported bout with pneumonia.

"I'm so much better," Lawrence, 22, told reporters backstage at Sunday's Screen Actors Guild Awards, where she won for lead female actor. "I'm a lot better. I've been on a lot of medication and got a really cool inhaler, so I'm doing much better."

The actress – who was "laying low all week," a source told PEOPLE – missed Saturday's Australian Academy of Cinema and Television Arts International Awards due to the illness, according to her costar Jacki Weaver.

"Poor Jen is really sick," Weaver reportedly said, after accepting an award for Lawrence. "She really is sick. She has pneumonia."

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CDC: Flu seems to level off except in the West

New government figures show that flu cases seem to be leveling off nationwide. Flu activity is declining in most regions although still rising in the West.

The Centers for Disease Control and Prevention says hospitalizations and deaths spiked again last week, especially among the elderly. The CDC says quick treatment with antiviral medicines is important, in particular for the very young or old. The season's first flu case resistant to treatment with Tamiflu was reported Friday.

Eight more children have died from the flu, bringing this season's total pediatric deaths to 37. About 100 children die in an average flu season.

There is still vaccine available although it may be hard to find. The CDC has a website that can help.

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CDC: http://www.cdc.gov/flu/

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