Quadruple Amputee Gets Two New Hands on Life

It's the simplest thing, the grasp of one hand in another. But Lindsay Ess will never see it that way, because her hands once belonged to someone else.

Growing up in Texas and Virginia, Lindsay, 29, was always one of the pretty girls. She went to college, did some modeling and started building a career in fashion, with an eye on producing fashion shows.

Then she lost her hands and feet.

Watch the full show in a special edition of "Nightline," "To Hold Again," TONIGHT at 11:35 p.m. ET on ABC

When she was 24 years old, Lindsay had just graduated from Virginia Commonwealth University's well-regarded fashion program when she developed a blockage in her small intestine from Crohn's Disease. After having surgery to correct the problem, an infection took over and shut down her entire body. To save her life, doctors put her in a medically-induced coma. When she came out of the coma a month later, still in a haze, Lindsay said she knew something was wrong with her hands and feet.

"I would look down and I would see black, almost like a body that had decomposed," she said.

The infection had turned her extremities into dead tissue. Still sedated, Lindsay said she didn't realize what that meant at first.

Quadruple Amputee Undergoes Hand Transplant Surgery Watch Video

After Hand Transplant, Relearning How to Hold Watch Video

"There was a period of time where they didn't tell me that they had to amputate, but somebody from the staff said, 'Oh honey, you know what they are going to do to your hands, right?' That's when I knew," she said.

After having her hands and feet amputated, Lindsay adapted. She learned how to drink from a cup, brush her teeth and even text on her cellphone with her arms, which were amputated just below the elbow.

"The most common questions I get are, 'How do you type,'" she said. "It's just like chicken-pecking."

PHOTOS: Lindsay Ess Gets New Hands

Despite her progress, Lindsay said she faced challenges being independent. Her mother, Judith Aronson, basically moved back into her daughter's life to provide basic care, including bathing, dressing and feeding. Having also lost her feet, Lindsay needed her mother to help put on her prosthetic legs.

"I've accepted the fact that my feet are gone, that's acceptable to me," Lindsay said. "My hands [are] not. It's still not. In my dreams I always have my hands."

Through her amputation recovery, Lindsay discovered a lot of things about herself, including that she felt better emotionally by not focusing on the life that was gone and how much she hated needing so much help but that she also truly depends on it.

"I'm such an independent person," she said. "But I'm also grateful that I have a mother like that, because what could I do?"

Lindsay said she found that her prosthetic arms were a struggle.

"These prosthetics are s---," she said. "I can't do anything with them. I can't do anything behind my head. They are heavy. They are made for men. They are claws, they are not feminine whatsoever."

For the next couple of years, Lindsay exercised diligently as part of the commitment she made to qualify for a hand transplant, which required her to be in shape. But the tough young woman now said she saw her body in a different way now.

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Eleven dead in Damascus gas station blast

AZAZ, Syria (Reuters) - At least 11 people were killed and 40 wounded when a car bomb exploded at a crowded petrol station in the Syrian capital Damascus on Thursday, opposition activists said.

The station was packed with people queuing for fuel that has become increasingly scarce during the country's 21-month-long insurgency aimed at overthrowing President Bashar al-Assad.

The semi-official al-Ikhbariya television station showed footage of 10 burnt bodies and Red Crescent workers searching for victims at the site.

The opposition Revolution Leadership Council in Damascus said the explosion was caused by a booby-trapped car.

There was no immediate indication of who was responsible for the bombing in the Barzeh al-Balad district, whose residents include members of the Sunni Muslim majority and other religious and ethnic minorities.

"The station is usually packed even when it has no fuel," said an opposition activist who did not want to be named. "There are lots of people who sleep there overnight, waiting for early morning fuel consignments."

It was the second time that a petrol station has been hit in Damascus this week. Dozens of people were incinerated in an air strike as they waited for fuel on Wednesday, according to opposition sources.

In northern Syria, rebels were battling to seize an air base in their campaign against the air power that Assad has used to bomb rebel-held towns.

More than 60,000 people have been killed in the uprising and civil war, the United Nations said this week, a much higher death toll than previously thought.

DRAMATIC ADVANCES

After dramatic advances over the second half of 2012, the rebels now hold wide swathes of territory in the north and east, but they cannot protect towns and villages from Assad's helicopters and jets.

Hundreds of rebel fighters were attempting to storm the Taftanaz air base, near the highway that links Syria's two main cities, Aleppo and Damascus.

A rebel fighter speaking from near the Taftanaz base overnight said much of the base was still in loyalist hands but insurgents had managed to destroy a helicopter and a fighter jet on the ground.

The northern rebel Idlib Coordination Committee said the rebels had detonated a car bomb inside the base.

The government's SANA news agency said the base had not fallen and that the military had "strongly confronted an attempt by the terrorists to attack the airport from several axes, inflicting heavy losses among them and destroying their weapons and munitions".

Rami Abdulrahman, head of the opposition-aligned Syrian Observatory for Human Rights which monitors the conflict from Britain, said as many as 800 fighters were involved in the assault, including Islamists from Jabhat al-Nusra, a powerful group that Washington considers terrorists.

Taftanaz is mainly a helicopter base, used for missions to resupply army positions cut off by the rebels, as well as for dropping crude "barrel bombs" on rebel-controlled areas.

Near Minakh, another northern air base that rebels have surrounded, government forces have retaliated by shelling and bombing nearby towns.

NIGHTLY BOMBARDMENTS

In the town of Azaz, where the bombardment has become a near nightly occurrence, shells hit a family house overnight. Zeinab Hammadi said her two wounded daughters, aged 10 and 12, had been rushed across the border to Turkey, one with her brain exposed.

"We were sleeping and it just landed on us in the blink of an eye," she said, weeping as she surveyed the damage.

Family members tried to salvage possessions from the wreckage, men lifting out furniture and children carrying out their belongings in tubs.

"He (Assad) wants revenge against the people," said Abu Hassan, 33, working at a garage near the destroyed house. "What is the fault of the children? Are they the ones fighting?"

Opposition activists said warplanes struck a residential building in another rebel-held northern town, Hayyan, killing at least eight civilians.

Video footage showed men carrying dismembered bodies of children and dozens of people searching for victims in the rubble. The provenance of the video could not be independently confirmed.

In addition to their tenuous grip on the north, the rebels also hold a crescent of suburbs on the edge of Damascus, which have come under bombardment by government forces that control the center of the capital.

On Wednesday, according to opposition activists, dozens of people died in an inferno caused by an air strike on a petrol station in a Damascus suburb where residents were lining up for fuel.

The civil war in Syria has become the longest and bloodiest of the conflicts that rose out of uprisings across the Arab world in the past two years.

Assad's family has ruled for 42 years since his father seized power in a coup. The war pits rebels, mainly from the Sunni Muslim majority, against a government supported by members of Assad's Shi'ite-derived Alawite minority sect and some members of other minorities who fear revenge if he falls.

The West, most Sunni-ruled Arab states and Turkey have called for Assad to step down. He is supported by Russia and Shi'ite Iran.

(Additional reporting by Khaled Yacoub Oweis in Amman and Dominic Evans in Beirut; Writing by Peter Graff; Editing by Ruth Pitchford and Giles Elgood)

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German minister says "never again" to nuclear power

BERLIN: German Environment Minister Peter Altmaier said on Friday his country would never again return to nuclear energy, hitting back at a top EU official who doubted Berlin's commitment to phase out nuclear power.

"I cannot see any plausible political line-up that would enable a revival of nuclear power in Germany," Altmaier told Friday's edition of the Leipziger Volkszeitung regional daily.

After the 2011 Fukushima disaster in Japan, Germany embarked on an ambitious "energy revolution", deciding to phase out its nuclear power plants by the end of 2022 and bolster renewable sources of energy such as solar and wind power.

However, concerns have mounted that this would entail a sharp rise in electricity prices amid difficulties in building a network able to transmit energy from the North Sea coast to the energy-hungry south of the country.

The European Union's Energy Commissioner, Guenther Oettinger, told Monday's edition of the Rheinische Post regional daily that there would "still be nuclear power on the German network in 40 years."

He said there were still 140 nuclear power stations in Europe and that nuclear fusion technology was progressing rapidly. "Maybe this technology will one day be accepted in Germany," said Oettinger, himself German.

Altmaier also vowed to find a permanent national storage site for nuclear waste by 2030. "We are together looking country-wide," he said, adding that the search would be accelerated in the coming years.

The search would be "co-financed and jointly carried out" by Germany's nuclear energy companies, he said.

- AFP/al

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Former Pakistani cricketer Javed Miandad cancels visit to India

NEW DELHI: Pakistan cricketer Javed Miandad on Friday has cancelled his tour of India. The news of Miandad being granted a visa by the authorities has generated a lot of controversy in India with a number of politicians questioning the decision as Miandad's family has ties with Dawood Ibrahim, India's most wanted terrorist.

There had been reports before a series in 2005 that any requests for a visa by the batting great could be turned down by the Indian government.
Miandad's son Junaid is married to Mahrukh, daughter of Dawood, who is wanted in India in connection with the 1993 Mumbai bomb blasts case.

Foreign minister Salman Khurshid on Thursday defended the decision, saying the visa was granted by the MHA while following the right procedures.

"It is a decision taken by the ministry of home affairs and the government. What are the circumstances, what is considered when an approval is given... what goes into it, is an internal government matter," Khurshid told reporters in Bangalore.

He was responding to a question about the opposition to the grant of visa to Miandad, an official of the Pakistan Cricket Board (PCB), for the India-Pakistan ODI to be played here on January 6.

Due to Miandad's family ties with Dawood, India's most wanted terrorist, there had been reports before a series in 2005 that any requests for a visa by Miandad could be turned down by the Indian government.

"It is the job of MHA. They have taken a decision. No Pakistani visa gets cleared without MHA clearance. Inputs from all agencies are taken into consideration. It is an internal procedure," Khurshid said.

On Shiv Sena's objections over grant of visa, he said, "Opposition only questions. Proper procedures have been gone through in this. Any law of prudence which had to be followed, it was followed, I am sure law will take care".

Criticizing the government's decision, BJP vice-president Mukhtar Abbas Naqvi said, "This country loves the game of cricket but does not love terrorists. Dawood has been the mastermind of several terror acts. Pakistan has refused to hand him over to India despite several efforts. India should not allow any relative of Dawood to come to India".

BJP maintained that Islamabad should hand over Dawood before Miandad is allowed to visit India. "Pakistan today is a factory of terror and manufactures terrorists who work against India," Naqvi said.

BJP MP Kirti Azad, who had played for India, asked why the government had allowed Miandad to visit the country after seven years when Indian government had refused to give him visa since 2005. "Will Dawood Ibrahim's relative come and the Indian government question him?.....giving him visa and playing cricket, how do they think it will improve relations?" Azad asked.

Shiv Sena, which had opposed renewing of cricketing ties with Pakistan, said the whole country should condemn the move. "He's a relative of Dawood and you lay out a red carpet for him.... The whole country should oppose it. Pakistan has spread terrorism whether it is in Delhi, Mumbai or Kashmir," Sena MP Sanjay Raut said.

"He is a well known cricketer. His visa application papers were in order and valid and that is why the government has decided to give him visa," the minister of state for home R P N Singh told reporters on Thursday.

When asked if Miandad was not on India's "negative list", Singh said "no, nothing like that". "He was given visa when his visa papers were found valid," he said.

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Indian court to rule on generic drug industry

NEW DELHI (AP) — From Africa's crowded AIDS clinics to the malarial jungles of Southeast Asia, the lives of millions of ill people in the developing world are hanging in the balance ahead of a legal ruling that will determine whether India's drug companies can continue to provide cheap versions of many life-saving medicines.

The case — involving Swiss drug maker Novartis AG's cancer drug Glivec — pits aid groups that argue India plays a vital role as the pharmacy to the poor against drug companies that insist they need strong patents to make drug development profitable. A ruling by India's Supreme Court is expected in early 2013.

"The implications of this case reach far beyond India, and far beyond this particular cancer drug," said Leena Menghaney, from the aid group Doctors Without Borders. "Across the world, there is a heavy dependence on India to supply affordable versions of expensive patented medicines."

With no costs for developing new drugs or conducting expensive trials, India's $26 billion generics industry is able to sell medicine for as little as one-tenth the price of the companies that developed them, making India the second-largest source of medicines distributed by UNICEF in its global programs.

Indian pharmaceutical companies such as Cipla, Cadila Laboratories and Lupin have emerged over the past decade as major sources of generic cancer, malaria, tuberculosis and AIDS drugs for poor countries that can't afford to pay Western prices.

The 6-year-old case that just wrapped up in the Supreme Court revolves around a legal provision in India's 2005 patent law that is aimed at preventing companies from getting fresh patents for making only minor changes to existing medicines — a practice known as "evergreening."

Novartis' argued that a new version of Glivec — marketed in the U.S. as Gleevec — was a significant change from the earlier version because it was more easily absorbed by the body.

India's Patent Controller turned down the application, saying the change was an obvious development, and the new medicine was not sufficiently distinct from the earlier version to warrant a patent extension.

Patient advocacy groups hailed the decision as a blow to "evergreening."

But Western companies argued that India's generic manufacturers were cutting the incentive for major drug makers to invest in research and innovation if they were not going to be able to reap the exclusive profits that patents bring.

"This case is about safeguarding incentives for better medicines so that patients' needs will be met in the future," says Eric Althoff, a Novartis spokesman.

International drug companies have accused India of disregarding intellectual property rights, and have pushed for stronger patent protection that would weaken India's generics industry.

Earlier this year, an Indian manufacturer was allowed to produce a far cheaper version of the kidney and liver cancer treatment sorefinib, manufactured by Bayer Corp.

Bayer was selling the drug for about $5,600 a month. Natco, the Indian company, said its generic version would cost $175 a month, less than 1/30th as much. Natco was ordered to pay 6 percent in royalties to Bayer.

Novartis says the outcome of the new case will not affect the availability of generic versions of Glivec because it is covered by a grandfather clause in India's patent law. Only the more easily absorbed drug would be affected, Althoff said, adding that its own generic business, Sandoz, produces cheap versions of its drugs for millions across the globe.

Public health activists say the question goes beyond Glivec to whether drug companies should get special protection for minor tweaks to medicines that others could easily have uncovered.

"We're looking to the Supreme Court to tell Novartis it won't open the floodgates and allow abusive patenting practices," said Eldred Tellis, of the Sankalp Rehabilitation Centre, a private group working with HIV patients.

The court's decision is expected to be a landmark that will influence future drug accessibility and price across the developing world.

"We're already paying very high prices for some of the new drugs that are patented in India," said Petros Isaakidis, an epidemiologist with Doctors Without Borders. "If Novartis' wins, even older medicines could be subject to patenting again, and it will become much more difficult for us in future to provide medicines to our patients being treated for HIV, hepatitis and drug resistant TB."

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Central African Republic rebels halt advance, agree to peace talks

DAMARA, Central African Republic (Reuters) - Rebels in Central African Republic said they had halted their advance on the capital on Wednesday and agreed to start peace talks, averting a clash with regionally backed troops.

The Seleka rebels had pushed to within striking distance of Bangui after a three-week onslaught and threatened to oust President Francois Bozize, accusing him of reneging on a previous peace deal and cracking down on dissidents.

Their announcement on Wednesday gave the leader only a limited reprieve as the fighters told Reuters they might insist on his removal in the negotiations.

"I have asked our forces not to move their positions starting today because we want to enter talks in (Gabon's capital) Libreville for a political solution," said Seleka spokesman Eric Massi, speaking by telephone from Paris.

"I am in discussion with our partners to come up with proposals to end the crisis, but one solution could be a political transition that excludes Bozize," he said.

Bozize on Wednesday sacked his Army Chief of Staff and took over the defense minister's role from his son, Jean Francis Bozize, according to a decree read on national radio, a day after publicly criticizing the military for failing to repel the rebels.

The advance by Seleka, an alliance of mostly northeastern rebel groups, was the latest in a series of revolts in a country at the heart of one of Africa's most turbulent regions - and the most serious since the Chad-backed insurgency that swept Bozize to power in 2003.

Diplomatic sources have said talks organized by central African regional bloc ECCAS could start on January 10. The United States, the European Union and France have called on both sides to negotiate and spare civilians.

Central African Republic is one of the least developed countries in the world despite its deposits of gold, diamonds and other minerals. French nuclear energy group Areva mines the country's Bakouma uranium deposit - France's biggest commercial interest in its former colony.

RELIEF IN BANGUI

News of the rebel halt eased tension in Bangui, where residents had been stockpiling food and water and staying indoors after dark.

"They say they are no longer going to attack Bangui, and that's great news for us," said Jaqueline Loza in the crumbling riverside city.

ECCAS members Chad, Congo Republic, Gabon and Cameroon have sent hundreds of soldiers to reinforce CAR's army after a string of rebel victories since early December.

Gabonese General Jean Felix Akaga, commander of the regional force, said his troops were defending the town of Damara, 75 km (45 miles) north of Bangui and close to the rebel front.

"Damara is a red line not to be crossed ... Damara is in our control and Bangui is secure," he told Reuters. "If the rebellion decides to approach Damara, they know they will encounter a force that will react."

Soldiers armed with Kalashnikovs, rocket propelled grenade launchers and truck-mounted machineguns had taken up positions across the town, which was otherwise nearly-abandoned.

Some of the fighters wore turbans that covered their faces and had charms strung around their necks and arms meant to protect them against enemy bullets.

Chad's President Idriss Deby, one of Bozize's closest allies, had warned the rebels the regional force would confront them if they approached the town.

Chad provided training and equipment to the rebellion that brought Bozize to power by ousting then-president Ange Felix Patasse, who Chad accused of supporting Chadian dissidents.

Chad is also keen to keep a lid on instability in the territory close to its main oil export pipeline and has stepped in to defend Bozize against insurgents in the past.

A CAR government minister told Reuters the foreign troop presence strengthened Bozize's bargaining position ahead of the Libreville peace talks.

"The rebels are now in a position of weakness," the minister said, asking not to be named. "They should therefore stop imposing conditions like the departure of the president."

Central African Republic is one of a number of countries in the region where U.S. Special Forces are helping local soldiers track down the Lord's Resistance Army, a rebel group which has killed thousands of civilians across four nations.

France has a 600-strong force in CAR to defend about 1,200 of its citizens who live there.

Paris used air strikes to defend Bozize against a rebellion in 2006. But French President Francois Hollande turned down a request for more help, saying the days of intervening in other countries' affairs were over.

(Additional reporting by Paul-Marin Ngoupana in Bangui and Jon Herskovitz in Johannesburg; Writing by Richard Valdmanis; Editing by Andrew Heavens and Janet Lawrence)

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Marine Life Park dolphins released from quarantine

SINGAPORE: The dolphins at Resorts World Sentosa's Marine Life Park have been released from quarantine and is expected to meet the public soon.

The park said the 24 dolphins have received the Agri-food and Veterinary Authority of Singapore's (AVA) approval for their release.

It added the mammals have adjusted well to their new home through the care of its staff and veterinary professionals.

The park looks forward to let the dolphins meet the public through progressive stages of introduction.

It also gave updates on the laboratory tests on the male dolphin that died on the flight to Singapore from the Philippines.

The final pathology report indicated that Wen Wen had succumbed to an acute bacterial infection.

There was, however, no evidence on the origins of the infection.

Medical examinations prior to the transport indicated that all animals were healthy prior to the move.

The park believes the infection was an isolated incident.

Recently, the park attracted controversy for its import of dolphins.

- CNA/xq

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Obese people at 29% higher risk of premature death

NEW DELHI: People who are obese have a 29% increased risk of premature death.

This could come as a wake-up call for 8 million women and 4.4 million men in India who are obese (body mass index of 30 kg/m2).

One of the largest analyses done - 100 studies that included 3 million adults - has found that obesity was associated with a significantly higher all-cause risk of death.

In this meta-analysis that looked at 2.7 lakh deaths that occurred in the US, Europe, Mexico, India, Israel, Brazil, Japan, Taiwan, China and Australia, researchers found a 18% higher risk of death for obesity - BMI equal or higher than 30 and a 29% increased risk of death among those whose BMI was higher than 35.

The study says that the presence of a wasting disease, heart disease, diabetes, renal dialysis or older age are all associated with an inverse relationship between BMI and mortality rate, an observation termed the obesity paradox.

Over one in 10 adults, who 20 years and above, are obese globally.

That's over half a billion people (205 million men and 297 million women were obese in 2008).

Researchers say excess bodyweight is an important risk factor for mortality and morbidity from cardiovascular diseases, diabetes, cancers and musculoskeletal disorders, causing nearly three million deaths every year worldwide.

While the number of obese men in India increased from 2.3 million to 4.4 million between 1980 and 2008, the number increased from 2.1 million to 8 million among women during the same period

According to the study that was published on the January 2nd issue of the Journal of American Medical Association (JAMA), "Estimates of the relative mortality risks associated with normal weight, overweight and obesity may help to inform decision making in the clinical setting."

Katherine Flegal, of the National Center for Health Statistics, Centers for Disease Control and Prevention, conducted the study to compile and summarize published analyses of body mass index (BMI) and all-cause mortality that provide hazard ratios (HRs) for standard BMI categories.

All-cause mortality HRs for overweight (BMI of 25 and 30), obesity (BMI of 30), grade 1 obesity (BMI of 30-35), and grades 2 and 3 obesity (BMI of 35) were calculated relative to normal weight (BMI of 18.5-25).

The researchers found that the summary HRs indicated a 6% lower risk of death for overweight; a 18% higher risk of death for obesity (all grades), a 5% lower risk of death for grade 1 obesity and a 29% increased risk of death for grades 2 and 3 obesity.

Professor Majid Ezzati from the School of Public Health at Imperial College London had said, "Excess bodyweight is a major public health concern."

Now, India is in the grip of an obesity epidemic. Experts say the trend needs to be immediately arrested by taxing junk food, restricting food ads and making food labelling clearer.

A study that looked at the burden of overweight citizens in six countries - Brazil, China, India, Mexico, Russia and South Africa - has found that between 1998 and 2005, India's overweight rates increased by 20%. Currently, almost one in five men and over one in six women are overweight. In some urban areas, the rates are as high as 40%.

Published in the Lancet by the Organization for Economic Co-operation and Development ( OECD), the annual cost of broad-based prevention strategies tackling obesity and other health threats, such as alcohol consumption, smoking, high blood pressure and cholesterol, would be less than $2 per person per year in India.

Obesity is the root for several non-communicable diseases (NCDs). Another study in the Lancet predicted that by 2030, nearly 70% of all global deaths will be from non-communicable diseases like cancer, diabetes, and respiratory and heart disease. Of these 70% of fatalities, 80% will be in less wealthy nations like India.

According to WHO, NCDs - principally cardiovascular diseases, diabetes, cancers and chronic respiratory diseases - caused an estimated 35 million deaths in 2005. This figure represents 60% of all deaths globally, with 80% of deaths due to noncommunicable diseases occurring in low- and middle-income countries, and approximately 16 million deaths involving people below 70 years.

The total deaths from NCDs are projected to increase by a further 17% over the next 10 years.

Up to 80% of heart disease, stroke and type-2 diabetes and over a third of cancers can be prevented by eliminating shared risk factors, mainly tobacco use, unhealthy diet, physical inactivity and the harmful use of alcohol.

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Flu? Malaria? Disease forecasters look to the sky

NEW YORK (AP) — Only a 10 percent chance of showers today, but a 70 percent chance of flu next month.

That's the kind of forecasting health scientists are trying to move toward, as they increasingly include weather data in their attempts to predict disease outbreaks.

In one recent study, two scientists reported they could predict — more than seven weeks in advance — when flu season was going to peak in New York City. Theirs was just the latest in a growing wave of computer models that factor in rainfall, temperature or other weather conditions to forecast disease.

Health officials are excited by this kind of work and the idea that it could be used to fine-tune vaccination campaigns or other disease prevention efforts.

At the same time, experts note that outbreaks are influenced as much, or more, by human behavior and other factors as by the weather. Some argue weather-based outbreak predictions still have a long way to go. And when government health officials warned in early December that flu season seemed to be off to an early start, they said there was no evidence it was driven by the weather.

This disease-forecasting concept is not new: Scientists have been working on mathematical models to predict outbreaks for decades and have long factored in the weather. They have known, for example, that temperature and rainfall affect the breeding of mosquitoes that carry malaria, West Nile virus and other dangerous diseases.

Recent improvements in weather-tracking have helped, including satellite technology and more sophisticated computer data processing.

As a result, "in the last five years or so, there's been quite an improvement and acceleration" in weather-focused disease modeling, said Ira Longini, a University of Florida biostatistician who's worked on outbreak prediction projects.

Some models have been labeled successes.

In the United States, researchers at Johns Hopkins University and the University of New Mexico tried to predict outbreaks of hantavirus in the late 1990s. They used rain and snow data and other information to study patterns of plant growth that attract rodents. People catch the disease from the droppings of infected rodents.

"We predicted what would happen later that year," said Gregory Glass, a Johns Hopkins researcher who worked on the project.

More recently, in east Africa, satellites have been used to predict rainfall by measuring sea-surface temperatures and cloud density. That's been used to generate "risk maps" for Rift Valley fever — a virus that spreads from animals to people and in severe cases can cause blindness or death. Researchers have said the system in some cases has given two to six weeks advance warning.

Last year, other researchers using satellite data in east Africa said they found that a small change in average temperature was a warning sign cholera cases would double within four months.

"We are getting very close to developing a viable forecasting system" against cholera that can help health officials in African countries ramp up emergency vaccinations and other efforts, said a statement by one of the authors, Rita Reyburn of the International Vaccine Institute in Seoul, South Korea.

Some diseases are hard to forecast, such as West Nile virus. Last year, the U.S. suffered one of its worst years since the virus arrived in 1999. There were more than 2,600 serious illnesses and nearly 240 deaths.

Officials said the mild winter, early spring and very hot summer helped spur mosquito breeding and the spread of the virus. But the danger wasn't spread uniformly. In Texas, the Dallas area was particularly hard-hit, while other places, including some with similar weather patterns and the same type of mosquitoes, were not as affected.

"Why Dallas, and not areas with similar ecological conditions? We don't really know," said Roger Nasci of the Centers for Disease Control and Prevention. He is chief of the CDC branch that tracks insect-borne viruses.

Some think flu lends itself to outbreak forecasting — there's already a predictability to the annual winter flu season. But that's been tricky, too.

Seasonal flu reports come from doctors' offices, but those show the disease when it's already spreading. Some researchers have studied tweets on Twitter and searches on Google, but their work has offered a jump of only a week or two on traditional methods.

In the study of New York City flu cases published last month in the Proceedings of the National Academy of Sciences, the authors said they could foredcast, by up to seven weeks, the peak of flu season.

They designed a model based on weather and flu data from past years, 2003-09. In part, their design was based on earlier studies that found flu virus spreads better when the air is dry and turns colder. They made calculations based on humidity readings and on Google Flu Trends, which tracks how many people are searching each day for information on flu-related topics (often because they're beginning to feel ill).

Using that model, they hope to try real-time predictions as early as next year, said Jeffrey Shaman of Columbia University, who led the work.

"It's certainly exciting," said Lyn Finelli, the CDC's flu surveillance chief. She said the CDC supports Shaman's work, but agency officials are eager to see follow-up studies showing the model can predict flu trends in places different from New York, like Miami.

Despite the optimism by some, Dr. Edward Ryan, a Harvard University professor of immunology and infectious diseases, is cautious about weather-based prediction models. "I'm not sure any of them are ready for prime time," he said.

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Obama Signs 'Fiscal Cliff' Bill With Autopen

Jan 3, 2013 12:53am

Charles Dharapak/AP Photo

HONOLULU, Hawaii — President Obama has signed the “fiscal cliff” legislation into law via autopen from Hawaii, where he is vacationing with his family.

The bill to avert the “fiscal cliff” arrived at the White House late this afternoon and it was immediately processed, according to a senior White House official. A copy was delivered to the president in Hawaii for review. He then directed the bill to be signed by autopen back in Washington, D.C.

The Bush administration deemed in 2005 that the use of the autopen is constitutional, although President George W. Bush never used the mechanical device to replicate his signature on a bill.

The office of legal counsel found at the time that Article 1, Section 7 of the Constitution allows the president to use the autopen to sign legislation, stating “the President need not personally perform the physical act of affixing his signature to a bill to sign it.”

Obama has used the autopen twice in the past to sign legislation, both times while he was overseas.

Use of the autopen has been controversial.  Conservative groups alleged last summer that Obama used an autopen to sign condolence letters to the families of Navy SEALs killed in a Chinook crash in Afghanistan — a charge the White House disputed flatly as false.

In 2004, then-Secretary of Defense Donald Rumsfeld was criticized for using an autopen to sign condolence letters to the families of fallen troops.

And in 1992 then-Vice President Dan Quayle even got into some hot water over his use of the autopen on official correspondence during an appearance on “This Week with David Brinkley.”

Obama, who arrived back in Hawaii early Wednesday morning to continue his family vacation, spent the afternoon golfing with friends at the Marine Corps base at Kaneohe Bay.

Obama is slated to remain in Hawaii through Saturday.

ABC News’ Jonathan Karl contributed to this report

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