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By Genevra Pittman
NEW YORK (Reuters Health) - Women who take the epilepsy drug valproate during pregnancy are three times more likely to have a child with an autism spectrum disorder, suggests new research based on close to 700,000 babies born in Denmark.
Previous studies have found more birth defects and lower intelligence among children of mothers who took valproate, but the new work represents the "strongest evidence to date" of a link between the drug and autism, according to an editorial published with the study on Tuesday.
The results don't prove the generic drug, also sold as valproic acid, causes autism. But researchers were able to account for a number of underlying factors - such as the age and health of the mothers and the babies' fathers - that make the study more convincing, Christopher Stodgell said.
"This finding isn't necessarily a brand new finding, but it's an important finding in that (researchers studied) really a much larger population, and they also looked at some other underlying drivers," said Stodgell, who studies the origins of autism at the University of Rochester Medical Center but wasn't involved in the new research.
Women "need to be very diligent about what the effects are if they're taking valproic acid," he told Reuters Health.
About one in 88 children has an autism spectrum disorder, or ASD, according to the U.S. Centers for Disease Control and Prevention. Those conditions range from autism itself to less disabling ones such as Asperger's syndrome.
For the new study, researchers tracked 656,000 kids born in Denmark between 1996 and 2006. Using a large prescription drug database, they found that just under 6,600 of the mothers of those children had epilepsy and 508 women took valproate while pregnant.
By 2010, 4.4 percent of the kids whose mothers had taken valproate during pregnancy were diagnosed with any ASD, including 2.5 percent with autism.
In contrast, 1.5 percent of all babies in the study had an ASD and 0.5 percent had autism, the study team reported in the Journal of the American Medical Association.
Mothers' underlying epilepsy didn't fully explain the link, according to Jakob Christensen from Aarhus University and his colleagues. In addition, autism rates were higher among children of women who used valproate during pregnancy than those who had previously used the drug but stopped before conceiving.
CONSIDER RISKS, BENEFITS
"Valproate is an effective drug, but it appears that it is being prescribed for women of childbearing potential at a rate that does not fully consider the ratio of benefits to risks," wrote Dr. Kimford Meador and David Loring from Emory University in Atlanta, in a linked editorial.
Valproate could affect maturation of a fetus's brain, Christensen suggested, including the signal-sending neurotransmitters.
Women who may become pregnant "certainly should discuss with their doctor if there are alternative treatments that would be reasonable," he told Reuters Health.
For those with certain syndromes or generalized epilepsy, there aren't necessarily other good options. Stopping valproate in that case isn't a good idea, Christensen said.
"It's also a risk if you have seizures, both for the mother and the unborn child. (Stopping medication) is not a thing that you take lightly," he said.
"Even those that are exposed to this drug, there's still a good chance - more than a 95-percent chance - that their child will never develop signs of autism."
The study didn't take into account whether women drank during pregnancy, or if they took folic acid - which has been tied to a lower risk of some birth defects.
Christensen said there are steps pregnant women on valproate can take to lower any risks to their baby, such as using the lowest possible dose and dividing it up during the day.
SOURCE: http://bit.ly/JjFzqx Journal of the American Medical Association, online April 23, 2013.
Source: http://news.yahoo.com/epilepsy-drug-pregnancy-tied-autism-risk-205345524.html
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Authorities say Dzhokhar Tsarnaev is beginning to respond in writing to questions from federal interrogators, though plenty of questions still remain. NBC's Pete Williams reports.
By Jeff Black, Staff Writer, NBC News, NBC News
As prosecutors prepare to charge 19-year-old Dzhokhar Tsarnaev in the deadly twin bomb blasts at the Boston Marathon, investigators are delving into numerous unanswered questions surrounding the attack and the brothers believed to have carried it out.
Officials say Tsarnaev is said to be unable to speak due to a possibly self-inflicted throat wound, but he is responding to investigators? questions in writing during brief interview sessions being conducted by a special interrogation team. And piecing together the facts will rely very heavily on him, since his older brother, Tamerlan, was killed early Friday during a gunfight with police in Watertown, Mass.
As we wait for word on what the suspect is saying, here are a few of the critical unanswered questions investigators are certain to put to him:
Were more attacks planned?
The most important question for investigators to answer is whether Tsarnaev and his brother had hoped to carry out more attacks and, if so, had they taken any steps toward planning them.
The brothers clearly had the means to cause more destruction: authorities say they have recovered what adds up to an arsenal of deadly weapons from various crime scenes, including homemade bombs, grenades, guns and hundreds of rounds of ammunition.
Police Commissioner Ed Davis said the stockpile suggests the marathon attack was intended to be just the first in a series.
"We have reason to believe, based upon the evidence that was found at that scene -- the explosions, the explosive ordnance that was unexploded and the firepower that they had -- that they were going to attack other individuals. That's my belief at this point." Davis said Sunday on CBS' "Face the Nation.
Did terrorist groups overseas aid the attack?
Investigators are focused on a six-month trip that Tamerlan Tsarnaev took in January 2012, traveling first to Moscow, then to Dagestan and Chechnya, according to his parents.
In an interview Sunday with The Associated Press, Anzor and Zubeidat Tsarnaev said he spent his time there sleeping and visiting with relatives -- not consorting with Islamic terrorists.
But some U.S. officials suggest that Tamerlan was not behaving like a typical vacationer.
Rep. Mike Rogers, R-Mich., chairman of the House Intelligence Committee, said Sunday on ?Meet the Press? that the elder brother may have traveled under an alias.
Suspicions that Tamerlan, who reportedly turned to more fundamental Islamic beliefs in recent years, could have received terrorist training or support abroad were heightened Friday, when an official familiar with the matter told NBC News that a foreign government (later said to be Russia) had expressed concern in 2011 that he could have ties to terrorism. The official said the FBI investigated, but found no such links and reported the findings back to the foreign government.
Were Islamist militant groups involved?
It remains unclear if Tamerlan had contact with Islamist militant groups in the restive and predominantly Muslim Caucasus region, which have been blamed for a variety of terrorist acts within Russia.?
On Sunday a group leading an Islamist insurgency against Russia told Reuters it was not at war with the United States and distanced itself from the Boston bombings.
"We are fighting with Russia, which is responsible not only for the occupation of the Caucasus but for monstrous crimes against Muslims," said a statement from Caucasus Emirate militants operating in Dagestan reported by Reuters.
Why target the Boston Marathon?
The motive behind the bombing at the Boston Marathon is the biggest mystery: Why would the brothers do this?
While the Tsarnaevs had surely had some issues adjusting to life in America, friends say they appear to have settled in fairly well since they arrived a decade ago.
Tamerlan was an accomplished boxer and even had sights on the U.S. Olympic team at one point.
Dzhokhar, who became a naturalized citizen last year, is almost universally described as a well-adjusted and smart teen.
While both of the brothers followed Islam, friends say they didn?t espouse violence or appear to be radicalized.
At some point Tamerlan Tsarnaev apparently adopted more fundamental Islamic beliefs, but no accounts have yet emerged to suggest he suddenly saw violence as an acceptable expression of his faith.
Were the bombs homemade, or were others involved?
Federal officials examining the bomb residue collected in Boston have described the bombs ? pressure-cookers packed with explosives and shrapnel ? as relatively simple in their basic design, but with ?sophisticated components, including what appeared to be an electronic detonation mechanism capable of being triggered by cellular phones.
Al Qaeda-linked groups and others have published instructions for making such bombs on the Internet, but it remains unclear whether those blueprints would have provided adequate instruction.
Authorities also say it is unlikely that the pressure-cooker bombs could have been successfully detonated without some practice runs, but so far they have no reports of such trials.
Investigators also say they are still trying to determine where the suspects got their guns.
Why didn?t the brothers flee after the bombings?
Investigators continue to probe Dzhokhar's behavior after he returned to the campus of the University of Massachusetts at Dartmouth on Tuesday and resumed the life of a student after allegedly dropping a bomb-filled knapsack into a crowd watching the marathon.
?There is evidence of some frankly kind of normal student behavior in those ensuing days, which when you consider the enormity of what he was responsible for certainly raises a lot of questions in my mind and as I say more to the point in the minds of law enforcement as well,??Massachusetts?Gov. Deval Patrick said Sunday on ?Meet the Press.? ?Those are the kinds of leads that still have to be pursued and run to ground.?
Tamerlan also was said to have returned to his Cambridge home before a fatal chase and gunbattle with police in Watertown.
The suspects' actions suggest that they did not expect to attract the attention of authorities, at least in the immediate aftermath of the attack.
How did Tamerlan Tsarnaev die?
Tamerlan Tsarnaev was killed during a ferocious gunbattle early Friday with Watertown, Mass.,? police, but officials have not yet determined how he died.
After allegedly shooting to death MIT police officer Sean Collier, 26, in Cambridge late Thursday night, and then carjacking an SUV nearby, the Tsarnaevs were tracked by ?pinging? the carjack victim?s cellphone, which had been left in the vehicle, Watertown Police Chief Ed Deveau told the Boston Globe.
When police caught up with the pair later that night in Watertown, the brothers, then in separate vehicles, jumped out to engage officers in a gunbattle.
?Quickly we had six Watertown police officers and two bad guys in a gunfight,? Deveau told the Globe, saying at least 200 shots were fired. The brothers tossed what appeared to be a pressure cooker bomb at the officers and there was a large explosion. ?Crude grenades? were also tossed at officers, with three exploding, Deveau said.
Minutes later, Tamerlan walked toward officers firing, but then appeared to run out of bullets, Deveau said. Seizing on the opportunity, officers tackled him.
As they struggled to handcuff the suspect, the stolen Mercedes SUV came roaring at the officers, who scattered. According to Deveau, the younger brother plowed over Tamerlan, who was then briefly dragged under the SUV.
Dzhokar left the SUV on a nearby street and fled on foot, according to Deveau.
While the account suggests Tamerlan died from injuries suffered when he was run over, an autopsy report on his death has not been released.
NBC News? Pete Williams, Tom Winter and Michael Isikoff contributed to this report.
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WATERTOWN, Mass. (AP) ? Hundreds of rounds were exchanged in a deadly gun battle, a suspected terrorist's body was dragged under a stolen SUV and a bomb blast rattled residents.
"Now I know what it must be like to be in a war zone like Iraq or Afghanistan. When my house shook, I said 'I better get in.' We never went to sleep all night," said resident Anna Lanzo.
Watertown, a usually placid middle-class suburb where joggers and bikers share a path along the Charles River, children sell lemonade outside and residents meet for eggs at a classic chrome diner, was turned into a combat zone this week.
Relief was palpable here Saturday, a day after 19-year-old Boston Marathon bombing suspect Dzhokhar Tsarnaev surrendered from his hiding place in a covered boat in a Watertown backyard. Authorities said Tsarnaev and his alleged conspirator and older brother, Tamerlan Tsarnaev, killed an MIT police officer Thursday night, then carjacked an SUV before heading to Watertown.
Officers knew the stolen car was coming to Watertown because they were tracking its movement through the victim's cellphone. The suspects took $800 from an ATM in Watertown Square from the victim's account before an officer spotted the car. The brothers ? one in the stolen car, the other in a second car ? jumped out of the cars and started shooting at the lone officer even as backup rushed to the scene, said Watertown Police Chief Edward Deveau.
"We're in a gunfight, a serious gunfight. Rounds are going and then all of the sudden they see something being thrown at them and there's a huge explosion," Deveau said. "I'm told it's exactly the same type of explosive that we'd seen ... at the Boston Marathon. The pressure cooker lid was found embedded in a car down the street."
The suspects tossed grenades. Tamerlan Tsarnaev got within 10 feet of officers involved in the shootout before he ran out of ammunition and was tackled. Police put him down and began to handcuff him when Dzhokhar Tsarnaev drove the stolen car at them.
"They dove out of the way at the last second and he ran over his brother, dragged him down the street and then fled," Deveau said.
Tamerlan Tsarnaev died. Though bleeding, his younger brother fled the car and eluded the officers. Police locked down the region and searched house to house in Watertown.
Christie Majocha described heavily armed police and helicopters with M16s circling her neighborhood. "Everybody saw them on TV, but as I saw them on TV, they were driving on my street. As we heard the helicopters on TV, they were over our heads," she said.
Lauren Kelleher said she saw State Police with massive automatic weapons in her backyard, walking past her children's swing set and a plastic silver castle.
"The troopers went through. They looked in our yard, they looked in our garage," she said.
"It was crazy," said her husband, Tim Kelleher. "We had SWAT teams, ATF on our lawn."
Deveau said a resident was checking his boat after the lockdown was lifted Friday evening and noticed the straps weren't the way he left them. He looked in the boat, saw blood and someone huddled in a corner and quickly called police. The discovery set up the final confrontation and capture with Dzhokhar Tsarnaev. Officials used Dumitru Ciuc's home as a staging area, taking out the windows and ripping down curtains and window blinds to monitor the boat.
"They didn't say nothing," about why they were there. "They just said leave the house and go up the street."
On Saturday, Ciuc's home was cordoned off by police tape, and his Nissan Xterra remained underneath a tarp. The street where Dzhokhar Tsarnaev was found was still closed down and roped off by police tape. An agent typing on a computer sat on the steps of the home where the owner of the boat lived, and authorities erected a white tent in the middle of the street.
Nearby at the Watertown police station, a stream of grateful residents dropped off more cookies, cupcakes, pizzas and chicken than the small force could eat. Children dropped off handmade cards, which were quickly pinned up. On Saturday evening, at least 250 people gathered at the town's Victory Field to pay tribute to victims of the Boston Marathon bombers and to thank law enforcement and emergency workers.
"These policemen, the FBI, everyone who's been involved, they deserve our support. They deserve our applause," Majocha said. "We can't thank them enough for what they've done."
___
Associated Press writers Carla K. Johnson, Bridget Murphy and Rodrique Ngowi contributed to this report.
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Source: http://news.yahoo.com/suburb-becomes-war-zone-days-bombings-021315038.html
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Researchers unveiled a total of three planets Thursday, including two potentially livable super-Earths. The discoveries bring the Kepler team closer to its goal.
By Pete Spotts,?Staff writer / April 18, 2013
An artist drew (l. to r.) Kepler-22b, Kepler-69c, Kepler-62e, Kepler 62f, and Earth to scale to show the similarities in size. Scientists using NASA's Kepler space telescope have found the best candidates yet for potentially life-bearing worlds beyond our solar system, officials said Thursday.
JPL-Caltech / NASA Ames / Reuters
EnlargeTwo potentially livable super-Earths and an outsized version of Venus were unveiled Thursday, the latest in a string of remarkable discoveries from NASA's Kepler mission.
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Kepler is a space-based observatory whose unblinking gaze has rested on some 170,000 stars simultaneously since May 2009.
The three planets are the smallest the observatory has yet detected in stellar habitable zones. These zones represent distances where a planet receives enough light from its host star to harbor liquid water on its surface. Liquid water is essential for the emergence of organic life.
The discoveries bring the Kepler team tantalizingly close to its ultimate goal ? to find Earth-mass planets orbiting sun-like stars at Earth-like distances, while also taking a broader census to see how many planetary systems with an Earth-like planet the Milky Way may hold.
Led by William Borucki, a researcher at the National Aeronautic and Space Administration's Ames Research Center near Mountain View, Calif., the team has confirmed 115 extra-solar planets so far, and it has amassed a roster of more than 2,700 planet candidates.
Two of the new planets are part of a five-planet system orbiting a star some 1,200 light-years away in the constellation Lyra. The star, Kepler 62, is about two-thirds the size of the sun and has 70 percent of the sun's mass. It's also about 3 billion years older than the sun.
The system's three inner planets, one comparable in size to Mars, are too close to their sun to be livable. Kepler 62-e, the fourth planet out, however, falls within the habitable zone. Orbiting once every 122 days, the planet is about 60 percent larger than Earth.
The team speculates that the planet is covered with water, although the system is too far away to take the measurements needed to estimate the planet's mass. Researchers need that measurement to determine the planet's density, a major clue as to its bulk composition.
Instead, modeling studies have indicated that planets ranging from 1.5 to two times Earth's size tend to be far more watery than planets closer to Earth's size. Thus, while the nature of the planet remains speculative for now, "the fascinating idea is that we've actually found the first ocean planet, the first water world out there," said Lisa Kaltenegger, an astronomer with the Max Planck Institute for Astronomy in Germany and the Harvard-Smithsonian Center for Astrophysics in Cambridge, Mass., during a mission briefing Thursday afternoon.
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