Study: Stem cells from strangers can repair hearts

LOS ANGELES (AP) — Researchers are reporting a key advance in using stem cells to repair hearts damaged by heart attacks. In a study, stem cells donated by strangers proved as safe and effective as patients' own cells for helping restore heart tissue.

The work involved just 30 patients in Miami and Baltimore, but it proves the concept that anyone's cells can be used to treat such cases. Doctors are excited because this suggests that stem cells could be banked for off-the-shelf use after heart attacks, just as blood is kept on hand now.

Results were discussed Monday at an American Heart Association conference in California and published in the Journal of the American Medical Association.

The study used a specific type of stem cells from bone marrow that researchers believed would not be rejected by recipients. Unlike other cells, these lack a key feature on their surface that makes the immune system see them as foreign tissue and attack them, explained the study's leader, Dr. Joshua Hare of the University of Miami.

The patients in the study had suffered heart attacks years earlier, some as long as 30 years ago. All had developed heart failure because the scar tissue from the heart attack had weakened their hearts so much that they grew large and flabby, unable to pump blood effectively.

Researchers advertised for people to supply marrow, which is removed using a needle into a hip bone. The cells were taken from the marrow and amplified for about a month in a lab at Baltimore's Johns Hopkins University, then returned to Miami to be used for treatment, which did not involve surgery.

The cells were delivered through a tube pushed through a groin artery into the heart near the scarred area. Fifteen patients were given cells from their own marrow and 15 others, cells from strangers.

About a year later, scar tissue had been reduced by about one-third. Both groups had improvements in how far they could walk and in quality of life. There was no significant difference in one measure of how well their hearts were able to pump blood, but doctors hope these patients will continue to improve over time, or that refinements in treatment will lead to better results.

The big attraction is being able to use cells supplied by others, with no blood or tissue matching needed.

"You could have the cells ready to go in the blood bank so when the patient comes in for a therapy — there's no delay," Hare said. "It's also cheaper to make the donor cells," and a single marrow donor can supply enough cells to treat as many as 10 people.

Dr. Elliott Antman of Harvard-affiliated Brigham and Women's Hospital in Boston who heads the heart conference, praised the work.

"That opens up an entire new avenue for stem cell therapy, like a sophisticated version of a blood bank," he said. There's an advantage in not having to create a cell therapy for each patient, and it could spare them the pain and wait of having their own marrow harvested, he said.

The study was sponsored by the National Institutes of Health. Hare owns stock in a biotech company working on a treatment using a mixture of cells.

Juan Lopez received his own cells in the study, and said it improved his symptoms so much that at age 70, he was able to return to his job as an engineer and sales manager for a roofing manufacturer and ride an exercise bike.

"It has been a life-changing experience," said Lopez, who lives in Miami. "I can feel day by day, week by week, month by month, my improvement. I don't have any shortness of breath and my energy level is way up there. I don't have any fluid in my lungs."

And, he said happily, "My sex drive has improved!"

___

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

___

Online:

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

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

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Long, bitter White House race finally in voters' hands

WASHINGTON (Reuters) - President Barack Obama and Republican challenger Mitt Romney face the verdict of voters on Tuesday after a long and bitter White House campaign, with polls showing them deadlocked in a race that will be decided in a handful of states where it is extraordinarily close.

At least 120 million Americans are expected to vote on giving Obama a second term or replacing him with Romney. Their decision will set the country's course for four years on spending, taxes, healthcare and foreign policy challenges like the rise of China and Iran's nuclear ambitions.

National opinion polls show Obama and Romney in a virtual dead heat, although the Democratic incumbent has a slight advantage in several vital swing states - most notably Ohio - that could give him the 270 electoral votes he needs to win.

Romney, the multimillionaire former head of a private equity fund, would be the first Mormon president and one of the wealthiest Americans to occupy the White House. Obama, the first black president, is vying to be the first Democrat to win a second term since Bill Clinton in 1996.

Fueled by record spending on negative ads, the battle between the two men was focused primarily on the lagging economic recovery and persistent high unemployment, but at times it turned personal.

Polls will begin to close in Indiana and Kentucky at 6 p.m. ESTon Tuesday, with voting ending across the country over the next six hours.

The first results, by tradition, were tallied in Dixville Notch and Hart's Location, New Hampshire, shortly after midnight . Obama and Romney each received five votes in Dixville Notch. In Hart's Location, Obama got 23 votes to 9 votes for Romney and two votes for Libertarian candidate Gary Johnson.

The close presidential race raises fears of a disputed outcome similar to the 2000 election, which was decided by the U.S. Supreme Court. Both campaigns have assembled legal teams to deal with possible voting problems, challenges or recounts.

The balance of power in the U.S. Congress will also be at stake in Senate and House of Representatives races that could impact the outcome of "fiscal cliff" negotiations on spending cuts and tax increases, which kick in at the end of the year unless a deal is reached.

Obama's Democrats are now expected to narrowly hold their Senate majority, while Romney's Republicans are favored to retain House control.

Despite the weak economy, Obama appeared in September to be cruising to a relatively easy win after a strong party convention and a series of stumbles by Romney, including a secretly recorded video showing the Republican writing off 47 percent of the electorate as government-dependent victims.

But Romney rebounded in the first debate on October 3 in Denver, where his sure-footed criticism of the president and Obama's listless response started a slow rise for Romney in polls. Obama seemed to regain his footing in recent days at the head of federal relief efforts for victims of the storm Sandy.

The presidential contest is now likely to be determined by voter turnout - specifically, what combination of Republicans, Democrats, white, minority, young, old and independent voters shows up at polling stations.

Obama and Romney raced through seven battleground states on the final day of campaigning to hammer home their final themes, urge supporters to get to the polls and woo the last remaining undecided voters.

'WE KNOW WHAT CHANGE LOOKS LIKE'

Obama focused on Wisconsin, Ohio and Iowa, the three Midwestern swing states that, barring surprises elsewhere, would give him 270 electoral votes. Romney visited the must-win states of Florida, Virginia and Ohio before finishing in New Hampshire, where he launched his presidential run in June 2011.

After two days of nearly round-the-clock travel, Obama wrapped up his final campaign tour in Des Moines, Iowa, with a speech that hearkened back to his 2008 campaign.

"I've come back to Iowa one more time to ask for your vote. I came back to ask you to help us finish what we've started, because this is where our movement for change began," he told a crowd of some 20,000 people.

Obama's voice broke and he wiped away tears from his eyes as he reflected on those who had helped his campaign.

Romney's final day included stops in Florida, Virginia, Ohio and New Hampshire. The former governor of Massachusetts ended the day at a raucous "Final Victory" rally in Manchester, New Hampshire, the city where he launched his campaign last year.

"We're one day away from a fresh start. We're one day away from a new beginning," the candidate, sounding hoarse at his fifth rally of the day, told the crowd of 12,000 at a sports arena in the center of the city.

Obama ridiculed Romney's claims to be the candidate of change and said the challenger would be a rubber stamp for a conservative Tea Party agenda. "We know what change looks like, and what he's selling ain't it," he said in Columbus, Ohio.

Romney argued he was the candidate who could break the partisan gridlock in Washington, and said four more years of Obama could mean another economic recession.

"His plan for the next four years is to take all the ideas from the first term - the stimulus, the borrowing, Obamacare, all the rest - and do them over again," he said in Lynchburg, Virginia.

The common denominator for both candidates was Ohio, the most critical of the battlegrounds, particularly for Romney. Without the state's 18 electoral votes, the path to victory becomes very narrow for the Republican.

Polls have shown Obama with a small but steady lead in the state for months, sparked in part by his support for a federal bailout of the auto industry, which accounts for one of every eight jobs in Ohio, and by a strong state economy with an unemployment rate lower than the 7.9 percent national rate.

That undercut the central argument of Romney's campaign - that his business experience made him uniquely qualified to create jobs and lead an economic recovery. Obama fought back through the summer with ads criticizing Romney's experience at the equity fund Bain Capital and portraying him as out of touch with ordinary Americans.

That was part of a steady barrage of advertising in the most heavily contested battleground states from both candidates and their party allies, who raised a combined $2 billion.

The rise of "Super PACs," unaffiliated outside groups that can spend unlimited sums on behalf of candidates, also helped fuel the record spending on political ads that swamped swing-state voters.

Romney planned to vote at home in Massachusetts on Tuesday morning before a final trip to Ohio and Pennsylvania, a Democratic-leaning state that he has tried to put in play in recent weeks.

Obama, who voted in October, will spend the day at his home in Chicago.

The two candidates took a break from campaign rallies to tape interviews that aired during halftime of Monday Night Football, a U.S. television institution.

Romney said the New England Patriots were his favorite football team and jokingly said that, as a former Massachusetts governor, he took credit for the team's Super Bowl victories.

Obama expressed faith that his hometown team, the Chicago Bears, can make it to the Super Bowl championship in January because they have the "best defense in the league."

(Additional reporting by Jeff Mason in Iowa and Patricia Zengerle and Herb Swanson in New Hampshire; Editing by Alistair Bell, Christopher Wilson and Paul Simao)

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US election fascinates Chinese; some envy voters

BEIJING (AP) — Where can a pop star score a hit by talking about the U.S. Electoral College for 33 minutes? In China, where Gao Xiaosong's straightforward explanation of the system drew more than 1 million hits in four days.

Chinese have long been fascinated with U.S. presidential elections, but interest is particularly high this year because Americans are voting at the same time Beijing is going through its own political transition. A generation of Communist Party leaders will step down next week to make way for younger colleagues after a highly secretive selection process.

For many ordinary Chinese, comparisons are irresistible.

In a political cartoon circulated online, an American voter covers his ears as the candidates verbally attack each other on TV, while a Chinese man struggles to hear anything from the party congress, taking place behind closed doors.

"Every political system has its pros and cons, but I do think it will be great if I get to participate and get to make a decision after the candidates tell me what their platforms are for the next four years," said Guo Xiaoqiao, a freelance worker in human resources.

Chinese delight in speculating whether President Barack Obama will fend off Republican challenger Mitt Romney, but they are more captivated by Americans' ability to vote for their leader. Their own leaders are distant figures whom they have no way of replacing.

"The 18th Party Congress is a meeting for the party. We ordinary people can only watch it as an audience," said Wang Xiaojian, a 21-year-old Peking University student. "The U.S. presidential election is a campaign that gets everyone involved."

As Gao, a pop singer known for his syrupy ballads, found out, many Chinese are even interested in the U.S. Electoral College, the often perplexing system in which the president is elected not by individual votes, but by the candidates' state-by-state performance.

In a video from his online talk show that was posted on the popular video-sharing site Youku.com, Gao explained that the college is an attempt to balance the rights of states with the will of the majority.

"The opinion of the state is important; so is that of the people," Gao said. He called America's founding fathers the "greatest group of people in history."

As a public performer used to censorship, Gao was careful not to draw direct comparisons to China's system or its leaders. But even explaining America's election system is somewhat at odds with Beijing's practice.

For decades, China's public knowledge of U.S. elections was limited to state propaganda, which depicts the election as a money game controlled by Wall Street. Campaign finance scandals and vote fraud dominate coverage. Even if Chinese don't wholly believe it, the repetitive line of state media has an impact on how they view U.S. politics.

"The coverage is to serve the internal propaganda needs but not explain how the U.S. election works," said Chinese media critic Zhao Chu. "You hardly see any reports that can clearly explain how the U.S. election works."

The less-censored Internet has changed the game, giving Chinese space to comment and exchange opinions. Videos of the presidential debates are available online.

Censorship on the U.S. election has mostly been in form of guidance from censors. State media have been told to play down reports on the election and keep them short and factual, according to editors at two media outlets.

Amateur translator Guo Xiaohui, who has produced Chinese captions of U.S. political programs, said he believes giving the public an unfiltered look at American politics could get them thinking more about their own government, though he added that it also reveals the negative aspects of the U.S. system.

"The two sides are very confrontational and uncompromising," he said. "It would be better off if they can soften a bit, like the Chinese do."

Others see the U.S. system as clearly superior.

"I admire the voting rights protected by the U.S. Constitution. I pay attention to the fairness and seriousness in the election procedure," said Li Youli, a retired manager in a commerce regulatory agency in Beijing who learned about U.S. elections through an English language class.

"China's political system is so backward that it should implement one thing first: to unconditionally ensure the basic political right for citizens in a republic: the voting rights," he said.

Admiration for the U.S. political system does not necessarily extend to the U.S. itself. U.S.-China relations have been buffeted by tiffs over trade, nuclear proliferation and global hotspots like Syria and Iran. Romney has promised to label China a currency manipulator if elected, a step that could lead to a trade war between the world's two largest economies.

Many Chinese resent what they see as scolding by U.S. presidents, politicians and media about China's human rights lapses and its authoritarian system.

A Pew Global Attitudes Project survey released last month found that nearly half of Chinese have a negative view of the United States. Still, the survey registered a small increase among Chinese who like American democracy, up to 52 percent, from 48 percent in 2007. More dramatic was a decrease in Chinese rejecting American democracy, down to 29 percent from 36 percent in 2007.

Xu Chunliu, a content editor for the microblogging site Tencent Weibo, said he has observed little criticism of the U.S. election system among Chinese web users.

"I don't think Chinese people are holding their own political system in such high esteem that they feel they can criticize others," said Xu.

But he added that even being able to have conversations about voting and democracy is a positive step.

"From the Taiwan election to the U.S. election, the Chinese are always thinking and debating among themselves," Xu said. "I think China is developing into a more normal country."

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Google's Android software in 3 out of 4 smartphones

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Lucas plans 'little personal films' in future

NEW YORK (AP) — George Lucas is done with "Star Wars," but not with filmmaking.

The "Star Wars" creator says he's looking forward to making his "own little personal films" that he doubts will be for the theater crowd.

Lucas spoke Friday night at Ebony magazine's Power 100 Gala, days after announcing the sale of his storied Lucasfilm to Disney for $4.05 billion. The deal would allow for more "Star Wars" films.

Lucas was "very sad" let Lucasfilm go but excited about his educational foundation, which will benefit from the sale. He also plans to make more movies. His last one was this year's "Red Tails," about the Tuskegee Airmen, but he said he barely got it in theaters. He said the movies he's working on now "will never get into theaters."

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Doctors debate value of 'fringe' heart treatment

LOS ANGELES (AP) — A heart disease treatment that many doctors consider fringe medicine unexpectedly showed promise in a federal study marred by controversy, causing debate about the results.

The study tested chelation ("kee-LAY'shun"), periodic intravenous infusions said to remove calcium from hardened arteries. Chelation is used to treat lead poisoning but its safety and value for heart disease are unproven.

In a study of 1,700 heart attack survivors, fewer of those getting chelation suffered heart problems in later years than others given dummy infusions. But so many quit the study that the results are unclear. Doctors say chelation cannot be recommended yet.

Results were discussed Sunday at a heart conference in California.

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Despite storm damage, election officials in N.Y., N.J. remain hopeful

NEW YORK (AP) — Power generators are being marshaled, polling locations moved and voting machines hurriedly put into place as officials prepare to hold an national election in storm-ravaged sections of New York and New Jersey barely a week after Superstorm Sandy.

Organizers expressed guarded confidence Sunday that the presidential vote will proceed with no major disruptions in most areas hit by the storm, though it was unclear whether the preparations would be enough to avoid depressed turnout in communities where people still lack power or have been driven from their damaged homes.

Some voters will be casting ballots in places different from their usual polls.

In Long Beach, N.Y., a barrier-island city that was inundated with water during the storm, the number of polling places will be cut to four, down from the usual 11. Residents of the devastated borough of Sea Bright, on the New Jersey shore, will have to drive two towns over to vote.

But with two days to go until Election Day, officials in both states said Sunday that they were overcoming many of their biggest challenges.

Hundreds of emergency generators have been rushed into place to ensure power at polling places, even if the neighborhoods around them are still dark. Electric utilities were putting a priority on restoring power to others and had assured election officials they would be up and running by Monday.

Of the 1,256 polling locations in New York City, only 59 needed to be moved or closed, said Valerie Vazquez, a spokeswoman for the city's Board of Elections. Most were in coastal areas of Brooklyn and Queens or other neighborhoods where buildings normally used for voting had been turned into shelters.

Some New York City leaders remained worried. Mayor Michael Bloomberg noted that the polling-place changes would affect some 143,000 New Yorkers.

"Over the next day, it's going to be critical that the Board of Elections communicate this new information to their poll workers," he said.

The board, which is independent of the mayor's office, has historically had problems opening all voting locations on time, even in a normal year, the mayor noted.

Just east of the city, in Nassau County, Elections Commissioner William Biamonte warned that some voting locations would have a "paramilitary look," with portable toilets, emergency lighting and voting machines running off a generator.

As of Sunday morning, the county had 266,000 homes and business without power — more than anyplace else in the state. Some 30 to 40 polling locations, out of 375 in the county, were expected to be changed because of storm problems.

But Biamonte said he didn't expect that the problems would keep large numbers of people from casting ballots.

"I think people will be voting in less-than-optimal situations, but they will not be voting in a way that disenfranchises them," Biamonte said.

Yet for some residents of the hardest-hit areas, the hassle of having to travel even a few miles to find an open polling place was likely to be one burden too many.

William Agosto, who lost everything he owned when his basement apartment in the Far Rockaway area of Queens flooded, said he hoped to vote but couldn't guarantee he would have the energy or the time.

"I'm going to try," he said, clutching a garbage bag filled with donated clothing. "I have so much on my mind. What I'm going through, it's too much."

On Staten Island, where two polling locations were being relocated due to storm problems, bus driver Jim Holden said the election should be postponed.

"People can't get out to vote. Half these cars are under water," he said.

New Jersey residents driven from their homes by the storm were being given extra voting options. Registered voters will be able to apply for an absentee ballot by fax or email right through 5 p.m. on Election Day, and cast it via fax or email until 8 p.m. Displaced voters can also cast provisional ballots at any polling place in the state.

Monmouth County spokeswoman Laura Kirkpatrick said elections officials there had consolidated some polling locations and moved others, but expected to have working polls for all 53 municipalities come Election Day. She said the county was confident enough that it was encouraging people to vote in person, rather than scramble to file an absentee ballot by email.

"We are looking very good," she said.

Kirkpatrick said officials were somewhat concerned that residents might misunderstand the email voting option and try casting write-in ballots by sending messages to election officials, rather than go through the formal process of obtaining, signing and scanning an official ballot.

John Conklin, a spokesman for the New York Board of Elections, said some counties were training additional poll workers. The companies that make the state's electronic voting machines had sent scores of generators from other parts of the country to ensure enough power. And each polling location will be able to switch to paper ballots, if there is an unexpected loss of power on Election Day.

Utility companies in Connecticut promised that all polling places in that state would have power Tuesday.

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US Air Force struggles with aging fleet

TOKYO (AP) — For decades, the U.S. Air Force has grown accustomed to such superlatives as unrivaled and unbeatable. Now some of its key aircraft are being described with terms like decrepit.

The aging of the Air Force made a brief appearance in the presidential debates when Republican nominee Mitt Romney cited it as evidence of the decline of U.S. military readiness. His contention that the Navy is the smallest it's been since 1917 got more attention thanks to President Barack Obama's quip about "horses and bayonets."

But analysts say the Air Force has a problem that likely will worsen no matter who wins Tuesday. It was created in part by a lack of urgency in the post-Cold War era, and by design glitches and cost overruns that have delayed next-generation aircraft.

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Google's Android software in 3 out of 4 smartphones

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Floods render NYC hospitals powerless

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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