Dozens of Syrians Killed in Explosions Around Damascus

Andoni Lubaki/Associated Press

Rebel fighters patrol a neighborhood in Aleppo on Wednesday.

BEIRUT, Lebanon — Dozens of Syrians were killed or wounded in an explosion at a gas station east of Damascus, the Syrian capital, on Wednesday, and explosions in another Damascus suburb killed at least six people and wounded many more, including women and children, according to videos and reports from antigovernment activists.

The violence came as the United Nations released a study showing that more than 60,000 people had been killed in Syria’s 22-month-old conflict, a third higher than estimates by antigovernment activist groups.

Also on Wednesday, the family of James Foley, a reporter for the Global Post Web site, announced that Mr. Foley had been kidnapped on Nov. 22 by unidentified gunmen in northwest Syria. Mr. Foley had survived an abduction in Libya while covering the conflict there.

A recent flurry of diplomatic activity by Russia, the United Nations’ special envoy and others aimed at finding a political solution appeared to founder in recent days as neither Bashar al-Assad, the Syrian president, nor his opponents expressed a willingness to make concessions to end the bloody conflict.

The explosion near Damascus, which witnesses blamed on an airstrike, took place in a heavily contested suburban area. It hit a gas station where scores of people had lined up for fuel, which had just become available there after about a month, residents said. Videos posted by antigovernment activists showed charred bodies.

One man, using the nickname Abu Fuad, said in a telephone interview that he had just filled up his gas tank and was driving away when he heard the screech of fighter jets.

He was less than a quarter mile away when he heard the explosions, he said.

“There were many cars waiting their turn,” he said. “Yesterday, we heard that the government sent fuel to the gas station here, so all the people around came to fill up their cars.”

In a sign of the depth of distrust the conflict has spawned, Abu Fuad suggested that restocking the station was a government ruse. “They sent fuel as a trap,” he said.

In northern Syria, rebels used rockets to attack the Taftanaz military airport, a long-contested area in the province of Idlib, activists reported. Rebels have also stepped up attacks on airports in the neighboring province of Aleppo, trying to disrupt the warplanes and helicopters that government forces increasingly rely on for attacks, and even for supply lines, in the north.

The United Nations study suggested that the human toll of the war was even greater than previously estimated. Two days ago, the Syrian Observatory for Human Rights, a rebel group that tracks the war from Britain, reported 45,000 deaths, mostly civilian, since the conflict began in March 2011.

“The number of casualties is much higher than we expected, and is truly shocking,” the United Nations high commissioner for human rights, Navi Pillay, said in a statement after her agency released the study.

“We must not compound the existing disaster by failing to prepare for the inevitable — and very dangerous — instability that will occur when the conflict ends,” she added. To avoid repeating the experience of collapsed states like Afghanistan, Iraq and Somalia, she said, “serious planning needs to get under way immediately, not just to provide humanitarian aid to all those who need it, but to protect all Syrian citizens from extrajudicial reprisals and acts of revenge.”

The study’s surprisingly high death toll reflected only those killings in which victims had been identified by their full name, and the date and location of their death had been recorded, leaving the possibility of many more dead.

Independent researchers compiled reports of more than 147,000 killings in Syria’s conflict from seven sources, including the government. When duplicates were removed, there remained a list of 59,648 people killed between March 2011 and the end of November.

Meanwhile, John Foley, James Foley’s father, stressed that his son was an “objective journalist” and issued a plea to his captors to contact the family so that they can work for his release.

“We want Jim to come safely home, or at least we need to speak with him to know he’s O.K.,” John Foley said. “Jim is an objective journalist and we appeal for the release of Jim unharmed. To the people who have Jim, please contact us so we can work together toward his release.”

Hwaida Saad contributed reporting.

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Four Android productivity apps you should use in 2013

Happy New Year! Like most folks, I am working on some resolutions for 2013. One resolution I have is to be more productive. One way I am going to do this is by using my Android phone better. Now there are apps that I have, but really have not used to their fullest. As I work on this resolution, I might discover even better apps. For now I will focus on these impressive apps that can make anyone more productive.

I use Hootsuite on the computer, but rarely find myself engaging with it on my smartphone. With Hootsuite, you can manage Twitter, Facebook, LinkedIn, and Foursquare accounts. The free version allows for up to five accounts and one member of your team to access the account. There is a pro version with a monthly fee, in which you can have more accounts and team members and helpful analytics tools.

The design of the app is very good. If you sync the web version to mobile, you will have everything automatically downloaded to the phone. When viewing content, you swipe left or right to change columns or streams. If you are in the middle of a stream, simply tap the top menu bar to automatically return to the top. The app allows for multiple profiles and scheduled tweets. My goal is to keep up with my feeds and tweets in real-time rather than waiting until I get to a computer.

Another web service that I started to use, but find myself not using it to the fullest. Producteev is a web-based task management service. With Producteev you can work as an individual or in a team by setting up workspaces and then organize tasks by labels. For each task you can assign a priority, due date, and share with team members, if you have any. Overall, this is a great service, since I like making lists, even though I rarely remember having made them.

The Producteev app is available for all platforms. The app has a very clean interface and is easy to find tasks. Probably the best way to keep up with tasks is to use the different widget for the home screen. Seeing the widgets will help keep those key tasks in the forefront of your mind. The app will work offline and syncs in the background.

I read blogs every single day, especially those related to new apps, Android, or mobile news. The only way I can do that is via my Google Reader. I find myself trying to catch up each day on the computer (just like with Twitter activity) when I would be better off reading a little bit over time during the day. NewsRob is a Google Reader that I have had for years. The interface is very clean and easy to use. The developer created a bunch of customizations options, which really make this reader stand out.

With NewsRob you can set up a notification of new articles, how you synchronize with Google and when, how many articles to keep in your cache, and more. If you set up folders within Google Reader, NewsRob will download the folders, too. This enables you to read the posts by blog or folder. The app provides a very clean blogpost display optimized for smaller screens. With each post you can zoom in or out, mark a post read or unread, view in the browser, and share the link to email or services such as Evernote. There is a free version of the app.

The last task I need to work on to be more productive is to keep up with the calendar. I find myself checking on the computer, after the fact, finding out that I am either late or forgot about a meeting or appointment. Using Google calendar is a good place to start, but I have not found the standard calendar app on my Droid was all that helpful.

Business Calendar is a very capable calendar app that has a ton of features. The app lets you view your calendar in a number of different views, and has search and favorite-calendar features, to name a few. The option of viewing different calendars, color coding and being able to easily add, delete, and edit events is helpful. The ability to use widgets for reminders is important. The pro version has over 10 different sizes and allows for the import or export of calendar files in the iCalendar format. Business Calendar also has a free version.

So my top goal or resolution for 2013 is to be more productive. I think using these apps more will help me accomplish that goal. Are there any apps you have but not using to their fullest? What resolutions do you have for 2013?

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Restaurateur Joe Bastianich Blogs: Why Quitting Can Be the Best Start to Your New Year

Celebrity Blog

01/01/2013 at 04:40 PM EST

Joe Bastianich is a successful restaurateur, vineyard owner and author of the memoir Restaurant Man. He's also a judge on MasterChef, which challenges home cooks to prove they can cut it in top professional kitchens. This week he's blogging about helping people keep one big New Year's resolution – quitting smoking.

There are many things I'm looking forward to in 2013, both personally and professionally. Plans for new restaurants in the U.S., including Eataly Chicago, are underway, and I'm gearing up for the 2013 Ironman world championships in Hawaii – if I'm lucky enough to get a spot! But one big life change kick-started all of it 15 years ago, my decision to quit smoking. This choice is something many of you are probably also considering in the New Year and trust me, it's worth it.

You might be surprised to hear that those in the restaurant industry – people who rely on their palate for work every single day – have a higher population of smokers than many other occupation in the U.S. I used to be one of those smokers.

It may be the hours we keep, the high stress levels or being surrounded by triggers like food and wine all the time. Whatever it is, the high amount of smoking in the industry makes it hard to say no to a cigarette when there's always someone asking you to join them on a smoke break. As a former smoker, I've not only seen how many people in the hospitality business struggle with this addiction, but I've been in their shoes.

That's why I want to share my story and help people kick the habit for good. But, it's easier said than done, right?

My Story

I was a smoker for 18 years. At my worst, I smoked up to two-and-a-half packs of cigarettes a day, buying a third pack on my way home from Babbo each night. Like many smokers, I tried to quit… and quit… and quit again. I tried over a dozen times, but I would always eventually cave to the cravings.

It wasn't until my first child was born that the reality of my bad habit hit hard. My wife laid down the law, so to speak, and helped me realize I had to get healthy if I wanted to be a good role model for my new family. At the same time, I realized my passion for food and wine was being compromised; my senses were becoming dull from smoking, and in the food and wine industry these senses are crucial.

I've had a lot of challenges in my life, but this was one of the biggest. I was finally able to give up cigarettes with the help of quit smoking products – and support from my friends and family. I need to give special recognition to my wife for giving me the final push! Support was crucial in my quitting, which is why I'm partnering with Blueprint to Quit – a comprehensive quit smoking program available only at Walmart – to help others get started on the right foot. The program can help with physical cravings associated with smoking and provides behavioral support online when you need it.

Quitting enabled me to focus on making lifestyle changes I associated with smoking, things like having a cup of coffee, wine tasting and late nights at the restaurant. It was difficult, but I'm happy to report that 15 years later I'm still smoke-free. I can truly say I'm healthier today at age 44 than when I was in my 20s.

To all the smokers reading this: you CAN quit. Things that helped me were identifying situations where I would smoke and replacing them with other activities or eliminating them all together and making my plan public to friends and family so they could keep me on track.

If there's one thing to take away from this, it's don't focus on the big picture. Instead, take it one cigarette at a time and be proud of yourself for even making the decision to try to quit.

Anything worthwhile is difficult, and overcoming an addiction like smoking may seem impossible, but I can tell you that some of the best years of my life have been smoke-free.

Cheers to a happy and healthy New Year.

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Brain image study: Fructose may spur overeating

This is your brain on sugar — for real. Scientists have used imaging tests to show for the first time that fructose, a sugar that saturates the American diet, can trigger brain changes that may lead to overeating.

After drinking a fructose beverage, the brain doesn't register the feeling of being full as it does when simple glucose is consumed, researchers found.

It's a small study and does not prove that fructose or its relative, high-fructose corn syrup, can cause obesity, but experts say it adds evidence they may play a role. These sugars often are added to processed foods and beverages, and consumption has risen dramatically since the 1970s along with obesity. A third of U.S. children and teens and more than two-thirds of adults are obese or overweight.

All sugars are not equal — even though they contain the same amount of calories — because they are metabolized differently in the body. Table sugar is sucrose, which is half fructose, half glucose. High-fructose corn syrup is 55 percent fructose and 45 percent glucose. Some nutrition experts say this sweetener may pose special risks, but others and the industry reject that claim. And doctors say we eat too much sugar in all forms.

For the study, scientists used magnetic resonance imaging, or MRI, scans to track blood flow in the brain in 20 young, normal-weight people before and after they had drinks containing glucose or fructose in two sessions several weeks apart.

Scans showed that drinking glucose "turns off or suppresses the activity of areas of the brain that are critical for reward and desire for food," said one study leader, Yale University endocrinologist Dr. Robert Sherwin. With fructose, "we don't see those changes," he said. "As a result, the desire to eat continues — it isn't turned off."

What's convincing, said Dr. Jonathan Purnell, an endocrinologist at Oregon Health & Science University, is that the imaging results mirrored how hungry the people said they felt, as well as what earlier studies found in animals.

"It implies that fructose, at least with regards to promoting food intake and weight gain, is a bad actor compared to glucose," said Purnell. He wrote a commentary that appears with the federally funded study in Wednesday's Journal of the American Medical Association.

Researchers now are testing obese people to see if they react the same way to fructose and glucose as the normal-weight people in this study did.

What to do? Cook more at home and limit processed foods containing fructose and high-fructose corn syrup, Purnell suggested. "Try to avoid the sugar-sweetened beverages. It doesn't mean you can't ever have them," but control their size and how often they are consumed, he said.

A second study in the journal suggests that only severe obesity carries a high death risk — and that a few extra pounds might even provide a survival advantage. However, independent experts say the methods are too flawed to make those claims.

The study comes from a federal researcher who drew controversy in 2005 with a report that found thin and normal-weight people had a slightly higher risk of death than those who were overweight. Many experts criticized that work, saying the researcher — Katherine Flegal of the Centers for Disease Control and Prevention — painted a misleading picture by including smokers and people with health problems ranging from cancer to heart disease. Those people tend to weigh less and therefore make pudgy people look healthy by comparison.

Flegal's new analysis bolsters her original one, by assessing nearly 100 other studies covering almost 2.9 million people around the world. She again concludes that very obese people had the highest risk of death but that overweight people had a 6 percent lower mortality rate than thinner people. She also concludes that mildly obese people had a death risk similar to that of normal-weight people.

Critics again have focused on her methods. This time, she included people too thin to fit what some consider to be normal weight, which could have taken in people emaciated by cancer or other diseases, as well as smokers with elevated risks of heart disease and cancer.

"Some portion of those thin people are actually sick, and sick people tend to die sooner," said Donald Berry, a biostatistician at the University of Texas MD Anderson Cancer Center in Houston.

The problems created by the study's inclusion of smokers and people with pre-existing illness "cannot be ignored," said Susan Gapstur, vice president of epidemiology for the American Cancer Society.

A third critic, Dr. Walter Willett of the Harvard School of Public Health, was blunter: "This is an even greater pile of rubbish" than the 2005 study, he said. Willett and others have done research since the 2005 study that found higher death risks from being overweight or obese.

Flegal defended her work. She noted that she used standard categories for weight classes. She said statistical adjustments were made for smokers, who were included to give a more real-world sample. She also said study participants were not in hospitals or hospices, making it unlikely that large numbers of sick people skewed the results.

"We still have to learn about obesity, including how best to measure it," Flegal's boss, CDC Director Dr. Thomas Frieden, said in a written statement. "However, it's clear that being obese is not healthy - it increases the risk of diabetes, heart disease, cancer, and many other health problems. Small, sustainable increases in physical activity and improvements in nutrition can lead to significant health improvements."

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Online:

Obesity info: http://www.cdc.gov/obesity/data/trends.html

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

Mike Stobbe can be followed at http://twitter.com/MikeStobbe

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House Republicans balk at "fiscal cliff" deal

WASHINGTON (Reuters) - Washington's last-minute scramble to step back from a "fiscal cliff" ran into trouble on Tuesday as Republicans in the House of Representatives balked at a deal to avert a budget crisis.

Republican leaders in the House said they might try to change the bill approved by the Senate which voted to raise taxes on the wealthy in a late-night show of unity.

That would set up a high-stakes game of chicken between the two chambers and risk a stinging rebuke from financial markets that are due to open in Asia in six hours.

The bill drew overwhelming support from Republicans and Democrats alike in the Senate when it passed by a vote of 89 to 8. But Majority Leader Eric Cantor, the No. 2 Republican in the House, told reporters after huddling with other Republicans that he does not support the measure.

Republicans said they might try to add more spending cuts to the bill, which contains over $600 billion in tax increases but only around $12 billion in spending cuts.

With the Senate adjourned until Thursday, it appeared possible that Congress could push the country over the "fiscal cliff" after all, despite months of effort.

Republicans could face a backlash if they scuttle the deal. Income tax rates technically rose back to 1990s levels for all Americans at midnight, and across-the-board spending cuts on defense and domestic programs are due to kick in on Wednesday.

Economists say the $600 billion combination of tax cuts and spending cuts could push the economy into recession, and public opinion polls show Republicans would shoulder the blame.

Lingering uncertainty over U.S. fiscal policy has unnerved investors and depressed business activity for months.

Financial markets have staved off a steep plunge on the assumption that Washington would ultimately avoid pushing the country off the fiscal cliff into a recession.

With financial markets closed for the New Year's Day holiday, lawmakers have only Tuesday to close the deal before Wall Street has time to weigh in.

"My district cannot afford to wait a few days and have the stock market go down 300 points tomorrow if we don't get together and do something," Representative Steve Cohen, a Democrat from Tennessee, said on the House floor.

The bill passed by the Democratic-led Senate at around 2 a.m. would raise income taxes on families earning more than $450,000 per year and limit the amount of deductions they can take to lower their tax bill.

Low temporary rates that have been in place for less affluent taxpayers for the past decade would be made permanent, along with a range of targeted tax breaks put in place by President Barack Obama in the depths of the 2009 recession.

However, workers would see up to $2,000 more taken out of their paychecks annually as a temporary payroll tax cut was set to expire.

(Additional reporting by Thomas Ferraro; Writing by Andy Sullivan; Editing by Alistair Bell and Jackie Frank)

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Laos May Bear Cost of a Chinese Railroad

OUDOM XAI, Laos — Wang Quan, the new Chinese owner of a hotel in this farm town tucked into the tropical mountains of northern Laos, is hoping that the first of 20,000 Chinese workers will arrive here soon to start construction on a new railroad.

Justin Mott for The New York Times

A Chinese construction truck passed through a small Hmong village on Route 13 in Oudom Xai Province, Laos.

The Chinese-financed railway is to snake its way through dozens of tunnels and bridges, eventually linking southern China to Bangkok, the capital of Thailand, and then on to the Bay of Bengal in Myanmar, significantly expanding China’s already enormous trade with Southeast Asia.

But Mr. Wang may have to wait a little longer to make his fortune from all the Chinese expected to descend on this obscure corner of Laos about 50 miles from the nearest border with China. Even though the project has run into some serious objections from international development organizations, most experts expect it to go ahead anyway. That is because China considers it vital to its strategy of pulling Southeast Asia closely into its orbit and providing Beijing with another route to transport oil from the Middle East.

The crucial connection would run through Oudom Xai between Kunming, the capital of China’s southern province of Yunnan, and the Laotian capital, Vientiane.

“China wants a fast-speed rail — Kunming to Vientiane,” George Yeo, a former foreign minister of Singapore, said in a recent speech to the Association of Southeast Asian Nations Business Club in Bangkok.

Mr. Yeo, chairman of Kerry Logistics Network, a major Asian freight and distribution company, is considered one of the best-informed experts on the expansion of new Asia trading routes. “The big objective is Bangkok,” he said. “It’s a huge market, lots of opportunities. From there, Bangkok to Dawei in Myanmar — that will enable China to bypass the Malacca Straits,” a potential choke point between the Indian Ocean and China’s east coast.

But China is not particularly interested in sharing much of the wealth the railroad would generate. Most of the benefits, critics say, would flow to China while most of the costs would be borne by the host nation. The price tag of the $7 billion, 260-mile rail project, which Laos will borrow from China, is nearly equal to the tiny $8 billion in annual economic activity in Laos, which lacks even a rudimentary railroad and whose rutted road system is largely a leftover from the French colonial era.

In mid-November, when Prime Minister Wen Jiabao of China visited Vientiane for a summit meeting of European and Asian leaders, he was expected to attend a groundbreaking for the railroad. The ceremony did not take place.

An assessment of the rail project by a consultant for the United Nations Development Program said the terms of the financing offered by China’s Export-Import Bank were so onerous they put Laos’s “macroeconomic stability in danger.” At the same time, the construction through northern Laos would turn the countryside into “a waste dump,” the consultant’s report said. “An expensive mistake” if signed under the terms on offer, the report concluded.

As collateral for the loan, Laos was bound to provide China with minerals, including potash and copper.

Other international donors echoed the findings. “Partners, including the Asian Development Bank and the World Bank, expressed concern, and the International Monetary Fund was here and said, ‘You have to be very careful,’ ” said an Asian diplomat briefed on the reservations expressed to the Laotian government.

Nonetheless, the National Assembly has approved the project as the nation’s part in the much broader trans-Asian rail agreement signed by nearly 20 Asian countries in 2006. While the workings of the Communist Party that runs Laos are extremely opaque, diplomats here said, the project is most strongly backed by the pro-China deputy prime minister, Somsavat Lengsavad. Efforts to interview Mr. Somsavat were unsuccessful.

China’s exploding trade with Southeast Asia reached nearly $370 billion in 2011, double that of the United States in the same year. By 2015, when the Southeast Asian countries aim to have completed an economic community, China projects that its trade with the region will equal about $500 billion.

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Sony No Longer Shipping PlayStation 2 in Japan

You may have grown up with it. Your children may have, too.

Sony‘s PlayStation 2 home game console, released in 2000, was one of the most popular game consoles of all time, rivaled in sales only by the different kinds of Nintendo DS handheld console. It continued to be sold new on store shelves until just recently, even years after Sony launched its PlayStation 3 successor.

Now, however, Sony’s sent out its last shipment of new “PS2″ consoles for the Japanese market, according to Japanese gaming news site Famitsu (as reported by Polygon’s Emily Gera). Some other regions are continuing to receive shipments for now, but the heart of the PlayStation 2 phenomenon has finally stopped beating.

A gaming legend

Japanese PlayStation fans saw thousands more titles released in their language than English-speaking players. The PlayStation 2 was especially well-known for its role-playing games, such as the MMORPG Final Fantasy XI, which was designed so closely around the PS2′s capabilities that its Windows PC version uses almost entirely the same graphics and controller-based interface.

New PS2 games continue to ship; Final Fantasy XI is even getting a full-fledged, retail-boxed expansion pack this March. It’ll only support the PS2 in Japan, however, where dedicated players continue to use the original “fat” PS2 consoles with the hard drive expansion slot. Internationally, it will only support the PC and Xbox 360.

PS2 games in a post-PS2 world

The first PlayStation 3 consoles — infamous for the silence which ensued at the Sony event where their price at launch was announced to be “599 U.S. dollars” — were backwards-compatible with the vast majority of PlayStation 2 and original PSOne games. Sony achieved PS2 backwards compatibility, however, by including the PS2′s actual “Emotion Engine” and “Graphics Synthesizer” chips inside each PS3, essentially making it two game consoles in one (and helping to drive up that launch price).

A redesign bumped down the price some, but at the cost of removing the Emotion Engine chip, which caused the redesigned PS3 consoles to sometimes have bugs or fail to play certain games. Today’s PS3 consoles lack both chips, which means that while they play PSOne games just fine, they don’t support PS2 game discs at all and can’t be upgraded to do so.

The legend lives on?

Sony has made HD remakes of certain PS2 titles, and republished others for the PS3 under the “PlayStation 2 Classics” brand. Dozens of such titles have been re-released as digital downloads in the PlayStation Network store.

This method of playing a PS2 game on the PS3, however, involves essentially buying the game again (assuming that it’s even in the store), sort of like Sony’s method of playing PlayStation Portable games on the Vita. Even rebuying the games for the PS3 doesn’t ensure continued playability on modern Sony consoles; the upcoming “PlayStation 4″ (not its actual name) reportedly won’t be able to play games made for the PS3.

Jared Spurbeck is an open-source software enthusiast, who uses an Android phone and an Ubuntu laptop PC. He has been writing about technology and electronics since 2008.
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Kim Kardashian: From Divorce Drama to Baby Mama in 5 Clicks

Follow her odyssey from her messy split with Kris Humphries to her great expectation with Kanye West

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AP IMPACT: Big Pharma cashes in on HGH abuse

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

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

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

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

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

___

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Some of these medical records even give explicit hints of use to combat aging, justifying treatment with reasons like fatigue, bone thinning and "off-label," which means treatment of an unapproved condition

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

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

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

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

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

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

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

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

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

The clinics offer personalized programs of "age management" to business executives, affluent retirees, and other patients of means, sometimes coupled with the amenities of a vacation resort. The operations insist there are few, if any, side effects from HGH. Mainstream medical authorities say otherwise.

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

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

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

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

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

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

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

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

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Wall Street ends 2012 riding high on "cliff" deal optimism

NEW YORK (Reuters) - U.S. stocks closed out 2012 with their strongest day in more than a month, putting the S&P 500 up 13.4 percent for the year, as lawmakers in Washington closed in on a resolution to the "fiscal cliff" negotiations.

The S&P 500's gain for the year marks its best performance since 2009, as stocks navigated through debt crises in Europe and the United States that dominated the headlines. Still, with numerous issues involving budget talks unresolved, markets could still be open to a shock should the deal break down unexpectedly.

Fittingly, in the last session of the year, stocks bounced back and forth on the headlines out of Washington, as both President Barack Obama and Republican Senate leader Mitch McConnell issued statements indicating a deal to avert the cliff was close.

"The worst news could have been the president coming out and saying, 'We don't have a deal and we've giving up,' and he didn't say that," said Ron Florance, managing director of investment strategy for Wells Fargo Private Bank, based in Scottsdale, Arizona.

"My personal skepticism, I don't trust anything out of Washington until it is signed, sealed and delivered, and it is not signed, sealed and delivered."

While a deal on the cliff is not yet official, investors may be ready to take on more risk next year in hopes of a greater reward.

McConnell said an agreement had been reached with Democrats on all of the tax issues in the potential deal, removing a large hurdle in the talks. An agreement is needed in order to avert a combination of tax hikes and spending cuts that many believe could push the U.S. economy into recession.

A source familiar with the matter said an emerging deal, if adopted by Congress and President Barack Obama, would raise $600 billion in revenue over the next 10 years by increasing tax rates for individuals making more than $400,000 and households earning above $450,000 annually.

Despite the uncertainty, the market encountered only occasional bouts of volatility this year. For the first time since 2006, the CBOE Volatility Index or VIX <.vix>, the market's favored indicator of anxiety, did not surpass the 30 level, a threshold that usually signals heightened worry among investors.

"Given all the threats in 2012, the VIX was relatively tranquil," said Bill Luby, the author of the VIX and More blog in San Francisco, citing the crises in Spain and Greece, along with constant intervention from the Federal Reserve.

The Dow Jones industrial average <.dji> gained 166.03 points, or 1.28 percent, to end at 13,104.14. The Standard & Poor's 500 Index <.spx> gained 23.76 points, or 1.69 percent, to finish at 1,426.19. The Nasdaq Composite Index <.ixic> gained 59.20 points, or 2.00 percent, to close at 3,019.51.

Monday's gains enabled the S&P 500 to snap a five-day losing streak, its longest skid since September.

The S&P 500 closed out 2012 with a 13.4 percent gain for the year, compared with a flat performance in 2011. The Dow rose 7.3 percent in 2012 and the Nasdaq climbed 15.9 percent.

Financials <.gspf> were the strongest of the S&P's 10 industry sectors this year, gaining more than 26 percent, led by Bank of America , which more than doubled in 2012, and was the best performer of the Dow industrials.

Of the S&P's 10 sectors, only defensively oriented utilities <.gspu> ended the year lower, falling 2.9 percent.

Gains in Apple Inc , the most valuable U.S. company, helped lift the Nasdaq. The stock rose 4.4 percent to $532.17, lifting the S&P information technology sector index <.gspt> up 2.2 percent. For the year, Apple rose 31.4 percent, ending with a market value of about $501.4 billion.

Each of the Dow's 30 components finished the session in positive territory, led by a 3.2 percent climb in Caterpillar Inc to $89.58.

Volume was modest, with about 6.06 billion shares traded on the New York Stock Exchange, the Nasdaq and the NYSE MKT, slightly below the daily average of 6.42 billion.

Advancing stocks outnumbered declining ones on the NYSE by a ratio of 6 to 1, while on the Nasdaq, four stocks rose for every one that fell.

(Reporting by Chuck Mikolajczak; Editing by Jan Paschal)

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