Soldier with new arms determined to be independent

BALTIMORE (AP) — After weeks of round-the-clock medical care, Brendan Marrocco insisted on rolling his own wheelchair into a news conference using his new transplanted arms. Then he brushed his hair to one side.

Such simple tasks would go unnoticed in most patients. But for Marrocco, who lost all four limbs while serving in Iraq, these little actions demonstrate how far he's come only six weeks after getting a double-arm transplant.

Wounded by a roadside bomb in 2009, the former soldier said he could get by without legs, but he hated living without arms.

"Not having arms takes so much away from you. Even your personality, you know. You talk with your hands. You do everything with your hands, and when you don't have that, you're kind of lost for a while," the 26-year-old New Yorker told reporters Tuesday at Johns Hopkins Hospital.

Doctors don't want him using his new arms too much yet, but his gritty determination to regain independence was one of the chief reasons he was chosen to receive the surgery, which has been performed in the U.S. only seven times.

That's the message Marrocco said he has for other wounded soldiers.

"Just not to give up hope. You know, life always gets better, and you're still alive," he said. "And to be stubborn. There's a lot of people who will say you can't do something. Just be stubborn and do it anyway. Work your ass off and do it."

Dr. W.P. Andrew Lee, head of the team that conducted the surgery, said the new arms could eventually provide much of the same function as his original arms and hands. Another double-arm transplant patient can now use chopsticks and tie his shoes.

Lee said Marrocco's recovery has been remarkable, and the transplant is helping to "restore physical and psychological well-being."

Tuesday's news conference was held to mark a milestone in his recovery — the day he was to be discharged from the hospital.

Next comes several years of rehabilitation, including physical therapy that is going to become more difficult as feeling returns to the arms.

Before the surgery, he had been living with his older brother in a specially equipped home on New York's Staten Island that had been built with the help of several charities. Shortly after moving in, he said it was "a relief to not have to rely on other people so much."

The home was heavily damaged by Superstorm Sandy last fall.

"We'll get it back together. We've been through a lot worse than that," his father, Alex Marrocco, said.

For the next few months, Marrocco plans to live with his brother in an apartment near the hospital.

The former infantryman said he can already move the elbow on his left arm and rotate it a little bit, but there hasn't been much movement yet for his right arm, which was transplanted higher up.

Marrocco's mother, Michelle Marrocco, said he can't hug her yet, so he brushes his left arm against her face.

The first time he moved his left arm was a complete surprise, an involuntary motion while friends were visiting him in the hospital, he said.

"I had no idea what was going through my mind. I was with my friends, and it happened by accident," he recalled. "One of my friends said 'Did you do that on purpose?' And I didn't know I did it."

Marrocco's operation also involved a technical feat not tried in previous cases, Lee said in an interview after the news conference.

A small part of Marrocco's left forearm remained just below his elbow, and doctors transplanted a whole new forearm around and on top of it, then rewired nerves to serve the old and new muscles in that arm.

"We wanted to save his joint. In the unlucky event we would lose the transplant, we still wanted him to have the elbow joint," Lee said.

He also explained why leg transplants are not done for people missing those limbs — "it's not very practical." That's because nerves regrow at best about an inch a month, so it would be many years before a transplanted leg was useful.

Even if movement returned, a patient might lack sensation on the soles of the feet, which would be unsafe if the person stepped on sharp objects and couldn't feel the pain.

And unlike prosthetic arms and hands, which many patients find frustrating, the ones for legs are good. That makes the risks of a transplant not worth taking.

"It's premature" until there are better ways to help nerves regrow, Lee said.

Now Marrocco, who was the first soldier to survive losing all four limbs in the Iraq War, is looking forward to getting behind the wheel of his black 2006 Dodge Charger and hand-cycling a marathon.

Asked if he could one day throw a football, Dr. Jaimie Shores said sure, but maybe not like Baltimore Ravens quarterback Joe Flacco.

"Thanks for having faith in me," Marrocco interjected, drawing laughter from the crowd.

His mother said Marrocco has always been "a tough cookie."

"He's not changed that, and he's just taken it and made it an art form," Michelle Marrocco said. "He's never going to stop. He's going to be that boy I knew was going to be a pain in my butt forever. And he's going to show people how to live their lives."

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Associated Press Chief Medical Writer Marilynn Marchione in Milwaukee and AP writer David Dishneau in Hagerstown, Md., contributed to this report.

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Jodi Arias Borrowed Gas Cans Before Killing Ex

Accused murderer Jodi Arias borrowed two five-gallon gas cans from a former boyfriend the day before she drove to Arizona to kill another ex, Travis Alexander, according to testimony in Arias' murder trial today.

In cross examination, prosecutors also forced Arias' former live-in boyfriend Darryl Brewer to describe his sex life with Arias as "pretty aggressive."

Brewer, 52, dated Arias for four years and shared a home with her in California for two years. He told the court today that Arias called him in May 2008, asking to borrow gas cans, but would not explain why. She called him again at least two more times, and arrived at his house on June 2008, to borrow the cans.

On the day she picked up the gas cans she told Brewer that she was going to visit friends in California and Arizona.

Prosecutors argue that Arias then drove to Mesa, Ariz., where she allegedly had sex with Alexander, took nude photos of him, and then stabbed him 27 times, slashed his throat, and shot him twice in the head. She is charged with murder and could face the death penalty if convicted.

Arias, who claims she killed Alexander in self defense, had approached prosecutors two years ago offering to plea to a second degree murder charge, which could carry a 25 year term, but the state rejected the offer, Nancy Grace reported on Good Morning America today.

Brewer said that Arias never returned the gas cans. The pair had been broken up two years earlier and they had only spoken "sporadically," he said.

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Prosecutors also showed receipts from Arias' trip from her California home to Alexander's home in Mesa, showing that she purchased a 10 gallons of gas at one gas station the night before she drove to Arizona, and then another 10 gallons from a different gas station 10 minutes later. Prosecutors are expected to argue she brought the gas with her to fill up her car secretly on the way to Alexander's home, showing premeditation for the murder.

Arias' attorneys called Brewer as one of their first witnesses as they began mounting their case that Arias killed Alexander in self defense, arguing that Alexander was controlling and abusive toward Arias.

They asked Brewer to explain how he and Arias had been in a stable relationship for four years, from 2002 to 2006, and had bought a home together before Arias met Alexander at a business conference and began to change.

"I saw a lot of changes in Jodi. She became a different person than I had known previously," Brewer said, describing how Arias' behavior changed in May 2006 when she joined a company called Pre-Paid Legal. There, she met Alexander and began seeing him. She continued to live with Brewer.

"She had continued to pay the mortgage, but she was not paying other household bills, she began getting into debt or financial trouble," Brewer said. "For me it seemed she was not as rational or logical."

Arias also converted to Mormonism while living with Brewer, telling him that he could no longer curse and she would no longer have sex with him because she was saving herself for marriage.

The pair had previously had an "enthusiastic" and "aggressive" sex life, Brewer admitted to prosecutors. They had engaged in anal sex, Arias had taken nude photos of Brewer, and Arias had purchased breast implants in 2006, he testified.

Brewer said that after Arias began to change, he made arrangements to move closer to his son from his first marriage, and he and Arias broke up.

They kept in touch with occasional phone calls until Arias asked to borrow the gas cans in June 2008, and then called him a week after borrowing the cans to say that her friend had been killed.

Martinez, reading notes from an interview Brewer gave to authorities during the investigation into Alexander's death, asked if Arias had ever mentioned needing an "alibi." Brewer said he did not recall any conversation about alibis.

"After this date of June 4, 2008," Martinez asked, "you received a call from Jodi Arias, and she was very agitated?"

"She was sad," Brewer said.

"Did she tell you that her friend had been killed and she did not have an alibi?"

"I don't remember that," Brewer said.

Arias was arrested a month after Alexander was found dead, in July 2008.

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French seal off Mali's Timbuktu, rebels torch library

GAO, Mali (Reuters) - French and Malian troops retook control of Timbuktu, a UNESCO World Heritage site, on Monday after Islamist rebel occupiers fled the ancient Sahara trading town and torched several buildings, including a library holding priceless manuscripts.

The United States and the European Union are backing a French-led intervention in Mali against al Qaeda-allied militants they fear could use the West African state's desert north as a springboard for international attacks.

The recovery of Timbuktu followed the swift capture by French and Malian forces at the weekend of Gao, another major town in Mali's north that had been occupied by the alliance of jihadist groups since last year.

The two-week-old mission by France in its former Sahel colony, at the request of Mali's government, has driven the Islamist rebels northwards out of towns into the desert and mountains.

Without a shot being fired, 1,000 French soldiers and paratroopers and 200 Malian troops seized Timbuktu airport and surrounded the town on the banks of the Niger River, looking to block the escape of insurgents.

In both Timbuktu and Gao, cheering crowds turned out to welcome the French and Malian troops.

A third town in Mali's vast desert north, Kidal, had remained in Islamist militant hands. But Malian Tuareg MNLA rebels, who are seeking autonomy for their northern region, said on Monday they had taken charge in Kidal after Islamist fighters abandoned it.

A diplomat in Bamako confirmed the MNLA takeover of Kidal.

A French military spokesman said the assault forces at Timbuktu were avoiding any fighting inside the city to protect the cultural treasures, mosques and religious shrines in what is considered a seat of Islamic learning.

But Timbuktu Mayor Ousmane Halle told Reuters departing Islamist gunmen had four days earlier set fire to the town's new Ahmed Baba Institute, which contained thousands of manuscripts.

UNESCO spokesman Roni Amelan said the Paris-based U.N. cultural agency was "horrified" by the news of the fire, but was awaiting a full assessment of the damage.

Ali Baba, a worker at the Ahmed Baba Institute, told Sky News in Timbuktu more than 3,000 manuscripts had been destroyed. "They are bandits. They have burned some manuscripts and also stole a lot of manuscripts which they took with them," he said.

Marie Rodet, an African history lecturer at Britain's School of Oriental and African Studies, said Timbuktu held one of the greatest libraries of Islamic manuscripts in the world.

"It's pure retaliation. They (the Islamist militant rebels) knew they were losing the battle and they hit where it really hurts," Rodet told Reuters. "These people are not interested in any intellectual debate. They are anti-intellectual."

ISLAMISTS "ALL FLED"

The Ahmed Baba Institute, one of several libraries and collections in Timbuktu containing fragile documents dating back to the 13th century, is named after a Timbuktu-born contemporary of William Shakespeare and houses more than 20,000 scholarly manuscripts. Some were stored in underground vaults.

The French and Malians have encountered no resistance so far in Timbuktu. But they will now have to comb through a labyrinth of ancient mosques, monuments, mud-brick homes and narrow alleyways to flush out any hiding fighters.

The Islamist forces comprise a loose alliance that groups Al Qaeda in the Islamic Maghreb (AQIM) with Malian Islamist group Ansar Dine and AQIM splinter MUJWA.

They have retreated in the face of relentless French air strikes and superior firepower and are believed to be sheltering in the rugged Adrar des Ifoghas mountain range, north of Kidal.

The MNLA Tuareg rebels who say they now hold Kidal have offered to help the French-led offensive against the al Qaeda-affiliated Islamists. It was not clear, however, whether the French and Malians would steer their offensive further towards Kidal, or hold negotiations with the MNLA.

FRANCE: MALI "BEING LIBERATED"

The world was shocked by Timbuktu's capture in April by Tuareg fighters, whose separatist rebellion was later hijacked by Islamist radicals who imposed severe sharia (Islamic law).

Provoking international outrage, the Muslim militants - who follow a more radical Salafist brand of Islam - destroyed dozens of ancient shrines in Timbuktu sacred to Sufi Muslims, condemning them as idolatrous and un-Islamic.

They also imposed a strict form of Islamic law, or sharia, authorizing the stoning of adulterers and amputations for thieves, while forcing women to go veiled.

On Sunday, many women among the thousands of Gao residents who came out to celebrate the rebels' expulsion made a point of going unveiled. Other residents smoked cigarettes and played music to flout the bans previously imposed by the rebels.

Hundreds of troops from Niger and Chad have been brought to Gao to help secure the town.

"Little by little, Mali is being liberated," French Foreign Minister Laurent Fabius told France 2 television.

Speaking at a news conference in Paris, French President Francois Hollande said French troops would take a step back once the job of retaking key towns was complete, and Malian and other African troops would take over the task of hunting the rebels.

"They are the ones who will go into the northern part, which we know is the most difficult because that's where the terrorists are hiding," Hollande said.

As the French and Malian troops thrust into northern Mali, African troops for a U.N.-backed continental intervention force for Mali, expected to number 7,700, are being flown into the country, despite severe delays and logistical problems.

Outgoing African Union Chairman President Thomas Boni Yayi of Benin scolded AU states at a weekend summit in Addis Ababa for their slow response to assist Mali while former colonial power France took the lead in the military operation.

Burkina Faso, Benin, Nigeria, Senegal, Togo, Niger and Chad are providing soldiers for the AFISMA force. Burundi and other nations have pledged to contribute.

AU Peace and Security Commissioner Ramtane Lamamra said these regional troops could play a useful "clean-up" role once the main military operations against the Islamist rebels end.

Speaking in Addis Ababa on Monday, U.N. Secretary-General Ban Ki-moon said the U.N. was "actively considering" helping the troop-contributing African countries with logistical support.

(Additional reporting by Richard Valdmanis in Sevare, Mali, Bate Felix and David Lewis in Dakar, Maria Golovina in London, Alexandria Sage, Vicky Buffery and Emmanuel Jarry in Paris, Tiemoko Diallo in Bamako, Abdoulaye Massalatchi in Niamey, Richard Lough and Aaron Masho in Addis Ababa; Writing by Pascal Fletcher; Editing by Andrew Heavens)

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Australia PM's partner apologises for Asian doctor joke

SYDNEY: The partner of Australian Prime Minister Julia Gillard, whose fiery speech against sexism last year made global headlines, apologised Tuesday for making a quip about an "Asian female doctor".

Tim Mathieson made the comment during a reception at The Lodge in Canberra on Monday night attended by members of the West Indies cricket team.

Mathieson, who has worked to raise awareness about men's health issues, brought up the need for men to have regular checks for prostate cancer.

"Go and get that exam that none of us like to have done, but we know we should," Mathieson said. Gillard was standing behind him at the time.

"We can get a blood test for it but the digital examination is the only true way to get a correct reading on your prostate, so make sure you go and do that. And perhaps look(ing) for a small Asian female doctor is probably the best way..."

The comment was met with laughter at the time, but the opposition said Mathieson's remark was in bad taste and he later apologised.

"It was meant as a joke, and on reflection I accept it was in poor taste," he said in a statement.

"I apologise for any offence caused."

Gillard, the nation's first female leader, caused a global stir in October when she lashed out at opposition leader Tony Abbott in parliament, saying she would not be "lectured about sexism and misogyny by this man".

She said Tuesday that Mathieson was passionate about getting out the message to men to get recommended health checks, but agreed the apology was the right thing to do.

"Tim's apologised for a joke that was in poor taste," she said.

-AFP/fl

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Court adjourns Patiala gang rape case till Feb 4

PATIALA: Patiala court, on Monday, adjourned the Patiala gang rape and suicide case till February 4 after the defence lawyer sought the copy of a compact disc, allegedly containing statement of the victim.

"The CD was prepared by a cameraman of Samana and now police have made that a case property. We want to hear the exact wording of the girl," said Kundan Singh Nagra, counsel of the accused, after coming out of court. All five accused including Balwinder Singh, Gurprit Singh, Sandip Singh, Chinder Kaur and dismissed sub-inspector Nasib Singh were present in the court.

On November 13, 2012, Balwinder and Gurprit had allegedly kidnapped the minor girl from Badshahpr village, and repeatedly raped her at the tubewell room of Sandip Singh near Brahamanmajra village. Instead of taking any action, the cops had allegedly pressurized the family for compromise and had finally registered a rape case on November 27. But since the police did not arrest any accused, who continued to harass the victim, she consumed poison on December 26 and died in the evening.

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Soldier who lost 4 limbs has double-arm transplant

On Facebook, he describes himself as a "wounded warrior...very wounded."

Brendan Marrocco was the first soldier to survive losing all four limbs in the Iraq War, and doctors revealed Monday that he's received a double-arm transplant.

Those new arms "already move a little," he tweeted a month after the operation.

Marrocco, a 26-year-old New Yorker, was injured by a roadside bomb in 2009. He had the transplant Dec. 18 at Johns Hopkins Hospital in Baltimore, his father said Monday.

Alex Marrocco said his son does not want to talk with reporters until a news conference Tuesday at the hospital, but the younger Marrocco has repeatedly mentioned the transplant on Twitter and posted photos.

"Ohh yeah today has been one month since my surgery and they already move a little," Brendan Marrocco tweeted Jan. 18.

Responding to a tweet from NASCAR driver Brad Keselowski, he wrote: "dude I can't tell you how exciting this is for me. I feel like I finally get to start over."

The infantryman also received bone marrow from the same dead donor who supplied his new arms. That novel approach is aimed at helping his body accept the new limbs with minimal medication to prevent rejection.

The military sponsors operations like these to help wounded troops. About 300 have lost arms or hands in Iraq or Afghanistan.

Unlike a life-saving heart or liver transplant, limb transplants are aimed at improving quality of life, not extending it. Quality of life is a key concern for people missing arms and hands — prosthetics for those limbs are not as advanced as those for feet and legs.

"He was the first quad amputee to survive," and there have been four others since then, Alex Marrocco said.

The Marroccos want to thank the donor's family for "making a selfless decision ... making a difference in Brendan's life," the father said.

Brendan Marrocco has been in public many times. During a July 4 visit last year to the Sept. 11 Memorial with other disabled soldiers, he said he had no regrets about his military service.

"I wouldn't change it in any way. ... I feel great. I'm still the same person," he said.

The 13-hour operation was led by Dr. W.P. Andrew Lee, plastic surgery chief at Johns Hopkins. It was the seventh double-hand or double-arm transplant done in the United States.

Lee led three of those earlier operations when he worked at the University of Pittsburgh, including the only above-elbow transplant that had been done at the time, in 2010.

Marrocco's "was the most complicated one" so far, Lee said in an interview Monday. It will take more than a year to know how fully Marrocco will be able to use the new arms.

"The maximum speed is an inch a month for nerve regeneration," he explained. "We're easily looking at a couple years" until the full extent of recovery is known.

While at Pittsburgh, Lee pioneered the immune-suppression approach used for Marrocco. The surgeon led hand-transplant operations on five patients, giving them marrow from their donors in addition to the new limbs. All five recipients have done well, and four have been able to take just one anti-rejection drug instead of combination treatments most transplant patients receive.

Minimizing anti-rejection drugs is important because they have side effects and raise the risk of cancer over the long term. Those risks have limited the willingness of surgeons and patients to do more hand, arm and even face transplants.

Lee has received funding for his work from AFIRM, the Armed Forces Institute of Regenerative Medicine, a cooperative research network of top hospitals and universities around the country that the government formed about five years ago. With government money, he and several other plastic surgeons around the country are preparing to do more face transplants, possibly using the new immune-suppression approach.

Marrocco expects to spend three to four months at Hopkins, then return to a military hospital to continue physical therapy, his father said. Before the operation, he had been fitted with prosthetic legs and had learned to walk on his own.

He had been living with his older brother in a specially equipped home on New York's Staten Island that had been built with the help of several charities. Shortly after moving in, he said it was "a relief to not have to rely on other people so much."

The home was heavily damaged by Superstorm Sandy last fall.

Despite being in a lot of pain for some time after the operation, Marrocco showed a sense of humor, his father said. He had a hoarse voice from the tube that was in his throat during the long surgery and decided he sounded like Al Pacino. He soon started doing movie lines.

"He was making the nurses laugh," Alex Marrocco said.

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Associated Press Writer Stephanie Nano in New York contributed to this report.

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Online:

Army regenerative medicine:

http://www.afirm.mil/index.cfm?pageid=home

and http://www.afirm.mil/assets/documents/annual_report_2011.pdf

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Follow Marilynn Marchione at http://twitter.com/MMarchioneAP .

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US Mom Missing in Turkey Took Side Trips

Sarai Sierra, the New York mother who disappeared in Turkey while on a solo trip, took several side excursions out of the country, but stayed in contact with her family the entire time, a family friend told ABC News.

Turkish media reported today that police were trying to establish why Sierra visited Amsterdam and Munich. Police were also trying to establish the identity of a man Sierra, 33, was chatting with on the Internet, according to local media.

Rachel Norman, a family friend, said the man was a group tour guide from the Netherlands and said Sierra stayed in regular touch with her family in New York.

Steven Sierra, Sarai's husband, and David Jimenez, her brother, arrived in Istanbul today to aid in the search.

The men have been in contact with officials from the U.S. consulate in the country and plan to meet with them as soon as they open on Tuesday, Norman said.

After that, she said Sierra and Jimenez would meet with Turkish officials to discuss plans and search efforts.

Family of Sarai Sierra|AP Photo

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Sarai Sierra was supposed to fly back to the United States on Jan. 22, but she never showed up for her flight home.

Her two boys, ages 11 and 9, have not been told their mother is missing.

Sierra, an avid photographer, left New York on Jan. 7. It was her first overseas trip, and she decided to go ahead after a friend had to cancel, her family said.

"It was her first time outside of the United States, and every day while she was there she pretty much kept in contact with us, letting us know what she was up to, where she was going, whether it be through texting or whether it be through video chat, she was touching base with us," Steven Sierra told ABC News before he departed for Istanbul.

But when it came time to pick her up from Newark Liberty International Airport in New Jersey, Sierra wasn't on board her scheduled flight.

Steven Sierra called United Airlines and was told his wife had never boarded the flight home.

Further investigation revealed she had left her passport, clothes, phone chargers and medical cards in her room at a hostel in Beyoglu, Turkey, he said.

The family is suspicious and said it is completely out of character for the happily married mother, who met her husband in church youth group, to disappear.

The U.S. Embassy in Turkey and the Turkish National Police are involved in the investigation, WABC-TV reported.

"They've been keeping us posted, from my understanding they've been looking into hospitals and sending out word to police stations over there," Steven Sierra said. "Maybe she's, you know, locked up, so they are doing what they can."

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Nightclub fire kills 233 in Brazil

SANTA MARIA, Brazil (Reuters) - A nightclub fire killed at least 233 people in southern Brazil on Sunday when a band's pyrotechnics show set the building ablaze and fleeing partygoers stampeded toward blocked exits in the ensuing panic.

Most of those who died were suffocated by toxic fumes that rapidly filled the crowded club after sparks from pyrotechnics used by the band for visual effects set fire to soundproofing on the ceiling, local fire officials said.

"Smoke filled the place instantly, the heat became unbearable," survivor Murilo Tiescher, a medical student, told GloboNews TV. "People could not find the only exit. They went to the toilet thinking it was the exit and many died there."

Firemen said one exit was locked and that club bouncers, who at first thought those fleeing were trying to skip out on bar tabs, initially blocked patrons from leaving. The security staff relented only when they saw flames engulfing the ceiling.

The tragedy in the university town of Santa Maria in one of Brazil's most prosperous states comes as the country scrambles to improve safety, security and logistical shortfalls before the 2014 World Cup soccer tournament and the 2016 Olympics, both intended to showcase the economic advances and first-world ambitions of Latin America's largest nation.

In Santa Maria, a city of more than 275,000 people, rescue workers and weary officials wept alongside family and friends of the victims at a gymnasium being used as a makeshift morgue.

"It's the saddest, saddest day of my life," said Neusa Soares, the mother of one of those killed, 22-year-old Viviane Tolio Soares. "I never thought I would have to live to see my girl go away."

President Dilma Rousseff cut short an official visit to Chile and flew to Santa Maria, where she wept as she spoke to relatives of the victims, most of whom were university students.

"All I can say at the moment is that my feelings are of deep sorrow," said Rousseff, who began her political career in Rio Grande do Sul, the state where the fire occurred.

It was the deadliest nightclub fire since 309 people died in a discotheque blaze in China in 2000 and Brazil's worst fire at an entertainment venue since a disgruntled employee set fire to a circus in 1961, killing well over 300 people.

'BARRIER OF THE DEAD'

Local authorities said 120 men and 113 women died in the fire, and 92 people are still being treated in hospitals.

News of the fire broke on Sunday morning, when local news broadcast images of shocked people outside the nightclub called Boate Kiss. Gradually, grisly details emerged.

"We ran into a barrier of the dead at the exit," Colonel Guido Pedroso de Melo, commander of the fire brigade in Rio Grande do Sul, said of the scene that firefighters found on arrival. "We had to clear a path to get to the rest of those that were inside."

Pedroso de Melo said the popular nightclub was overcrowded with 1,500 people packed inside and they could not exit fast.

"Security guards blocked their exit and did not allow them to leave quickly. That caused panic," he said.

The fire chief said the club was authorized to be open, though its permit was in the process of being renewed. But he pointed to several egregious safety violations - from the flare that went off during the show to the locked door that kept people from getting out.

"The problem was the use of pyrotechnics, which is not permitted," Pedroso de Melo said.

The club's management said in a statement that its staff was trained and prepared to deal with any emergency. It said it would help authorities with their investigation.

One of the club's owners has surrendered to police for questioning, GloboNews TV reported.

When the fire began at about 2:30 a.m., many revelers were unable to find their way out in the chaos.

"It all happened so fast," survivor Taynne Vendrusculo told GloboNews TV. "Both the panic and the fire spread rapidly, in seconds."

Once security guards realized the building was on fire, they tried in vain to control the blaze with a fire extinguisher, according to a televised interview with one of the guards, Rodrigo Moura. He said patrons were trampled as they rushed for the doors, describing it as "a horror film."

Band member Rodrigo Martins said the fire started after the fourth or fifth song and the extinguisher did not work.

"It could have been a short circuit, there were many cables there," Martins told Porto Alegre's Radio Gaucha station. He said there was only one door and it was locked. A band member died in the fire.

CELL PHONES STILL RINGING

TV footage showed people sobbing outside the club before dawn, while shirtless firefighters used sledge hammers and axes to knock down an exterior wall to open up an exit.

Rescue officials moved the bodies to the local gym and separated them by gender. Male victims were easier to identify because most had identification on them, unlike the women, whose purses were left scattered in the devastated nightclub.

Piles of shoes remained in the burnt-out club, along with tufts of hair pulled out by people fleeing desperately. Firemen who removed bodies said victims' cell phones were still ringing.

The disaster recalls other incidents including a 2003 fire at a nightclub in West Warwick, Rhode Island, that killed 100 people, and a Buenos Aires nightclub blaze in 2004 that killed nearly 200. In both incidents, a band or members of the audience ignited fires that set the establishment ablaze.

The Rhode Island fire shocked local and federal officials because of the rarity of such incidents in the United States, where enforcement of safety codes is considered relatively strict. After the Buenos Aires blaze, Argentine officials closed many nightclubs and other venues and ultimately forced the city's mayor from office because of poor oversight of municipal codes.

The fire early on Sunday occurred in one of the wealthiest, most industrious and culturally distinct regions of Brazil. Santa Maria is about 186 miles west of Porto Alegre, the capital of a state settled by Germans and other immigrants from northern Europe.

Local clichés paint the region as stricter and more organized than the rest of Brazil, where most residents are a mix descended from native tribes, Portuguese colonists, African slaves, and later influxes of immigrants from southern Europe.

Rio Grande do Sul state's health secretary, Ciro Simoni, said emergency medical supplies from all over the state were being sent to the scene. States from all over Brazil offered support, and messages of sympathy poured in from foreign leaders.

(Additional reporting by Guillermo Parra-Bernal, Gustavo Bonato, Jeferson Ribeiro, Eduardo Simões, Brian Winter and Guido Nejamkis.; Writing by Paulo Prada and Anthony Boadle; Editing by Todd Benson, Kieran Murray and Christopher Wilson)

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Sensitive skin problems aren't skin deep

SINGAPORE: Most might assume that sensitive skin is mainly due to in an intake of the wrong food, or the application of the wrong product.

However, the main reason for sensitive skin lies on the surface of the skin, and what that layer is subjected to from the daily environment.

In a sensitive skin survey held by Curél, the dermatological research oriented brainchild of Japanese chemical and cosmetics giant Kao, almost half of the respondents from various countries claimed to suffer from sensitive skin.

And within this number, Singaporeans make up a whopping 70 percent.

Part of the reason lies in Singapore's tropical climate –from wet and rainy, to sunny but humid – coupled with hours spent in drying air-conditioned environments whether at work, home or even shopping.

More precisely, as explained by Curél's skincare expert Koicihi Ishida, skin in the Singapore environment is subject to "enhanced blood circulation and skin dryness due to the rapid change of the temperature and humidity within a short time frame".

"At high temperatures and humidity, skin cells swell when sweat is produced, reducing the skin's barrier function" he explains.

"On the other hand, low temperatures and a humidity level of 50 percent or less will cause the skin's moisture to decrease directly and become dry. Either way, the skin becomes sensitive and easily irritated."

In other words, the root of the problem of sensitive skin isn't skin deep.

In fact, it lies with the outermost layer of the skin, known as the stratum corneum (SC).

It is the first barrier between the skin and the external environment, and offers protection to the underlying tissue from infection, dehydration, chemicals and physical stress.

The top layer stratum corneum is largely held together by ceramide.

According to Curél, about half of all sensitive skin cases is due to the SC's impaired function, making it the main cause, as well as solution, to various sensitive skin conditions.

As skin expert Ishida points out, sensitive skins possess low levels of ceramide, a key element in the SC.

In developing a skincare range that targets sensitive skin, Curél therefore focused its attention on ceramide and replenishing the skin's supply of this intercellular lipid.

Tackling the problem from within also helps, with an intake of naturally occurring ceramide in food stuffs such as soya beans, spinach, rice, wheat flour and the high-fibre, jelly-like konjac or konnyaku, as the product is known in Japan where it's often served in oden or as noodle strips.

Ceramide works by fusing with the skin's moisture and oil to prevent moisture loss while holding skin cells together, similar to a brick and mortar structure that creates a barrier function for the SC.

With ceramide care, sensitive skin is directly treated to improve and replenish the impaired SC barrier which will in turn suppresses the sensitive symptoms and conditions, making the skin more resistant to external irritants.

But this is not a one-hit, one-week solution as the experts will point out.

The newly recovered skin can revert to its troubled state without proper maintenance, or in the case of more serious skin conditions such as atopic dermatitis, where ceramide drops to its original low state.

The Curél skincare range for sensitive skin runs a gamut of applications, from face and body to scalp and hair, and everyone from adults to babies, are supposed to be able to use the products.

How could so that be so?

"Although the two skin types may differ in thickness, appendices and sensitivity, the fundamental structure and function of the skin is common for the young and old of both sexes," explains Ishida.

"For the elderly, they have dry skin due to old age and it's usually accompanied with itchiness, which can be seen especially on the lower thigh area. In many cases, their SC's barrier function is damaged."

The same concept of reinforcing the SC's protective function applies to babies and the young, as the risk of sensitive skin is in fact higher in the young, than when a person ages.

"After birth, a baby's skin tends to be influenced by the environment and thus its skin condition might worsen as it is naturally delicate and sensitive," Ishida points out, while adding that "it is proven by the mild skin care from an early stage that a baby can maintain the healthy skin after growing up."

"Therefore, it is important to have a skincare regime from an early stage to prevent skin issues during their growing up process" he advises.

So even if you don't suffer from sensitive skin, there's little reason not to protect your skin the way it has been protecting you all this while.

-CNA/fl

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TOI Social Impact Awards: An evening to honour India's changemakers

They took the path less travelled, and on Monday it will lead a group of remarkable men and women to the stage for the second Times of India Social Impact Awards in association with J P Morgan. The awards are being given to changemakers within NGOs, corporates and the government who have quietly worked to transform the lives of millions of marginalized Indians.

President Pranab Mukherjee will be the chief guest at the awards function. Joining him, and a power-packed audience consisting of top achievers from diverse fields, will be beneficiaries of the organisations selected for the awards.

For some beneficiaries, this visit to the capital will mark the first time they have travelled beyond the boundaries of their district. Awards in 17 categories will be presented by the beneficiaries.

The awardees and beneficiaries collectively represent the very best of India in all its fascinating diversity. They range from nine-year-old Jyoti Prajapat from Ajmer district to 83-year-old Thokchom Ramani Leima from Imphal. Jyoti will join 10-year-old Ujala Kumari from Delhi to present the award for educat8ion in the NGO sector to Room to Read India, whose libraries gave both girls an abiding love for reading. Leima will take the stage with four other women members of Meira Paibi, the fearless group of women from Manipur who will share the Lifetime Achievement Award with the Naga Mothers Association. The two groups have battled social evils like alcoholism and drug abuse, and spearheaded peace efforts in the insurgency-ridden region.

Others who will present awards include Sarjubai Meena, a grandmother from Bhilwara who is known as the "woman with the turban". Sarjubai will present the award for Environment in the NGO category to the Foundation for Ecological Security, which helped her and others turn the village into a fertile, prosperous one, in which Sarjubai, a dalit woman, now feels she has earned the right to wear a turban.

Eleven-year-old twins Hiranya and Thiruvara Bhargavi who were born with cerebral palsy, will present the award for health in the Government category to the National Trust for the Welfare of Persons with Autism, Cerebral Palsy, Mental Retardation and Multiple Disabilities, whose pioneering insurance scheme helped them access life-saving surgeries.

The hunt for India's real heroes began in August last year when the Times of India invited applications from NGOs, corporates and government organisations in five categories: livelihoods, advocacy and empowerment, education, health and the environment. Online applications were accepted between October 2 and 30, 2012 through a dedicated website. A National Search Panel of eight eminent persons with long experience in the development sector was also constituted in early August, which identified 126 organisations worth consideration, who were then motivated to apply.

Facebook and Twitter pages helped answer questions about application procedures and kick-start a discussion. Finally, over 1500 entries were received, spanning the length and breadth of the country. The majority of applications were from NGOs.

The eight key parameters to evaluate the entries were significance of the issue addressed, scale, replicability, sustainability, finances, people's participation, innovativeness and promotion of equity. Every claim had to be backed up with documents and financial details had to be transparent. A specialist group consisting of philanthropy specialists from Dasra, GiveIndia and GuideStar India screened the entries and 20 sector-experts then evaluated these entries to prepare a final shortlist of 41 entries. TOI reporters conducted field visits of each entry.

An eminent jury comprising Unique Identification Authority of India chairperson Nandan Nilekani; Magsaysay awardee and National Advisory Council member Aruna Roy; former Cabinet Secretary Naresh Chandra; Magsaysay awardee and former Chief Election Commissioner J M Lyngdoh; Planning Commission member Syeda Hameed; former chairperson of Thermax Limited and Rajya Sabha MP Anu Aga; Centre for Science and Education director-general Sunita Narain and HDFC Bank chairperson Deepak Parekh spent an afternoon debating and discussing, before selecting the winners. The jury also nominated a Global Contribution to India award winner and a Lifetime Achievement award winner.

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