Do drunks have to go to the ER?

NEW YORK (Reuters Health) – With the help of a checklist, ambulance workers may be able to safely reroute drunk patients to detoxification centers instead of emergency rooms, according to a new study.

Researchers in Colorado found no serious medical problems were reported after 138 people were sent to a detox center to sleep it off, instead of to an ER.

In 2004, according to the researchers, it’s estimated that 0.6 percent of all U.S. ER visits were made by people without any problems other than being drunk. Those visits ended up costing about $ 900 million.

“Part of the issue has been – as it is in many busy ER departments – there’s a lot of chronic alcoholics that are brought in by ambulance, police or just come in. Often they are brought in because they have not committed a crime or there is limited space in our detoxification center. So the majority were brought to the ER department,” said Dr. David Ross, the study’s lead author from Penrose-St. Francis Health Services in Colorado Springs.

Ross said the ambulance company where he serves as medical director created the checklist with the help of the local detox center, which provided limited medical care by a nurse, and the local hospitals to reduce the number of drunks without medical needs being sent to the local ERs.

They created a checklist with 29 yes-or-no questions, such as whether the patient is cooperating with the ambulance worker’s examination and if the patient is willing to go to the detox center.

The patient was sent to the ER if the ambulance worker checked “no” on any question.

The researchers then went back to look at the patients they transported between December 2003 and December 2005 to see whether or not any of them ended up having serious medical problems at the detox center.

During that two year period, the ambulance workers transported 718 drunks. The detox center received 138 and the local ERs got 580.

Overall, 11 of the patients who were taken to detox were turned away because there was no room, their blood alcohol level exceeded the limit, their family came to pick them up or they were combative.

Another four patients at the detox center were taken to the ER because of minor complications, including chest and knee pain. However, there were no serious complications reported.

“We really believe that we did not miss anybody with a serious illness and injury that didn’t go to the ER as they should have,” said Ross.

But the researchers write in the Annals of Emergency Medicine that their study did have some limitations.

Specifically, the researchers did not plan in advance to do a study when they were creating the checklist, which means their findings are limited to whatever information was collected at the detox center and ERs.

Also, the number of people who were sent to the detox center in their study is relatively small, so it’s hard to tell how many serious complications they’d see among a larger group of people.

“We tried to estimate how likely we would have been to encounter a serious event… We estimated at most we’d encounter three serious adverse events (in 748 patients),” Ross told Reuters Health.

SOURCE: http://bit.ly/QgPCT5 Annals of Emergency Medicine, online November 9, 2012.

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Thanksgiving Day parade offers respite for storm victims

Some of the very same Republicans who have spent the last two weeks bashing Mitt Romney were, indeed, sucking up to him at a massive rally the Friday before the election — even angling for jobs in the Romney administration — a Romney adviser complains. At a rally with 100 Romney surrogates in West Chester, Ohio, Romney aide Dan Senor revealed on MSNBC Wednesday, the Romney bashers were Romney fawners. "I’m backstage with some of them, I won’t mention their names, but they’re talking about Romney like he’s Reagan," Senor said. ...

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Ivory Coast: New prime minister named

ABIDJAN, Ivory Coast (AP) — President Alassane Ouattara has tapped Foreign Minister Daniel Kablan Duncan to serve as prime minister in a new government one week after the surprise dissolution of cabinet.

The appointment of Duncan, a member of the PDCI party of former President Henri Konan Bedie, was announced at a press conference Wednesday by Amadou Gon Coulibaly, general secretary of the presidency.

Ouattara dissolved the cabinet last week over a feud between his political party and the PDCI over proposed changes to the country’s marriage law.

The PDCI supported Ouattara in the November 2010 runoff election in exchange for the prime minister’s post, helping him defeat incumbent President Laurent Gbagbo. Gbagbo’s refusal to cede office led to five months of violence that claimed at least 3,000 lives before Ouattara’s forces won.

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Exclusive: TV networks start seven-day ratings push with advertisers

LOS ANGELES (Reuters) – U.S. television broadcast networks are taking the first steps to persuade advertisers to pay for commercial viewership that occurs up to seven days after a program airs, a shift that would provide a new revenue stream to help combat ratings erosion.

The networks argue that the rising popularity of digital video recorders is pushing a sizeable number of viewers to delay watching their favorite programs beyond the first three days, the time period most often used for calculating ad payments.

Some advertisers are ready to make the move to a seven-day metric. One of the big four networks, Walt Disney Co’s ABC, earlier this year reached deals with some sponsors that bring in payments for eyeballs counted between days four and seven.

The other broadcasters have begun talks with advertisers and hope to convince them to switch to the longer window in time for the “upfront” selling season that starts early next year, when billions of dollars in ad commitments will be made, according to people familiar with the discussions.

Since 2007, most TV ad time has been bought and sold based on “C3,” a ratings measurement based of the average number of commercial minutes watched during a program either live or within three days of its airing.

TV networks want advertisers to shift to “C7,” which captures commercials watched within seven days.

Advertisers hesitate to pay for the added days, particularly for time-sensitive ads pitching a department store’s one-day sale or the opening of a summer movie blockbuster. Media buyers are pushing for precise measurements of each commercial viewed, rather than an average for an entire program, as well as a tabulation of how many people are watching on mobile devices.

The debate intensified after Nielsen data showed a sharp decline in three-day viewing at the start of the fall TV season compared with last year.

The drop is partly due to “the greater penetration of DVRs and the greater usage of DVRs, which clearly have shifted the rating in the direction of C3, and ultimately, hopefully, C7,” Disney CEO Bob Iger told analysts on a November 8 conference call.

Most viewing of network prime time shows still takes place within three days. But the post-three day viewers are growing and can be significant. Ratings for ABC comedy hit “Modern Family” increased by 5 percent, to 6.5 million viewers age 18 to 49 viewers, when counted by the C7 measurement instead of C3.

The later viewers also are among the most-coveted by advertisers, according to ABC research, which showed people who watched a show after three days were more highly educated and had higher incomes. For days four through seven, “the people who are doing the viewing are some of the most desirable available from an advertiser’s perspective,” said Charles Kennedy, senior vice president of research for ABC and the ABC Family cable network.

Earlier this year, ABC made deals with some sponsors to pay for ad time based on C7 numbers, ABC spokesman Kevin Brockman said. “We expect to do more of them if they make sense for us and our clients,” Brockman said.

At CBS, the flagship network of CBS Corp, CEO Leslie Moonves has been outspoken in pressing for a C7 metric and said it “represents a significant opportunity for us that is still in the very early stages.”

“As we move forward, we will make it a priority to get paid for all of the viewing that is going on across our shows, including DVR viewing beyond C3,” Moonves told analysts on a November 7 conference call.

Advertisers are not ready to commit to the switch and will be looking for something in return if they agree to a longer window. Timing is a big concern for many brands that want to get a message out to large numbers of consumers during a specific time period. Some commercials lose their value for sponsors over a few days.

“In moving to C7, you’ve got to be careful because you are taking away some of the advantage of why clients buy television,” said Sam Armando, director of strategic intelligence for SMGx, a division of media buying agency Starcom MediaVest Group.

Advertisers believe simply adding more days to the current metric fails to adequately capture viewership. Brands are lobbying for a more precise measurement that tracks viewership of each commercial, rather than an average for a program over a time period, they say. They also want information on how many people see their ads on programs watched on computers or Internet-connected mobile devices like phones and tablets.

“If the industry is going to make a move, we need to consider it all before we just make a little baby step to C7,” Armando said.

(Reporting By Lisa Richwine; Edited by Ronald Grover and Andrew Hay)

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“Man of Steel” Trailer to Play Before “The Hobbit”

LOS ANGELES (TheWrap.com) – Director Zack Snyder has told MTV News that a trailer for “Man of Steel” will play before “The Hobbit: An Unexpected Journey,” when it opens on December 14.

“It’s fun. I can’t wait for ‘The Hobbit,’ so it will be fun to see our crazy ‘Man of Steel’ trailer and then enjoy ‘The Hobbit’ because tat’s going to be great,” Snyder told the network.

A teaser trailer for the feature was released earlier this year. “Man of Steel” opens on June 14, 2013.

Both films are distributed by Warner Bros., which declined to comment.

Earlier this month, it was announced that nine minutes of the “Star Trek” sequel “Star Trek Into Darkness” would be shown in 500 select theaters before the IMAX version of “The Hobbit.”

Russell Crowe stars in “Man of Steel.”

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Injection Site Infections Join Meningitis, Joint Infections from Tainted Drugs

As if the more than 14,000 people who were potentially exposed to tainted injectable drugs through back or joint injections don’t have enough on their plate, public health officials announced Nov. 20 that they are seeing an increase in serious injection site infections. These injection site infections have been reported both in individuals who have fungal meningitis or peripheral joint infections and in individuals who had neither of the illnesses.

CDC Issues Public Health Advisory

The U.S. Centers for Disease Control and Prevention, working closely with state public health officials whose residents may have been exposed to the tainted drugs produced and distributed by the New England Compounding Center, NECC, issued a health alert on Tuesday. In addition to updated information about the fungal meningitis outbreak of 2012, the alert also explains that since Nov. 4, 61 people have been reported to have spinal or paraspinal epidural abscesses or osteomyelitis, two people had injection site infections in joints other than the spine, and an additional two individuals had these infections along with meningitis.

Those Who Received Potentially Contaminated Injections Receive New Information

USAToday.com reported that Dr. Marion Kainer , director of health care-related infections with the Tennessee Health Department and one of two doctors credited with solving the initial mystery cause of the fungal meningitis outbreak, is cautioning people who’ve received the potentially contaminated injections between May 10 and Sept. 26 not to rush to hospital emergency rooms. While it’s important such people be aware of the symptoms of injection site infections, the infections themselves develop more slowly than meningitis and are not cause for panic.

Symptoms of Injection Site Infections

One of the difficulties in recognizing the symptoms of injection site infections to the spinal area in the affected individuals is the fact that back pain is one of the principal symptoms. The people who received the outpatient injections were doing so due to chronic back pain. A change in the intensity of the pain may be difficult for the individual to notice, or even for the health care provider to discern.

Other symptoms to be alert for include changes in bowel or bladder habits; if these are noted, your health care provider should be immediately notified.

There may be no outward visible signs of the injection site infections, but a feeling of swelling under the skin or increased warmth or redness of the injection site should also be reported.

CDC Advises Health Care Providers to Order MRIs

The CDC advised health care providers to order magnetic resonance imaging, MRI, with contrast on anyone potentially exposed to the tainted injectable drugs if that person experiences any new or worsening symptoms of pain or discomfort to the back.

If injection site infection is diagnosed, health care providers are encouraged to consult early with a neurosurgeon to develop an appropriate treatment plan.

Most Recent Updates on Meningitis Outbreak Statistics

The good news is that the rate at which new cases of meningitis are being reported has been decreasing. The current case count is 490 with 34 deaths having occurred, according to the CDC . Michigan, with 164 cases reported, and Tennessee, with 82 cases reported, have the highest case counts of the 19 states involved in the fungal meningitis outbreak.

Medications/Drugs News Headlines – Yahoo! News

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Mistrust runs deep despite cease-fire

CAIRO/GAZA (Reuters) - A ceasefire between Israel and Gaza's Hamas rulers took hold on Thursday after eight days of conflict, although deep mistrust on both sides cast doubt on how long the Egyptian-sponsored deal can last.

Even after the ceasefire came into force late on Wednesday, a dozen rockets from the Gaza Strip landed in Israel, all in open areas, a police spokesman said. In Gaza, witnesses reported an explosion shortly after the truce took effect at 9 p.m (14:00 EDT), but there were no casualties and the cause was unclear.

The deal prevented, at least for the moment, an Israeli ground invasion of the Palestinian enclave following bombing and rocket fire which killed five Israelis and 162 Gazans, including 37 children.

But trust was in short supply. The exiled leader of Hamas, Khaled Meshaal, said his Islamist movement would respect the truce if Israel did, but would respond to any violations. "If Israel complies, we are compliant. If it does not comply, our hands are on the trigger," he told a news conference in Cairo.

Israeli Prime Minister Benjamin Netanyahu said he had agreed to "exhaust this opportunity for an extended truce", but told his people a tougher approach might be required in the future.

Both sides quickly began offering differing interpretations of the ceasefire, brokered by Egypt's new Islamist government and backed by the United States, highlighting the many actual or potential areas of discord.

If it holds, the truce will give 1.7 million Gazans respite from days of ferocious air strikes and halt rocket salvoes from militants that unnerved a million people in southern Israel and reached Tel Aviv and Jerusalem for the first time.

"Allahu akbar, (God is greatest), dear people of Gaza you won," blared mosque loudspeakers in Gaza as the truce took effect. "You have broken the arrogance of the Jews."

Fifteen minutes later, wild celebratory gunfire echoed across the darkened streets, which gradually filled with crowds waving Palestinian flags. Ululating women leaned out of windows and fireworks lit up the sky.

Meshaal thanked Egypt for mediating and praised Iran for providing Gazans with financing and arms. "We have come out of this battle with our heads up high," he said, adding that Israel had been defeated and failed in its "adventure".

Some Israelis staged protests against the deal, notably in the southern town of Kiryat Malachi, where three people were killed by a Gaza rocket during the conflict, army radio said.

Netanyahu said he was willing to give the truce a chance but held open the possibility of reopening the conflict. "I know there are citizens expecting a more severe military action, and perhaps we shall need to do so," he said.

The Israeli leader, who faces a parliamentary election in January, delivered a similar message earlier in a telephone call with U.S. President Barack Obama, his office said.

"AN OPEN PRISON"

According to a text of the agreement seen by Reuters, both sides should halt all hostilities, with Israel desisting from incursions and targeting of individuals, while all Palestinian factions should cease rocket fire and cross-border attacks.

The deal also provides for easing Israeli restrictions on Gaza's residents, who live in what British Prime Minister David Cameron has called an "open prison".

The text said procedures for implementing this would be "dealt with after 24 hours from the start of the ceasefire".

Israeli sources said Israel would not lift a blockade of the enclave it enforced after Hamas, which rejects the Jewish state's right to exist, won a Palestinian election in 2006.

However, Meshaal said the deal covered the opening of all of the territory's border crossings. "The document stipulates the opening of the crossings, all the crossings, and not just Rafah," he said. Israel controls all of Gaza's crossings apart from the Rafah post with Egypt.

Hamas lost its top military commander to an Israeli strike in the conflict and suffered serious hits to its infrastructure and weaponry, but has emerged with its reputation both in the Arab world and at home stronger.

Israel can take comfort from the fact it dealt painful blows to its enemy, which will take many months to recover, and showed that it can defend itself from a barrage of missiles.

"No one is under the illusion that this is going to be an everlasting ceasefire. It is clear to everyone it will only be temporary," said Michael Herzog, a former chief of staff at the Israeli ministry of defence.

"But there is a chance that it could hold for a significant period of time, if all goes well," he told Reuters.

Egypt, an important U.S. ally now under Islamist leadership, took centre stage in diplomacy to halt the bloodshed. Cairo has walked a fine line between its sympathies for Hamas, an offshoot of the Muslim Brotherhood to which President Mohamed Mursi belongs, and its need to preserve its 1979 peace treaty with Israel and its ties with Washington, its main aid donor.

Announcing the agreement in Cairo, Egyptian Foreign Minister Mohamed Kamel Amr said mediation had "resulted in understandings to cease fire, restore calm and halt the bloodshed".

U.S. Secretary of State Hillary Clinton, standing beside Amr, thanked Mursi for peace efforts that showed "responsibility, leadership" in the region.

The Gaza conflict erupted in a Middle East already shaken by last year's Arab uprisings that toppled several veteran U.S.-backed leaders, including Egypt's Hosni Mubarak, and by a civil war in Syria, where President Bashar al-Assad is fighting for survival.

In his call with Netanyahu, Obama in turn repeated U.S. commitment to Israel's security and promised to seek funds for a joint missile defence program, the White House said.

BUS BOMBING

The ceasefire was forged despite a bus bomb explosion that wounded 15 Israelis in Tel Aviv earlier in the day and despite more Israeli air strikes that killed 10 Gazans. It was the first serious bombing in Israel's commercial capital since 2006.

Israel, the United States and the European Union all classify Hamas as a terrorist organization. It seized the Gaza Strip from the Western-backed Palestinian President Mahmoud Abbas in 2007 in a brief but bloody war with his Fatah movement.

"This is a critical moment for the region," Clinton said. "Egypt's new government is assuming the responsibility and leadership that has long made this country a cornerstone for regional stability and peace."

In Amman, U.N. chief Ban Ki-moon urged both sides to stick to their ceasefire pledges. "There may be challenges implementing this agreement," he said, urging "maximum restraint".

(Additional reporting by Noah Browning in Gaza, Ori Lewis, Allyn Fisher-Ilan and Crispian Balmer in Jerusalem, Yasmine Saleh, Shaimaa Fayed and Tom Perry in Cairo, Suleiman al-Khalidi in Amman and Margaret Chadbourn in Washington; Writing by Alistair Lyon and David Stamp; Editing by Louise Ireland)

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AP Exclusive: Syrian rebels seize base, arms trove

BASE OF THE 46TH REGIMENT, Syria (AP) — After a nearly two-month siege, Syrian rebels overwhelmed a large military base in the north of the country and made off with tanks, armored vehicles and truckloads of munitions that rebel leaders say will give them a boost in the fight against President Bashar Assad‘s army.

The rebel capture of the base of the Syrian army’s 46th Regiment is a sharp blow to the government’s efforts to roll back rebels gains and shows a rising level of organization among opposition forces.

More important than the base’s fall, however, are the weapons the rebels found inside.

At a rebel base where the much of the haul was taken after the weekend victory, rebel fighters unloaded half a dozen large trucks piled high with green boxes full of mortars, artillery shells, rockets and rifles taken from the base. Parked nearby were five tanks, two armored vehicles, two rocket launchers and two heavy-caliber artillery cannons.

Around 20 Syrian soldiers captured in the battle were put to work carrying munitions boxes, barefoot and stripped to the waist. Rebels refused to let reporters talk to them or see where they were being held.

“There has never been a battle before with this much booty,” said Gen. Ahmad al-Faj of the rebels Joint Command, a grouping of rebel brigades that was involved in the siege. Speaking on Monday at the rebel base, set up in a former customs office at Syria’s Bab al-Hawa border crossing with Turkey, he said the haul would be distributed among the brigades.

For months, Syria’s rebels have gradually been destroying government checkpoints and taking over towns in the northern provinces of Idlib and Aleppo along the Turkish border.

Rebel fighters say that weapons seized in such battles have been essential to their transformation from ragtag brigades into forces capable of challenging Assad’s professional army. Cross-border arms smuggling from Turkey and Iraq has also played a role, although the most common complaint among rebel fighters is that they lack ammunition and heavy weapons, munitions and anti-aircraft weapons to fight Assad’s air force.

It is unclear how many government bases the rebels have overrun during the 20-month conflict, mostly because they rarely try to hold captured facilities. Staying in the captured bases would make them sitting ducks for regime airstrikes.

“Their strategy is to hit and run,” said Elias Hanna, a retired Lebanese army general and Beirut-based strategic analyst. “They’re trying to hurt the regime where it hurts by bisecting and compartmentalizing Syria in order to dilute the regime’s power.”

The 46th Regiment was a major pillar of the government’s force near the northern city of Aleppo, Syria’s economic hub, and its fall cuts a major supply line to the regime’s army, Hanna said. Government forces have been battling rebels for months over control of Aleppo.

“It’s a tactical turning point that may lead to a strategic shift,” he said.

At the 46th Regiment’s base, about 25 kilometers (15 miles) west of Aleppo, the main three-story command building showed signs of the battle — its walls punctured apparently from rebel rocket attacks. The smaller barracks buildings scattered around the compound, about 2.6 square kilometers (1 square mile) in size, had been looted, with mattresses overturned. A number of buildings had been torched.

Reporters from The Associated Press who visited the base late Monday saw no trace of the government troops who had been defending it — other than the dead bodies of seven soldiers.

Two of them, in camouflage uniforms, lay outside the command building. One of them was missing his head, apparently blown off in an explosion.

The rest were in a nearby clinic. Four dead soldiers were on stretchers set on the floor, one with a large gash in his arm, another with what appeared to be a large shrapnel hole in the back of his head. The last lay on a gurney in another room, his arms and legs bandaged, a bullet hole in his cheek and a splatter of blood on the wall and ceiling behind him as if he had been shot where he lay.

It could not be determined how or when the soldiers had been killed.

The final assault that took the base came after more than 50 days of siege that left the soldiers inside demoralized, according to fighters who took part.

Working together and communicating by radio, a number of different rebels groups divided up the area surrounding the base and each cut the regime’s supply lines, said Abdullah Qadi, a rebel field commander. Over the course of the siege, dozens of soldiers defected, some telling the rebels that those inside were short of food, Qadi said.

The rebels decided to attack Saturday afternoon when they felt the soldiers inside were weak and the rebels had enough ammunition to finish the battle, Qadi said. The battle was over by nightfall on Sunday. Seven rebel fighters were killed in the battle, said al-Faj of the rebels’ Joint Command. Other rebel leaders gave similar numbers.

It remains unclear how many soldiers remained in the base when the rebels launched their attack and what happened to them.

Al-Faj said all soldiers inside were either killed or captured. He said he didn’t know how many were killed, but that the rebels had taken about 50 prisoners, all of whom would be tried in a rebel court. Aside from the 20 prisoners seen at the rebel’s Bab al-Hawa base, the AP was unable to see any other captured soldiers.

The Syrian government does not respond to requests for comment on military affairs and said nothing about the base’s capture. It says the rebels are terrorists backed by foreign powers that seek to destroy the country.

Disorganization has plagued the Syrian opposition since the start of the anti-Assad uprising in March 2011, with exile groups pleading for international help even when they have no control over those fighting inside of Syria.

A newly formed Syrian opposition coalition received a boost Tuesday, when Britain officially recognized it as the sole representative of the Syrian people.

The National Coalition of the Syrian Revolutionary and Opposition Forces was formed in the Gulf nation of Qatar on Oct. 11 under pressure from the United States for a stronger, more united opposition body to serve as a counterweight to more extremist forces.

British Foreign Secretary William Hague said Tuesday the body’s members gave assurances to be a “moderate political force committed to democracy” and that the West must “support them and deny space to extremist groups.”

The United States and the European Union have both spoken well of the body but stopped short of offering it full recognition.

Key to the body’s success will be its ability to build ties with the disparate rebel groups fighting inside Syria. Many rebel leaders say they don’t recognize the new body, and a group of extremist Islamist factions on Monday rejected it, announcing that they had formed an “Islamic state” in Aleppo.

Anti-regime activists say nearly 40,000 people have been killed since Syria’s crisis started 20 months ago.

___

Associated Press write Elizabeth Kennedy contributed reporting from Beirut, Lebanon.

Middle East News Headlines – Yahoo! News

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“Life of Pi” and “Rise of Guardians” Debut, but It’s Still “Twilight” Time at Box Office

LOS ANGELES (TheWrap.com) – Ang Lee‘s lyrical epic “Life of Pi,” the computer-animated 3D holiday tale “Rise of the Guardians” and the “Red Dawn” reboot all debut in theaters Wednesday, as the holiday movie season kicks into high gear.

But the current No. 1, “Twilight: Breaking Dawn 2,” will almost surely out-earn the newcomers and dominate the Thanksgiving weekend box office, with a second week that analysts are projecting will hit $ 65 million over the five days. DreamWorks Animation‘s “Rise of the Guardians” will wind up with around $ 55 million and run second, they say.

Add in sturdy holdovers like Sony’s record-breaking James Bond movie “Skyfall” and Disney’s animated “Wreck-It Ralph,” along with expanding awards hopefuls “Lincoln” and “Silver Linings Playbook,” and it shapes up as a very busy weekend at the cineplexes.

Summit Entertainment’s “Breaking Dawn 2″ remains in 4,070 theaters after rolling up $ 141 million in its U.S. debut last weekend.

That was the year’s fourth best opening – behind “The Avengers,” “Dark Knight Rises” and “The Hunger Games” – but fell short of the franchise-best $ 142.8 million set by “New Moon” in 2009. “Breaking Dawn” is expected to play more strongly abroad than domestically, and the first-week numbers reflect that: It took in nearly $ 200 million in its first week of release overseas.

“In the U.S., it didn’t get that finale bump that the last Harry Potter movie did, which was surprising,” Exhibitor Relations senior analyst Jeff Bock told TheWrap, “Its fan base was committed, but Summit couldn’t expand it beyond that.”

“Harry Potter and the Deathly Hallows, Part 2″ opened to $ 169 million in 2011, well ahead of “Deathly Hallows 2,” which opened to $ 125 million the previous year.

“Skyfall,” which took in $ 41 million in its second week as it became the top-grossing Bond film of all time, is looking at a five-day total of around $ 39 million, the analysts say. Its worldwide gross now stands at $ 672 million, $ 507 million of which has come from overseas.

Buoyed by surprisingly strong results, Disney is expanding “Lincoln” into roughly 2,000 theaters, up from 1,775, on Friday. The DreamWorks Oscar contender was a surprise No. 3 finisher with $ 21 million last weekend, well above analysts’ and the studio’s projections. It’s projected to finish with $ 24 million over the long weekend.

Among the newcomers, Oscar contender “The Life of Pi” is the most difficult to peg in terms of box-office potential.

It’s hard to imagine a tale tougher to bring to the screen than Yann Martel’s 2001 saga of an Indian youth lost at sea with a ravenous Bengal tiger aboard his small lifeboat and their ensuing adventures. But Lee brought martial arts (“Crouching Tiger, Hidden Dragon”) and gay cowboys (“Brokeback Mountain”) into the movie mainstream, and he’s employed the highest-tech digital tools to bring David Magee’s adaptation to life in 3D.

Indian Suraj Sharma, who was 17 and had no acting experience when he shot “Pi,” plays the lead and spends a good bit of the film alone in a boat with the tiger.

The critics love it (92 percent positive on Rotten Tomatoes), calling it gorgeous, innovative and a provocative and soulful examination of faith. Those are admirable qualities in a film, but hardly requisites for – or a guarantee of – box office success.

Fox has the PG-rated “Pi” in 2,700 theaters and it will have the advantage of premium pricing going for it. Analysts see it opening with about $ 25 million over the five days, and feel its long-term playability will hinge on word-of-mouth and awards buzz.

In terms of the box office, the most comparable film could be last year’s Martin Scorsese-directed 3D family adventure “Hugo.” Paramount opened that film around the same time last year to $ 11 million, and it went on to make $ 73 million, $ 185 million worldwide.

With its international cast and exotic settings, “Pi” is another example of a film expected to perform far better internationally than in the U.S. Fox is rolling it out in Taiwan Tuesday, China Wednesday and Hong Kong, India and Puerto Rico this weekend. With Lee’s following in China and young star Sharma expected to draw crowds in India, those two markets should give it fast start overseas.

“Pi” was produced for $ 120 million by Lee, Fox 2000 and special effects firm Rhythm and Hues.

Distributor Paramount is rolling out DreamWorks Animation‘s computer animated family film “Rise of the Guardians” on 3,500 3D screens.

The holiday rollout is a natural for the PG-rated “Rise of the Guardians,” which has a star-studded voice cast, and is executive produced by Guillermo Del Toro and produced by Gary Goetzman.

Based on the William Joyce’s “Guardians of Childhood” series, it tells the tale of Jack Frost (Chris Pine), who gets help from Santa Claus (Alec Baldwin), the Tooth Fairy (Isla Fisher) and the Easter Bunny (Hugh Jackman) after the evil Pitch (Jude Law) threatens the children of the world.

Awareness of the film is strong, and the critics think it’s pretty good. Seventy percent of the reviews on Rotten Tomatoes are positive, 67 percent at Movie Review Intelligence. DreamWorks Animation has been on a hot streak, and this its first release since “Madagascar 3: Europe’s Most Wanted,” which has made over $ 735 million worldwide this year.

“Red Dawn” is a remake of the 1984 John Millius war film that helped launch the careers of young stars Patrick Swayze, Lea Thompson, Jennifer Grey and Charlie Sheen. Released at the peak of the Cold War, its populist and patriotic themes resonated strongly. In that film, Swayze’s character leads a group of teens who turn guerrilla fighters to resist Soviet and Cuban invaders who are occupying their state.

Shot in 2009, the “Red Dawn” reboot was to have been released in 2010, but was delayed by the financial troubles of the studio behind it, MGM.

Since then, the careers of several of the film’s stars have taken off. Since shooting “Red Dawn,” Chris Hemsworth has starred in “Thor,” “The Avengers” and “Snow White and the Huntsman,” while Josh Peck was featured in “The Hunger Games.” Josh Hutcherson, Adrianne Palicki, Isabel Lucas and Jeffrey Dean Morgan co-star.

This “Red Dawn” plays more like an action film and is less jingoistic than the original, and FilmDistrict has marketed that way. In addition to targeting fan boys at the Fantastic Fest in Austin, Texas, and college campuses, “Red Dawn” has been show at more than 100 military bases. The cast did a special screening at Port Hueneme Naval Base in Oxnard, Calif.

Speaking of militaries, while the film was on the shelf: the filmmakers digitally turned the invaders from Chinese into North Koreans after angry denunciations of the portrayals from the Beijing press. The switch shouldn’t hurt at the Chinese box office, either.

FilmDistrict is opening the PG-13-rated “Red Dawn” in 2,600 theaters. The original made the equivalent of $ 90 million when adjusted to today’s ticket prices, while this reboot will be fortunate to make half that amount. A five-day total of around $ 15 million is what the analysts are projecting for the opening.

Fox Searchlight is rolling out “Hitchcock,” starring Anthony Hopkins as the late director Alfred Hitchcock, in 17 theaters on Friday.

Directed by Sacha Gervasi, with a screenplay from John G. McLaughlin, the film explores the relationship between Hitchcock and his wife and partner Alma Reville (Helen Mirren) while they were working on “Psycho,” one of his most successful films.

Scarlett Johansson, Danny Huston, Jessica Biel, Toni Collette, Michael Wincott, and James D’Arcy co-star in the Montecito Picture Company production.

“Hitchcock” premiered at the AFI Film Festival and has been well-received by the critics. It has a 76 percent positive rating on Rotten Tomatoes.

Fox Searchlight plans to expand the film gradually over the next three weeks, ahead of its national release on December 14, when it will be on between 500 and 600 theaters.

The Weinstein Company is expanding its Oscar hopeful “Silver Linings Playbook” into 420 theaters. The dark romantic comedy is directed by David O. Russell and stars Jennifer Lawrence, Bradley Cooper and Robert De Niro.

“Silver Linings Playbook” averaged $ 28,652 on 16 screens in its debut and was to have expanded into 2,000 theaters on Wednesday. But the Weinstein Co. shifted gears last week and decided on a more gradual platform release in hopes of building awards buzz. The Weinstein Co. knows Oscar campaigns; they were behind the last two Best Picture winners, “The King’s Speech” and “The Artist.”

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U.S. soldier accused of Iraq shooting “psychotic”: doctor

TACOMA (Reuters) – A U.S. soldier accused of killing five fellow servicemen at a military combat stress center in Baghdad in 2009 was psychotic and suffered from post-traumatic stress disorder during the shooting frenzy, a top U.S. forensic psychiatrist testified on Tuesday.

Sergeant John Russell, 48, is accused of going on a shooting spree at Camp Liberty, near the Baghdad airport, in an assault the military said at the time could have been triggered by combat stress.

Russell, of the 54th Engineer Battalion based in Bamberg, Germany, faces five charges of premeditated murder, one charge of aggravated assault and one charge of attempted murder in connection with the May 2009 shootings.

Six months ago, he was ordered to stand trial in a military court that has the power to sentence him to death, if he is convicted.

Russell’s civilian attorney, James Culp, entered no plea at an arraignment on Monday at a military base in Washington state. Russell’s court martial is tentatively set for mid-March and could last four to five weeks, attorneys told Reuters on Tuesday.

In a second day of hearings to discuss Russell’s state of mind at the time of the shooting and establish what evidence or testimony to admit at the court martial, Robert Sadoff, a University of Pennsylvania forensic psychiatry expert, gave the opinion that Russell was suffering from post-traumatic stress disorder.

Russell has “dissociative disorder,” or a lack of memory about the shootings, said Sadoff, who examined Russell for a total of 20 hours after the shootings. “He cannot remember. It’s a legitimate disorder. He also has post-traumatic stress disorder.”

Sadoff, a veteran of 10,000 criminal cases added: “It’s a matter of what’s going on in this man’s mind. He was psychotic. He was not dealing with reality. That’s what psychosis is.”

If the defense can persuade a jury that Russell was not in control of his actions, it may be able to argue that he is not legally responsible and could spare him from the death penalty, if convicted.

During Tuesday’s hearing, Culp sought authority from Judge Colonel David Conn to hire a forensic hypnotist to unlock Russell’s buried memories and conduct a specialized magnetic resonance imaging (MRI) test to measure Russell’s “mild diffused brain atrophy”, which Culp argues played a part in his behavior.

This would help diagnose “the extent of brain damage as it relates to criminal responsibility,” Culp said.

Army prosecutors urged the judge to decline. Major Dan Mazzone, one of four Army attorneys prosecuting the case, told the judge that an Army medical review already indicated that Russell’s brain atrophy was typical of a man his age and further testing is an unnecessary expense to the Army.

“The bottom line, this is just not necessary. It’s something the government should not be entitled to fund,” Mazzone said.

The judge is set to rule on the matter over the next few days.

The proceedings, held at Joint Base Lewis-McChord near Tacoma, Washington, come at a sensitive time for the Army, which is in the process of deciding how to prosecute Staff Sergeant Robert Bales, a soldier accused of killing Afghan villagers in cold blood earlier this year.

A two-week hearing at Lewis-McChord to establish if there is sufficient evidence to send Bales to a court martial wrapped up last week after harrowing testimony from Afghan adults and children wounded in the attack.

Bales’ civilian defense lawyers have also suggested he was suffering from post-traumatic stress disorder.

On Monday, Russell’s attorney outlined a defense based on his declining mental state.

Russell suffered from depression, thoughts of suicide, anxiety and stress from multiple deployments, and suffered “at least one traumatic experience involving civilian casualties” and “mass grave sites” while serving in Bosnia and Kosovo during 1998 and 1999, Culp said in presenting arguments to the judge after the arraignment.

(Reporting by Bill Rigby; Editing by Lisa Shumaker)

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