DNA Analysis, More Accessible Than Ever, Opens New Doors

Matt Roth for The New York Times

Sam Bosley of Frederick, Md., going shopping with his daughter, Lillian, 13, who has a malformed brain and severe developmental delays, seizures and vision problems. More Photos »

Debra Sukin and her husband were determined to take no chances with her second pregnancy. Their first child, Jacob, who had a serious genetic disorder, did not babble when he was a year old and had severe developmental delays. So the second time around, Ms. Sukin had what was then the most advanced prenatal testing.

The test found no sign of Angelman syndrome, the rare genetic disorder that had struck Jacob. But as months passed, Eli was not crawling or walking or babbling at ages when other babies were.

“Whatever the milestones were, my son was not meeting them,” Ms. Sukin said.

Desperate to find out what is wrong with Eli, now 8, the Sukins, of The Woodlands, Tex., have become pioneers in a new kind of testing that is proving particularly helpful in diagnosing mysterious neurological illnesses in children. Scientists sequence all of a patient’s genes, systematically searching for disease-causing mutations.

A few years ago, this sort of test was so difficult and expensive that it was generally only available to participants in research projects like those sponsored by the National Institutes of Health. But the price has plunged in just a few years from tens of thousands of dollars to around $7,000 to $9,000 for a family. Baylor College of Medicine and a handful of companies are now offering it. Insurers usually pay.

Demand has soared — at Baylor, for example, scientists analyzed 5 to 10 DNA sequences a month when the program started in November 2011. Now they are doing more than 130 analyses a month. At the National Institutes of Health, which handles about 300 cases a year as part of its research program, demand is so great that the program is expected to ultimately take on 800 to 900 a year.

The test is beginning to transform life for patients and families who have often spent years searching for answers. They can now start the grueling process with DNA sequencing, says Dr. Wendy K. Chung, professor of pediatrics and medicine at Columbia University.

“Most people originally thought of using it as a court of last resort,” Dr. Chung said. “Now we can think of it as a first-line test.”

Even if there is no treatment, there is almost always some benefit to diagnosis, geneticists say. It can give patients and their families the certainty of knowing what is wrong and even a prognosis. It can also ease the processing of medical claims, qualifying for special education services, and learning whether subsequent children might be at risk.

“Imagine the people who drive across the whole country looking for that one neurologist who can help, or scrubbing the whole house with Lysol because they think it might be an allergy,” said Richard A. Gibbs, the director of Baylor College of Medicine’s gene sequencing program. “Those kinds of stories are the rule, not the exception.”

Experts caution that gene sequencing is no panacea. It finds a genetic aberration in only about 25 to 30 percent of cases. About 3 percent of patients end up with better management of their disorder. About 1 percent get a treatment and a major benefit.

“People come to us with huge expectations,” said Dr. William A. Gahl, who directs the N.I.H. program. “They think, ‘You will take my DNA and find the causes and give me a treatment.’ ”

“We give the impression that we can do these things because we only publish our successes,” Dr. Gahl said, adding that when patients come to him, “we try to make expectations realistic.”

DNA sequencing was not available when Debra and Steven Sukin began trying to find out what was wrong with Eli. When he was 3, they tried microarray analysis, a genetic test that is nowhere near as sensitive as sequencing. It detected no problems.

“My husband and I looked at each other and said, ‘The good news is that everything is fine; the bad news is that everything is not fine,’ ” Ms. Sukin said.

In November 2011, when Eli was 6, Ms. Sukin consulted Dr. Arthur L. Beaudet, a medical geneticist at Baylor.

“Is there a protein missing?” she recalled asking him. “Is there something biochemical we could be missing?”

By now, DNA sequencing had come of age. Dr. Beaudet said that Eli was a great candidate, and it turned out that the new procedure held an answer.

A single DNA base was altered in a gene called CASK, resulting in a disorder so rare that there are fewer than 10 cases in all the world’s medical literature.

“It really became definitive for my husband and me,” Ms. Sukin said. “We would need to do lifelong planning for dependent care for the rest of his life.”

Now, when doctors bill for medical services, insurers pay without as many questions. And Eli’s schools recognize how profound his needs are. “This isn’t just some kid with dyslexia,” his mother said, adding: “My son needs someone who literally is holding his hand. He runs, he doesn’t know ‘no.’ And he does not talk.”

The typical patient with a mystery disease has neurological problems, and is often a baby or a child. There are reasons for that.

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Draghi Seeks to Quiet Talk About Global Currency War

BRUSSELS — The president of the European Central Bank sought Monday to ease fears that countries including Japan were deliberately weakening their currencies and that European exporters were threatened by a round of competitive devaluations among the world’s major economies.

The comments by Mario Draghi appeared to show how some of the world’s most senior economic policy makers were continuing to grapple with the prospect of a “currency war,” even after finance ministers from the Group of 20 pledged over the weekend to refrain from devaluing their currencies to gain a competitive advantage in global trade.

During an afternoon of scheduled testimony before the European Parliament’s Economic and Finance Committee in Brussels, Mr. Draghi noted that the euro’s current exchange rate was close to its long-term average. He advised officials not to make alarmist comments.

“Most of the exchange rate movements that we have seen were not explicitly targeted; they were the result of domestic macroeconomic policies meant to boost the economy,” Mr. Draghi told the committee, without mentioning any countries by name. “In this sense, I find really excessive any language referring to currency wars.”

But Mr. Draghi also seemed to suggest that central banks could succumb to mutual suspicion about whether they were deliberately seeking to set exchange rates. “The less we talk about this, the better it is,” he said.

Underscoring the point, Mr. Draghi said he had “urged all parties” to exercise “very, very strong verbal discipline” at the G-20 finance ministers’ meeting in Moscow over the weekend.

The euro hit a record of ¥127.18 on Feb. 2, up from ¥114.48 at the start of the year. It stood at just ¥94.31 in July 2012. The euro traded at ¥125.46 on Monday, up slightly, and was flat against the dollar, at $1.3352.

Since the rapid strengthening of the euro against the yen and other major currencies, there has been a concerted push by industrialized nations to convey the message that they will let the markets determine the value of their currencies.

Last week the Group of 7 sought to quell fears of a developing currency war. Then, over the weekend, the G-20 finance ministers issued a statement saying they had concluded that loose monetary policy, including steps to weaken currencies, were acceptable if used as a means to stimulate domestic growth. But they also warned that such policies should not be used to benefit a country’s position in global trade.

Guntram B. Wolff, the deputy director of Bruegel, a research organization, said that he believed Japan’s central bank policy makers were carrying out an expansionary monetary policy in an appropriate way — as a means to spur economic growth, not as a way to aid Japanese exporters.

Instead, Mr. Wolff said, Mr. Draghi might be concerned about the U.S. Federal Reserve, where policy makers are considering continuing their expansionist monetary policy until the unemployment rate falls significantly, and about the Bank of England, which may end up pursuing similar policies as it revises the way it sets goals for economic growth.

“The bigger question is what central banks in the developed world are doing — I’m thinking here about the Bank of England and the Federal Reserve — and whether we have a danger of competitive devaluation,” Mr. Wolff said. “While we claim that all of this is done for domestic purposes, the internal and external goal can become the same, and then you have the risk that this turns toxic.”

A loose monetary policy intended to spur growth often has the effect of devaluing a currency, making a country’s exports more affordable and its competitors’ exports more expensive. For example, a strong euro means that exports like cars and wines become more expensive abroad. That puts European producers at a disadvantage in competing with foreign producers on world markets.

Yet a strong euro also brings some advantages for Europe. Certain imports — like energy, in the form of oil and natural gas — become more affordable.

Over the past few years, emerging-market countries like Brazil have openly accused slow-growing advanced countries like the United States of unfairly pushing down the value of their currencies with their aggressive monetary policies. And, for years, the United States has accused export-reliant emerging economies, in particular China, of manipulating their currencies, too.

More recently, in Japan, stimulus programs backed by the newly elected prime minister, Shinzo Abe, have kept interest rates near zero and flooded the economy with money, which has reduced the cost of Japanese products around the world.

In Europe, while confidence has grown that the Union will be able to manage its sovereign debt crisis, the euro has made significant gains against the dollar and other currencies. That is making European exports more expensive, a factor that could hamper growth.

The gains have prompted François Hollande, the president of France — which has traditionally taken a more interventionist stance in economic matters — to call for a European exchange-rate policy.

Mr. Draghi did allow that the relative strength of the euro “is important for growth and price stability” and that “to the downside,” an “appreciation of the euro is a risk.” He said the E.C.B. would assess whether the exchange rate was having an effect on inflation.

But for now, Mr. Hollande has very little traction on the issue. Jeroen Dijsselbloem, the newly appointed president of the Eurogroup of euro zone finance ministers, gave the French request short shrift this month, and a senior German official has decried the French initiative as a poor substitute for policy overhauls.

“Can you have a managed exchange rate in Europe?” asked Karel Lannoo, the chief executive of the Center for European Policy Studies, a research organization in Brussels. “Probably not, when you consider how hard it would be to agree on a rate and the means to maintain it. ”

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Blasts Across Baghdad Kill at Least 21 People

BAGHDAD — A wave of attacks in Shiite neighborhoods in Baghdad killed at least 21 people and wounded 125 on Sunday, a security official said.

Four car bombs exploded in a market, a bus station and on a major road in the Sadr City district, killing seven people and wounding more than 30 others, officials said.

More people were killed and dozens were wounded when car bombs were set off in a market in Husseiniya, northeast of Baghdad; in the southeastern Baghdad neighborhood of Al Ameen; and in the Kamaliya area in Baghdad’s eastern suburbs.

In the central Baghdad neighborhood of Karrada, near the Babil Hotel, a roadside bomb killed one person and wounded five others.

No group immediately claimed responsibility for the attacks, but Sunni extremists have stepped up their efforts to undermine the Shiite-led government and stoke sectarian divisions since the beginning of the year. More than 200 people have been killed in attacks across Iraq since January.

Sunnis, who are a minority in Iraq, complain of discrimination by officials and accuse Prime Minister Nuri Kamal al-Maliki and his political allies of seeking to monopolize power before the provincial elections this spring.

The government’s arrests of a Sunni politician’s bodyguards in December set off weekly protests in several Iraqi cities. But the protesters have rejected calls for violence and have distanced themselves from extremist groups.

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Agent: Oscar has received 'overwhelming support'

JOHANNESBURG (AP) — Oscar Pistorius has received "overwhelming support" from his fans, his agent said Sunday, as he remained in custody in a South African police station charged with the shooting murder of his model girlfriend.

Peet van Zyl said outside the Brooklyn police station soon after visiting Pistorius that "a lot of fans" had sent their good wishes. Van Zyl said the support was "really on a global scale. South African fans, international fans from literally all over the world."

Van Zyl said he visited Pistorius primarily to discuss his running career and would not respond to a question about the mental and emotional state of the 26-year-old athlete.

Pistorius broke down and wept at his first court appearance on Friday after he was charged with the murder of model and reality TV show contestant Reeva Steenkamp, who was shot multiple times in his house in the early hours of Thursday.

"I am not going to comment on anything except that (what) is related to his athletics career at this point in time," Van Zyl told reporters outside the police station in the South African capital, Pretoria.

Van Zyl called Steenkamp's killing tragic and said he visited Pistorius as a friend as well as an agent.

"Obviously from a management side and also as a friend, it's a tragic circumstance," Van Zyl said, "and we can only give Oscar our support at this point in time."

The main point of the visit was to update the multiple Paralympic champion and Olympic athlete on his crumbling track career and the situation with his sponsors, which were now expected to step back from their association with the world's most famous disabled athlete.

Van Zyl would release a statement either later Sunday or on Monday, he said, with exact details of the races and sponsorship deals that were now affected by Pistorius' arrest and murder charge.

He told The Associated Press on Saturday that he had begun canceling races for Pistorius scheduled for 2013, including Diamond League appearances and exhibition runs against fellow Paralympic champions Alan Oliveria of Brazil and Jonnie Peacock of Britain.

Sunday was likely the first time that Pistorius was told about the cancelations.

"The nature of my visit was on a professional manner to discuss his career and the plans that we had made for this year with the IAAF (world) championships in Moscow as the main goal for this year," Van Zyl said. "We obviously just discussed the races and the contracts that had been signed and secured for this year and also to keep him up to date with regard to the sponsors."

Sportswear giant Nike and eyewear manufacturer Oakley are among Pistorius' big-name sponsors.

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Cuomo Bucks Tide With Bill to Lift Abortion Limits

ALBANY — Bucking a trend in which states have been seeking to restrict abortion, Gov. Andrew M. Cuomo is putting the finishing touches on legislation that would guarantee women in New York the right to late-term abortions when their health is in danger or the fetus is not viable.

Mr. Cuomo, seeking to deliver on a promise he made in his recent State of the State address, would rewrite a law that currently allows abortions after 24 weeks of pregnancy only if the pregnant woman’s life is at risk. The law is not enforced, because it is superseded by federal court rulings that allow late-term abortions to protect a woman’s health, even if her life is not in jeopardy. But abortion rights advocates say the existence of the more restrictive state law has a chilling effect on some doctors and prompts some women to leave the state for late-term abortions.

Mr. Cuomo’s proposal, which has not yet been made public, would also clarify that licensed health care practitioners, and not only physicians, can perform abortions. It would remove abortion from the state’s penal law and regulate it through the state’s public health law.

Abortion rights advocates have welcomed Mr. Cuomo’s plan, which he outlined in general terms as part of a broader package of women’s rights initiatives in his State of the State address in January. But the Roman Catholic Church and anti-abortion groups are dismayed; opponents have labeled the legislation the Abortion Expansion Act.

The prospects for Mr. Cuomo’s effort are uncertain. The State Assembly is controlled by Democrats who support abortion rights; the Senate is more difficult to predict because this year it is controlled by a coalition of Republicans who have tended to oppose new abortion rights laws and breakaway Democrats who support abortion rights.

New York legalized abortion in 1970, three years before it was legalized nationally by the Supreme Court in Roe v. Wade. Mr. Cuomo’s proposal would update the state law so that it could stand alone if the broader federal standard set by Roe were to be undone.

“Why are we doing this? The Supreme Court could change,” said a senior Cuomo administration official, who spoke on the condition of anonymity because the governor had not formally introduced his proposal.

But opponents of abortion rights, already upset at the high rate of abortions in New York State, worry that rewriting the abortion law would encourage an even greater number of abortions. For example, they suggest that the provision to allow abortions late in a woman’s pregnancy for health reasons could be used as a loophole to allow unchecked late-term abortions.

“I am hard pressed to think of a piece of legislation that is less needed or more harmful than this one,” the archbishop of New York, Cardinal Timothy M. Dolan, wrote in a letter to Mr. Cuomo last month. Referring to Albany lawmakers in a subsequent column, he added, “It’s as though, in their minds, our state motto, ‘Excelsior’ (‘Ever Upward’), applies to the abortion rate.”

National abortion rights groups have sought for years to persuade state legislatures to adopt laws guaranteeing abortion rights as a backup to Roe. But they have had limited success: Only seven states have such measures in place, including California, Connecticut and Maryland; the most recent state to adopt such a law is Hawaii, which did so in 2006.

“Pretty much all of the energy, all of the momentum, has been to restrict abortion, which makes what could potentially happen in New York so interesting,” said Elizabeth Nash, state issues manager at the Guttmacher Institute, a research group that supports abortion rights. “There’s no other state that’s even contemplating this right now.”

In most statehouses, the push by lawmakers has been in the opposite direction. The past two years has seen more provisions adopted at the state level to restrict abortion rights than in any two-year period in decades, according to the Guttmacher Institute; last year, 19 states adopted 43 new provisions restricting abortion access, while not a single significant measure was adopted to expand access to abortion or to comprehensive sex education.

“It’s an extraordinary moment in terms of the degree to which there is government interference in a woman’s ability to make these basic health care decisions,” said Andrea Miller, the president of NARAL Pro-Choice New York. “For New York to be able to send a signal, a hopeful sign, a sense of the turning of the tide, we think is really important.”

Abortion rights advocates say that even though the Roe decision supersedes state law, some doctors are hesitant to perform late-term abortions when a woman’s health is at risk because the criminal statutes remain on the books.

“Doctors and hospitals shouldn’t be reading criminal laws to determine what types of health services they can offer and provide to their patients,” said M. Tracey Brooks, the president of Family Planning Advocates of New York State.

For Mr. Cuomo, the debate over passing a new abortion law presents an opportunity to appeal to women as well as to liberals, who have sought action in Albany without success since Eliot Spitzer made a similar proposal when he was governor. But it also poses a challenge to the coalition of Republicans and a few Democrats that controls the State Senate, the chamber that has in the past stood as the primary obstacle to passing abortion legislation in the capital.

The governor has said that his Reproductive Health Act would be one plank of a 10-part Women’s Equality Act that also would include equal pay and anti-discrimination provisions. Conservative groups, still stinging from the willingness of Republican lawmakers to go along with Mr. Cuomo’s push to legalize same-sex marriage in 2011, are mobilizing against the proposal. Seven thousand New Yorkers who oppose the measure have sent messages to Mr. Cuomo and legislators via the Web site of the New York State Catholic Conference.

A number of anti-abortion groups have also formed a coalition called New Yorkers for Life, which is seeking to rally opposition to the governor’s proposal using social media.

“If you ask anyone on the street, ‘Is there enough abortion in New York?’ no one in their right mind would say we need more abortion,” said the Rev. Jason J. McGuire, the executive director of New Yorkers for Constitutional Freedoms, which is part of the coalition.

Members of both parties say that the issue of reproductive rights was a significant one in November’s legislative elections. Democrats, who were bolstered by an independent expenditure campaign by NARAL, credit their victories in several key Senate races in part to their pledge to fight for legislation similar to what Mr. Cuomo is planning to propose.

Republicans, who make up most of the coalition that controls the Senate, have generally opposed new abortion rights measures. Speaking with reporters recently, the leader of the Republicans, Dean G. Skelos of Long Island, strenuously objected to rewriting the state’s abortion laws, especially in a manner similar to what the governor is seeking.

“You could have an abortion up until the day the child would be born, and I think that’s just wrong,” Mr. Skelos said. He suggested that the entire debate was unnecessary, noting that abortion is legal in New York State and saying that is “not going to be changed.”

The Senate Democratic leader, Andrea Stewart-Cousins of Yonkers, who is the sponsor of a bill that is similar to the legislation the governor is drafting, said she was optimistic that an abortion measure would reach the Senate floor this year.

“New York State’s abortion laws were passed in 1970 in a bipartisan fashion,” she said. “It would be a sad commentary that over 40 years later we could not manage to do the same thing.”

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Some Chinese Are Souring on Being North Korea’s Best Friend

Eugene Hoshiko/Associated Press

A billboard showing Mao Zedong, right, and North Korea’s founding father, Kim Il-sung, near the China-North Korea border.

YANJI CITY, China — Beds shook and teacups clattered in this town bordering North Korea, less than 100 miles from the site where the North said it detonated a nuclear test that exploded midmorning in the midst of Chinese New Year festivities.

At home and abroad, China has long been regarded as North Korea’s best friend, but at home that sense of fraternity appears to be souring as ordinary people express anxiety about possible fallout from the test last Tuesday. The fact that North Korea detonated the device on a special Chinese holiday did not sit well, either.

Among Chinese officials, the mood toward the young North Korean leader, Kim Jong-un, has darkened. The Chinese government is reported by analysts to be wrestling with what to do about a man who, in power for a little more than a year, thumbed his nose at China by ignoring its appeals not to conduct the country’s third nuclear test, and who shows no gratitude for China’s largess as the main supplier of oil and food.

“The public does not want China to be the only friend of an evil regime, and we’re not even recognized by North Korea as a friend,” said Jin Qiangyi, director of the Center for North and South Korea Studies at Yanbian University in Yanji City. “For the first time the Chinese government has felt the pressure of public opinion not to be too friendly with North Korea.”

With its site near the border, Yanji City has long been a hub of North Korean affairs inside China, and people here have a relatively good understanding of their opaque and recalcitrant neighbor. This is often where desperate defectors from the impoverished police state first seek shelter, where legal and illegal cross-border trade thrives, and where much of the population has roots in North Korea.

That familiarity breeds mixed attitudes. There is tolerance among some toward the regime — mostly from those who profit financially. But there is also great anger among many ethnic Korean Chinese about the almost incalculable suffering of the people living under the Kim dynasty, which relies on gulags to deal with even the glimmers of dissent and where years of failed economic policies have left many people near the edge of starvation.

The test detonated at Punggye-ri in northeastern North Korea last week was considerably more powerful than its first nuclear test in 2006 and as large as, or larger than, one in 2009, according to Western and Chinese experts. It remained unclear whether the test was fueled by plutonium or uranium; a uranium test would exacerbate tensions, suggesting the North had a new and faster way of building its nuclear fuel stockpile.

But to some Chinese, the technicalities seem irrelevant.

In postings on Weibo, China’s equivalent of Twitter, people asked about the possible dangers of radioactive fallout from a nuclear test. Many said they were dissatisfied by assurances from the Ministry of Environmental Protection that it had checked for radiation at various border areas after the blast and announced that the levels were normal.

“I’m worried about radiation,” said a 26-year-old woman as she served customers in a bookstore here. “My family lives in the mountains close to the border. They felt the bed shake on the day of the test. I have no idea whether it is safe or not, though the government says it is.”

There are growing uncertainties among at least some of China’s foreign policy experts, too. In the aftermath of the test, a prominent Chinese political scientist with a penchant for provocative ideas, Shen Dingli at Fudan University in Shanghai, wrote on the Web site of Foreign Policy, based in Washington, that it was time for China “to cut its losses and cut North Korea loose.”

Other experts suggested the test could worsen relations between the North and China and urged China’s new leadership to consider taking a tougher stance to curb the North’s nuclear weapons program, which appears to be advancing after some early technical difficulties.

Such opinions, coupled with new worries among some ordinary Chinese people, pose a problem for the new Chinese leader, Xi Jinping, according to Mr. Jin, who often goes to Beijing to participate in policy discussions about North Korea.

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If China decides to go along with the United States’ calls for much more stringent sanctions than exist now, there are fears among China’s policy makers that the North’s government would collapse, possibly setting the stage for mayhem on the border and a reunification of Korea as an American ally. But if China maintains the status quo, it could face mounting criticism among its own citizens.

If it decided to take a harder stance, China could punish North Korea by curtailing its oil shipments, by far the major source of fuel in the energy-starved North, Mr. Jin said.

Mia Li contributed research.

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Pistorius' family strongly denies murder charge

PRETORIA, South Africa (AP) — Oscar Pistorius is "numb with shock as well as grief" after the shooting death of his model girlfriend at his home in South Africa, the runner's uncle said Saturday, as his family strongly denied prosecutors' claims that he murdered her.

Arnold Pistorius spoke with The Associated Press and two other South African journalists about his nephew's arrest in the killing of Reeva Steenkamp, who was shot four times on the morning of Valentine's Day. Arnold Pistorius spoke to reporters from the garden of his three-story home in the eastern suburbs of South Africa's capital, Pretoria.

The statement, the first on camera and directly made in person by Pistorius' family, also came out strongly against prosecutors seeking to upgrade the charge against Pistorius to one of premeditated murder, which carries a sentence of life in prison.

"After consulting with legal representatives, we deeply regret the allegation of premeditated murder," Arnold Pistorius said. "We have no doubt there is no substance to the allegation and that the state's own case, including its own forensic evidence, strongly refutes any possibility of a premeditated murder or murder as such."

He said the family was "battling to come to terms with Oscar being charged with murder."

The track star's arrest in the killing of 29-year-old Steenkamp shocked South Africa, where Pistorius was a national hero and icon dubbed the Blade Runner for his high-tech carbon fiber running blades and revered for overcoming his disability to compete at the London Olympics. She was discovered in a pool of blood before dawn Thursday by police called to Pistorius' upscale home in a gated community. Authorities said she had been shot four times, and a 9 mm pistol was recovered at the home.

Pistorius remains held at a police station pending a bail hearing Tuesday. Police have already said they'll oppose Pistorius being released before trial. A premeditated murder charge also makes it more difficult for his defense team to get bail.

On Saturday afternoon, Pistorius' lawyers visited the Brooklyn police station in Pretoria, where the athlete is being held. His younger sister Aimee, who stood alongside Arnold Pistorius when he made his statement, also was at the police station later.

There will be a variety of hearings before Pistorius, 26, could go on trial. In South Africa, there are no juries, so a judge ultimately would decide Pistorius' guilt or innocence, sometimes with the help of two advisers. At an initial hearing Friday, Pistorius sobbed and held his head in his hands at times. He has yet to enter a plea in the case.

The family denial that Pistorius committed murder doesn't necessarily mean that they say he didn't shoot her, as murder is a legal term. Initial speculation immediately after the shooting Thursday suggested that it could have been accidental, though police say they are not currently considering that.

Arnold Pistorius did not discuss the circumstances of the shooting, but said that his nephew and Steenkamp had become very close since they started dating in November.

"They had plans together and Oscar was happier in his private life than he had been for a long time," the uncle said.

As Arnold Pistorius read his statement, Pistorius' sister Aimee stood nearby and broke down in tears at one point. Her uncle stopped reading for a moment to put his right arm around her. Pistorius remains very close with his uncle, a man he once lived with as a teenager.

"Words cannot adequately describe our feelings," his uncle said. "The lives of our entire family have been turned upside down forever by this unimaginable human tragedy and Reeva's family have suffered a terrible loss. As a family we are trying to be strong and supportive to Oscar as any close family would be in these dreadful circumstances."

The entire family was "devastated," Pistorius' uncle said, and was "grieving for Reeva, her family and her friends."

Since news of the killing, shock waves have rippled across South Africa, a nation of 50 million where nearly 50 people are killed each day, one of the world's highest murder rates. U.N. statistics say the nation has the second highest rate of shooting deaths in the world, behind only Colombia. Others have focused their attention on Pistorius and his fascination with fast cars, cage fighting and firearms.

Steenkamp, who graduated from law school, is known in South Africa for appearing in commercials and as a bikini-clad model in men's magazines. On Saturday, South Africa's state broadcaster SABC planned to air a reality TV show featuring the model. Another portion of the show released earlier Saturday included a clip of her swimming with two dolphins, which tap her on the cheek with their snouts.

"I think the way that you go out, not just your journey in life, but the way that you go out and the way you make your exit is so important," the blonde-haired Steenkamp says in the video. "You either made an impact in a positive or a negative way, but just maintain integrity and maintain class and just remain true to yourself.

"I'm going to miss you all so much and I love you very, very much."

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Jon Gambrell reported from Johannesburg.

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Gerald Imray can be reached at www.twitter.com/geraldimrayAP . Jon Gambrell can be reached at www.twitter.com/jongambrellAP .

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Livestrong Tattoos as Reminder of Personal Connections, Not Tarnished Brand

As Jax Mariash went under the tattoo needle to have “Livestrong” emblazoned on her wrist in bold black letters, she did not think about Lance Armstrong or doping allegations, but rather the 10 people affected by cancer she wanted to commemorate in ink. It was Jan. 22, 2010, exactly a year since the disease had taken the life of her stepfather. After years of wearing yellow Livestrong wristbands, she wanted something permanent.

A lifelong runner, Mariash got the tattoo to mark her 10-10-10 goal to run the Chicago Marathon on Oct. 10, 2010, and fund-raising efforts for Livestrong. Less than three years later, antidoping officials laid out their case against Armstrong — a lengthy account of his practice of doping and bullying. He did not contest the charges and was barred for life from competing in Olympic sports.

“It’s heartbreaking,” Mariash, of Wilson, Wyo., said of the antidoping officials’ report, released in October, and Armstrong’s subsequent confession to Oprah Winfrey. “When I look at the tattoo now, I just think of living strong, and it’s more connected to the cancer fight and optimal health than Lance.”

Mariash is among those dealing with the fallout from Armstrong’s descent. She is not alone in having Livestrong permanently emblazoned on her skin.

Now the tattoos are a complicated, internationally recognized symbol of both an epic crusade against cancer and a cyclist who stood defiant in the face of accusations for years but ultimately admitted to lying.

The Internet abounds with epidermal reminders of the power of the Armstrong and Livestrong brands: the iconic yellow bracelet permanently wrapped around a wrist; block letters stretching along a rib cage; a heart on a foot bearing the word Livestrong; a mural on a back depicting Armstrong with the years of his now-stripped seven Tour de France victories and the phrase “ride with pride.”

While history has provided numerous examples of ill-fated tattoos to commemorate lovers, sports teams, gang membership and bands that break up, the Livestrong image is a complex one, said Michael Atkinson, a sociologist at the University of Toronto who has studied tattoos.

“People often regret the pop culture tattoos, the mass commodified tattoos,” said Atkinson, who has a Guns N’ Roses tattoo as a marker of his younger days. “A lot of people can’t divorce the movement from Lance Armstrong, and the Livestrong movement is a social movement. It’s very real and visceral and embodied in narrative survivorship. But we’re still not at a place where we look at a tattoo on the body and say that it’s a meaningful thing to someone.”

Geoff Livingston, a 40-year-old marketing professional in Washington, D.C., said that since Armstrong’s confession to Winfrey, he has received taunts on Twitter and inquiries at the gym regarding the yellow Livestrong armband tattoo that curls around his right bicep.

“People see it and go, ‘Wow,’ ” he said, “But I’m not going to get rid of it, and I’m not going to stop wearing short sleeves because of it. It’s about my family, not Lance Armstrong.”

Livingston got the tattoo in 2010 to commemorate his brother-in-law, who was told he had cancer and embarked on a fund-raising campaign for the charity. If he could raise $5,000, he agreed to get a tattoo. Within four days, the goal was exceeded, and Livingston went to a tattoo parlor to get his seventh tattoo.

“It’s actually grown in emotional significance for me,” Livingston said of the tattoo. “It brought me closer to my sister. It was a big statement of support.”

For Eddie Bonds, co-owner of Rabbit Bicycle in Hill City, S.D., getting a Livestrong tattoo was also a reflection of the growth of the sport of cycling. His wife, Joey, operates a tattoo parlor in front of their store, and in 2006 she designed a yellow Livestrong band that wraps around his right calf, topped off with a series of small cyclists.

“He kept breaking the Livestrong bands,” Joey Bonds said. “So it made more sense to tattoo it on him.”

“It’s about the cancer, not Lance,” Eddie Bonds said.

That was also the case for Jeremy Nienhouse, a 37-year old in Denver, Colo., who used a Livestrong tattoo to commemorate his own triumph over testicular cancer.

Given the diagnosis in 2004, Nienhouse had three rounds of chemotherapy, which ended on March 15, 2005, the date he had tattooed on his left arm the day after his five-year anniversary of being cancer free in 2010. It reads: “3-15-05” and “LIVESTRONG” on the image of a yellow band.

Nienhouse said he had heard about Livestrong and Armstrong’s own battle with the cancer around the time he learned he had cancer, which alerted him to the fact that even though he was young and healthy, he, too, could have cancer.

“On a personal level,” Nienhouse said, “he sounds like kind of a jerk. But if he hadn’t been in the public eye, I don’t know if I would have been diagnosed when I had been.”

Nienhouse said he had no plans to have the tattoo removed.

As for Mariash, she said she read every page of the antidoping officials’ report. She soon donated her Livestrong shirts, shorts and running gear. She watched Armstrong’s confession to Winfrey and wondered if his apology was an effort to reduce his ban from the sport or a genuine appeal to those who showed their support to him and now wear a visible sign of it.

“People called me ‘Miss Livestrong,’ ” Mariash said. “It was part of my identity.”

She also said she did not plan to have her tattoo removed.

“I wanted to show it’s forever,” she said. “Cancer isn’t something that just goes away from people. I wanted to show this is permanent and keep people remembering the fight.”

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Indian Troops Kill Pakistani Soldier in Kashmir Border Clash

NEW DELHI — Indian troops have shot and killed another Pakistani soldier at the de facto border between the two countries in Kashmir, adding to an unusually tense period in the disputed region.

A statement released Friday by the Indian Army said that Indian soldiers saw an intruder at 3 p.m. on Thursday in the Nowshera sector of the so-called Line of Control separating the Indian- and Pakistani-held parts of Kashmir. The Indian soldiers challenged the intruder, who “opened indiscriminate fire,” wounding two soldiers, the statement said. The soldiers returned fire and later found a dead Pakistani soldier in uniform, it said.

On Friday at 10 a.m., Pakistani commanders called their Indian counterparts and asked for the body to be returned, according to the Indian statement.

“Acceding to this request,” the statement said, “the dead body was returned to Pakistan Army personnel in the same sector in the evening with military respects.”

A Pakistani military official sent a text message to reporters on Friday saying that the soldier had accidentally crossed the boundary, The Associated Press reported.

The A.P. report said the Pakistani military later issued a statement accusing the Indian troops of killing the soldier after he had explained his mistake.

“We condemn such an inhuman and brutal act of killing our soldier after he had identified himself and explained his position,” the statement said, according to The A. P.

Last month, three Pakistani soldiers and two Indian soldiers were killed at the border, and one of the Indian soldiers was beheaded. The killings heightened tensions between the two nuclear-armed countries to their worst since they agreed to a cease-fire in 2003. The two countries have been in conflict over Kashmir almost since their founding in 1947.

Border skirmishes are not the only immediate problem in Kashmir. Last weekend, Indian authorities executed Mohammed Afzal, known as Afzal Guru, a Kashmiri who was convicted of participating in a 2001 attack on India’s Parliament. Many in Kashmir believe that Mr. Afzal did not receive a fair trial, and have expressed outrage over the timing and circumstances of his execution.

Indian officials put a curfew in place following the execution. Nevertheless, as many as 25 protests have flared around the Indian-held parts of Kashmir, and there have been at least 110 arrests. The region is predominantly Muslim, and curfew was tightened Friday, the Muslim day of prayer, and many of the major mosques in Srinagar, the main city, were closed Friday.

The week before the execution, a Kashmiri girls’ rock band decided to disband after threats against the members were posted on social media sites and a top Muslim cleric asked that they stop performing.

Hari Kumar contributed reporting.

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Weeping Pistorius faces life in prison in shooting

PRETORIA, South Africa (AP) — Olympic athlete Oscar Pistorius wept in court Friday as prosecutors said they'll pursue a charge of premeditated murder against him in the killing of his model girlfriend, meaning the man who once inspired the world could spend the rest of his life in prison.

Pistorius' family and London-based management issued a statement disputing the murder charge he now faces for the slaying of Reeva Steenkamp. The athlete himself initially appeared solemn and collected in his first court appearance, but later sobbed loud enough for his cries to be heard over the more than 100 spectators gathered for the hearing.

His tears even drew the attention of Chief Magistrate Desmond Nasir, who at one point simply said: "Take it easy."

The double-amputee athlete's arrest stunned South Africa, which awoke the morning of Valentine's Day to hear that Steenkamp had been shot to death at Pistorius' home in a gated community in an eastern suburb of South Africa's capital, Pretoria. Police said investigators recovered a 9 mm pistol from the home.

In Pretoria Magistrate's Court on Friday, throngs of photographers, videographers and journalists besieged the brick-walled Courtroom C, where Pistorius appeared. Nasir's first ruling in the matter focused on the press: He dismissed requests from a private television station and the state broadcaster to air the hearing live.

Nasir also ordered that no photographs be taken while court was in session. That left kneeling photographers less than a meter (three feet) from Pistorius to simply stare at a man some previously photographed sprinting on his famous carbon-fiber blades as he cried uncontrollably. Pistorius' brother, Carl, and his father, Henke, reached out at separate times to comfort him as he sat in the dock.

Prosecutor Gerrie Nel said in court he would pursue a charge of premeditated murder against Pistorius for allegedly killing Steenkamp, a 29-year-old model known for her vamping, bikini pictures in men's magazines and appearances in cosmetics commercials. Police have said Steenkamp is 30. The discrepancy has not been explained.

Police said Friday that investigators conducted an autopsy on Steenkamp's body. Lt. Col. Katlego Mogale said the results of the autopsy would not be published.

Pistorius entered no plea at the hearing and his family left quickly, without speaking to journalists who followed them outside. In a statement later Friday, his family and management questioned the criminal charge the 26-year-old athlete faces.

"The alleged murder is disputed in the strongest terms," the statement read, without elaborating.

The statement also said Pistorius wanted to "send his deepest sympathies to the family of Reeva."

"He would also like to express his thanks through us today for all the messages of support he has received — but as stated our thoughts and prayers today should be for Reeva and her family — regardless of the circumstances of this terrible, terrible tragedy," the statement read.

South Africa continues to question itself over what to think about the shooting, with local newspaper headlines veering from the lurid to "Blade gunner?" on Friday morning, playing on Pistorius' nickname given for his running blades. The nation of 50 million has one of the world's highest rates of shooting deaths, behind only Colombia. South Africa as whole recently recoiled at the brutal gang rape and attack that killed a 17-year-old girl and many wore black Friday to demonstrate against the high levels of violence against women in the country.

Others focused their attention on Pistorius, who is fascinated by fast cars, cage fighting and firearms. He crashed a speedboat in February 2009, breaking his nose, jaw and several ribs and damaging an eye socket. He later required 180 stitches to his face. Witnesses said he had been drinking, and officers found alcoholic beverages in the wreckage, though they did not do a blood test on Pistorius.

His love life, the fodder of gossip columns in the country, also saw turmoil. In November, Pistorius was involved in an altercation over a woman with a local coal mining millionaire, South African media reported.

Gianni Merlo, who co-authored the 2009 biography "Blade Runner" with Pistorius, told The Associated Press in a phone interview Friday from Italy that Pistorius once drove out in the middle of the night to see his first love after a fight. Pistorius crashed his car when he fell asleep behind the wheel, though Merlo said it showed his devotion.

However, he said Pistorius once threw a friend's girlfriend out of his house, prompting police to investigate and take him in for questioning.

"He explained that this was a kind of (plot) against him, planned against him," Merlo said.

At the defense's request, the chief magistrate delayed Pistorius' bail hearing until Tuesday and Wednesday. Prosecutors and defense lawyers agreed to keep Pistorius in a police holding cell, rather than transfer him to prison like most normal suspects. While Nasir acknowledged that could give them impression that the athlete was getting "preferential treatment," he agreed to it. Police have said they oppose Pistorius being freed on bail.

In saying they'll seek a premeditated murder charge against Pistorius, prosecutors likely are claiming they have evidence that the athlete planned the killing ahead of time, said William Booth, a prominent defense lawyer from Cape Town. The charge, which carries a sentence of life in prison, also makes it more difficult for Pistorius to successfully apply for bail, Booth said, though it could be a challenge to get a conviction.

"It's quite difficult to prove that in a situation where there isn't a witness," the defense lawyer said. "If I just plan it in my mind and I arrive at somebody's house and there's no witnesses and I shoot the person, it's really tough for the prosecution to show that planning."

On call-in radio shows and in private conversation Friday, some in South Africa compared Pistorius' case to that of O.J. Simpson, a former football star accused of the slayings of his former wife, Nicole Brown Simpson, and her friend, Ronald Goldman. That case, drawing international media attention, saw Simpson acquitted by a jury in 1995. However, in South Africa, there is no jury system, leaving Pistorius face largely to the judge who will oversee his possible trial.

Pistorius made history at the London Olympics last year when he became the first double-amputee track athlete to compete at any games. He didn't win a medal but did make the semifinals of the 400 meters and the final of the 4X400 relay, propelling the world's best-known Paralympian to the level of an international track star and one of the world's best-known sportsmen.

But police hinted at a troubled lifestyle away from public scrutiny for the runner Thursday when they said there had previously been domestic incidents at Pistorius' home.

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AP Sports Writer Gerald Imray reported from Johannesburg. Associated Press writer Michelle Faul in Johannesburg contributed to this report.

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Jon Gambrell can be reached at www.twitter.com/jongambrellAP . Gerald Imray can be reached at www.twitter.com/geraldimrayAP .

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