Study: Stem cells from strangers can repair hearts

LOS ANGELES (AP) — Researchers are reporting a key advance in using stem cells to repair hearts damaged by heart attacks. In a study, stem cells donated by strangers proved as safe and effective as patients' own cells for helping restore heart tissue.

The work involved just 30 patients in Miami and Baltimore, but it proves the concept that anyone's cells can be used to treat such cases. Doctors are excited because this suggests that stem cells could be banked for off-the-shelf use after heart attacks, just as blood is kept on hand now.

Results were discussed Monday at an American Heart Association conference in California and published in the Journal of the American Medical Association.

The study used a specific type of stem cells from bone marrow that researchers believed would not be rejected by recipients. Unlike other cells, these lack a key feature on their surface that makes the immune system see them as foreign tissue and attack them, explained the study's leader, Dr. Joshua Hare of the University of Miami.

The patients in the study had suffered heart attacks years earlier, some as long as 30 years ago. All had developed heart failure because the scar tissue from the heart attack had weakened their hearts so much that they grew large and flabby, unable to pump blood effectively.

Researchers advertised for people to supply marrow, which is removed using a needle into a hip bone. The cells were taken from the marrow and amplified for about a month in a lab at Baltimore's Johns Hopkins University, then returned to Miami to be used for treatment, which did not involve surgery.

The cells were delivered through a tube pushed through a groin artery into the heart near the scarred area. Fifteen patients were given cells from their own marrow and 15 others, cells from strangers.

About a year later, scar tissue had been reduced by about one-third. Both groups had improvements in how far they could walk and in quality of life. There was no significant difference in one measure of how well their hearts were able to pump blood, but doctors hope these patients will continue to improve over time, or that refinements in treatment will lead to better results.

The big attraction is being able to use cells supplied by others, with no blood or tissue matching needed.

"You could have the cells ready to go in the blood bank so when the patient comes in for a therapy — there's no delay," Hare said. "It's also cheaper to make the donor cells," and a single marrow donor can supply enough cells to treat as many as 10 people.

Dr. Elliott Antman of Harvard-affiliated Brigham and Women's Hospital in Boston who heads the heart conference, praised the work.

"That opens up an entire new avenue for stem cell therapy, like a sophisticated version of a blood bank," he said. There's an advantage in not having to create a cell therapy for each patient, and it could spare them the pain and wait of having their own marrow harvested, he said.

The study was sponsored by the National Institutes of Health. Hare owns stock in a biotech company working on a treatment using a mixture of cells.

Juan Lopez received his own cells in the study, and said it improved his symptoms so much that at age 70, he was able to return to his job as an engineer and sales manager for a roofing manufacturer and ride an exercise bike.

"It has been a life-changing experience," said Lopez, who lives in Miami. "I can feel day by day, week by week, month by month, my improvement. I don't have any shortness of breath and my energy level is way up there. I don't have any fluid in my lungs."

And, he said happily, "My sex drive has improved!"

___

Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP .

___

Online:

Heart Association: http://www.heart.org

JAMA: http://www.jama.ama-assn.org

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Long, bitter White House race finally in voters' hands

WASHINGTON (Reuters) - President Barack Obama and Republican challenger Mitt Romney face the verdict of voters on Tuesday after a long and bitter White House campaign, with polls showing them deadlocked in a race that will be decided in a handful of states where it is extraordinarily close.

At least 120 million Americans are expected to vote on giving Obama a second term or replacing him with Romney. Their decision will set the country's course for four years on spending, taxes, healthcare and foreign policy challenges like the rise of China and Iran's nuclear ambitions.

National opinion polls show Obama and Romney in a virtual dead heat, although the Democratic incumbent has a slight advantage in several vital swing states - most notably Ohio - that could give him the 270 electoral votes he needs to win.

Romney, the multimillionaire former head of a private equity fund, would be the first Mormon president and one of the wealthiest Americans to occupy the White House. Obama, the first black president, is vying to be the first Democrat to win a second term since Bill Clinton in 1996.

Fueled by record spending on negative ads, the battle between the two men was focused primarily on the lagging economic recovery and persistent high unemployment, but at times it turned personal.

Polls will begin to close in Indiana and Kentucky at 6 p.m. ESTon Tuesday, with voting ending across the country over the next six hours.

The first results, by tradition, were tallied in Dixville Notch and Hart's Location, New Hampshire, shortly after midnight . Obama and Romney each received five votes in Dixville Notch. In Hart's Location, Obama got 23 votes to 9 votes for Romney and two votes for Libertarian candidate Gary Johnson.

The close presidential race raises fears of a disputed outcome similar to the 2000 election, which was decided by the U.S. Supreme Court. Both campaigns have assembled legal teams to deal with possible voting problems, challenges or recounts.

The balance of power in the U.S. Congress will also be at stake in Senate and House of Representatives races that could impact the outcome of "fiscal cliff" negotiations on spending cuts and tax increases, which kick in at the end of the year unless a deal is reached.

Obama's Democrats are now expected to narrowly hold their Senate majority, while Romney's Republicans are favored to retain House control.

Despite the weak economy, Obama appeared in September to be cruising to a relatively easy win after a strong party convention and a series of stumbles by Romney, including a secretly recorded video showing the Republican writing off 47 percent of the electorate as government-dependent victims.

But Romney rebounded in the first debate on October 3 in Denver, where his sure-footed criticism of the president and Obama's listless response started a slow rise for Romney in polls. Obama seemed to regain his footing in recent days at the head of federal relief efforts for victims of the storm Sandy.

The presidential contest is now likely to be determined by voter turnout - specifically, what combination of Republicans, Democrats, white, minority, young, old and independent voters shows up at polling stations.

Obama and Romney raced through seven battleground states on the final day of campaigning to hammer home their final themes, urge supporters to get to the polls and woo the last remaining undecided voters.

'WE KNOW WHAT CHANGE LOOKS LIKE'

Obama focused on Wisconsin, Ohio and Iowa, the three Midwestern swing states that, barring surprises elsewhere, would give him 270 electoral votes. Romney visited the must-win states of Florida, Virginia and Ohio before finishing in New Hampshire, where he launched his presidential run in June 2011.

After two days of nearly round-the-clock travel, Obama wrapped up his final campaign tour in Des Moines, Iowa, with a speech that hearkened back to his 2008 campaign.

"I've come back to Iowa one more time to ask for your vote. I came back to ask you to help us finish what we've started, because this is where our movement for change began," he told a crowd of some 20,000 people.

Obama's voice broke and he wiped away tears from his eyes as he reflected on those who had helped his campaign.

Romney's final day included stops in Florida, Virginia, Ohio and New Hampshire. The former governor of Massachusetts ended the day at a raucous "Final Victory" rally in Manchester, New Hampshire, the city where he launched his campaign last year.

"We're one day away from a fresh start. We're one day away from a new beginning," the candidate, sounding hoarse at his fifth rally of the day, told the crowd of 12,000 at a sports arena in the center of the city.

Obama ridiculed Romney's claims to be the candidate of change and said the challenger would be a rubber stamp for a conservative Tea Party agenda. "We know what change looks like, and what he's selling ain't it," he said in Columbus, Ohio.

Romney argued he was the candidate who could break the partisan gridlock in Washington, and said four more years of Obama could mean another economic recession.

"His plan for the next four years is to take all the ideas from the first term - the stimulus, the borrowing, Obamacare, all the rest - and do them over again," he said in Lynchburg, Virginia.

The common denominator for both candidates was Ohio, the most critical of the battlegrounds, particularly for Romney. Without the state's 18 electoral votes, the path to victory becomes very narrow for the Republican.

Polls have shown Obama with a small but steady lead in the state for months, sparked in part by his support for a federal bailout of the auto industry, which accounts for one of every eight jobs in Ohio, and by a strong state economy with an unemployment rate lower than the 7.9 percent national rate.

That undercut the central argument of Romney's campaign - that his business experience made him uniquely qualified to create jobs and lead an economic recovery. Obama fought back through the summer with ads criticizing Romney's experience at the equity fund Bain Capital and portraying him as out of touch with ordinary Americans.

That was part of a steady barrage of advertising in the most heavily contested battleground states from both candidates and their party allies, who raised a combined $2 billion.

The rise of "Super PACs," unaffiliated outside groups that can spend unlimited sums on behalf of candidates, also helped fuel the record spending on political ads that swamped swing-state voters.

Romney planned to vote at home in Massachusetts on Tuesday morning before a final trip to Ohio and Pennsylvania, a Democratic-leaning state that he has tried to put in play in recent weeks.

Obama, who voted in October, will spend the day at his home in Chicago.

The two candidates took a break from campaign rallies to tape interviews that aired during halftime of Monday Night Football, a U.S. television institution.

Romney said the New England Patriots were his favorite football team and jokingly said that, as a former Massachusetts governor, he took credit for the team's Super Bowl victories.

Obama expressed faith that his hometown team, the Chicago Bears, can make it to the Super Bowl championship in January because they have the "best defense in the league."

(Additional reporting by Jeff Mason in Iowa and Patricia Zengerle and Herb Swanson in New Hampshire; Editing by Alistair Bell, Christopher Wilson and Paul Simao)

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Methane warnings ignored before NZ mine disaster

WELLINGTON, New Zealand (AP) — A New Zealand coal mining company ignored 21 warnings that methane gas had accumulated to explosive levels before an underground explosion killed 29 workers two years ago, an investigation concluded.

The official report released Monday after 11 weeks of hearings on the disaster found broad safety problems in New Zealand workplaces and said the Pike River Coal company was exposing miners to unacceptable risks as it strove to meet financial targets.

"The company completely and utterly failed to protect its workers," New Zealand Prime Minister John Key said Monday.

The country's labor minister, Kate Wilkinson, resigned from her labor portfolio after the report's release, saying she felt it was the honorable thing to do after the tragedy occurred on her watch. She plans to retain her remaining government responsibilities.

The Royal Commission report said New Zealand has a poor workplace safety record and its regulators failed to provide adequate oversight before the explosion.

At the time of the disaster, New Zealand had just two mine inspectors who were unable to keep up with their workload, the report said. Pike River was able to obtain a permit with no scrutiny of its initial health and safety plans and little ongoing scrutiny.

Key said he agrees with the report's conclusion that there needs to be a philosophical shift in New Zealand from believing that companies are acting in the best interests of workers to a more proscriptive set of regulations that forces companies to do the right thing.

The commission's report recommended a new agency be formed to focus solely on workplace health and safety problems. It also recommended a raft of measures to strengthen mine oversight.

Key said his government would consider the recommendations and hoped to implement most of them. He would not commit on forming a new agency. Workplace safety issues are currently one of the responsibilities of the Ministry of Business, Innovation and Employment.

In the seven weeks before the explosion, the Pike River company received 21 warnings from mine workers that methane gas had built up to explosive levels below ground and another 27 warnings of dangerous levels, the report said. The warnings continued right up until the morning of the deadly explosion.

The company used unconventional methods to get rid of methane, the report said. Some workers even rigged their machines to bypass the methane sensors after the machines kept automatically shutting down — something they were designed to do when methane levels got too high.

The company made a "major error" by placing a ventilation fan underground instead of on the surface, the report found. The fan failed after the first of several explosions, effectively shutting down the entire ventilation system. The company was also using water jets to cut the coal face, a highly specialized technique than can release large amounts of methane.

The report did not definitively conclude what sparked the explosion itself, although it noted that a pump was switched on immediately before the explosion, raising the possibility it was triggered by an electrical arc.

The now-bankrupt Pike River Coal company is not defending itself against charges it committed nine labor violations related to the disaster. Former chief executive Peter Whittall has pleaded not guilty to 12 violations and his lawyers say he is being scapegoated.

An Australian contractor was fined last month for three safety violations after its methane detector was found to be faulty at the time of the explosion.

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Google's Android software in 3 out of 4 smartphones

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Lucas plans 'little personal films' in future

NEW YORK (AP) — George Lucas is done with "Star Wars," but not with filmmaking.

The "Star Wars" creator says he's looking forward to making his "own little personal films" that he doubts will be for the theater crowd.

Lucas spoke Friday night at Ebony magazine's Power 100 Gala, days after announcing the sale of his storied Lucasfilm to Disney for $4.05 billion. The deal would allow for more "Star Wars" films.

Lucas was "very sad" let Lucasfilm go but excited about his educational foundation, which will benefit from the sale. He also plans to make more movies. His last one was this year's "Red Tails," about the Tuskegee Airmen, but he said he barely got it in theaters. He said the movies he's working on now "will never get into theaters."

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Doctors debate value of 'fringe' heart treatment

LOS ANGELES (AP) — A heart disease treatment that many doctors consider fringe medicine unexpectedly showed promise in a federal study marred by controversy, causing debate about the results.

The study tested chelation ("kee-LAY'shun"), periodic intravenous infusions said to remove calcium from hardened arteries. Chelation is used to treat lead poisoning but its safety and value for heart disease are unproven.

In a study of 1,700 heart attack survivors, fewer of those getting chelation suffered heart problems in later years than others given dummy infusions. But so many quit the study that the results are unclear. Doctors say chelation cannot be recommended yet.

Results were discussed Sunday at a heart conference in California.

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US Air Force struggles with aging fleet

TOKYO (AP) — For decades, the U.S. Air Force has grown accustomed to such superlatives as unrivaled and unbeatable. Now some of its key aircraft are being described with terms like decrepit.

The aging of the Air Force made a brief appearance in the presidential debates when Republican nominee Mitt Romney cited it as evidence of the decline of U.S. military readiness. His contention that the Navy is the smallest it's been since 1917 got more attention thanks to President Barack Obama's quip about "horses and bayonets."

But analysts say the Air Force has a problem that likely will worsen no matter who wins Tuesday. It was created in part by a lack of urgency in the post-Cold War era, and by design glitches and cost overruns that have delayed next-generation aircraft.

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Google's Android software in 3 out of 4 smartphones

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George Lucas' filmmaking rooted in rebellion

LOS ANGELES (AP) — There's no mistaking the similarities. A childhood on a dusty farm, a love of fast vehicles, a rebel who battles an overpowering empire — George Lucas is the hero he created, Luke Skywalker.

His filmmaking outpost, Skywalker Ranch, is so far removed from the Hollywood moviemaking machine he once despised, that it may as well be on the forest moon of Endor.

That's why this week's announcement that Lucas is selling the "Star Wars" franchise and the entire Lucasfilm business to The Walt Disney Co. for more than $4 billion is like a laser blast from outer space.

Lucas built his film operation in Marin County near San Francisco largely to avoid the meddling of Los Angeles-based studios. His aim was to finish the "Star Wars" series— his way.

Today the enterprise has far surpassed the 68-year-old filmmaker's original goals. The ranch covers 6,100 acres and houses one of the industry's most acclaimed visual effects companies, Industrial Light & Magic. Lucasfilm, with its headquarters now in San Francisco proper, has ventured into books, video games, merchandise, special effects and marketing. Just as Anakin Skywalker became the villain Darth Vader, Lucas —once the outsider— had grown to become the leader of an empire.

"What I was trying to do was stay independent so that I could make the movies I wanted to make," Lucas says in the 2004 documentary "Empire of Dreams." ''But now I've found myself being the head of a corporation ... I have become the very thing that I was trying to avoid."

After the blockbuster sale announcement Tuesday, Lucas expressed a desire to give away much of his fortune, donate to educational causes and return to the experimental filmmaking of his youth. Still, the move stunned those who've followed him. He'd contemplated retirement for years and said he'd never make another "Star Wars" film.

Dale Pollock, the author of the 1999 biography "Skywalking," said Lucas disdained the Disney culture in interviews he gave in the 1980s, even though he admired the company's founder. "He felt the corporate 'Disneyization' had destroyed the spirit of Walt," Pollock said.

Lucas said through a spokeswoman on Saturday that he never said such a thing. But his anti-corporate streak is renowned. In the Lucasfilm-sanctioned documentary "Empire of Dreams", Lucas says on camera that he is "not happy that corporations have taken over the film industry."

Growing up in the central California town of Modesto, the independent streak was strong in young Lucas. The family lived on a walnut ranch and Lucas' father owned a stationery store. But, like his fictional protege Luke, George had no interest in taking over the family business. Lucas and his father fought when George made it clear that he'd rather go to college to study art than follow in his father's footsteps.

Lucas loved fast cars, and dreamed that racing them would be his ticket out. A near-fatal car crash the day before his high school graduation convinced him otherwise.

"I decided I'd better settle down and go to school," he told sci-fi magazine Starlog in 1981.

As a film student at the University of Southern California, he experimented with "cinema verite," a provocative form of documentary, and "tone poems" that visualized a piece of music or other artistic work.

The style is reflected in some of the short films he made at USC: "1:42:08" focused on the sound of a Lotus race car's engine driving at full speed and "Anyone Who Lived in a Pretty How Town," inspired by an e.e. Cummings poem. In later interviews, Lucas described his early films as "visual exercises."

Lucas' intellectual explorations led to an interest in anthropology, especially the work of American mythologist Joseph Campbell, who studied the common thread linking the myths of disparate cultures. This inspired Lucas to explore archetypal storylines that resonated across the ages and around the world.

Lucas' epic battle with the movie industry began after Warner Bros. forced him to make unwanted changes to an early film, "THX 1138." Later, Universal Pictures insisted on revisions to "American Graffiti" that Lucas felt impinged on his creative freedom. The experience led Lucas to insist on having total control of all his work, just like Charlie Chaplin and Walt Disney in their heyday.

"In order to get my vision out there, I really needed to learn how to manipulate the system because the system is designed to tear you down and destroy everything you are doing," Lucas said in an interview with Charlie Rose.

He shopped his outline for "Star Wars" to several studios before finding a friend in Alan Ladd Jr., an executive at 20th Century Fox. Despite budget and deadline overruns, and pressure from the studio, the movie was a huge success when it was released in 1977. It grossed $798 million in theaters worldwide and caused Fox's stock price at the time to double.

In one of the wisest business moves in Hollywood history, Lucas cut a deal with distributor Fox before the film's release so that he could retain ownership of the sequels and rights for merchandise. He figured in the 1970s that might mean peddling a few T-shirts and posters to fans to help market the movie. Over the decades, merchandising has formed the bedrock of his multi-billion-dollar enterprise, resulting in a bonanza for Lucas from action figures, toys, spinoff books and other products.

Industrial Light & Magic, the unit he started in a makeshift space in the Los Angeles suburb of Van Nuys, moved to the ranch in northern California and lent its prowess to other movies. It broke ground using computers, motion-controlled cameras, models and masks. Its reach is breathtaking, notably among the biggest science fiction movies of the 1980s: "E.T. The Extra-Terrestrial," ''Poltergeist," ''Back to the Future," ''Indiana Jones and the Raiders of the Lost Ark," ''Star Trek II: The Wrath of Khan" and more.

"Between him and (Steven) Spielberg, they changed how movies got made," said Matt Atchity, editor-in-chief of movie review website Rotten Tomatoes.

These days, the talent at ILM has spread around the globe, and many former employees have become top executives at other special effects companies, said Chris DeFaria, executive vice president of digital production at Warner Bros.

"You meet anybody who's a significant executive or artist at a company, they've spent their time at ILM or got their start there. That's probably one of George's greatest gifts to the business," DeFaria said.

Lucas helped make the tools that were needed for his films. ILM developed the world's first computerized film editing and music mixing technology, revolutionizing what had been a cut-and-splice affair. Pixar, the imaging computer he founded as a division of Lucasfilm, became a world-famous animated movie company. Apple's Steve Jobs bought and later sold it to Disney in 2006.

But the goliath Lucas created began to weigh on him. Fans-turned-critics felt the "Star Wars" prequel trilogy he directed fell short of the first films. Others believed his revisions to the re-released classics undid some of what made the first movies great.

Giving up his role at the head of Lucasfilm may shield him from the fury of rebellious fans and critics. He said in a video released by Disney that the sale would allow him to "do other things, things in philanthropy and doing more experimental kind of films."

"I couldn't really drag my company into that."

Still, Lucas is not planning on going to a galaxy far, far away.

Speaking on Friday night at Ebony magazine's Power 100 event in New York, Lucas said: "It's 40 years of work and it's been my life, but I'm ready to move on to bigger and better things. I have a foundation, an educational foundation. I do a lot of work with education, and I'm very excited about doing that."

This week he assured the incoming president of Lucasfilm, Kathleen Kennedy that he'd be around to advise her on future "Star Wars" movies —just like the apparition of Jedi Knight Obi-Wan Kenobi helps Luke through his adventures.

"They're finishing the hologram now," he told Kennedy. "Don't worry."

___

Liedtke reported from San Francisco. Global Entertainment Editor Nekesa Mumbi Moody in New York contributed to this story.

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Floods render NYC hospitals powerless

NEW YORK (AP) — There are few places in the U.S. where hospitals have put as much thought and money into disaster planning as New York. And yet two of the city's busiest, most important medical centers failed a fundamental test of readiness during Superstorm Sandy this week: They lost power.

Their backup generators failed, or proved inadequate. Nearly 1,000 patients had to be evacuated.

The closures led to dramatic scenes of doctors carrying patients down dark stairwells, nurses operating respirators by hand, and a bucket brigade of National Guard troops hauling fuel to rooftop generators in a vain attempt to keep the electricity on.

Both hospitals, NYU Langone Medical Center and Bellevue Hospital Center, were still trying to figure out exactly what led to the power failures Thursday, but the culprit appeared to be the most common type of flood damage there is: water in the basement.

While both hospitals put their generators on high floors where they could be protected in a flood, other critical components of the backup power system, such as fuel pumps and tanks, remained in basements just a block from the East River.

Both hospitals had fortified that equipment against floods within the past few years, but the water — which rushed with tremendous force — found a way in.

"This reveals to me that we have to be much more imaginative and detail-oriented in our planning to make sure hospitals are as resilient as they need to be," said Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University's Mailman School of Public Health.

The problem of unreliable backup electricity at hospitals is nothing new.

Over the first six months of the year, 23 percent of the hospitals inspected by the Joint Commission, a health care facility accreditation group, were found to be out of compliance with standards for backup power and lighting, according to a spokesman.

Power failures crippled New Orleans hospitals after Hurricane Katrina. The backup generator failed at a hospital in Stafford Springs, Conn., after the remnants of Hurricane Irene blew through the state in 2011. Hospitals in Houston were crippled when Tropical Storm Allison flooded their basements and knocked out electrical equipment in 2001.

When the Northeast was hit with a crippling blackout in 2003, the backup power at several of New York City's hospitals failed or performed poorly. Generators malfunctioned or overheated. Fuel ran out too quickly. Even where the backup systems worked, they provided electricity to only some parts of the hospital and left others in the dark.

Afterward, a mayoral task force recommended upgrading testing standards for generators and requiring backup plans for blood banks and health care facilities that provide dialysis treatment.

Alan Aviles, president of New York City's Health and Hospitals Corp., which operates Bellevue, said that after a scare last summer when Hurricane Irene threatened to cause flooding, Bellevue put its basement-level fuel pumps in flood-resistant chambers.

It still isn't clear whether water breached those defenses, but when an estimated 17 million gallons of water rushed through loading docks and into the hospital's 1-million-square-foot basement, the fuel feed to the generators stopped working. The floodwaters also knocked out the hospital's elevators.

For two days, National Guardsmen carried fuel to the generators, but conditions inside the hospital for patients and staff deteriorated anyway. The generators were designed to supply only 30 percent of the usual electrical load at the hospital, leaving a lot of equipment and labs hobbled. The hospital also lost all water pressure on Tuesday. Nearly 700 patients had been evacuated by Thursday afternoon.

"The precautions we had taken to date had served us well," Aviles said. "But Mother Nature can always up the stakes."

NYU Langone Medical Center had also tried to armor itself against floods.

All seven of the generators providing backup power to the parts of the hospital involved in patient care are only a few years old and are on higher floors. The fuel tank is in a watertight vault. New fuel pumps were installed just this year in a pump house upgraded to withstand a high flood, said the hospital's vice president of facilities operation, Richard Cohen.

"The medical center invested quite a bit of money to upgrade the facility," he said.

The pump house remained "bone dry," Cohen said. But water shoved aside plastic and plywood defenses and infiltrated the fuel vault, where sensors detected the potentially damaging liquid and shut the generators down. "The force of the surge that came in was unbelievable. It dislodged our additional protection and caused a breach of the vault as well," Cohen said.

The power at NYU went out in a flash, leaving the staff scrambling to evacuate 300 patients with no notice.

Dr. Robert Berg, an obstetrician, said that when he lost power in his apartment, he went to the hospital to charge his cellphone and was stunned to find it in chaos.

"It didn't really occur to me that the hospital was going to be in trouble," he said. Even after finding the lobby dark, "I thought, 'We'll have power upstairs. We're an operating room.'"

He wound up carrying two patients down flights of stairs on a "med sled."

"There was a Category 1 outside and a Category 4 inside," he said. "I can't say that they were very well prepared for it."

That has left only one hospital, Beth Israel Medical Center, functioning in the southern third of Manhattan. It is also on backup power, but brought in two huge new generators Thursday, just in case.

Aviles said Bellevue might be out of commission for at least two more weeks. NYU Langone's generators are operating again, but the hospital is waiting for Consolidated Edison to restore its power before it starts taking patients again. That could happen in a matter of days.

Flooding may pose less of a danger to the hospital's power supply in the future. Construction is under way on a new power plant, at a cost of more than $200 million, that will run on natural gas and supply all the hospital's power needs.

"It's a tremendous facility, with a lot of hardening built into it," Cohen said.

___

AP Medical Writer Mike Stobbe contributed to this report.

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