Clinton receiving blood thinners to dissolve clot

WASHINGTON (AP) — Secretary of State Hillary Rodham Clinton continues to recover in a New York hospital where she's being treated for a blood clot in her head.

Her doctors say blood thinners are being used to dissolve the clot and they are confident she will make a full recovery. Clinton didn't suffer a stroke or neurological damage from the clot that formed after she suffered a concussion during a fainting spell at her home in early December, doctors said in a statement Monday.

Clinton, 65, was admitted to New York-Presbyterian Hospital on Sunday when the clot turned up on a follow-up exam on the concussion, Clinton spokesman Phillipe Reines said. The clot is located in the vein in the space between the brain and the skull behind the right ear. She will be released once the medication dose for the blood thinners has been established, the doctors said.

In their statement, Dr. Lisa Bardack of the Mount Kisco Medical Group and Dr. Gigi El-Bayoumi of George Washington University said Clinton was making excellent progress and was in good spirits.

Clinton's complication "certainly isn't the most common thing to happen after a concussion" and is one of the few types of blood clots in the skull or head that are treated with blood thinners, said Dr. Larry Goldstein, a neurologist who is director of Duke University's stroke center. He is not involved in Clinton's care.

The area where Clinton's clot developed is "a drainage channel, the equivalent of a big vein inside the skull. It's how the blood gets back to the heart," Goldstein said.

Blood thinners usually are enough to treat the clot and it should have no long-term consequences if her doctors are saying she has suffered no neurological damage from it, Goldstein said.

Clinton returned to the U.S. from a trip to Europe, then fell ill with a stomach virus in early December that left her severely dehydrated and forced her to cancel a trip to North Africa and the Middle East. Until then, she had canceled only two scheduled overseas trips, one to Europe after breaking her elbow in June 2009 and one to Asia after the February 2010 earthquake in Haiti.

Her condition worsened when she fainted, fell and suffered a concussion while at home alone in mid-December as she recovered from the virus.

This isn't the first time Clinton has suffered a blood clot. In 1998, midway through her husband's second term as president, Clinton was in New York fundraising for the midterm elections when a swollen right foot led her doctor to diagnose a clot in her knee requiring immediate treatment.

Clinton had planned to step down as secretary of state at the beginning of President Barack Obama's second term. Whether she will return to work before she resigns remains a question.

Democrats are privately if not publicly speculating: How might her illness affect a decision about running for president in 2016?

After decades in politics, Clinton says she plans to spend the next year resting. She has long insisted she had no intention of mounting a second campaign for the White House four years from now. But the door is not entirely closed, and she would almost certainly emerge as the Democrat to beat if she decided to give in to calls by Democratic fans and run again.

Her age — and thereby health — would probably be a factor under consideration, given that Clinton would be 69 when sworn in, if she were elected in 2016. That might become even more of an issue in the early jockeying for 2016 if what started as a bad stomach bug becomes a prolonged, public bout with more serious infirmity.

Not that Democrats are willing to talk openly about the political implications of a long illness, choosing to keep any discussions about her condition behind closed doors. Publicly, Democrats reject the notion that a blood clot could hinder her political prospects.

"Some of those concerns could be borderline sexist," said Basil Smikle, a Democratic strategist who worked for Clinton when she was a senator. "Dick Cheney had significant heart problems when he was vice president, and people joked about it. He took the time he needed to get better, and it wasn't a problem."

It isn't uncommon for presidential candidates' health — and age — to be an issue. Both in 2000 and 2008, Sen. John McCain, R-Ariz., had to rebut concerns he was too old to be commander in chief or that his skin cancer could resurface.

Beyond talk of future politics, Clinton's three-week absence from the State Department has raised eyebrows among some conservative commentators who questioned the seriousness of her ailment after she canceled planned Dec. 20 testimony before Congress on the deadly attack on the U.S. diplomatic mission in Benghazi, Libya.

Clinton had been due to discuss with lawmakers a scathing report she had commissioned on the attack. It found serious failures of leadership and management in two State Department bureaus were to blame for insufficient security at the facility. Clinton took responsibility for the incident before the report was released, but she was not blamed. Four officials cited in the report have either resigned or been reassigned.

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New School for Sandy Hook Duplicated to the Crayons

The students and staff of Sandy Hook Elementary School will return to school on Thursday for the first time since the shooting rampage that left 20 young students and six adults dead. The students will be in a new building where their old classrooms have been completely recreated.

Instead of returning to the halls of Sandy Hook Elementary School in Newtown, Conn., they will be going to the building that used to be the Chalk Hill Middle School in Monroe, about six miles away.

Sandy Hook school was shut since Adam Lanza carried out his massacre shortly before Christmas.

Since principal Dawn Hochsprung was one of the victims of the shooting, the school will be led by interim principal Donna Page. Page was the school's prior principal who retired in 2010.

"Please know the inspiration you and your children have been to my staff and me as we connect with you at Chalk Hill," Page wrote in a letter posted on the school's website. "Be assured that the towns of Monroe and Newtown are working night and day to ensure the facility is safe, secure, and fully operational for our return," Page wrote.

The school will host a walk-through for families on Wednesday and "Opening Day" will be Thursday.

"I want to reassure you that we understand many parents may need to be near their children on their first day(s) of school and you will be welcome," Page wrote.

Don Emmert/AFP/Getty Images

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The school is encouraging students to take the bus in order to help them return to familiar routines and said parents may come to the school's classrooms or auditorium throughout the day after the 9:07 a.m. opening. They are asking that no more than one adult family member accompany each child in order "to ensure a safe and secure environment."

In addition to a parental presence at the school, comfort dogs will be returning to brighten the day. Small armies of golden retrievers spread out all over Newtown in the days following the shooting to comfort mourners young and old.

Chicago's Lutheran Church Charities' K-9 Parish Comfort Dogs were in Newtown after the shooting and are traveling back to Connecticut today. Nine dogs and their handlers gathered at their building at 1 a.m. this morning to board a caravan of one RV and two vans heading to Connecticut.

"The community of Newtown will be going through the healing process for a very long time," the group wrote on their website. "The LCC K-9 Comfort dogs will be returning to Newtown...They will be there to greet children as they return to school."

The rest of the Newtown school district resumes classes on Wednesday.

Furniture and supplies from Sandy Hook were moved to Chalk Hill in order to recreate the classrooms just as they were.

Teachers photographed their classrooms at Sandy Hook in order to replicate everything about them, from the pictures on the walls to the crayons left on the students' desks. This is all part of an effort to make the students feel as comfortable as possible.

Workers completely retrofitted the former middle school to fit the needs of its young students, including tearing out bathrooms that were made for teenagers and rebuilding them for elementary-aged kids.

New security systems are being installed at Chalk Hill school, and Newtown Councilman Steve Vavrek told ABC News that the school will be "the safest school in America."

For a school that has gone through so much, moving forward does not mean forgetting.

"I want parents and families enduring the loss of their precious children to know their loved ones are foremost in our hearts and minds as we move forward," Page wrote. "Your strength and compassion has been, and will continue to be an inspiration to me and countless others as we work to honor the memory of your precious children and our beloved staff."

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State Department made "grievous mistake" over Benghazi: Senate report

WASHINGTON (Reuters) - The State Department made a "grievous mistake" in keeping the U.S. mission in Benghazi open despite inadequate security and increasingly alarming threat assessments in the weeks before a deadly attack by militants, a Senate committee said on Monday.

A report from the Senate Homeland Security Committee on the September 11 attacks on the U.S. mission and a nearby CIA annex, in which the U.S. ambassador to Libya and three other Americans died, faulted intelligence agencies for not focusing tightly enough on Libyan extremists.

It also faulted the State Department for waiting for specific warnings instead of improving security.

The committee's assessment, "Flashing Red: A Special Report On The Terrorist Attack At Benghazi," follows a scathing report by an independent State Department accountability review board that resulted in a top security official resigning and three others at the department being relieved of their duties.

Joseph Lieberman, an independent senator who chairs the committee, said that in thousands of documents it reviewed, there was no indication that Secretary of State Hillary Clinton had personally denied a request for extra funding or security for the Benghazi mission. He said key decisions were made by "midlevel managers" who have since been held accountable.

Republican Senator Susan Collins said it was likely that others needed to be held accountable, but that decision was best made by the Secretary of State, who has the best understanding "of how far up the chain of command the request for additional security went."

The attacks and the death of U.S. Ambassador Christopher Stevens put diplomatic security practices at posts in risky areas under scrutiny and raised questions about whether intelligence on militant activity in the region was adequate.

The Senate report said the lack of specific intelligence of an imminent threat in Benghazi "may reflect a failure" by intelligence agencies to focus closely enough on militant groups with weak or no operational ties to al Qaeda and its affiliates.

"With Osama bin Laden dead and core al Qaeda weakened, a new collection of violent Islamist extremist organizations and cells have emerged in the last two to three years," the report said. That trend has been seen in the "Arab Spring" countries undergoing political transition or military conflict, it said.

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The report recommended that U.S. intelligence agencies "broaden and deepen their focus in Libya and beyond, on nascent violent Islamist extremist groups in the region that lack strong operational ties to core al Qaeda or its main affiliate groups."

Neither the Senate report nor the unclassified accountability review board report pinned blame for the Benghazi attack on a specific militant group. The FBI is investigating who was behind the assaults.

President Barack Obama, in an interview on NBC's "Meet the Press" on Sunday, said the United States had "very good leads" about who carried out the attacks. He did not provide details.

The Senate committee said the State Department should not have waited for specific warnings before acting on improving security in Benghazi.

It also said it was widely known that the post-revolution Libyan government was "incapable of performing its duty to protect U.S. diplomatic facilities and personnel," but the State Department failed to fill the security gap.

"Despite the inability of the Libyan government to fulfill its duties to secure the facility, the increasingly dangerous threat assessments, and a particularly vulnerable facility, the Department of State officials did not conclude the facility in Benghazi should be closed or temporarily shut down," the report said. "That was a grievous mistake."

The Senate panel reviewed changing comments made by the Obama administration after the attack, which led to a political firestorm in the run-up to the November presidential election and resulted in U.S. Ambassador to the United Nations Susan Rice withdrawing her name from consideration to replace Clinton, who is stepping down early next year.

Rice had said her initial comments that the attack grew out of a spontaneous protest over an anti-Islam film were based on talking points provided by intelligence agencies.

Lieberman said it was not the job of intelligence agencies to formulate unclassified talking points and they should decline such requests in the future.

The report said the original talking points included a line saying "we know" that individuals associated with al Qaeda or its affiliates participated in the attacks. But the final version had been changed to say: "There are indications that extremists participated," and the reference to al Qaeda and its affiliates was deleted.

The report said that while James Clapper, the director of national intelligence, had offered to provide the committee with a detailed chronology of how the talking points were written and evolved, this had still not been delivered to Capitol Hill because the administration had spent weeks "debating internally" whether or not it should turn over information considered "deliberative" to Congress.

(Editing by Warren Strobel and David Brunnstrom)

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President Obama says deal in sight to avert fiscal cliff

WASHINGTON: President Barack Obama said on Monday a deal to avert the fiscal cliff budget crisis was in sight, as dramatic New Year's Eve negotiations went down to the wire ahead of a midnight deadline.

"It appears that an agreement to prevent this New Year's tax hike is within sight. It's not done. There are still issues left to resolve, but we're hopeful that Congress can get it done," Obama said at the White House.

The framework of a possible deal to head off automatic tax increases due to kick in with the turn of a year appeared to be in place after through the night negotiations between Democrats and Republicans on Capitol Hill.

But Obama hinted that the proposed pact would not deal with complementary and punishing cuts to government spending also due to take place in the New Year, which he said would have to be dealt with down the line.

The president said the deal would extend tax credits for clean energy firms and also unemployment insurance for two million people which are due to expire later Monday.

"For now, our most immediate priority is to stop taxes going up for middle class families, starting tomorrow. I think that is a modest goal that we can accomplish. Democrats and Republicans in congress have to get this done."

Even if the Democratic-controlled Senate does sign off on a deal Monday, avoiding the cliff could go down to the wire.

The bill must then go to the Republican-held House of Representatives.

The chamber is in session on Monday, but House Speaker John Boehner has struggled to control his party's restive conservatives, many of whom may balk at signing on to any Obama-approved deal that raises taxes.

The key areas of friction are the income threshold at which taxes should rise, Obama's insistence on extending unemployment benefits and Republican demands for increased federal spending cuts.

Reports said that the deal would see taxes rise for families earning more than $450,000 a year. Obama had originally campaigned for the threshold to kick in for those making $250,000 and above.

"There are a number of issues on which the two sides are still apart," Democratic Senate Majority Harry Reid conceded. "Negotiations are continuing as I speak, but we really are running out of time."

Days of last-gasp talks have produced no deal between US political leaders struggling for a compromise to head off a fiscal crisis that could roil global markets and plunge the United States back into a punishing recession.

Republicans have dropped their demand for a new way of calculating inflation that would have cut the level of benefits for Social Security recipients.

But they were reportedly maintaining their insistence that estate inheritance tax rates stay at current levels.

The two sides remained bitterly at odds over the $109 billion in automatic spending cuts set to hit the Pentagon as well as other federal agencies beginning in early January.

Democrats said they were pushing for a delay of the cuts, known as the "sequester," for about two years, while some Republicans, including Senator Roy Blunt, said it was inconceivable to allow a delay without imposing more targeted offsets to pay for such a postponement.

Don Stewart, McConnell's spokesman, said in a statement on Monday that the Republican leader and Biden had talked long into the night to try to hammer out a deal.

Democratic congressman Chris Van Hollen said there was better than a 50-50 chance of a pre-midnight agreement, but his Republican rivals were a question mark.

"One big question of course is whether an agreement put together by the senators on a bipartisan basis, whether that can pass the House of Representatives," he told CNN.

Republicans largely oppose raising taxes on anyone.

There may be a push by conservatives to let the economy slide off the cliff so that taxes rise on all Americans, only for lawmakers to quickly turn around and vote for a tax cut on the middle class.

- AFP/de

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UP government to give Rs 20 lakh compensation for Delhi-gang-rape victim's family

LUCKNOW: Uttar Pradesh (UP) government on Monday announced Rs 20 lakh compensation for the family of the Delhi gang-rape victim who succumbed to injuries two days ago. The compensation will be given from the chief minister's discretionary fund.

Earlier, on December 21, chief minister Akhilesh Yadav had announced to give Rs five lakh financial assistance to the family of the victim in addition to the the offer to all medical expenses and a job after recovery.

The family hails from a village in Ballia district of the state and had moved to Delhi 20 years ago but is still connected to its native place.

He had taken a loan for the education of his daughter who wanted to be a physiotherapist. His two sons are still studying.

The chief minister announced the Rs 20 lakh compensation overlooking the criticism of Bahujan Samaj Party (BSP) chief Mayawati and Shahi Imam of Delhi's Jama Masjid Imam Bukhari. Mayawati had said that compensation is fine but the state government should focus on preventing rapes and provide speedy justice. She had also alleged that crime against women has increased manifold in first nine months of Samajwadi Party (SP) rule in the state. Bukhari had said that SP government should have also announced compensation for the Muslim rape victims.

Earlier today, the Delhi government announced financial aid of Rs 15 lakh for the next of the kin of the 23-year-old gang-rape victim and offered a job to a family member of the girl, who died two days ago.

The decisions were taken at a cabinet meeting presided over by chief minister Sheila Dikshit.

The phsyiotherapy student was brutally gang-raped and assaulted in a moving bus in south Delhi on December 16. She breathed her last in a Singapore hospital on Saturday morning and her mortal remains were cremated here on Sunday.

(Inputs from PTI)

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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.

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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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Time's Up: Sides Closing In on 'Fiscal Cliff' Deal

President Obama said an 11th-hour agreement to avert year-end tax hikes on 98 percent of Americans is "within sight" but not yet complete with just hours to go before the nation reaches the so-called fiscal cliff.

"There are still issues left to resolve but we're hopeful Congress can get it done," Obama said at a midday White House news conference. "But it's not done."

Congressional and White House negotiators have forged the contours of an agreement that would extend current tax rates for households making $450,000 or less; raise the estate tax from 35 to 40 percent for estates larger than $5 million; and prevent the Alternative Minimum Tax from hammering millions of middle-class workers, sources said.

The deal would also extend for one year unemployment insurance benefits set to expire Tuesday, and avert a steep cut to Medicare payments for doctors.

"There is an agreement to fix the tax problem; that is finalized," an aide to Senate Minority Leader Mitch McConnell told ABC News.

Both sides remained at odds over what to do about the other significant piece of the "fiscal cliff" -- the more than $1 trillion of automatic cuts to defense and domestic programs set to begin tomorrow.

The White House has proposed a three-month delay of the cuts to allow more time to hash out details for deficit reduction, while many Senate Democrats want a flat one-year delay. Republicans insist that some spending cuts should be implemented now as part of any deal.

Chip Somodevilla/Getty Images

"In order to get the sequester moved, you're going to have to have real, concrete spending cuts," Rep. Mike Rogers, R-Mich., said. "[Without that], I don't know how it passes the House."

Vice President Joe Biden and McConnell, R-Ky., have been locked in behind-the-scenes negotiations for much of the day, sources said, following several "good" conversations that stretched late into Sunday night.

If a deal is reached between Biden and McConnell, members in both chambers would still need to review it and vote on it later today. Passage is far from guaranteed.

"This is one Democrat that doesn't agree with that at all," Iowa Democratic Sen. Tom Harkin said of the tentative deal. "No deal is better than a bad deal, and this looks like a very bad deal the way this is shaping up."

"I don't see how you get something voted on today," Rogers said. "Even if they get a handshake deal today, you have to put the whole thing together and that's probably not going to happen before midnight. So it would make sense to roll into tomorrow to do that."

Failure of Congress to act on a tax measure by Tuesday morning would trigger income tax hikes on all Americans. The average family would pay an extra $3,446 in 2013 under the higher rates, according to the Tax Policy Center.

Regardless of the "cliff," virtually all workers are due to see less in their paychecks starting in January when the temporary 2 percent payroll tax cut will expire.

More than $1 trillion in automatic spending cuts to defense and domestic programs will also begin to take effect later this week unless Congress delays or replaces them.

"It is absolutely inexcusable that all of us find ourselves in this place at this time," Sen. Joe Manchin, D-W.Va., said Sunday night on the Senate floor.

"Something has gone terribly wrong when the biggest threat to our American economy is our American Congress," he said, echoing a frustration shared by many Americans.

Both sides say the cost of failure is high.

"If we are not able to reach an agreement, it will be dire," Sen. Jon Kyl, R-Ariz., said Sunday on ABC's "This Week." "Probably at least another million jobs lost, an unemployment rate over 9 percent, and putting us back into recession."

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C. Africa's pressured leader open to unity government

BANGUI: The president of the Central African Republic was on Sunday said to be ready to make important concessions to a rebel coalition that has easily pushed its way across the impoverished country and was within striking distance of the capital Bangui.

After meeting with President Francois Bozize, African Union chief Thomas Boni Yayi said Bozize was ready to take part in talks to end the crisis, and that he would not run for president in 2016.

The talks "should lead to a national unity government", Boni Yayi said, adding that Bozize, who seized power in a 2003 coup and then won two elections, would not run for re-election in 2016 and would "respect constitutional provisions".

Opposition figures have criticised the president, whom they suspect wants to modify the constitution to enable a third term in office.

Rebels from a coalition known as Seleka, who took up arms December 10 near the Chad border and have met little resistance from government troops, on Sunday warned they could enter Bangui.

The rebels, now controlling five regional capitals in the centre and north of the country, faced no opposition as they entered the town of Sibut around 150 kilometres from Bangui on Saturday, a military official told AFP.

The country's armed forces had retreated to Damara, the last major town on the way to the capital, about 75 kilometres to the southwest.

Rebel spokesman Eric Massi on Sunday had said rebels would enter Bangui "if the situation demands it" but later said he had "taken note" of Bozize's pledges.

"A meeting shall be held with (Boni Yayi) to study in detail President Bozize's proposals and together create a plan to end the crisis," he told French radio.

With the rebels closing in, the Economic Community of Central African States (ECCAS), which has troops in the country, warned both sides Sunday that Damara must remain in government control.

"The ECCAS forces are on maximum alert, and the city of Damara is the line not to be crossed. We ask the FACA (government forces) and the rebels not to advance from their current positions and to give talks a chance," said Antonio Di Garcia, head of the regional bloc's mission, on national radio.

The rebels have been insisting on Bozize's departure.

"That issue must be discussed with the African Union," Massi told AFP. "President Bozize must recognise his military defeat on the ground ... and draw the necessary conclusions".

Officials on both sides said the rebels had also repelled army soldiers trying to recapture Bambari, a former military stronghold in the landlocked country, one of the world's poorest despite vast mineral wealth.

The coalition of three rebel movements in Seleka -- or the "alliance" in the Sango language -- launched their offensive claiming the government failed to meet the terms of peace pacts signed in 2007 and 2011, which include providing for disarmament, pay and social reintegration for insurgents.

Bozize on Sunday asked for a meeting with French President Francois Hollande, but calls for help from former colonial power France, as well as from the United States, have so far not been heeded.

France has a military presence of about 580 troops in the country, 180 of whom arrived overnight Saturday, the French defence ministry said.

This contingent is on hand to help protect and evacuate French and European nationals, should the need arise.

Hollande late Sunday urged all sides involved in the conflict to end hostilities, and welcomed efforts to find a negotiated solution to the crisis.

Neighbouring Chad, which helped Bozize with rebellions in 2010, has sent a contingent to the country, but those troops too have retreated from the rebel advance.

In Bangui, the population was fearful of a rebel attack and the uncertainty has caused a sharp spike in food prices. Authorities have imposed a night-time curfew, resulting in an eerie quiet in the usually noisy city.

In the town centre, businesses had hired guards armed with machetes to stand watch and prevent looting.

"I'm afraid of the rebels coming," said vegetable vendor Euphrasie Ngotanga in the city's huge Sambo market. "We're not going to sell our produce if there's no peace. And then how we will feed our children?"

The landlocked Central African Republic, with a population of about five million, is notorious for unrest including coups, army mutinies and rebellions.

- AFP/jc

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Don't take my daughter away from me, let her remain with me: Nirbhaya's mother

NEW DELHI: After nearly two weeks of watching their daughter fight a losing battle for her life, family members of the gang-rape victim had less than four hours to attend to VVIPs and arrange for her final rites.

They arrived at IGI Airport with her body at 3.30 am and by 7.30 am the last rites were completed.

Half-an-hour was spent meeting Prime Minister Manmohan Singh and Congress president Sonia Gandhi at the airport and another 30 minutes to rush the body home in a cavalcade of police vans.

Between 4.30 am and 6.30 am, the parents met their relatives at home and made arrangements for the last rites. The funeral procession of the braveheart was restricted to a distance as long as only five houses.

The mother of the 23-year-old woman fainted several times after the body was brought to their family home. "Meri bachchi ko mere paas rehne do, usey mujhse door mat karo (don't take my daughter away from me, let her remain with me)," cried out the distraught mother as the body of her young daughter was being taken to the crematorium.

The family was asked to rush to the crematorium in an ambulance after that and the relatives and neighbours were packed into two mini vans.

At 6.45 am, when the body reached the crematorium, it was dark. The pyre was prepared in torchlight and with the help of searchlights carried by the policemen.

The Congress MP from the area, Mahabal Mishra, and his supporters could be seen 'helping' the parents in arranging things for the last rites like the wood and even calling in the mourners, which included union minister of state for home affairs R P N Singh and chief minister Sheila Dikshit among others.

The funeral pyre was lit at 7.30 am by the victim's father. "I have lost everything I had. My daughter..," the bereaved father cried. The victim's younger brother was inconsolable.

State BJP president Vijender Gupta, Matiala councillor Rajesh Gehlot and BJP leader Jagdish Mukhi also paid a brief visit to the bereaved parents.

The crematorium was guarded by over 500 policemen, including BSF jawans. Almost all senior police officers from the area, including DCP, South, Chhaya Sharma, Joint CP, South-West, Vivek Gogia, and DCP airport J S Deswal, were present at the venue while the last rites were being performed.

"We did know that the deceased was the one we were hearing about on news channels. Her family had told everyone that she met with an accident. But now everyone knows thanks to heavy police deployment in the area and the visits by VVIPs. Last night, some policemen had come to the locality to put up barricades around 8 am and they also told us not to allow any mediaperson into the home for shooting videos," said a neighbour.

The police officers, who did not want to be named, justified the deployment, saying they did not want to take any chances as there were fears of some mischief-makers trying to incite violence.

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Kenya hospital imprisons new mothers with no money

NAIROBI, Kenya (AP) — The director of the Pumwani Maternity Hospital, located in a hardscrabble neighborhood of downtown Nairobi, freely acknowledges what he's accused of: detaining mothers who can't pay their bills. Lazarus Omondi says it's the only way he can keep his medical center running.

Two mothers who live in a mud-wall and tin-roof slum a short walk from the maternity hospital, which is affiliated with the Nairobi City Council, told The Associated Press that Pumwani wouldn't let them leave after delivering their babies. The bills the mothers couldn't afford were $60 and $160. Guards would beat mothers with sticks who tried to leave without paying, one of the women said.

Now, a New York-based group has filed a lawsuit on the women's behalf in hopes of forcing Pumwani to stop the practice, a practice Omondi is candid about.

"We hold you and squeeze you until we get what we can get. We must be self-sufficient," Omondi said in an interview in his hospital office. "The hospital must get money to pay electricity, to pay water. We must pay our doctors and our workers."

"They stay there until they pay. They must pay," he said of the 350 mothers who give birth each week on average. "If you don't pay the hospital will collapse."

The Center for Reproductive Rights, which filed the suit this month in the High Court of Kenya, says detaining women for not paying is illegal. Pumwani is associated with the Nairobi City Council, one reason it might be able to get away with such practices, and the patients are among Nairobi's poorest with hardly anyone to stand up for them.

Maimouna Awuor was an impoverished mother of four when she was to give birth to her fifth in October 2010. Like many who live in Nairobi's slums, Awuor performs odd jobs in the hopes of earning enough money to feed her kids that day. Awuor, who is named in the lawsuit, says she had saved $12 and hoped to go to a lower-cost clinic but was turned away and sent to Pumwani. After giving birth, she couldn't pay the $60 bill, and was held with what she believes was about 60 other women and their infants.

"We were sleeping three to a bed, sometimes four," she said. "They abuse you, they call you names," she said of the hospital staff.

She said saw some women tried to flee but they were beaten by the guards and turned back. While her husband worked at a faraway refugee camp, Awuor's 9-year-old daughter took care of her siblings. A friend helped feed them, she said, while the children stayed in the family's 50-square-foot shack, where rent is $18 a month. She says she was released after 20 days after Nairobi's mayor paid her bill. Politicians in Kenya in general are expected to give out money and get a budget to do so.

A second mother named in the lawsuit, Margaret Anyoso, says she was locked up in Pumwani for six days in 2010 because she could not pay her $160 bill. Her pregnancy was complicated by a punctured bladder and heavy bleeding.

"I did not see my child until the sixth day after the surgery. The hospital staff were keeping her away from me and it was only when I caused a scene that they brought her to me," said Anyoso, a vegetable seller and a single mother with five children who makes $5 on a good day.

Anyoso said she didn't have clothes for her child so she wrapped her in a blood-stained blouse. She was released after relatives paid the bill.

One woman says she was detained for nine months and was released only after going on a hunger strike. The Center for Reproductive Rights says other hospitals also detain non-paying patients.

Judy Okal, the acting Africa director for the Center for Reproductive Rights, said her group filed the lawsuit so all Kenyan women, regardless of socio-economic status, are able to receive health care without fear of imprisonment. The hospital, the attorney general, the City Council of Nairobi and two government ministries are named in the suit.

___

Associated Press reporter Tom Odula contributed to this report.

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