Drug, alcohol abuse tied to early-life strokes: study

(Reuters) – Younger adults who suffered a stroke were often smokers or had abused drugs or alcohol, according to a U.S. study that looked at over 1,000 patients.

Strokes are often thought of as a condition of the elderly, but researchers said long-term changes in the heart, arteries or and blood as a result of drug abuse or heavy drinking may put users at higher-than-average risk earlier in life.

“Substance abuse is common in young adults experiencing a stroke,” wrote lead researcher Brett Kissela from the University of Cincinnati in the journal Stroke.

“Patients aged younger than 55 years who experience a stroke should be routinely screened and counseled regarding substance abuse.”

It’s also possible that some drugs, particularly cocaine and methamphetamines, may trigger a stroke more immediately, according to S. Andrew Josephson, a neurologist from the University of California, San Francisco, who has studied drug use and stroke but was not involved in the study.

“We know that even with vascular risk factors that are prevalent – smoking, high blood pressure… most people still don’t have a stroke until they’re older,” he added.

“When a young person has a stroke, it is probably much more likely that the cause of their stroke is something other than traditional risk factors.”

According to the U.S. Centers for Disease Control and Prevention, close to 800,000 people in the United States have a stroke every year, and they are the most common cause of serious long-term disability. One study of 2007 data found that almost five percent of people who had a stroke that year were between ages 18 and 44.

The current study involved people from Greater Cincinnati and Northern Kentucky who’d had a stroke before they hit 55.

The researchers reviewed medical charts for blood or urine test results of other records of substance abuse for close to 1,200 stroke patients.

In 2005, the most recent year covered, just over half of young adults who suffered a stroke were smokers at the time, and one in five used illicit drugs, including marijuana and cocaine. Thirteen percent of people had used drugs or alcohol within 24 hours of their stoke.

“The rate of substance abuse, particularly illicit drug abuse, is almost certainly an underestimate because toxicology screens were not obtained on all patients,” said Steven Kittner, a professor of neurology at the University of Maryland School of Medicine in Baltimore who also wasn’t part of the research.

The rate of smoking, drug use and alcohol abuse – defined as three or more drinks per day – seemed to increase among stroke patients between the mid-1990s and the mid-2000s.

But Kissela and his team said they can’t be sure whether more people were actually using those substances or doctors were just getting better at testing for and recording drug abuse.

The study also can’t prove that patients’ drug or alcohol use directly contributed to their strokes. It’s possible, for example, that people who abuse drugs also see their doctors less often or engage in other risky behaviors that increase the chance of strokes, Josephson explained.

He added that the study emphasizes the need to learn and quickly recognizing the signs of strokes, even in young people, since some treatments can only be used in a short window of opportunity after the stroke. SOURCE: http://bit.ly/TVQvpi

(Reporting from New York by Genevra Pittman at Reuters Health; editing by Elaine Lies)

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Lawmakers unveil new round of Iran sanctions

WASHINGTON (AP) — Senators pressed ahead Thursday on a new set of tough sanctions against Iran‘s domestic industries as it seeks to cripple the Islamic republic’s economy and thwart its nuclear ambitions.

Sens. Bob Menendez, D-N.J., and Mark Kirk, R-Ill., unveiled a package of penalties that would designate Iran‘s energy, port, shipping and ship-building sectors as entities of proliferation and sanction transactions with these areas. The legislation also would penalize individuals selling or supplying commodities such as graphite, aluminum and steel to Iran.

The punitive measures build on the sanctions on Tehran’s oil industry that the two lawmakers have shepherded through Congress in the past year.

“Yes, our sanctions are having a significant impact, but Iran continues their work to develop nuclear weapons,” Menendez said in a statement, adding that with the new penalties, “We will send a message to Iran that they can’t just try to wait us out.”

Kirk said the measure “will greatly increase the economic pressure on the Iranian regime and send a clear message of support to the Iranian people.”

The sanctions are contained in an amendment the two lawmakers hope to add to a far-reaching defense policy bill that the Senate was debating and could wrap up by week’s end. Congress has overwhelmingly backed previous efforts by Menendez and Kirk.

The legislation also would designate the Islamic Republic of Iran Broadcasting and its president as human rights abusers for broadcasting forced televised confessions and show trials.

The United States and European Union have imposed tough sanctions on Iran that have weakened its economy. But Tehran has found ways to bypass the penalties, such as Turkey’s use of gold to pay for Iranian natural gas imports.

The Menendez-Kirk measure would allow the president to impose sanctions in cases of the sale or transfer of precious metals, targeting efforts by Iran to circumvent the penalties.

Iran maintains that its nuclear program is for peaceful purposes only.

Mark Dubowitz, a sanctions expert and executive director of the Foundation for Defense of Democracies, said there is strong bipartisan support for intense sanctions, with the goal of pushing the Iranian economy to the brink of economic collapse.

Only then “can the central thesis of the administration’s sanctions policy be fairly tested: That crippling economic pressure will break the nuclear will of Iran’s supreme leader and his Revolutionary Guards and lead them to meet their obligations under international law,” Dubowitz said.

The president has 90 days from the legislation’s enactment to act. The bill does include the authority to waive the sanctions based on national security.

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Noisy city: Cacophony in Caracas sparks complaints

CARACAS, Venezuela (AP) — This metropolis of 6 million people may be one of the world’s most intense, overwhelming cities, with tremendous levels of crime, traffic and social strife. The sounds of Caracas‘ streets live up to its reputation.

Stand on any downtown corner, and the cacophony can be overpowering: Deafening horns blast from oncoming buses, traffic police shrilly blow their whistles and sirens shriek atop ambulances stuck in bumper-to-bumper traffic.

Air horns routinely used by bus drivers are so powerful they make pedestrians on crosswalks recoil, and can even leave their ears ringing. Loud salsa music blares from the windows of buses, trucks with old mufflers rumble past belching exhaust, and “moto-taxis” weave through traffic beeping high-pitched horns.

Growing numbers of Venezuelans are saying they’re fed up with the noise that they say is getting worse, and the numbers of complaints to the authorities have risen in recent years.

One affluent district, Chacao, put up signs along a main avenue reading: “A honk won’t make the traffic light change.”

“The noise is terrible. Sometimes it seems like it’s never going to end,” said Jose Santander, a street vendor who stands in the middle of a highway selling fried pork rinds and potato chips to commuters in traffic.

Prosecutor General Luisa Ortega recently told a news conference that officials have started “putting an increased emphasis on promoting peaceful coexistence” by punishing misdemeanors such as violations of anti-noise regulations and other minor crimes. That effort has translated into hundreds of noise-related cases in recent years.

Some violators are ordered to perform community service. For instance, two young musicians who were recently caught playing loud music near a subway station were sentenced to 120 hours of community service giving music lessons to students in public schools.

Others caught playing loud music on the street have been charged with disturbing the peace after complaints from neighbors. Fines can run as high as 9,000 bolivars, or $ 2,093.

On the streets of their capital, however, Venezuelans have grown used to living loudly. The noisescape adds to a general sense of anarchy, with many drivers ignoring red lights and blocking intersections along potholed streets strewn with trash.

“This is something that everybody does. Nobody should be complaining,” said Gregorio Hernandez, a 23-year-old college student, as he listened to Latin rock songs booming from his car stereo on a Saturday night in downtown Caracas. “We’re just having fun. We’re not hurting anybody.”

Adding to the mess is the country’s notoriously divisive politics, which regularly fill the streets with marches and demonstrations.

On many days, the shouts of protesters streaming through downtown can be heard from blocks away, demanding pay hikes or unpaid benefits.

And the sporadic crackling of gunfire in the slums can be confused for firecrackers tossed by boisterous partygoers.

It’s difficult to rank the world’s noisiest cities because many, including Venezuela’s capital, don’t take measurements of sound pollution, said Victor Rastelli, a mechanical engineering professor and sound pollution expert at Simon Bolivar University in Caracas. But Rastelli said he suspects Caracas is right up there among the noisiest, along with Sao Paulo, Mexico City and Mumbai.

Excessive noise can be more than simply an annoyance, Rastelli said. “This is a public health problem.”

Dr. Carmen Mijares, an audiologist at a private Caracas hospital, said she treats at least a dozen patients every month for hearing damage caused by prolonged exposure to loud noises.

“Many of them work in bars or night clubs, and their maladies usually include temporary hearing loss and headaches,” Mijares said. For others, she said, the day-to-day noise of traffic, car horns and loud music can exacerbate stress and sleeping disorders.

Several cities have successfully reduced noise pollution, said Stephen Stansfeld, a London psychiatry professor and coordinator of the European Network on Noise and Health.

One of the most noteworthy initiatives, Stansfeld said, was in Copenhagen, Denmark, where officials used sound walls, noise-reducing asphalt and other infrastructure as well as public awareness campaigns to fight noise pollution.

But such high-tech solutions seem like a remote possibility in Caracas, where streets are literally falling apart and aging overpasses regularly lack portions of their guard rails. Prosecutors, angry neighbors and others hoping to fight the noise will have to persuade Venezuelans to do nothing less than change their loud behavior.

For Carlos Pinto, however, making noise is practically a political right.

The 26-year-old law student and his friends danced at a recent street party to house music booming from woofers in his car’s open trunk, with neon lights on the speakers that pulsed to the beat.

When asked about the noise, he answered: “We will be heard.”

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AP freelance video journalist Ricardo Nunes contributed to this report.

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Christopher Toothaker on Twitter: http://twitter.com/ctoothaker

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Obama takes “fiscal cliff” battle to Twitter

WASHINGTON (Reuters) – President Barack Obama opened a new front on Wednesday in the battle between Democrats and Republicans over the best way to avoid the year-end “fiscal cliff” – Twitter.

The web-savvy Obama administration launched a social media campaign that asks Twitter users to add the “#my2k” hashtag to messages with examples of what $ 2,000 means to them.

The amount is roughly what a middle-class family of four would have to pay extra in taxes next year if Congress cannot strike a deal to remove the threat of roughly $ 600 billion in tax hikes and federal spending cuts.

The fast-paced social networking site known for its zippy 140-character comments is a tried-and-true method of reaching Americans. The latest call for such searchable references is an effort to pressure Congress into finding compromise on long-held partisan views.

Obama announced the new Twitter hashtag campaign at a news conference on Wednesday. He and fellow Democrats, who oppose significant cuts to U.S. “entitlement” programs such as Medicare as a way of balancing the budget, have been trying to break Republican opposition to hiking taxes on anyone, including the wealthy.

Promotions of “#my2k” quickly went out to millions of followers of the White House Twitter account and scores of Democratic backers, including former House of Representatives Speaker Nancy Pelosi. Soon, “my2k” was a top-trending subject.

“#My2K means food for a year, the remainder of my student loan paid off or a full month of child care. $ 2200 can make or break a family,” wrote Twitter user Katrina Burchett.

In the anarchic spirit of social media, Republicans, who also polished their Twitter hashtag skills during the bitter 2012 presidential campaign, pounced quickly.

The conservative Heritage Foundation bought the promotional tweet that pops up at the top of the list if one searches for “#my2k” mentions, where the think tank offered its own take on solutions to the fiscal cliff.

House Speaker John Boehner and scores of fellow Republican lawmakers started sharing examples they hoped would put the blame for the lack of a resolution on the Democrats.

“We in the House took steps this summer to avert #fiscalcliff and stop #my2K tax hikes,” wrote Representative Mike Turner. “It’s time for @whitehouse and @SenateDems to act.”

‘BEING AWARE OF WHAT’S GOING ON’

Users on Twitter can sign up to follow one another’s messages, making searchable hashtags a helpful way to sort by subject or theme.

Marcus Messner, who studies social media at Virginia Commonwealth University, said Twitter was a perfect environment to reignite Obama’s base swiftly and gauge public engagement on the issue.

The Obama administration has used Twitter hashtags as part of lobbying campaigns to keep student loan rates low with #dontdoublemyrate and to extend payroll tax cuts with #40dollars, which was their estimate of how much the cuts saved an average family each year.

White House Social Media Director Macon Phillips later called the $ 40dollars hashtag “one of the most significant campaigns we ran on Twitter.”

“It’s about being aware of what’s going on and understanding that in the age of social media, you’re just a participant,” he told an Entrepreneur.com blogger in February. “It’s not something that you can control.”

(Editing by Peter Cooney)

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Some 20 percent of women overwhelmed by cancer treatment options: study

(Reuters) – More than one in five women with early-stage breast cancer said they were given too much responsibility for treatment-related decisions – and those patients were more likely to end up regretting the choices they made, according to a U.S. study.

The findings, which appeared in the Journal of General Internal Medicine, don’t mean that women should not be fully informed about their treatment options, researchers said, but rather that doctors may need to find new strategies to communicate with patients, especially the less educated.

“Some women may feel overwhelmed or burdened by treatment choices, particularly if they are not also given the tools to understand and weigh the benefits and harms of these choices,” wrote research leader Jennifer Livaudais and colleagues.

Her team from the Mount Sinai School of Medicine in New York surveyed 368 women who had just had surgery for early-stage breast cancer at one of eight New York City hospitals, and again six months later.

The majority said they typically had trouble understanding medical information and less than one-third knew the possible benefits of surgery, radiation and chemotherapy, Livaudais and her colleagues found.

Lack of both “health literacy” and knowledge about treatment benefits was common among the 21 percent of women who said they had too much responsibility for decision-making – as well as among the seven percent who felt they didn’t have enough responsibility.

Women who were poor, non-white or didn’t finish high school were also more likely to feel that they had either too much or too little say in their treatment.

Close to two-thirds of women on both ends of the spectrum had some regret about their original treatment decisions six months down the line. That compared to one-third of women who originally said they had a “reasonable amount” of decision-making responsibility.

Steven Katz, who has studied cancer-related decision-making at the University of Michigan in Ann Arbor, said that compared to past years, doctors now have better ways to tailor treatment to individual patients. But that also means treatment options are based on more convoluted information.

“The treatments are linked in complicated ways, and the information that doctors draw on to make recommendations has increasingly become more and more complex” said Katz, who wasn’t involved in the new study.

He said that for patients trying to make the best treatment choices, the smartest thing they can do is have a team of doctors – an experienced surgeon, a medical oncologist, a radiation oncologist and a plastic surgeon – all working on their case and sharing ideas.

“The purpose (of the study) was not to say women shouldn’t be provided with these treatment options, but that the information really needs to be tailored better,” said Livaudais, who is now at the University of California, San Francisco.

She recommended that doctors ask each patient how much responsibility she feels comfortable taking.

“Some patients prefer… for the information to be presented in simpler terms, or for the physician to recommend something to them,” she added. SOURCE: http://bit.ly/11d6IIW

(Reporting from New York by Genevra Pittman at Reuters Health; editing by Elaine Lies)

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Buying That First Home Is Getting Harder

The housing market may be recovering, but not everyone’s along for the ride. First-time buyers are becoming a shrinking share of purchasers, according to the results of a monthly survey of 2,500 real estate agents. New home buyers made just 34.7 percent of all purchases in October, the lowest since the Campbell/Inside Mortgage Finance HousingPulse Tracking Survey started in September 2009. Three years ago, first-time borrowers were 47 percent of all buyers, buoyed at the time in part by a tax credit.

First-time homeowners, who typically buy lower-priced homes and need extra financing, are losing share as the market shifts from distressed properties such as foreclosures. Distressed sales, which usually cost less, were almost half of all of purchases a year ago, but now they’re just over a third of sales. At the same time, prices for all existing homes have been rising—prices were up 4.4 percent in September over the previous year, according to the Federal Housing Finance Agency—making homes less affordable for first-time buyers.

For new buyers, rising prices are coupled with difficulties in getting a mortgage. About half of all first-time buyers get their loans through HUD’s Federal Housing Administration, which allows down payments as low as 3.5 percent. Because loans with lower down payments are riskier, the FHA’s rates are typically higher than those of traditional mortgages. With interest rates at near-record lows, the incremental difference wasn’t causing much consternation in the past. But facing concerns that it has taken on too much risk and may need a bailout, the FHA raised rates in August and plans to do so again next year.

Interest rates are still near historic lows, rents are rising, and home prices (adjusted for inflation) are still at levels not seen in more than a decade. That means first-time buyers may be missing out on quite the opportunity, if they just can find a loan and a home they can afford.

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Rapper PSY wants Tom Cruise to go ‘Gangnam Style’

BANGKOK (AP) — The South Korean rapper behind YouTube’s most-viewed video ever has set what might be a “Mission: Impossible” for himself.

Asked which celebrity he would like to see go “Gangnam Style,” the singer PSY told The Associated Press: “Tom Cruise!”

Surrounded by screaming fans, he then chuckled at the idea of the American movie star doing his now famous horse-riding dance.

PSY’s comments Wednesday in Bangkok were his first public remarks since his viral smash video — with 838 million views — surpassed Justin Bieber‘s “Baby,” which until Saturday held the record with 803 million views.

“It’s amazing,” PSY told a news conference, saying he never set out to become an international star. “I made this video just for Korea, actually. And when I released this song — wow.”

The video has spawned hundreds of parodies and tribute videos and earned him a spotlight alongside a variety of superstars.

Earlier this month, Madonna invited PSY onstage and they danced to his song at one of her New York City concerts. MC Hammer introduced the Korean star at the American Music Awards as, “My Homeboy PSY!”

Even President Barack Obama is talking about him. Asked on Election Day if he could do the dance, Obama replied: “I think I can do that move,” but then concluded he might “do it privately for Michelle,” the first lady.

PSY was in Thailand to give a free concert Wednesday night organized as a tribute to the country’s revered King Bhumibol Adulyadej, who turns 85 next month. He paid respects to the king at a Bangkok shopping mall, signing his name in an autograph book placed beside a giant poster of the king. He then gave an outdoor press conference, as screaming fans nearby performed the pop star’s dance.

Determined not to be a one-hit wonder, PSY said he plans to release a worldwide album in March with dance moves that he thinks his international fans will like.

“I think I have plenty of dance moves left,” he said, in his trademark sunglasses and dark suit. “But I’m really concerned about the (next) music video.”

“How can I beat ‘Gangnam Style’?” he asked, smiling. “How can I beat 850 million views?”

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Associated Press writer Thanyarat Doksone contributed to this report.

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Nintendo Unveils Wii Mini for the Canucks

Nintendo‘s pushing the new $ 299 Wii U console hard (and has already sold 400K units in the process), but in at least one region, the gaming company has a new back-up plan: The $ 99 Nintendo Wii Mini.

[More from Mashable: Wii U Sells 400,000 Units in First Week]

The new smaller, black box with red trim is a simpler game console. It offers no Internet access and cannot play older GameCube console games. What it does do is play virtually all Wii games (Nintendo says there are around 1,300 of them). The other major caveat is that the console is only available in Canada. According to a Nintendo press release on the new system, “Wii Mini is available exclusively in Canada during the holiday season. No information is available about its potential availability in other territories in the future.”

Nintendo also left out some details on the console itself. We do not know the exact size or weight of the box, though judging from the above image, it’s not much wider than a Wii Remote.

[More from Mashable: Meet the Super Fan Who Waited in Line for a Month for a Wii U [VIDEO]]

As Nintendo describes it, the Wii Mini is “all about games,” and without the Internet, it has to be. No Web browsing, cavorting with other Mii’s or multi-player gaming. It’s also worth noting that while the Wii Mini ships with a single Wii Remote Plus and Nunchuk (both red), a brand new Black Wii with Wii Sports and Wii Sports Resort (including Remote and Nunchuk) is currently $ 119 at Best Buy.

What do you think of the Wii Mini? Would you game without the Internet? Is this the perfect gift for young, Canadian children? Let us know in the comments.

GamePad

The Wii U GamePad has a 6.2-inch touchscreen.

Click here to view this gallery.

This story originally published on Mashable here.

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Cloudy with a chance of flu? Study offers influenza forecast

WASHINGTON (Reuters) – New research suggests it may be possible to forecast flu outbreaks in much the same way meteorologists predict weather, a potential boon for public health officials and consumers, one of the study’s authors said on Tuesday.

Using real-time U.S. data gathered by Google Inc, along with a computer model showing how flu spreads, the researchers offered a system that could generate local forecasts of the severity and length of a particular flu outbreak.

This kind of forecasting could improve preparation and management of annual flu outbreaks in the United States, said Irene Eckstrand of the National Institutes of Health.

Influenza kills 250,000 to 500,000 people each year around the globe; the U.S. annual flu death toll is 35,000.

If the forecasts are reasonably accurate, they could help public health officials target vaccines and anti-viral drugs to areas of greatest need, said study co-author Jeffrey Shaman of Columbia University’s Mailman School of Public Health.

“If you have a six-week forecast with good confidence that you’re going to have an outbreak in New York City and nothing’s going on in L.A., you’d send the vaccines there (to New York) because there’s enough time to distribute them … before there’s an actual outbreak,” Shaman said.

He suggested that flu forecasts might be distributed through TV weather programming. Individuals then could decide whether to get the flu vaccine, keep their distance from people who sneeze or cough and closely monitor symptoms.

This pilot study, published on Monday in the journal Proceedings of the National Academy of Sciences, looked only at the New York City area, using data from 2003 through 2008.

TRACKING FLU MOVEMENTS

Even so, if all goes well, the system could offer rudimentary forecasts as soon as next year’s flu season, Shaman said. It might be possible to issue a few flu forecasts this season, though those would be in “test-case form,” he said.

“We have to try it for other regions, other cities,” said Shaman. “We have to look and see how it worked during the pandemic years … we have to see the differences in performance depending on the aggressiveness of the strain of flu.”

The computer program the scientists used is a standard epidemiological model showing how influenza moves through a population, from those who are susceptible to flu, to those who have it, to those who have recovered, said study co-author Alicia Karspeck of the National Center for Atmospheric Research in Boulder, Colorado.

The problem with this model is that it’s nearly impossible to pinpoint who is susceptible and difficult to track recoveries, though it is possible to figure out the trajectory of an outbreak, Karspeck said.

To conduct their research, the authors said, they needed real-time data, and they found it in an online tool called Google Flu Trends, which uses search terms people put into the Web-based search engine to figure out where influenza is occurring. The tool, launched in 2008, then notifies the U.S. Centers for Disease Control and Prevention in real time.

In a process known as retrospective forecasting, the scientists tested their findings against what happened in the New York area from 2003 through 2008. Because they knew what had happened in these years, they could check their work.

Using the computer program and the flu trends data, they generated retrospective weekly flu forecasts, which predicted the peak of the outbreak more than seven weeks before it occurred.

(Reporting by Deborah Zabarenko, Environment Correspondent; Edited by Marilyn W. Thompson and Lisa Shumaker)

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Obama promotes tax agenda, Congress in stand-off

WASHINGTON (Reuters) – President Barack Obama on Tuesday launched a public relations push for his bid to raise taxes on wealthy Americans, but U.S. lawmakers remained deadlocked over dramatic, year-end tax increases and spending cuts known as the “fiscal cliff.”

At the White House, small business leaders emerged from a one-hour meeting with Obama to voice support for his goal of extending low tax rates for the middle class beyond the end of the year, while letting rates rise for wealthier taxpayers.

The business owners urged Obama “to fight to keep the middle class tax cuts,” said Lew Prince, co-founder of Vintage Vinyl, an independent music store in St. Louis, Mo.

“What grows jobs in America is consumers spending money, and the average person needs that two or three thousand dollars a year in his pocket to help drive the economy,” Prince told reporters at a news conference outside the White House.

Republicans want to extend low tax rates – enacted a decade ago under the administration of former Republican President George W. Bush – for all taxpayers, including households earning more than $ 250,000 a year.

Raising tax rates on the wealthy would discourage investment and hiring at a time of high unemployment, Republicans say.

Congressional Democrats allied with the president showed no signs of backing down from his stance on raising taxes for the wealthy. But both sides have softened on some long-held positions: Republicans have been showing a willingness to consider new revenue increases while Democrats have relaxed their hard line against new savings to the Medicare and Medicaid healthcare programs.

With just a month left before the Bush tax cuts expire and automatic spending cuts begin to take hold, markets were anxious about predictions that falling off the “fiscal cliff” could trigger another recession.

“There remains no clarity on the ultimate status on the Bush tax cuts, which have to be resolved before you can move forward with the remainder of the fiscal cliff,” said Chris Krueger, an analyst at Guggenheim Securities’ Washington Research Group.

MARKETS DOWN MODESTLY

Stock prices declined modestly despite government reports that planned U.S. business spending rose again in October and that single-family home prices rose again in September.

Despite a mild sell-off in stocks, the Dow Jones industrial average closed at about 12,878, up 14 percent from a year ago.

Brian Gardner, an analyst at financial firm Keefe Bruyette & Woods, said a limited deal would likely be struck to avert the fiscal cliff, with larger fiscal issues pushed into 2013.

“Fiscal cliff headlines could have the biggest impact on the market,” he said. “Over the coming weeks, we expect many headlines that will raise and then dash investors’ hopes … The next three weeks could be a bumpy ride.”

Fresh from his November 6 re-election, Obama was set to hold another meeting with business executives from larger companies on Wednesday and then to travel to a toy factory in Pennsylvania on Friday to press his case on taxes.

Senate Republican leader Mitch McConnell ripped into Obama for planning to take his agenda to the public. “Rather than sitting down with lawmakers of both parties and working out an agreement, he’s back out on the campaign trail,” McConnell roared on the Senate floor.

“We already know the president is a very good campaigner. What we don’t know is whether he has the leadership qualities necessary to lead his party to a bipartisan agreement.”

Obama last met with congressional leaders on November 16. A follow-up session was not expected this week, but could come next week, congressional aides said.

In the interim, little progress was made over the holidays in meetings between the staffs of the White House and Republican Speaker of the House of Representatives John Boehner, aides said.

LEADERS CANVAS RANKS

Ron Bonjean, a former aide to Republican leaders in the House and Senate, said leaders were still checking with their rank-and-file to gauge what concessions they might be able to stomach. In a week or so, Bonjean said, “the level of intensity will go up” with more meetings.

Senate Democratic leader Harry Reid said he was disappointed there has been “little progress” on a deal to avoid the “fiscal cliff” and warned that “we only have a couple weeks to get something done.

Despite frustration, Reid said he was optimistic lawmakers would avoid plunging off the “cliff,” a convergence of an estimated $ 600 billion in tax increases and spending cuts. “I’m extremely hopeful, and I do not believe that the Republicans are going to allow us to go over the cliff,” he said.

While Republicans have not shifted from their opposition to tax rate increases, a few have publicly disavowed a no-new-taxes pledge to which most of them have adhered for years, putting tax revenues, if not higher rates, on the negotiating table.

Also on Tuesday, Dick Durbin, a senior Senate Democrat and close Obama ally, urged fellow liberals to consider reforming the costly Medicare and Medicaid healthcare programs, signaling possible Democratic compromise in an area where they have steadfastly resisted change.

“Progressives should be willing to talk about ways to ensure the long-term viability of Medicare and Medicaid” for the elderly and poor, Durbin said in excerpts from a speech.

But he added that Medicare and Medicaid should not be part of the current negotiations on averting the fiscal cliff. On that front, Durbin stood firmly with Obama, urging extension of middle class tax cuts for 98 percent of Americans.

(Additional reporting by Thomas Ferraro, Kim Dixon, Patricia Zengerle, Lucia Mutikani and Mark Felsenthal, with Adam Kerlin in New York. Writing by Kevin Drawbaugh. Editing by Karey Wutkowski, Jackie Frank and Vicki Allen)

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