TOI Social Impact Awards: Wheeling healthcare to remote corners

Mental health and trauma — two of India's top killers — have seldom received the attention they deserve from the government. But the awards jury turned the spotlight squarely on these problems. This year, it awarded organizations that provide emergency care or work for the welfare of persons with mental disabilities.

In the corporate category, Ziqitza Health Care, which operates over 860 ambulances in Rajasthan, Punjab, Bihar , Kerala and Mumbai, and says it has transported more than 1.8 million people, has won the award.

Ziqitza was set up to help establish an ambulance service that's accessible and affordable to all sections of society in medical emergencies, irrespective of the affected person's capacity to pay for it. It conceived a cross-subsidy , fee-based service using differential pricing where wealthier customers would pay the full rate for the ambulance service while the poor get hefty discounts and free service.

In the government category, the jury unanimously approved the National Trust for the Welfare of Persons with Autism Cerebral Palsy Mental Retardation and Multiple Disabilities. The organization provides health insurance for people with intellectual and developmental disabilities . Under the ministry of social justice & empowerment, this centre was started in 2007 when no health insurance products were available for people with intellectual and developmental disabilities.

The scheme does not discriminate on severity of any pre-insurance condition and is for all ages. It provides for a bouquet of services, including therapy, surgery and even alternative medicine up to Rs 1 lakh per annum at a nominal premium of Rs 250 per annum for those earning just Rs 15,000 per month and a premium of Rs 500 per annum for those earning more. Over 800 NGOs across India are involved in rolling out the scheme.

In the NGO category, the Karuna Trust that provides free primary healthcare in remote, tribal and insurgency-prone regions in partnership with the government left behind all other claimants. The trust was started by Dr H Sudarshan in BR Hills, Karnataka for the integrated development of tribal people. Karuna Trust has worked to "reach the unreached" and provide free primary healthcare for the past 26 years.

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Retooling Pap test to spot more kinds of cancer

WASHINGTON (AP) — For years, doctors have lamented that there's no Pap test for deadly ovarian cancer. Wednesday, scientists reported encouraging signs that one day, there might be.

Researchers are trying to retool the Pap, a test for cervical cancer that millions of women get, so that it could spot early signs of other gynecologic cancers, too.

How? It turns out that cells can flake off of tumors in the ovaries or the lining of the uterus, and float down to rest in the cervix, where Pap tests are performed. These cells are too rare to recognize under the microscope. But researchers from Johns Hopkins University used some sophisticated DNA testing on the Pap samples to uncover the evidence — gene mutations that show cancer is present.

In a pilot study, they analyzed Pap smears from 46 women who already were diagnosed with either ovarian or endometrial cancer. The new technique found all the endometrial cancers and 41 percent of the ovarian tumors, the team reported Wednesday in the journal Science Translational Medicine.

This is very early-stage research, and women shouldn't expect any change in their routine Paps. It will take years of additional testing to prove if the so-called PapGene technique really could work as a screening tool, used to spot cancer in women who thought they were healthy.

"Now the hard work begins," said Hopkins oncologist Dr. Luis Diaz, whose team is collecting hundreds of additional Pap samples for more study and is exploring ways to enhance the detection of ovarian cancer.

But if it ultimately pans out, "the neat part about this is, the patient won't feel anything different," and the Pap wouldn't be performed differently, Diaz added. The extra work would come in a lab.

The gene-based technique marks a new approach toward cancer screening, and specialists are watching closely.

"This is very encouraging, and it shows great potential," said American Cancer Society genetics expert Michael Melner.

"We are a long way from being able to see any impact on our patients," cautioned Dr. Shannon Westin of the University of Texas MD Anderson Cancer Center. She reviewed the research in an accompanying editorial, and said the ovarian cancer detection would need improvement if the test is to work.

But she noted that ovarian cancer has poor survival rates because it's rarely caught early. "If this screening test could identify ovarian cancer at an early stage, there would be a profound impact on patient outcomes and mortality," Westin said.

More than 22,000 U.S. women are diagnosed with ovarian cancer each year, and more than 15,000 die. Symptoms such as pain and bloating seldom are obvious until the cancer is more advanced, and numerous attempts at screening tests have failed.

Endometrial cancer affects about 47,000 women a year, and kills about 8,000. There is no screening test for it either, but most women are diagnosed early because of postmenopausal bleeding.

The Hopkins research piggybacks on one of the most successful cancer screening tools, the Pap, and a newer technology used along with it. With a standard Pap, a little brush scrapes off cells from the cervix, which are stored in a vial to examine for signs of cervical cancer. Today, many women's Paps undergo an additional DNA-based test to see if they harbor the HPV virus, which can spur cervical cancer.

So the Hopkins team, funded largely by cancer advocacy groups, decided to look for DNA evidence of other gynecologic tumors. It developed a method to rapidly screen the Pap samples for those mutations using standard genetics equipment that Diaz said wouldn't add much to the cost of a Pap-plus-HPV test. He said the technique could detect both early-stage and more advanced tumors. Importantly, tests of Paps from 14 healthy women turned up no false alarms.

The endometrial cancers may have been easier to find because cells from those tumors don't have as far to travel as ovarian cancer cells, Diaz said. Researchers will study whether inserting the Pap brush deeper, testing during different times of the menstrual cycle, or other factors might improve detection of ovarian cancer.

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Arias Caught Lying to Cops in Recorded Phone Calls

Jodi Arias blatantly lied to police who asked her about Travis Alexander's death, telling them in recorded phone calls that she kept trying to call and message Alexander the week of his death but never heard back from him.

The phone calls were played as evidence during the fourth day of Arias' trial, in which she is charged with murder and could face the death penalty if convicted of killing Alexander in a "depraved and heinous" way. Arias has admitted to killing her former boyfriend, but claims it was self-defense.

During the phone conversations played in court, Arias can be heard telling Mesa, Ariz., detective Esteban Flores that she last talked to Alexander on Tuesday night, June 3, 2008, around 10 p.m. She had been in Los Angeles, about to leave to go to Utah to visit a new love interest, she said.

After June 3, he stopped calling her back, she said.

Photos of Key Players and Evidence in the Jodi Arias Murder Trial

"On Tuesday night (I talked to him), it was brief though, 10 o'clock maybe. I'd say 10 p.m. or 9 - 9:30. I was calling people because I was bored on the road. He was nice and cordial, but kind of acting like he had hurt feelings," she said.

"I may have called him Wednesday, from the road, and I sent him a couple of text messages, and a couple of pictures," she said, though Alexander didn't pick up and his voice mailbox was full. "That's unusual. He deletes all of his messages. I didn't want to be obsessive about it because we're not together anymore and I didn't like to call too much."

According to court records, Arias, 32, actually went to Alexander's home on in Mesa on Wednesday morning. There, the pair had sex and took graphic photos of one another with Alexander's camera.

Then, Arias is believed to have killed Alexander, 30, in his shower by stabbing him, slashing his throat from ear to ear, and shooting him in the head.

In the phone conversations, Arias told Flores that she considered calling Alexander's friends when he stopped returning her calls on Wednesday, but didn't want to act like "his mother."

Alexander's friends found his body five days later with stab wounds and a bullet wound, lying in blood in his home.

Flores asked Arias if she ever considered buying a gun, she said she was too scared of handguns.

Jodi Arias/Myspace | ABC News

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"I've looked into handguns. I have a list of things I'm scared of that I'm trying to overcome," she said. "I got that from Travis, you know, to push yourself out of your comfort zone, and do things you're afraid of. But handguns are expensive and not really in my price range right now."

Arias is accused of stealing her grandmother's handgun and using it to shoot Alexander in the head during the attack.
The detective interviewed Arias by phone multiple times in June after Alexander's body was discovered by his friends on June 9.

Arias was indicted on July 9, 2008, and changed her story again before her arraignment, telling a TV news station that she was at Alexander's house when he was killed and witnessed two intruders kill him.

After she was arraigned, Arias told police she killed Alexander, but did it in self-defense. Arias's attorneys have said that Alexander was controlling and abusive toward Arias, and described him as a "sexual deviant."

In earlier testimony in court today, Arias's new love interest, Ryan Burns, testified that Arias showed up to his house on the morning of Thursday, Dec. 5, just 24 hours after she killed Alexander.

There, the pair cuddled, kissed, and watched movies, according to Burns.

Burns, who met Arias at a business conference in spring, 2008, said he exchanged frequent long phone calls and online conversations with Arias before inviting her to come visit him in West Jordan, Utah, in June. Arias lived in California at the time.

She arrived at Burns's home 24 hours after she was expected there, telling him that she got lost, drove the wrong way on a freeway for a few hours, fell asleep for awhile, and then got lost again, Burns testified today.

She never told him that she had confronted Alexander with a knife or gun and ended up killing him just hours before their date.

When she arrived, the pair quickly got physical, he testified.

"We went back to my house. We talked for awhile, and agreed that we were going to watch a movie. At some point we were talking and we kissed. Every time we started kissing it got a little more escalated. Our clothes never came off, but at some point she was kissing my neck, I was kissing hers, but our clothes never came off," he said.

Burns said that both he and Arias stopped kissing at the time, though they again became physically involved later in the evening when Arias climbed on top of Burns and began kissing him. Burns said that they stopped kissing because he did not want her to "regret the visit" because of her Mormon beliefs about sex.

He also told prosecutors upon questioning that Arias was physically strong.

"She's very fit," he said, describing their encounter when she climbed on top of him. "She's very strong. She has close to a six pack (of abs)."

Prosecutors likely asked about the strength of Arias because in testimony Tuesday Maricopa County medical examiner Kevin Horn said Alexander was stabbed so forcefully that the blade chipped his skull and his neck was cut all the way back to the spinal cord.

Burns, who is also a Mormon, said he noticed two bandages on Arias's hand when she arrived at his house, which she told him she got when a glass broke at her place of employment, Margaritaville.

During her visit, the pair also went to a business meeting and went out with Burns' friends where Burns described Arias as acting "shy" and a "little awkward."

"She was fine, she was laughing about simple little things like any other person. I never once felt like anything was wrong during the day. With a crowd she was a little awkward in social areas, but one on one she was very talkative and excitable," he said.

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Venezuela postpones inauguration for cancer-stricken Chavez

CARACAS (Reuters) - Venezuela will postpone the inauguration of President Hugo Chavez for a new term due to health problems, the government said on Tuesday, another sign the socialist leader's cancer may be bringing an end to his 14 years in power.

The 58-year-old former soldier who has dominated the South American OPEC nation since 1999 has not been heard from since surgery on December 11 in Cuba - his fourth operation since he was diagnosed with an undisclosed type of cancer in June 2011.

The announcement outraged opposition leaders who insist that Chavez must be sworn in before the National Assembly on January 10 as laid out in the constitution, or temporarily step aside and leave an ally in power.

"The commander president wants us to inform that, based on his medical team's recommendations, the post-operative recovery should extend past January 10," said Vice President Nicolas Maduro, Chavez's chosen successor, in a letter read to the legislature.

"As a result, he will not be able to be present at the National Assembly on that date."

The letter said authorities would seek another date for the inauguration ceremony but did not say when it would take place or give a time frame for Chavez's return from Havana.

Rather than being sworn in by the legislature, he would take his oath at a later date before the Supreme Court, the letter said, as allowed by the constitution.

Government leaders insist Chavez is completely fulfilling his duties as head of state, even though official medical bulletins say he has a severe pulmonary infection and has had trouble breathing.

The government has called for a massive rally outside the presidential palace on Thursday, and allied presidents including Uruguay's Jose Mujica and Bolivia's Evo Morales have confirmed they will visit Venezuela this week despite Chavez's absence.

Argentine President Cristina Fernandez has announced plans to visit Chavez in Havana on Friday.

But the unprecedented silence by the president - famous for regularly speaking for hours in meandering broadcasts - has left many convinced he could be in his last days.

His resignation or death would upend politics in the oil-rich nation, where he enjoys a deity-like status among poor supporters thankful for his social largesse.

His critics call him a fledgling dictator who has squandered billions of dollars from crude sales while dashing the independence of state institutions.

CONSTITUTION DISPUTE

The constitution does not specify what happens if the president does not take office on January 10.

The Supreme Court, controlled by Chavez allies, called a news conference for Wednesday. It is widely expected to announce an interpretation of the constitution that will give Chavez leeway to take office when he is fit to do so.

If he dies or steps aside, new elections would be called within 30 days. Before leaving for Havana in December, the president instructed his supporters to back Maduro in that vote if he were unable to continue.

Opposition leaders argue that Congress chief and Chavez ally Diosdado Cabello should take over, as mandated by the constitution if the president's absence is formally declared.

Cabello has ruled that out, saying the president continues to be in charge.

"Who could have believed the opposition would be screaming for Diosdado Cabello to be given the presidency of the republic?" he said during a rambunctious session of Congress. "That's crazy, the opposition is losing it."

Meanwhile opposition deputies accused the Socialist Party of failing to follow Chavez's instructions - a scene that would have been unimaginable before Chavez's prolonged absence.

"President Chavez is the only one among you who has spoken clearly," said opposition leader Julio Borges.

He was drowned out by pro-Chavez deputies clapping and chanting the socialist leader's name and rebuffed by Cabello, who had long been considered a potential successor to Chavez until he was passed over for Maduro.

"It's not my fault you weren't chosen, don't take your frustration out on me," Borges quipped.

Another opposition deputy complained that during the debate a copy of the constitution was thrown across the chamber from the direction of the Socialist Party's deputies.

Chavez's supporters have held near-daily vigils for his recovery, while opposition activists accuse the president's allies of a Cuban-inspired manipulation of the situation.

Maduro has taken over the day-to-day running of the government and looks set to continue in the role past Thursday.

The mustachioed former bus driver lacks Chavez's charisma, but he has sought to imitate the president's style with vituperative attacks on the opposition and televised ribbon-cutting ceremonies.

With the micro-managing Chavez away, major policy decisions in Venezuela, such as a widely expected devaluation of the bolivar currency, appear to be on hold.

Venezuelan bond prices, which had soared in recent weeks on Chavez's health woes, dipped on Monday and Tuesday as investors' expectations of a quick government change apparently dimmed.

"The 'regime change' euphoria seems excessive taking into account the unclear legal transition and perhaps, more importantly, the risk that regime change does not allow for policy change," New York-based Jefferies' managing director Siobhan Morden said in a note on the bonds.

(Editing by Daniel Wallis and Eric Beech)

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Japan plans US$2.1b military spend in stimulus package: official

TOKYO: Japan plans to spend $2.1 billion on its military over the next few months as part of a huge stimulus package, a defence ministry official said Wednesday, amid growing concerns over a rising China.

The cash is in addition to the regular military spending for 2012-13 and is separate from a boosted budget request for next fiscal year that ruling party policy makers called for on Tuesday.

"We will request 180.5 billion yen to be allocated to military spending from a stimulus package," a defence ministry spokesman told AFP, adding that some of the cash will be used to buy PAC-3 surface-to-air anti-ballistic missile systems and modernise four F-15 fighter jets.

The request for funds has to be approved by the finance ministry before being officially included in the stimulus the government is set to announce later this month, reportedly worth 13.1 trillion yen for this fiscal year to March.

The announcement came a day after Prime Minister Shinzo Abe's ruling Liberal Democratic Party said Japan will increase military spending for the first time in 11 years next fiscal year starting from April.

Japan is involved in a territorial tussle with China over a group of uninhabited islands in the East China Sea. Beijing has sent vessels to the area dozens of times and late last year dispatched a plane.

Nerves in Tokyo have also been rattled by an unpredictable North Korea. It sent a rocket over Japan's southern islands last month in what it insisted was a satellite launch. Tokyo and its allies said the launch was a covert ballistic missile test.

"Out of 180.5 billion yen, the defence ministry plans to use 60.5 billion yen to prepare for the changing security environment surrounding Japan," the spokesman said.

The defence ministry also plans to purchase three SH-60K patrol helicopters and to add a battery for an intermediate-range ballistic missile system, he said.

"We need to update our equipment as the security environment surrounding Japan is becoming harsher as North Korea has test-launched missiles twice in the last year and tensions with China continue," he said.

Under usual precedent, 70-80 percent of a defence order must be spent with domestic firms, although this is not a legal requirement, he said.

-AFP/ac

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Hate speech case: MIM MLA Akbaruddin Owaisi sent to 14- day judicial custody

HYDERABAD: Majlis-e-Ittehadul Muslimeen MLA Akbaruddin Owaisi, facing multiple cases for his alleged " hate speech", was today remanded to 14-day judicial custody by a magistrate in Nirmal town of Adilabad district.

Akbaruddin was reportedly questioned and produced before the magistrate at 5:30am, after which he was sent to judicial custody.

The Magistrate also asked the police to produce the MLA before the court later today at 10:30 am.

Owaisi has been taken to the Nirmal town police station, and his petition is expected to be listed at the Andhra Pradesh high court today.

Owaisi was arrested yesterday, a day after he returned from London and was admitted to a hospital for a medical check up, before being taken into custody.

Following the arrest of the MIM leader, the state government has imposed a prohibitory orders in the town to maintain law and order.

Additional security forces have been deployed in Hyderabad and Adilabad as a precautionary measure.

Owaisi, the floor leader of his party in the Andhra Pradesh Assembly, is facing a case against him in Adilabad for alleged provocative speeches regarding the disputed Bhagyalakshmi shrine in the Charminar area.

Complaints have been filed against him in regard to the same speeches in various police stations in Hyderabad and other parts of the state.

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Report: Death rates from cancer still inching down

WASHINGTON (AP) — Death rates from cancer are continuing to inch down, researchers reported Monday.

Now the question is how to hold onto those gains, and do even better, even as the population gets older and fatter, both risks for developing cancer.

"There has been clear progress," said Dr. Otis Brawley of the American Cancer Society, which compiled the annual cancer report with government and cancer advocacy groups.

But bad diets, lack of physical activity and obesity together wield "incredible forces against this decline in mortality," Brawley said. He warned that over the next decade, that trio could surpass tobacco as the leading cause of cancer in the U.S.

Overall, deaths from cancer began slowly dropping in the 1990s, and Monday's report shows the trend holding. Among men, cancer death rates dropped by 1.8 percent a year between 2000 and 2009, and by 1.4 percent a year among women. The drops are thanks mostly to gains against some of the leading types — lung, colorectal, breast and prostate cancers — because of treatment advances and better screening.

The news isn't all good. Deaths still are rising for certain cancer types including liver, pancreatic and, among men, melanoma, the most serious kind of skin cancer.

Preventing cancer is better than treating it, but when it comes to new cases of cancer, the picture is more complicated.

Cancer incidence is dropping slightly among men, by just over half a percent a year, said the report published by the Journal of the National Cancer Institute. Prostate, lung and colorectal cancers all saw declines.

But for women, earlier drops have leveled off, the report found. That may be due in part to breast cancer. There were decreases in new breast cancer cases about a decade ago, as many women quit using hormone therapy after menopause. Since then, overall breast cancer incidence has plateaued, and rates have increased among black women.

Another problem area: Oral and anal cancers caused by HPV, the sexually transmitted human papillomavirus, are on the rise among both genders. HPV is better known for causing cervical cancer, and a protective vaccine is available. Government figures show just 32 percent of teen girls have received all three doses, fewer than in Canada, Britain and Australia. The vaccine was recommended for U.S. boys about a year ago.

Among children, overall cancer death rates are dropping by 1.8 percent a year, but incidence is continuing to increase by just over half a percent a year. Brawley said it's not clear why.

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Holmes Played Childish Games After Aurora Carnage

As police confronted the movie theater carnage and a massive booby trap left behind by accused Aurora gunman James Holmes, the suspect loopily played with hand puppets, tried to stick a metal staple in an electrical socket and clamly flipped a styrofoam cup, according to court testimony today.

Holmes, 25, displayed the bizarre behavior once he was in custody and taken to Aurora police headquarters after the shooting that left 12 people dead and dozens injured, the lead investigator in the case testified today.

While being cross examined by Colorado public defender Daniel King, Police Detective Craig Appel was asked about the observations of two Aurora officers assigned to watch over Holmes in an interrogation room.

Appel said that to preserve possible gunshot residue, police had placed paper bags over Holmes' hands. One officer, King said, noted in a report that Holmes began moving his hands "in a talking puppet motion."

Click here for full coverage of the Aurora movie theater shooting.

King asked if Appel was also aware that the officer "observed Holmes take a staple out of the table and tried to stick it in an electrical socket?" Appel confirmed Holmes' actions.

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The officers also noted that they watched as Holmes began playing with an empty styrofoam cup, trying to "flip it" on the table.

While Holmes was carrying out his childish antics, police were puzzling over a complex booby trap Holmes had left behind in his apartment, according to testimony.

A gasoline-soaked carpet, loud music and a remote control car were part of Holmes' plan to trick someone into triggering a blast that would destroy his apartment and lure police to the explosion while he shot up a movie theater in Aurora, Colo., according to court testimony.

FBI agent Garrett Gumbinner told the court that he interviewed Holmes on July 20, hours after he killed 12 and wounded 58 during the midnight showing of "The Dark Knight Rises."

"He said he rigged the apartment to explode to get law enforcement to send resources to his apartment instead of the theater," Gumbinner said.

His plan failed to prompt someone into triggering the bombs.

Gumbinner said Holmes had created two traps that would have set off the blast.

The apartment was rigged with a tripwire at the front door connected to a mixture of chemicals that would create heat, sparks and flame. Holmes had soaked the carpet with a gasoline mixture that was designed to be ignited by the tripwire, Gumbinner said.

"It would have caused fire and sparks," the agent said, and "would have made the entire apartment explode or catch fire."

Holmes had set his computer to play 25 minutes of silence followed by loud music that he hoped would cause a disturbance loud enough that someone would call police, who would then respond and set off the explosion by entering the apartment.

Gumbinner said Holmes also told him he rigged a fuse between three glass jars that would explode. He filled the jars with a deadly homemade chemical mixture that would burn so hot it could not be extinguished with water.

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Ex-governor in North Korea with Google chief; seeks American's release

SEOUL (Reuters) - Former New Mexico Governor Bill Richardson and Google Executive Chairman Eric Schmidt began a controversial private mission to North Korea on Monday that will include an effort to secure the release of an imprisoned American.

The trip comes after North Korea carried out a long-range rocket test last month and as, according to satellite imagery, the reclusive state continues work on its nuclear testing facilities, potentially paving the way for a third nuclear bomb test.

Footage from North Korean state television showed Richardson and Schmidt at the Pyongyang airport on Monday evening.

"We are going to ask about the American who's been detained. A humanitarian private visit." Richardson said.

Richardson's efforts to seek the release of Kenneth Bae, a Korean-American tour guide who was detained last year will mark the latest in a series of high-profile visits over the years to free Americans detained by Pyongyang.

The delegation comprised Schmidt, his daughter, Richardson and Google executive Jared Cohen, according to South Korean news media and it arrived in Pyongyang on a flight from the Chinese capital, Beijing.

The mission has been criticized by the United States due to the sensitivity of the timing. The United States does not have diplomatic relations with North Korea and the isolated and impoverished state remains technically at war with U.S. ally South Korea.

"We continue to think the trip is ill-advised," U.S. State Department spokeswoman Victoria Nuland said in Washington. Last week she said the main U.S. objection was that the trip came so soon after North Korea's much-criticized December 12 rocket launch.

South Korea is in the midst of a transition to a new president who will take office in February, while Japan, another major U.S. ally in the region, has a new prime minister.

A U.S. official said the trip's timing was particularly bad from the Obama administration's point of view because it comes as the U.N. Security Council ponders how to respond to the North Korean missile launch.

"We are in kind of a classical provocation period with North Korea. Usually, their missile launches are followed by nuclear tests," said the official, who spoke on condition of anonymity.

"During these periods, it's very important that the international community come together, certainly at the level of the U.N. Security Council, to demonstrate to North Korea that they pay a price for not living up to their obligations."

Richardson, a former ambassador to the United Nations, has made numerous trips to North Korea in the past that have included efforts to free detained Americans. The reasons for Schmidt's involvement in the trip are not clear, though Google characterized it as "personal" travel.

Schmidt did not respond to requests for comment.

Richardson told CBS television last Friday that he had been contacted by Bae's family and that he would raise the issue while in North Korea.

Pyongyang's most notable success was securing a visit from former President Bill Clinton in 2009 to win the release of two American journalists.

Last year, Jared and Schmidt met defectors from North Korea, a state that ranks bottom in an annual survey of Internet and press freedom by Reporters Without Borders.

Media reports and think tanks say that officials from the North Korean government went to Google's headquarters in 2011, something the U.S. technology giant declined to comment on.

(Additional reporting by Cho Meeyoung and WASHINGTON Bureau; Editing by Michael Perry, Ron Popeski and David Brunnstrom)

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Obama to host Afghan president Friday at White House

WASHINGTON: US President Barack Obama will host Afghan President Hamid Karzai at the White House on Friday for talks centered on the long-term security compact between the two countries.

Obama looks forward to "discussing our continued transition in Afghanistan, and our shared vision of an enduring partnership between the United States and Afghanistan," a White House statement said.

The Afghan leader has expressed support for keeping US troops in Afghanistan, but sensitive details -- including immunity for American soldiers and the transfer of detainees into Afghan custody -- are still under negotiation.

Karzai's relationship with Washington has been troubled in recent years and fears remain that attention for Afghanistan, heavily dependent on international aid, could plummet after 2014, plunging it back into political turmoil.

The Afghan president's scheduled trip to the United States was formally confirmed on the same day as Obama revealed his nominations to head up the CIA and the Pentagon during his second White House term.

Obama, who last visited Kabul in May, named Chuck Hagel to lead the Pentagon and tapped John Brennan to replace scandal-tainted David Petraeus as CIA chief.

The US president last year signed a pact on future relations and declared that the "time of war" was ending in Afghanistan.

But the Defense Department reportedly has prepared plans to leave roughly 3,000, 6,000 or 9,000 America troops in the war-wracked state.

General John Allen, commander of US and NATO forces in Afghanistan, had earlier suggested leaving 6,000 to 20,000 American troops, US media reports have said.

Outgoing Defense Secretary Leon Panetta has said the force would focus on preventing Al-Qaeda, which was sheltered by the 1996-2001 Taliban government, from regaining a firm foothold in Afghanistan.

The number of foreign troops battling the Taliban-led insurgency has already fallen to 100,000 from about 150,000. There are currently 66,000 US troops.

The conflict has become increasingly unpopular in the United States, but some lawmakers in Washington have accused Obama of pushing for a hasty exit.

Karzai, who left Kabul on Monday, is expected to kick off his US trip by visiting his wounded spy chief, Asadullah Khalid, at an American hospital on Tuesday.

-AFP/ac

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