Study: Vitamins don't lower heart risks in men

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LOS ANGELES (AP) — Multivitamins might help lower the risk for cancer in healthy older men but do not affect their chances of developing heart disease, new research suggests.

Two other studies found fish oil didn't work for an irregular heartbeat condition called atrial fibrillation, even though it is thought to help certain people with heart disease or high levels of fats called triglycerides in their blood.

The bottom line: Dietary supplements have varied effects and whether one is right for you may depend on your personal health profile, diet and lifestyle.

"Many people take vitamin supplements as a crutch," said study leader Dr. Howard Sesso of Brigham and Women's Hospital in Boston. "They're no substitute for a heart-healthy diet, exercising, not smoking, keeping your weight down," especially for lowering heart risks.

The studies were presented Monday at an American Heart Association conference in Los Angeles.

A separate analysis released in connection with the meeting showed that at least 1 in 3 baby boomers who are in good shape will eventually develop heart problems or have a stroke. The upside is that that will happen about seven years later than for their less healthy peers.

The study is "a wake-up call that this disease is very prevalent in the United States and even if you're doing a good job, you're not immune," said Dr. Vincent Bufalino, a Chicago-area cardiologist and spokesman for the American Heart Association.

The findings came in an analysis of five major studies involving nearly 50,000 adults aged 45 and older who were followed for up to 50 years.

The research was published online by the Journal of the American Medical Association, along with the vitamin paper and one fish oil study.

Multivitamins are America's favorite dietary supplement. About one-third of adults take them. Yet no government agency recommends their routine use for preventing chronic diseases, and few studies have tested them to see if they can.

A leading preventive medicine task force even recommends against beta-carotene supplements, alone or with other vitamins, to prevent cancer or heart disease because some studies have found them harmful. And vitamin K can affect bleeding and interfere with some commonly used heart drugs.

Sesso's study involved nearly 15,000 healthy male doctors given monthly packets of Centrum Silver or fake multivitamins. After about 11 years, there were no differences between the groups in heart attacks, strokes, chest pain, heart failure or heart-related deaths.

Side effects were fairly similar except for more rashes among vitamin users. The National Institutes of Health paid for most of the study. Pfizer Inc. supplied the pills and other companies supplied the packaging.

The same study a few weeks ago found that multivitamins cut the chance of developing cancer by 8 percent — a modest amount and less than what can be achieved from a good diet, exercise and not smoking.

Multivitamins also may have different results in women or people less healthy than those in this study — only 4 percent smoked, for example.

The fish-oil studies tested prescription-strength omega-3 capsules from several companies in two different groups of people for preventing atrial fibrillation, a fluttering, irregular heartbeat.

One study from South America aimed to prevent recurrent episodes in 600 participants who already had the condition. The other sought to prevent it from developing in 1,500 people from the U.S., Italy and Argentina having various types of heart surgery, such as valve replacement. About one third of heart-surgery patients develop atrial fibrillation as a complication.

Both studies found fish oil ineffective.

___

AP Medical Writer Lindsey Tanner in Chicago contributed to this report.

___

Online:

Heart Association: http://www.heart.org

JAMA: http://www.jama.ama-assn.org

Vitamin facts: http://ods.od.nih.gov/factsheets/MVMS-QuickFacts/

Dietary advice: www.dietaryguidelines.gov

___

Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP .

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Everything you wanted to know about voting machines

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Ever since punch-card voting machines produced the "hanging chads" that led to the Florida recount in the 2000 election, Americans have been looking for new and more reliable technology to use on Election Day.


One result: The Help America Vote Act of 2002, which authorized $3.9 billion in federal funds for trading in punch-card and lever systems with either e-voting or optical scan systems. The act also stipulates that all polling places should make available a handicap-accessible voting device.


But while the country, for the most part, has moved on from the older, more unreliable machines, the new models present their own set of challenges. From shadowy conspiracy theories to genuine concerns about glitches, here's what you need to know about the machines that are supposed to make democracy work.


What kind of machines are used, and where?


Sixty percent of the country now supplies voters with optical scanners. To use them, voters shade in their choices on paper ballots (similar to how they would take an SAT test) before feeding it to the machines. These optical scanners, while not exactly a brand-new technology, are the state-of-the-art for both their accuracy in processing votes and their security against tampering.


But the same cannot always be said for the alternative, e-voting equipment (direct-recording electronic machines, or DREs), which is used in about 25 percent of the country. These are lined up in places like Georgia, Maryland, Utah, Nevada, New Jersey, Pennsylvania, Indiana and Texas.


E-voting machines come in three variants: push-button machines sporting a keypad; LCD touch-screens; and machines that use a rolling wheel to select and confirm a vote onscreen. All of these register votes on an electronic ballot. The absence of a paper trail, which is preserved by the optical scanners, has caused concerns since the inception of the machines.


VerifiedVoting.org provides more specifics on the history and different forms of voting technology, including a map showing the brand of election equipment for different states.


Does anyone still use punch-card or lever systems?


Four counties in Idaho still use punch-card ballots, while none in the country has used lever machines since 2010.


What are some of the examples of problems with e-voting machines?


In 2004, electronic votes were wiped from machines in New Jersey and North Carolina. But the much more ominous worries over the limits and liabilities of e-voting became clear in 2008, when a study by Princeton University revealed how easy it would be to hack into the Sequoia brand of e-voting machines (used chiefly in New Jersey, Pennsylvania and Louisiana) to steal votes.


More disturbing is this quote from Roger Johnston, a computer science expert leading a subsequent test on Diebold AccuVote e-voting machines just last year: "I've seen high-school science fair projects that are more sophisticated than what is needed to hijack a voting machine." His crash course in vote-jacking went as follows: The equipment was hacked by inserting a very inexpensive homemade device into the voting machine, which could be remotely controlled from afar. In practice, when the voter attempted to mark her e-ballot, the hacker could intercept and alter the vote from one party to the other.


Despite these widely reported studies, as well as HBO's 2006 documentary "Hacking Democracy," there has not yet been any effort to address these sorts of problems with either the Diebold machines or the smaller malfunctions of e-voting machines more broadly. (It is, of course, also true that there have been problems with fraud and machine error with more traditional forms of voting technology.)


The software for the e-voting machines is proprietary, which means that only the companies that manufacture them have access to their design, which they have kept from examination through extended legal battles.


What's with stories about Tagg Romney owning voting machines?


In a tight election, even the most tenuous connections can be spun quickly into a web of conspiracy. That's not to say that there aren't genuine links between very enthusiastic Mitt Romney donors and Hart InterCivic, a large supplier of voting machines in Ohio—but the theories attempting to prove that Tagg Romney, the Republican nominee's eldest son, owns Ohio voting machines overstep the boundaries of available evidence.


As Rick Ungar reported in Forbes, two Hart InterCivic board members made direct donations to the Romney campaign; furthermore, several directors of H.I.G. capital, which owns Hart, are major money-raisers for the campaign. (Some of them were in the room during Romney's infamous "47 percent" remarks.)


But there is no evidence that Tagg Romney's private equity firm, Solamere Capital, invests, owns or controls voting machines made by InterCivic. The closest one gets by following the money is to find Solamere investing in H.I.G.'s medical fund, BioVentures, a wholly separate fund, as reported by Eugene Kiely and Lucas Isakowitz at Factcheck.org.


What will superstorm Sandy's impact be on voting in the Northeast?


In the back of people's minds, Sandy's effect on voting in the Northeast has been a quiet but pressing concern. As Thad Hall, a University of Utah political scientist and researcher for the Voting Technology Project, told the Associated Foreign Press, "Some voters will literally not be able to vote because they will have been evacuated from their local polling place and there is no provision for remote voting."


The voting machines themselves will be left operating on batteries, not an encouraging prospect as Election Day drags on longer in areas where debris and destruction have complicated the process and organization.


In New Jersey, the state is allowing residents to combat the aftermath of the storm by voting through absentee ballots by email or fax. And state officials in New York have said that residents may be granted an extra day to vote if Tuesday's turnout is below 25 percent.

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China's Communists endorse Bo Xilai's expulsion

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BEIJING (AP) — China's ruling Communist elite have endorsed the expulsion of former high-flying politician Bo Xilai and approved final preparations for the party's upcoming congress, state media reported Sunday.

The closed-door meeting of the Central Committee that ended Sunday was the last before Communist Party leader Hu Jintao and others in his government begin to cede power to Vice President Xi Jinping and others at the congress, which opens Thursday.

The official Xinhua News Agency said the committee endorsed decisions to expel Bo and former Railways Minister Liu Zhijun from the Communist Party. Bo is accused of a range of misdeeds including covering up his wife's murder of a British businessman. Liu faces corruption charges.

The policy-setting committee also appointed two new vice chairmen of the Central Military Commission, Xinhua said.

The Central Committee is comprised of about 370 people from the upper ranks of the party, government and military.

Bo's ouster earlier this year widened rifts within a leadership that likes to project an image of unity. It also complicated the bargaining over the roster of new leaders.

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Google's Android software in 3 out of 4 smartphones

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Floods render NYC hospitals powerless

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NEW YORK (AP) — There are few places in the U.S. where hospitals have put as much thought and money into disaster planning as New York. And yet two of the city's busiest, most important medical centers failed a fundamental test of readiness during Superstorm Sandy this week: They lost power.

Their backup generators failed, or proved inadequate. Nearly 1,000 patients had to be evacuated.

The closures led to dramatic scenes of doctors carrying patients down dark stairwells, nurses operating respirators by hand, and a bucket brigade of National Guard troops hauling fuel to rooftop generators in a vain attempt to keep the electricity on.

Both hospitals, NYU Langone Medical Center and Bellevue Hospital Center, were still trying to figure out exactly what led to the power failures Thursday, but the culprit appeared to be the most common type of flood damage there is: water in the basement.

While both hospitals put their generators on high floors where they could be protected in a flood, other critical components of the backup power system, such as fuel pumps and tanks, remained in basements just a block from the East River.

Both hospitals had fortified that equipment against floods within the past few years, but the water — which rushed with tremendous force — found a way in.

"This reveals to me that we have to be much more imaginative and detail-oriented in our planning to make sure hospitals are as resilient as they need to be," said Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University's Mailman School of Public Health.

The problem of unreliable backup electricity at hospitals is nothing new.

Over the first six months of the year, 23 percent of the hospitals inspected by the Joint Commission, a health care facility accreditation group, were found to be out of compliance with standards for backup power and lighting, according to a spokesman.

Power failures crippled New Orleans hospitals after Hurricane Katrina. The backup generator failed at a hospital in Stafford Springs, Conn., after the remnants of Hurricane Irene blew through the state in 2011. Hospitals in Houston were crippled when Tropical Storm Allison flooded their basements and knocked out electrical equipment in 2001.

When the Northeast was hit with a crippling blackout in 2003, the backup power at several of New York City's hospitals failed or performed poorly. Generators malfunctioned or overheated. Fuel ran out too quickly. Even where the backup systems worked, they provided electricity to only some parts of the hospital and left others in the dark.

Afterward, a mayoral task force recommended upgrading testing standards for generators and requiring backup plans for blood banks and health care facilities that provide dialysis treatment.

Alan Aviles, president of New York City's Health and Hospitals Corp., which operates Bellevue, said that after a scare last summer when Hurricane Irene threatened to cause flooding, Bellevue put its basement-level fuel pumps in flood-resistant chambers.

It still isn't clear whether water breached those defenses, but when an estimated 17 million gallons of water rushed through loading docks and into the hospital's 1-million-square-foot basement, the fuel feed to the generators stopped working. The floodwaters also knocked out the hospital's elevators.

For two days, National Guardsmen carried fuel to the generators, but conditions inside the hospital for patients and staff deteriorated anyway. The generators were designed to supply only 30 percent of the usual electrical load at the hospital, leaving a lot of equipment and labs hobbled. The hospital also lost all water pressure on Tuesday. Nearly 700 patients had been evacuated by Thursday afternoon.

"The precautions we had taken to date had served us well," Aviles said. "But Mother Nature can always up the stakes."

NYU Langone Medical Center had also tried to armor itself against floods.

All seven of the generators providing backup power to the parts of the hospital involved in patient care are only a few years old and are on higher floors. The fuel tank is in a watertight vault. New fuel pumps were installed just this year in a pump house upgraded to withstand a high flood, said the hospital's vice president of facilities operation, Richard Cohen.

"The medical center invested quite a bit of money to upgrade the facility," he said.

The pump house remained "bone dry," Cohen said. But water shoved aside plastic and plywood defenses and infiltrated the fuel vault, where sensors detected the potentially damaging liquid and shut the generators down. "The force of the surge that came in was unbelievable. It dislodged our additional protection and caused a breach of the vault as well," Cohen said.

The power at NYU went out in a flash, leaving the staff scrambling to evacuate 300 patients with no notice.

Dr. Robert Berg, an obstetrician, said that when he lost power in his apartment, he went to the hospital to charge his cellphone and was stunned to find it in chaos.

"It didn't really occur to me that the hospital was going to be in trouble," he said. Even after finding the lobby dark, "I thought, 'We'll have power upstairs. We're an operating room.'"

He wound up carrying two patients down flights of stairs on a "med sled."

"There was a Category 1 outside and a Category 4 inside," he said. "I can't say that they were very well prepared for it."

That has left only one hospital, Beth Israel Medical Center, functioning in the southern third of Manhattan. It is also on backup power, but brought in two huge new generators Thursday, just in case.

Aviles said Bellevue might be out of commission for at least two more weeks. NYU Langone's generators are operating again, but the hospital is waiting for Consolidated Edison to restore its power before it starts taking patients again. That could happen in a matter of days.

Flooding may pose less of a danger to the hospital's power supply in the future. Construction is under way on a new power plant, at a cost of more than $200 million, that will run on natural gas and supply all the hospital's power needs.

"It's a tremendous facility, with a lot of hardening built into it," Cohen said.

___

AP Medical Writer Mike Stobbe contributed to this report.

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Florida's I-4 corridor: The mother road of swing voters

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By Bob Sacha and Maisie Crow


Interstate 4 bisects the center of America's most notorious swing state, running 132 miles from Tampa, through Orlando and ending near Daytona Beach. Fifty-five percent of Florida voters live in the I-4 corridor. It is often where elections are decided in a state that has frequently switched sides, voting for Republicans seven times and Democrats three times in the past 10 elections, and voting for the winning presidential candidate 90 percent of that time.


For the final installment of our Road Trip video series for Campaign 2012, Yahoo News headed to Florida in search of the exotic, perhaps mythical, undecided voter. Here are three of our conversations.


'I have been registered to vote for seven years, and I have never voted.'



In a state filled with colorful characters, Eve Banks, 25, entertains many of them at the Mons Venus club in Tampa. She also travels extensively for her work as an exotic dancer. Eve Banks is a stage name: "I don't want girls from my sorority looking me up online," she says.


"I'm living a version of the American dream," she told Yahoo News. "It's not like the white picket fence, but I do have the dogs and I do have the husband. And I have everything I want. It's just kind of a different way of achieving it."


In the 2012 presidential election, Banks will be voting for the first time, casting a ballot for Barack Obama, she says, because of his support for women. "I generally don't care about politics because I feel like little old me does not make a difference," she said. "But this year I think is a lot different than previous years because of what's at stake right now.


"There was a lot of discrimination against women, believe it or not, not even that long ago really if you think about it. And that'll all change if we don't put the right person in the position," Banks said. "No woman wants a government to control her body or her choices."


'It has gotten pretty ugly between the two. I'm not sure I would want to be a part of it.'



Lloyd Parker, 33, hasn't decided how he is going to vote. He was working for a land development company in Lake Tahoe in Nevada until business started to slow down. His best friend lured him to Florida to become an entrepreneur by starting the Savage Race, an obstacle race in the mud. We hung out with him during their third race in Dade City.


"The Savage Race is a four- to six-mile mud obstacle course," Parker said. "It's timed. Twenty to 25 military-style obstacles that challenge you in many different ways. And afterward it's a fun gathering with live music and a party atmosphere."


Parker called Florida a Savage Race of sorts for Obama and Mitt Romney: "It is everywhere. It seems to be all over Facebook, everything. Maybe that has turned me off a little bit. That it's just been too much of back and forth and negativity, and it probably pushed me away a little bit.


"I have not been following it very much lately," he told Yahoo News. "In the last month I have been extremely busy with this course. I'm out on a ranch with no cable."


'I think somebody that's been in the farming business as long as we have—I don't think we should have to pay any inheritance tax.'



When Dave Black, 73, started in the citrus-farming and ranching business 42 years ago in Clermont, he stood on his 22 acres and saw fruit trees everywhere. Now his property is down to 14 acres, and it is hemmed in by new housing developments on three sides.


"We've got enough houses," Black told Yahoo News. "I mean we should leave a little open space."


Black is voting for Romney because of his opposition to the inheritance tax, in the hope that he can pass his property to his children undivided and tax-free.


"The Electoral College, I don't care for," he said. "I want the people to decide, not this state or that state. You know, Bush, the first election, he won on electoral votes. He didn't win on popular votes. Gore beat him on popular votes. So, that's wrong. That's just my opinion."


Bob Sacha is a multimedia producer, a documentary filmmaker, a photojournalist and a teacher. Maisie Crow is a documentary photographer, a filmmaker and a visual storytelling teacher. Earlier this year, Bob Sacha and Zach Wise traveled to Nevada to talk to Hispanics about the presidential election. In October, they talked to small-business owners along Colorado's Colfax Avenue. In July, Bob Sacha and Miki Meek traveled to Northern Virginia to talk to Mormons about what a President Romney would mean to them. In March, they drove Ohio's I-71 and talked to Republicans before Super Tuesday.


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As foreigners go, Afghan city is feeling abandoned

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KANDAHAR, Afghanistan (AP) — By switching from studying business management to training as a nurse, 19-year-old Anita Taraky has placed a bet on the future of the southern Afghan city of Kandahar — that once foreign troops are gone, private-sector jobs will be fewer but nursing will always be in demand.

Besides, if the Taliban militants recapture the southern Afghan city that was their movement's birthplace and from which they were expelled by U.S.-led forces 11 years ago, nursing will likely be one of the few professions left open to women.

Taraky is one of thousands of Kandaharis who are weighing their options with the approaching departure of the U.S. and its coalition partners. But while she has opted to stay, businessman Esmatullah Khan is leaving.

Khan, 29, made his living in property dealing and supplying services to the Western contingents operating in the city. Property prices are down, and business with foreigners is already shrinking, so he is pulling out, as are many others, he said.

Many are driven by a certainty that the Taliban will return, and that there will be reprisals.   

"From our baker to our electrician to our plumber, everyone was engaged with the foreign troops and so they are all targets for the Taliban. And unless the government is much stronger, when the foreign troops leave, that is the end," Khan said.

The stakes are high. Kandahar, Afghanistan's second city, is the southern counterweight to Kabul, the capital. Keeping Kandahar under central government control is critical to preventing the country from breaking apart into warring fiefdoms as it did in the 1990s.

"Kandahar is the gate of Afghanistan," said Asan Noorzai, director of the provincial council. "If Kandahar is secure, the whole country is secure. If it is insecure, the whole country will soon be fighting."

Even though Kandahar city has traffic jams and street hawkers to give it an atmosphere of normality, there are dozens of shuttered stores on the main commercial street, it's almost too easy to find a parking space these days, and shopkeepers are feeling the pinch.

Dost Mohammad Nikzad said his profits from selling sweets have dropped by a half or more in the past year, to about $30 a day, and he has had to cut back on luxuries.

He said that every month he would buy a new shalwar kameez, the tunic favored by Afghan men; now he buys one every other month.

"I only go out to eat at a restaurant once a week. Before I would have gone multiple times a week," Nikzad said, as he stood behind his counter, waiting for customers to show.

The measurements of violence levels contradict each other. On the one hand, many Kandaharis say things are better this year. On the other hand, the types of violence have changed and, to some minds, gotten worse.

"Before, we were mostly worried about bomb blasts. Now ... we are afraid of worse things like assassinations and suicide attacks," said Gul Mohammad Stanakzai, 34, a bank cashier.

Prying open the Taliban grip on Kandahar and its surrounding province has cost the lives of more than 400 international troops since 2001, and many more Afghans, including hundreds of public officials who have been assassinated by the Taliban.

Kandahar province remains the most violent in the country, averaging more than five "security incidents" a day, according to independent monitors. In Kandahar city, suicide attacks have more than doubled so far this year compared with the same period of 2011, according to U.N. figures.

"They are not fighting in the open the way they were before. Instead they are planting bombs and trying to get at us through the police and the army," said Qadim Patyal, the deputy provincial governor.

The Taliban have said in official statements that they are focusing more on infiltrating Afghan and international forces to attack them. In the Kandahar governor's office, armed Afghan soldiers are barred from meetings with American officials lest they turn on them, Patyal said.

And many point out that the "better security" is only relative. By all measures — attacks, bombings and civilian casualties — Kandahar is a much more violent city now than in 2008, before U.S. President Barack Obama ordered a troop surge.

There are no statistics on how many people have left the city of 500,000, but people are fleeing the south more than any other part of the country, according to U.N. figures. About 32 percent of the approximately 397,000 people who were recorded as in-country refugees were fleeing violence in the south, according to U.N. figures from the end of May.

The provincial government, which is supposed to fill the void left by the departing international forces, has suffered heavily from assassinations. It suffered a double blow in July last year with the killing of Ahmed Wali Karzai, the half-brother of President Hamid Karzai who was seen as the man who made things work in Kandahar, and Ghulam Haider Hamidi, the mayor of the city.

Now, Noorzai says, he can neither get the attention of ministers in Kabul nor trust city officials to do their jobs.

He remembers 2001, when he and others traveled to the capital flying the Afghan flag which had just been reinstated in place of that of the ousted Taliban. "People were throwing flowers and money on our car, they were so happy to have the Afghan flag flying again," he said.

"When we got power, what did we give them in return? Poverty, corruption, abuse."

Mohammad Omer, Kandahar's current mayor, insists that if people are leaving the city, it is to return to villages they fled in previous years because now security has improved.

Zulmai Hafez disagrees. He has felt like a marked man since his father went to work for the government three years ago, and is too frightened to return to his home in the Panjwai district outside Kandahar city. He refused to have his picture taken or to have a reporter to his home, instead meeting at the city's media center.

"It's the Taliban who control the land, not the government," Hafez said. He notes that the government administrator for his district sold off half his land, saying he would not be able to protect the entire farm from insurgents. Many believe the previous mayor was murdered because he went after powerful land barons.

Land reform is badly needed, and the mayor is angry about people who steal land, but he offers no solution. Kandahar only gets electricity about half the day. The mayor says it's up to the Western allies to fix that. But the foreign aid is sharply down. Aid coming to Kandahar province through the U.S. Agency for International Development, the largest donor, has fallen to $63 million this year from $161 million in 2011, according to U.S. Embassy figures.

The mayor prefers to talk about investing in parks and planting trees. "I can't resolve the electricity problem, but at least I can provide a place in the city for people to relax," he said.

The only people thinking long-term appear to be the Taliban.

"The Americans are going and the Taliban need the people's support, so they are trying to avoid attacks that result in civilian casualties," said Noor Agha Mujahid, a member of the Taliban shadow government for Kandahar province, where he oversees operations in a rural district. "After 2014 ... it will not take a month to take every place back."

One of the biggest worries is the fate of women who have made strides in business and politics since the ouster of the Taliban.

"What will these women do?" asked Ehsanullah Ehsan, director of a center that trains more than 800 women a year in computers, English and business. It was at his center where Anita Taraky studied before switching to nursing.

"Even if the Taliban don't come back, even if the international community just leaves, there will be fewer opportunities for women," he said.

On the outskirts of the city stands one of the grandest projects of post-Taliban Kandahar — the gated community of Ayno Maina with tree-lined cement homes, wi-fi and rooftop satellite dishes.

Khan, the departing businessman, says he bought bought 10 lots for $66,000 in Ayno Maina and has yet to sell any of them despite slashing the price,

He recalled that when he first went to the project office it was packed with buyers. "Now it is full of empty houses. No one goes there," Khan said.

Only about 15,000 of the 40,000 lots have been sold, and 2,400 homes built and occupied, according to Mahmood Karzai, one of the development's main backers and a brother of President Karzai. He argues, however, that prices are down all over Afghanistan, and that Ayno Maina is still viable, provided his brother gets serious about reform that will attract investors.

"Afghanistan became a game," he said over lunch at the Ayno Maina office. "The game is to make money and get the hell out of here. That goes for politicians. That goes for contractors."

He shrugged off allegations that he skimmed money from Ayno Maina, saying the claims were started by competitors in Kabul who assume everyone who is building something in Afghanistan is also stealing money.

He said the money went where it was needed: to Western-style building standards and security.

In downtown Kandahar, a deserted park and Ferris wheel serve as another reminder of thwarted hopes. Built in the mid-2000s, the wheel has been idle for two years according to a guard, Abdullah Jan Samad. It isn't broken, he said, it just needs electricity. A major U.S.-funded project to get reliable electricity to the city has floundered and generators that were supposed to provide a temporary solution only operate part-time because of fuel shortages.

"The government should be paying for maintenance for the Ferris wheel," the guard said. "When you build something you should also make sure to maintain it."

____

Associated Press Writer Mirwais Khan contributed to this report from Kandahar.

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Floods render NYC hospitals powerless

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NEW YORK (AP) — There are few places in the U.S. where hospitals have put as much thought and money into disaster planning as New York. And yet two of the city's busiest, most important medical centers failed a fundamental test of readiness during Superstorm Sandy this week: They lost power.

Their backup generators failed, or proved inadequate. Nearly 1,000 patients had to be evacuated.

The closures led to dramatic scenes of doctors carrying patients down dark stairwells, nurses operating respirators by hand, and a bucket brigade of National Guard troops hauling fuel to rooftop generators in a vain attempt to keep the electricity on.

Both hospitals, NYU Langone Medical Center and Bellevue Hospital Center, were still trying to figure out exactly what led to the power failures Thursday, but the culprit appeared to be the most common type of flood damage there is: water in the basement.

While both hospitals put their generators on high floors where they could be protected in a flood, other critical components of the backup power system, such as fuel pumps and tanks, remained in basements just a block from the East River.

Both hospitals had fortified that equipment against floods within the past few years, but the water — which rushed with tremendous force — found a way in.

"This reveals to me that we have to be much more imaginative and detail-oriented in our planning to make sure hospitals are as resilient as they need to be," said Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University's Mailman School of Public Health.

The problem of unreliable backup electricity at hospitals is nothing new.

Over the first six months of the year, 23 percent of the hospitals inspected by the Joint Commission, a health care facility accreditation group, were found to be out of compliance with standards for backup power and lighting, according to a spokesman.

Power failures crippled New Orleans hospitals after Hurricane Katrina. The backup generator failed at a hospital in Stafford Springs, Conn., after the remnants of Hurricane Irene blew through the state in 2011. Hospitals in Houston were crippled when Tropical Storm Allison flooded their basements and knocked out electrical equipment in 2001.

When the Northeast was hit with a crippling blackout in 2003, the backup power at several of New York City's hospitals failed or performed poorly. Generators malfunctioned or overheated. Fuel ran out too quickly. Even where the backup systems worked, they provided electricity to only some parts of the hospital and left others in the dark.

Afterward, a mayoral task force recommended upgrading testing standards for generators and requiring backup plans for blood banks and health care facilities that provide dialysis treatment.

Alan Aviles, president of New York City's Health and Hospitals Corp., which operates Bellevue, said that after a scare last summer when Hurricane Irene threatened to cause flooding, Bellevue put its basement-level fuel pumps in flood-resistant chambers.

It still isn't clear whether water breached those defenses, but when an estimated 17 million gallons of water rushed through loading docks and into the hospital's 1-million-square-foot basement, the fuel feed to the generators stopped working. The floodwaters also knocked out the hospital's elevators.

For two days, National Guardsmen carried fuel to the generators, but conditions inside the hospital for patients and staff deteriorated anyway. The generators were designed to supply only 30 percent of the usual electrical load at the hospital, leaving a lot of equipment and labs hobbled. The hospital also lost all water pressure on Tuesday. Nearly 700 patients had been evacuated by Thursday afternoon.

"The precautions we had taken to date had served us well," Aviles said. "But Mother Nature can always up the stakes."

NYU Langone Medical Center had also tried to armor itself against floods.

All seven of the generators providing backup power to the parts of the hospital involved in patient care are only a few years old and are on higher floors. The fuel tank is in a watertight vault. New fuel pumps were installed just this year in a pump house upgraded to withstand a high flood, said the hospital's vice president of facilities operation, Richard Cohen.

"The medical center invested quite a bit of money to upgrade the facility," he said.

The pump house remained "bone dry," Cohen said. But water shoved aside plastic and plywood defenses and infiltrated the fuel vault, where sensors detected the potentially damaging liquid and shut the generators down. "The force of the surge that came in was unbelievable. It dislodged our additional protection and caused a breach of the vault as well," Cohen said.

The power at NYU went out in a flash, leaving the staff scrambling to evacuate 300 patients with no notice.

Dr. Robert Berg, an obstetrician, said that when he lost power in his apartment, he went to the hospital to charge his cellphone and was stunned to find it in chaos.

"It didn't really occur to me that the hospital was going to be in trouble," he said. Even after finding the lobby dark, "I thought, 'We'll have power upstairs. We're an operating room.'"

He wound up carrying two patients down flights of stairs on a "med sled."

"There was a Category 1 outside and a Category 4 inside," he said. "I can't say that they were very well prepared for it."

That has left only one hospital, Beth Israel Medical Center, functioning in the southern third of Manhattan. It is also on backup power, but brought in two huge new generators Thursday, just in case.

Aviles said Bellevue might be out of commission for at least two more weeks. NYU Langone's generators are operating again, but the hospital is waiting for Consolidated Edison to restore its power before it starts taking patients again. That could happen in a matter of days.

Flooding may pose less of a danger to the hospital's power supply in the future. Construction is under way on a new power plant, at a cost of more than $200 million, that will run on natural gas and supply all the hospital's power needs.

"It's a tremendous facility, with a lot of hardening built into it," Cohen said.

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AP Medical Writer Mike Stobbe contributed to this report.

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Romney, Obama look for edge as campaign nears end

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PORTSMOUTH, N.H. (AP) — Three days. Nine states — give or take. A magic 270 electoral votes. For President Barack Obama and rival Mitt Romney, the final touch-and-go stretch of campaigning is down to the numbers.

New hiring reports or a new jobless rate. Spending totals or early vote totals. Percentage points and rhetorical points. Frequency of stops or size of crowds. In a game of metrics, each camp is looking for that last measure that will separate them at the finish line.

After holding mostly small and mid-size rallies for much of the campaign, Obama's team is planning a series of larger events this weekend aimed at drawing big crowds in battleground states. Still, the campaign isn't expecting to draw the massive audiences Obama had in the closing days of the 2008 race, when his rallies drew more than 50,000.

Obama's closing weekend also includes two joint events with former President Bill Clinton: a rally Saturday night in Virginia and an event Sunday in New Hampshire. The two presidents had planned to campaign together across three states earlier this week, but that trip was called off because of Superstorm Sandy. And, of course, there is always Ohio, the top battleground of them all.

In a whiff of 2008 nostalgia, some of Obama's traveling companions from his campaign four years ago were planning to join him on the road for the final days of his last campaign. Among them are Robert Gibbs, who served as Obama's first White House press secretary, and Reggie Love, Obama's former personal aide who left the White House earlier this year.

Not to be outdone, Romney hosted a massive rally Friday night in West Chester, Ohio, drawing more than 10,000 people to the Cincinnati area for an event that featured rock stars, sports celebrities and dozens of Republican officials. It was a high-energy event on a cold night designed to kick off his own sprint to the finish.

Romney arrived in New Hampshire close to midnight on Friday after an 18-hour day on the campaign trail that took him from Virginia to Wisconsin to Ohio. He was attending a morning rally on the New Hampshire seacoast before making an afternoon appearance in Iowa, and two more in Colorado. He shifted an original plan to campaign in Nevada on Sunday in favor of a schedule likely to bring him back to Iowa, Ohio, Pennsylvania and Virginia.

Aides stress that his schedule is fluid and may change with little notice as they evaluate where his time is best spent.

On Saturday, Obama's first stop was in Mentor, Ohio, then he was campaigning in Milwaukee and Dubuque, Iowa, and ending the day in Bristow, Va. On Sunday, he was taking his campaign to New Hampshire, Florida, Colorado and, yes, Ohio.

Polling shows the race remains a toss-up heading into the final days. But Romney still has the tougher path; he must win more of the nine most-contested states to reach 270 electoral votes: Ohio, Florida, Virginia, North Carolina, Colorado, Nevada, Wisconsin, Iowa and New Hampshire.

Romney has added Pennsylvania to the mix, hoping to end a streak of five presidential contests where the Democratic candidate prevailed in the state. Obama won Pennsylvania by more than 10 percentage points in 2008; the latest polls in the state give him a 4- to 5-point margin. Romney will campaign in the Philadelphia suburbs on Sunday. Obama aides scoff at the Romney incursion, but they are carefully adding television spending in the state and are sending Clinton to campaign there Monday.

The final frenzy of campaigning comes in the wake of Superstorm Sandy that has dominated much of the news coverage for the past several days as New York, New Jersey and Connecticut recover from the brunt of its force. Friday also offered an economic finale to the campaign with the release of October jobs reports that contained better than average economic news but gave both campaigns a talking point. Employers added a better-than-expected 171,000 jobs last month, but the jobless rate ticked up to 7.9 percent from 7.8 percent — mainly because more people jumped back into the search for work.

In crucial early voting, Obama holds an apparent lead over Romney in key states. But Obama's advantage isn't as big as the one he had over John McCain four years ago, giving Romney hope that he could make up that gap in Tuesday's election.

About 25 million people already have voted in 34 states and the District of Columbia. No votes will be counted until Election Day, but several battleground states are releasing the party affiliation of people who have voted early. So far, Democratic voters outnumber Republicans in Florida, Iowa, Nevada, North Carolina and Ohio. Republicans have the edge in Colorado.

___

Kuhnhenn reported from Washington. Associated Press writers Julie Pace and Stephen Ohlemacher contributed to this report.

Follow Jim Kuhnhenn on Twitter at: https://twitter.com/jkuhnhenn

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Gunmen kill 18 in bus attack in southwest Pakistan

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QUETTA, Pakistan (AP) — Gunmen riding on two motorcycles opened fire on a bus at a small fuel station in southwest Pakistan on Friday, igniting a massive blaze and leaving 18 dead, a Pakistani official said.

Abdul Mansoor Kakar said all 16 people on the bus, including eight women and three children, were killed and the bodies badly burned. The vehicle had been parked next to fuel drums that ignited during the attack, starting a fire that engulfed the bus and killed two in a nearby car.

The attack took place in the town of Khuzdar in the province of Baluchistan.

No one claimed responsibility and the motive of the attack was unclear, Kakar said, adding that the incident was under investigation but no arrests were made.

Khuzdar is located 300 kilometers (180 miles) south of Quetta, the capital of Baluchistan province. The region has experienced a decades-long insurgency by nationalists who demand greater autonomy and a larger share of the province's natural resources.

The province is also thought to be home to many Afghan Taliban militants.

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