Tapping citizen-scientists for a novel gut check

WASHINGTON (AP) — The bacterial zoo inside your gut could look very different if you're a vegetarian or an Atkins dieter, a couch potato or an athlete, fat or thin.

Now for a fee — $69 and up — and a stool sample, the curious can find out just what's living in their intestines and take part in one of the hottest new fields in science.

Wait a minute: How many average Joes really want to pay for the privilege of mailing such, er, intimate samples to scientists?

A lot, hope the researchers running two novel citizen-science projects.

One, the American Gut Project, aims to enroll 10,000 people — and a bunch of their dogs and cats too — from around the country. The other, uBiome, separately aims to enroll nearly 2,000 people from anywhere in the world.

"We're finally enabling people to realize the power and value of bacteria in our lives," said microbiologist Jack Gilbert of the University of Chicago and Argonne National Laboratory. He's one of a team of well-known scientists involved with the American Gut Project.

Don't be squeamish: Yes, we share our bodies with trillions of microbes, living communities called microbiomes. Many of the bugs, especially those in the intestinal tract, play indispensable roles in keeping us healthy, from good digestion to a robust immune system.

But which combinations of bacteria seem to keep us healthy? Which ones might encourage problems like obesity, diabetes or irritable bowel syndrome?

And do diet and lifestyle affect those microbes in ways that we might control someday?

Answering those questions will require studying vast numbers of people. Getting started with a grassroots movement makes sense, said National Institutes of Health microbiologist Lita Proctor, who isn't involved with the new projects but is watching closely.

After all, there was much interest in the taxpayer-funded Human Microbiome Project, which last summer provided the first glimpse of what makes up a healthy bacterial community in a few hundred volunteers.

Proctor, who coordinated that project, had worried "there would be a real ick factor. That has not been the case," she said. Many people "want to engage in improving their health."

Scott Jackisch, a computer consultant in Oakland, Calif., ran across American Gut while exploring the science behind different diets, and signed up last week. He's read with fascination earlier microbiome research: "Most of the genetic matter in what we consider ourselves is not human, and that's crazy. I wanted to learn about that."

Testing a single stool sample costs $99 in that project, but he picked a three-sample deal for $260 to compare his own bacterial makeup after eating various foods.

"I want to be extra, extra well," said Jackisch, 42. Differing gut microbes may be the reason "there's no one magic bullet of diet that people can eat and be healthy."

It's clear that people's gut bacteria can change over time. What this new research could accomplish is a first look at how different diets may play a role, said American Gut lead researcher Rob Knight of the University of Colorado, Boulder.

One challenge is making sure participants don't expect that a map of their gut bacteria can predict their future health, or suggest lifestyle changes, anytime soon.

"I understand I'm not going to be able to say, 'Oh, my gosh, I'll be susceptible to this,'" said Bradley Heinz, 26, a financial consultant in San Francisco. He is paying uBiome $119 to analyze both his gut and mouth microbiomes; just the gut is $69.

"The more people that participate, the more information comes out and the more that everybody benefits," he added.

Participants can sign up for either project via the social fundraising site Indiegogo.com over the next month. They also can send scrapings from the skin, mouth and other sites, to analyze that bacteria. Sign up enough family members or body sites, or be tracked over time, and the price can rise into the thousands. American Gut researchers plan some free testing for those who can't afford the fees, to try to increase the experiment's diversity.

Don't forget the pets: "We sleep with them, play with them, they often eat our food," said American Gut co-founder Jeff Leach, an anthropologist. What bacteria we have in common is the next logical question.

Already, American Gut researchers are preparing to compare what they find in the typical U.S. gut with a few hundred people in rural Namibia, who eat what's described as hunter-gatherer fare. Also, Leach will spend three months living in Namibia next year, and is storing his own stool samples for before-and-after comparison.

But diet isn't the only factor. Your bacterial makeup starts at birth: Babies absorb different microbes when they're born vaginally than when they're born by C-section, a possible explanation for why cesareans raise the risk for certain infections. Taking antibiotics, especially in early childhood, can alter this teeming inner world, and it's not clear if there are lasting consequences.

Then there's your environment, such as the infections spread in hospitals. In February, a new University of Chicago hospital building opens and Gilbert will test the surfaces, the patients and their health workers to see how quickly bad bugs can move in and identify which bacteria are protective.

Whatever the findings, all the research marks "a huge teachable moment" about how we interact with microbes, Leach said.

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EDITOR'S NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.

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Online:

www.indiegogo.com/americangut

www.indiegogo.com/ubiome

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Wall Street flat, awaits movement on fiscal cliff talks

NEW YORK (Reuters) - Stocks were little changed in early trading on Tuesday as the market remains hostage to negotiations in Washington on how to avert a "fiscal cliff" that could push the U.S. economy into recession.

Republicans in Congress proposed steep spending cuts to bring down the budget deficit on Monday but gave no ground on President Barack Obama's call to raise taxes on the wealthiest Americans, and the proposal was quickly dismissed by the White House.

Headlines about the back-and-forth preliminary proposals by Republicans and Democrats have fixated the market. Still, many investors expect the two sides to come up with a deal before the year-end deadline, which could trigger a rally in equities.

"Support (for the market) is based on a belief that Washington will come to some agreement before we go over the fiscal cliff," said Art Hogan, managing director of Lazard Capital Markets in New York.

Hogan added, "On the first show of flexibility from either side, we'll get a relief rally."

Despite sudden moves in the market on the latest headlines about the fiscal cliff in recent days, a measure of investor anxiety has held surprisingly flat.

The CBOE volatility index <.vix>, a gauge of market anxiety, slipped to 16 and has not traded above 20 since July following its 2012 high near 28 hit in June. The VIX's 10-day Average True Range, an internal volatility measure, is at its lowest since early 2007.

Obama will meet with U.S. governors at the White House on Tuesday to talk about the fiscal cliff, a $600 billion package of tax hikes and federal spending cuts that would begin January 1.

The president is also expected to talk about the fiscal cliff during an interview scheduled for 12:30 p.m. (1730 GMT) on Bloomberg TV.

Coach became the latest company to advance the date of its next dividend payment. Expectations of higher taxes on dividends kicking in in 2013 have pushed many companies to pay special dividends this year or advance their next pay-back to investors.

The Dow Jones industrial average <.dji> rose 27.92 points, or 0.22 percent, to 12,993.52. The S&P 500 <.spx> edged up 0.44 points, or 0.03 percent, to 1,409.90. The Nasdaq Composite <.ixic> fell 4.44 points, or 0.15 percent, to 2,997.76.

Toll Brothers shares rose 1.8 percent to $33.01 after the largest U.S. luxury homebuilder reported a higher quarterly profit and said new orders rose sharply.

MetroPCS Communications shares dropped 6.5 percent to $10.07 after Sprint Nextel appeared unlikely to make a counter-offer for the wireless service provider.

Shares of Pep Boys-Manny Moe and Jack were down 12.4 percent at $9.36 a day after the release of the auto parts retailer's results.

(Reporting by Rodrigo Campos; Editing by Kenneth Barry)

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Pope Starts Personal Twitter Account

Osservatore Romano, via Reuters

Pope Benedict XVI using an iPad at the Vatican last year.

On Monday, the Vatican announced that the 85-year-old pontiff would begin posting messages on Twitter next week under the handle @pontifex, a term for pope that means bridge-builder in Latin. Within hours, he had more than 100,000 followers.

Benedict is expected to hit “send” on his first post at a general audience at the Vatican on Dec. 12 — a response to questions about matters of the faith that he is now accepting via the hashtag #askpontifex, officials said.

The Vatican acknowledged that it had chosen the @pontifex handle not only because of its meaning but also because many other handles had been taken.

The move is aimed at drawing in the church’s 1.2 billion followers, especially young people. “The pope’s presence on Twitter can be seen as the ‘tip of the iceberg’ that is the church’s presence in the world of new media,” the Vatican said in a statement.

Just do not expect the pope to start following you on Twitter or retweeting your posts, Greg Burke, a former Fox News correspondent in Rome who was named a Vatican communications adviser this year, said at a news conference. “He won’t follow anyone for now,” Mr. Burke added. “He will be followed.”

Benedict’s posts will go out in Arabic, English, French, German, Italian, Polish, Portuguese and Spanish. Other languages are expected to be added in the future. The messages will mostly feature the contents of the pope’s speeches at his weekly general audience and Sunday blessings, as well as homilies on major holidays and reaction to major world events, like natural disasters.

Aides will write the texts of Benedict’s posts, but the pope himself will “engage and approve” the content. The pope will post messages however often he feels like it.

“The pope is not the kind of person like the rest of us who in a meeting or a lunch is looking at their BlackBerrys to see if any messages have come in,” Mr. Burke said. “He is not walking around with an iPad, but all the pope’s tweets are the pope’s words.”

The pope’s account will not have special security, the Vatican said, but precautions have been taken to make sure the pope’s certified account is not hacked. All the posts will come from one computer in the Vatican’s Secretariat of State.

The prospect of the pope’s using Twitter has raised some puzzling theological questions. Asked whether the pope’s posts would be infallible, Msgr. Claudio Maria Celli, the president of the Pontifical Council for Social Communications, laughed and said that they would be part of the church Magisterium, or collective teaching, but should be considered “pearls of wisdom,” not exactly doctrine.

“In any case, it’s a papal teaching,” Monsignor Celli said. “The message is just entrusted to a new technology.”

A shy theologian who directed the Vatican’s doctrinal office for 25 years before becoming pope in 2005, Benedict is best known for complex theological positions that require far more than 140 characters to explain. His book “Jesus’s Childhood,” the last in his three-volume biography of Jesus, appeared last month and is a best seller in Italy.

The Catholic Church may be one of the slowest-changing institutions in the world, but when it comes to communicating with the faithful, it has generally been a pretty early adopter. In 1896, Pope Leo XIII became the first pope to appear on film. In 1931, Vatican Radio was founded, and Pope Piux XI was the first pope to make a radio broadcast. In 1949, Pope Pius XII was the first to appear on television.

In 2009, a Vatican Web site, www.pope2you.net, went live, offering an application called “The pope meets you on Facebook,” and another that allows readers to upload the pope’s speeches and messages to their smartphones. In 2011, the Vatican started its own news Web site, Newsva.va.

Last year, Benedict wrote that new media and social networks offered “a great opportunity,” but he also warned that they carried the risk of alienation and self-indulgence.

Gaia Pianigiani reported from Vatican City, and Rachel Donadio from Rome.

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Kate's Morning Sickness Is 'Acute'

By Simon Perry

12/03/2012 at 11:50 AM EST

Kate is still in the early stages of her pregnancy – less than 12 weeks – and already the next royal is making his or her presence dramatically known.

The Palace has described the Duchess of Cambridge's morning sickness as "acute" and she is at King Edward VII Hospital in Central London, joined by her husband, Prince William. According to a source at St James's Palace, Kate arrived at the hospital from her parents' new home in Bucklebury.

The source adds that the couple decided to "be open" about Kate's pregnancy because she was admitted to the hospital. But, since it's so early, "we aren't going into detail about the pregnancy itself," the source says.

Kate, 30, also has canceled her next three official engagements.

According to the Palace, Kate is suffering from hyperemesis gravidarum, characterized by severe and persistent nausea and vomiting during pregnancy. If untreated, the patient can suffer dehydration and dangerous weight loss.

This is the first child for the royal couple, who wed in April 2011.

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US envoy hits China's stand in UN climate talks

DOHA, Qatar (AP) — The United States on Monday challenged China's view of how to split the burden of curbing carbon emissions, saying the rich-poor divide in past climate agreements has no place in a future pact to fight global warming.

The U.S. envoy to international climate talks in Qatar, Todd Stern, said that the next climate deal must be based on "real-world" considerations, not "an ideology that says we're going to draw a line down the middle of the world."

Beijing wants to maintain a division between developed and developing nations, setting out softer emissions-cutting requirements for poorer countries. It notes that despite its roaring growth, millions of Chinese still live in poverty, and emission limits would slow the economic expansion that would improve their lot.

The climate pact is one of the key issues under discussion at the United Nations-led talks, which have entered their second week. Last year, governments agreed it should be adopted by 2015 and take effect five years later. The U.S. didn't join the only binding emissions agreement to date, the 1997 Kyoto Protocol, because it only covered industrialized nations and not major developing countries like India and China, which is now the world's biggest carbon emitter.

"It's going to be an enormously challenging, and I think enormously important, task to get this agreement right," Stern said.

The dispute will not be resolved in Doha, where negotiators are focusing on side issues including aid to help poor countries shift to renewable energy and protect themselves from rising sea levels and other effects of global warming.

They also plan to extend the Kyoto agreement, which expires this year, until a new treaty is in place. But several nations including Japan and New Zealand don't want to be part of the extension, meaning it will only cover European countries and Australia, which account for less than 15 percent of global emissions.

Even that has been complicated by disputes over whether emissions allowances granted to Poland and other eastern European countries to offset the early economic fallout after the collapse of communism should carry over into the second phase.

U.N. climate chief Christiana Figueres told reporters that people shouldn't expect the talks to yield success overnight because they deal with "a complete transformation of the economic structure of the world" — a shift from fossil fuels to renewable energy.

"What gives me frustration is the fact that we are very far behind what science tells us we should be doing," she said. "What gives me hope is the fact that ... over the past two to three years, this process has had more progress than it did in the past 10."

EU climate commissioner Connie Hedegaard said she would raise a host of side issues at a round-table discussion with environment ministers this week, including how to reduce subsidies for fossil fuels. Even though the G-20 group of industrialized and emerging nations called for the phasing-out of such subsidies already in 2009, the International Energy Agency recently said they grew 30 percent last year to $523 billion, primarily due to increases in the Middle East and Africa.

"It has been discussed for three years or more," Hedegaard said. "Now we need to start the phasing out."

In addition to the fuel subsidies in developing countries, rich nations in 2011 gave more than $58 billion in tax breaks and other production subsidies to oil and coal companies, according to a report Monday by Oil Change International, an advocacy group for clean energy. The U.S. figure was $13 billion.

Stern said that President Barack Obama has pushed for reducing fossil fuel subsidies domestically and internationally.

"It's difficult in other countries and it's difficult at home to carry it forward because there are a lot of entrenched interests," he said.

While he highlighted U.S. initiatives undertaken during Obama's first term — such as sharply increasing fuel efficiency standards for cars and trucks and investing in green energy — Stern noted that more ambitious climate legislation had stalled in Congress and that shifts in the U.S. climate position should not be expected following Obama's re-election.

"I don't know if I would think about this in terms of a different tone here," he said. "The U.S. has done quite significant things in the president's first four years."

Climate talks are scheduled to end on Friday.

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Wall Street up on China, but U.S. factory data pares gains

NEW YORK (Reuters) - The S&P 500 edged up to rise for a fourth straight day on Monday as upbeat Chinese data lifted sentiment, but weak U.S. factory numbers cut into gains.

Wall Street opened higher on that data but pared most of its gains after U.S. manufacturing unexpectedly contracted in November, falling to its lowest in over three years in a sign the sector may be struggling to gain traction.

Concerns over budget dealings in Washington are expected to keep traders cautious as political wrangling continues over how to deal with spending cuts and tax hikes scheduled to kick in next year that could tip the U.S. economy back into recession.

China's economy picked up in November even as a broader global recovery remains fragile, with factory activity patchy elsewhere in Asia as demand from the developed world remains weak.

"It's not clear exactly which numbers to focus on, but data is probably positive for markets starting from the China release last night," said Paul Zemsky, head of asset allocation at ING Investment Management in New York.

Adding to the upbeat market tone, Spain formally requested the disbursement more than $50 billion of European funds to recapitalize its crippled banking sector while Greece said it would spend 10 billion euros ($13 billion) to buy back bonds in a bid to reduce its ballooning debt.

"There's other positive news out of Europe with Greeks buying back their debt," Zemsky said. "Net-net the news cycle is positive for (equity) markets."

The Dow Jones industrial average <.dji> dipped 9.87 points, or 0.08 percent, to 13,015.71. The S&P 500 Index <.spx> gained 0.82 point, or 0.06 percent, to 1,417.00. The Nasdaq Composite <.ixic> added 6.24 points, or 0.21 percent, to 3,016.49.

The S&P 500 on Friday closed its fifth positive month in six and is up 8 percent since the end of May.

U.S. Treasury Secretary Timothy Geithner pushed Republicans on Sunday to offer specific ideas to cut the deficit and predicted that they would agree to raise tax rates on the rich to obtain a year-end deal to avoid the "fiscal cliff."

"Right now for both sides it's all about staying firm and determined to go to the very end," said Peter Cardillo, chief market economist at Rockwell Global Capital in New York about the negotiations. "But we all know the stakes are high and (Congress) can't be that stupid as to induce another recession."

Singapore Airlines said it was in talks with interested parties to sell its 49 percent stake in British carrier Virgin Atlantic, with sources saying that Delta Air Lines was among the potential suitors. Delta shares fell 1.9 percent to $9.81.

Dell shares rose 6.3 percent to $10.25 after Goldman Sachs upgraded its view on the stock to "buy" from "sell."

(Reporting by Rodrigo Campos, editing by Kenneth Barry)

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Egyptian Court Postpones Ruling on Charter

Wissam Nassar

Egyptian police officers stood guard outside Egypt's Supreme Constitutional Court on Sunday, while supporters of President Mohamed Morsi protested near the entrance of the building.

CAIRO — Egypt’s highest court on Sunday postponed its much-awaited ruling on the legitimacy of the legislative assembly that drafted a new charter last week, accusing a crowd of Islamists of blocking judges from entering their building on what it called “a dark black day in the history of the Egyptian judiciary.”

Although hundreds of security officers were on hand to ensure that judges of the Supreme Constitutional Court could get into the court, and civilians came and went without any problems, the accusations intensified a standoff between the judges appointed under former President Hosni Mubarak and Egypt’s new Islamist leaders that has thrown the political transition into a new crisis 22 months after Mr. Mubarak’s ouster.

Upon approaching the court on Sunday morning, the judges said in a statement that they saw crowds “closing the entrances of the roads to the gates, climbing the fences, chanting slogans denouncing its judges and inciting the people against them.”

The judges were prevented from entering “because of the threat of harm and danger to their safety,” the statement said, calling it “an abhorrent scene of shame and disgrace.”

As a result, the judges announced that they were “suspending the court’s sessions” until they could resume their work without “psychological and physical pressures.”

Anticipation of the court’s decision on the new constitution had set off the latest political crisis. Fear that the court would dissolve the assembly and undo months of work led President Mohamed Morsi, of the Muslim Brotherhood’s political party, to announce 10 days ago that his edicts were not be subject to judicial review until the completion of the constitution.

Despite Mr. Morsi’s attempt, the same anticipation of dissolution drove the Islamist-dominated assembly to rush out a hurried constitution before the court could act and against the objections of Egypt’s secular parties and the Coptic Christian Church. Judges appointed by Mr. Mubarak have previously dissolved the elected Parliament and the first constitutional assembly.

The sudden effort by the president and his Islamist allies to push through a constitution over any objections from their secular factions or the courts has unified the opposition, prompted hundreds of thousands of protesters to take to the streets and set off a wave of attacks on a dozen offices of the Brotherhood’s Freedom and Justice Party. A judicial trade association has urged judges across the country to go on strike, and some of the highest courts have joined it.

Over the weekend, Mr. Morsi continued to push his plans for the new constitution, setting a national referendum on it for Dec. 15.

“I pray to God and hope that it will be a new day of democracy in Egypt,” he said in a nationally televised speech, calling for a “national dialogue.”

But his recent tone and actions reminded critics of the autocratic ways of his predecessor, and have aroused a new debate here about his commitment to democracy and pluralism at a time when he and his Islamist allies dominate political life.

Mr. Morsi’s advisers call the tactics a regrettable but necessary response to genuine threats to the political transition from what they call the deep state — the vestiges of the autocracy of former President Mubarak, especially in the news media and the judiciary.

But his critics say they hear a familiar paranoia in Mr. Morsi’s new tone that reminds them of talk of the “hidden hands” and foreign plots that Mr. Mubarak once used to justify his authoritarianism.

“I have sent warnings to many people who know who they are, who may be committing crimes against the homeland,” Mr. Morsi declared in an interview with state television on Thursday night, referring repeatedly to secret information about a “conspiracy” and “real and imminent threats” that he would not disclose. “If anybody tries to derail the transition, I will not allow them.”

Mayy El Sheikh contributed reporting.

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Ashley Hebert and J.P. Rosenbaum Are Married

People Exclusive

By Monica Rizzo

12/01/2012 at 06:15 PM EST

J.P. Rosenbaum and Ashley Hebert

Victor Chavez/Getty

It’s official: Bachelorette star Ashley Hebert and her fiancé J.P. Rosenbaum tied the knot Saturday afternoon in Pasadena, Calif.

Surrounded by family, friends and fellow Bachelor and Bachelorette alumni like Ali Fedotowsky, Emily Maynard, and Jason and Molly Mesnick, the couple said "I do" in an outdoor ceremony officiated by franchise host Chris Harrison.

"Today is all about our friends and family," Hebert, whose nuptials will air Dec. 16 on a two-hour special on ABC, tells PEOPLE. "It's about standing with J.P., looking around at all the people we love in the same room there to celebrate our love."

The 28-year-old dentist from Madawaska, Maine, met New York construction manager Rosenbaum, 35, on season 7 of The Bachelorette. The couple became engaged on the season finale.

Hebert and Rosenbaum are the second couple in the franchise's 24 seasons to make it from their show finale to the altar, following in the footsteps of Bachelorette Trista Rehn, who married Vail, Colo., firefighter Ryan Sutter in 2003.

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Asperger's dropped from revised diagnosis manual

CHICAGO (AP) — The now familiar term "Asperger's disorder" is being dropped. And abnormally bad and frequent temper tantrums will be given a scientific-sounding diagnosis called DMDD. But "dyslexia" and other learning disorders remain.

The revisions come in the first major rewrite in nearly 20 years of the diagnostic guide used by the nation's psychiatrists. Changes were approved Saturday.

Full details of all the revisions will come next May when the American Psychiatric Association's new diagnostic manual is published, but the impact will be huge, affecting millions of children and adults worldwide. The manual also is important for the insurance industry in deciding what treatment to pay for, and it helps schools decide how to allot special education.

This diagnostic guide "defines what constellations of symptoms" doctors recognize as mental disorders, said Dr. Mark Olfson, a Columbia University psychiatry professor. More important, he said, it "shapes who will receive what treatment. Even seemingly subtle changes to the criteria can have substantial effects on patterns of care."

Olfson was not involved in the revision process. The changes were approved Saturday in suburban Washington, D.C., by the psychiatric association's board of trustees.

The aim is not to expand the number of people diagnosed with mental illness, but to ensure that affected children and adults are more accurately diagnosed so they can get the most appropriate treatment, said Dr. David Kupfer. He chaired the task force in charge of revising the manual and is a psychiatry professor at the University of Pittsburgh.

One of the most hotly argued changes was how to define the various ranges of autism. Some advocates opposed the idea of dropping the specific diagnosis for Asperger's disorder. People with that disorder often have high intelligence and vast knowledge on narrow subjects but lack social skills. Some who have the condition embrace their quirkiness and vow to continue to use the label.

And some Asperger's families opposed any change, fearing their kids would lose a diagnosis and no longer be eligible for special services.

But the revision will not affect their education services, experts say.

The new manual adds the term "autism spectrum disorder," which already is used by many experts in the field. Asperger's disorder will be dropped and incorporated under that umbrella diagnosis. The new category will include kids with severe autism, who often don't talk or interact, as well as those with milder forms.

Kelli Gibson of Battle Creek, Mich., who has four sons with various forms of autism, said Saturday she welcomes the change. Her boys all had different labels in the old diagnostic manual, including a 14-year-old with Asperger's.

"To give it separate names never made sense to me," Gibson said. "To me, my children all had autism."

Three of her boys receive special education services in public school; the fourth is enrolled in a school for disabled children. The new autism diagnosis won't affect those services, Gibson said. She also has a 3-year-old daughter without autism.

People with dyslexia also were closely watching for the new updated doctors' guide. Many with the reading disorder did not want their diagnosis to be dropped. And it won't be. Instead, the new manual will have a broader learning disorder category to cover several conditions including dyslexia, which causes difficulty understanding letters and recognizing written words.

The trustees on Saturday made the final decision on what proposals made the cut; recommendations came from experts in several work groups assigned to evaluate different mental illnesses.

The revised guidebook "represents a significant step forward for the field. It will improve our ability to accurately diagnose psychiatric disorders," Dr. David Fassler, the group's treasurer and a University of Vermont psychiatry professor, said after the vote.

The shorthand name for the new edition, the organization's fifth revision of the Diagnostic and Statistical Manual, is DSM-5. Group leaders said specifics won't be disclosed until the manual is published but they confirmed some changes. A 2000 edition of the manual made minor changes but the last major edition was published in 1994.

Olfson said the manual "seeks to capture the current state of knowledge of psychiatric disorders. Since 2000 ... there have been important advances in our understanding of the nature of psychiatric disorders."

Catherine Lord, an autism expert at Weill Cornell Medical College in New York who was on the psychiatric group's autism task force, said anyone who met criteria for Asperger's in the old manual would be included in the new diagnosis.

One reason for the change is that some states and school systems don't provide services for children and adults with Asperger's, or provide fewer services than those given an autism diagnosis, she said.

Autism researcher Geraldine Dawson, chief science officer for the advocacy group Autism Speaks, said small studies have suggested the new criteria will be effective. But she said it will be crucial to monitor so that children don't lose services.

Other changes include:

—A new diagnosis for severe recurrent temper tantrums — disruptive mood dysregulation disorder. Critics say it will medicalize kids' who have normal tantrums. Supporters say it will address concerns about too many kids being misdiagnosed with bipolar disorder and treated with powerful psychiatric drugs. Bipolar disorder involves sharp mood swings and affected children are sometimes very irritable or have explosive tantrums.

—Eliminating the term "gender identity disorder." It has been used for children or adults who strongly believe that they were born the wrong gender. But many activists believe the condition isn't a disorder and say calling it one is stigmatizing. The term would be replaced with "gender dysphoria," which means emotional distress over one's gender. Supporters equated the change with removing homosexuality as a mental illness in the diagnostic manual, which happened decades ago.

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner .

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Cliff fight may knock out December rally

NEW YORK (Reuters) - In normal times, next week's slew of U.S. economic data could be a springboard for a December rally in the stock market.

December is historically a strong month for markets. The S&P 500 has risen 16 times in the past 20 years during the month.

But the market hasn't been operating under normal circumstances since November 7 when a day after the U.S. election, investors' focus shifted squarely to the looming "fiscal cliff."

Investors are increasingly nervous about the ability of lawmakers to undo the $600 billion in tax increases and spending cuts that are set to begin in January; those changes, if they go into effect, could send the U.S. economy into a recession.

A string of economic indicators next week, which includes a key reading of the manufacturing sector on Monday, culminates with the November jobs report on Friday.

But the impact of those economic reports could be muted. Distortions in the data caused by Superstorm Sandy are discounted.

The spotlight will be more firmly on signs from Washington that politicians can settle their differences on how to avoid the fiscal cliff.

"We have a week with a lot of economic data, and obviously most of the economic data is going to reflect the effects of Sandy, and that might be a little bit negative for the market next week, but most of that is already expected - the main focus remains the fiscal cliff," said Peter Cardillo, chief market economist at Rockwell Global Capital in New York.

Concerns about the cliff sent the S&P 500 <.spx> into a two-week decline after the elections, dropping as much as 5.3 percent, only to rally back nearly 4 percent as the initial tone of talks offered hope that a compromise could be reached and investors snapped up stocks that were viewed as undervalued.

On Wednesday, the S&P 500 gained more than 20 points from its intraday low after House Speaker John Boehner said he was optimistic that a budget deal to avoid big spending cuts and tax hikes could be worked out. The next day, more pessimistic comments from Boehner, an Ohio Republican, briefly wiped out the day's gains in stocks.

On Friday, the sharp divide between the Democrats and the Republicans on taxes and spending was evident in comments from President Barack Obama, who favors raising taxes on the wealthy, and Boehner, the top Republican in Congress, who said Obama's plan was the wrong approach and declared that the talks had reached a stalemate.

"It's unusual to end up with one variable in this industry, it's unusual to have a single bullet that is the causal factor effect, and you are sitting here for the next maybe two weeks or more, on that kind of condition," said Sandy Lincoln, chief market strategist at BMO Asset Management U.S. in Chicago.

"And that is what is grabbing the markets."

BE CONTRARY AND MAKE MERRY

But investor attitudes and seasonality could also help spur a rally for the final month of the year.

The most recent survey by the American Association of Individual Investors reflected investor caution about the cliff. Although bullish sentiment rose above 40 percent for the first time since August 23, bearish sentiment remained above its historical average of 30.5 percent for the 14th straight week.

December is a critical month for retailers such as Target Corp and Macy's Inc . They saw monthly retail sales results dented by Sandy, although the start of the holiday shopping season fared better.

With consumer spending making up roughly 70 percent of the U.S. economy, a solid showing for retailers during the holiday season could help fuel any gains.

Ryan Detrick, senior technical strategist at Schaeffer's Investment Research in Cincinnati, believes the recent drop after the election could be a market bottom, with sentiment leaving stocks poised for a December rally.

"The concerns on the fiscal cliff - as valid as they might be - could be overblown. When you look at a lot of the overriding sentiment, that has gotten extremely negative," said Detrick.

"From that contrarian point of view with the historically bullish time frame of December, we once again could be setting ourselves up for a pretty nice end-of-year rally, based on lowered expectations."

SOME FEEL THE BIG CHILL

Others view the fiscal cliff as such an unusual event that any historical comparisons should be thrown out the window, with a rally unlikely because of a lack of confidence in Washington to reach an agreement and the economic hit caused by Sandy.

"History doesn't matter. You're dealing with an extraordinary set of circumstances that could very well end up in the U.S. economy going into a recession," said Phil Orlando, chief equity market strategist at Federated Investors in New York.

"And the likelihood of that is exclusively in the hands of our elected officials in Washington. They could absolutely drag us into a completely voluntary recession."

(Wall St Week Ahead runs every Friday. Questions or comments on this column can be emailed to: charles.mikolajczak(at)thomsonreuters.com )

(Reporting by Chuck Mikolajczak; Editing by Jan Paschal)

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