Courtney Lopez: Gia Thinks Our Dog Is Having a Baby

Mom & Babies
Celebrity Baby Blog

02/22/2013 at 01:00 PM ET

Denise Truscello/Wireimage

Mario Lopez is a man of his word.

Following a December wedding, the EXTRA host declared he and wife Courtney would get to work expanding their family immediately — and he wasn’t kidding.

In January, the couple discovered they were indeed expecting.

“Mario and I are so excited to add to our family! I found out a month ago and surprised Mario with the good news at breakfast,” Courtney tells PEOPLE.

But the proud parents aren’t the only ones gearing up for a new addition. Big sister Gia Francesca, 2, already has babies on the brain.

“Gia kind of understands that there is a baby in my belly,” Courtney notes. “She also told me our dog Julio has a baby in his belly — so who knows!”

Despite a bumpy start — “I had a rough couple of weeks when I first found out,” she shares — the mom-to-be is feeling better and already sporting quite the blossoming belly. “I am showing so much faster this time around,” she says.

And with warmer weather on the way, Courtney will be swathing her bump in floor-length frocks — but plans on forgoing a few fashion ensembles from her past.

“I love being pregnant in the summer! I live in maxi dresses,” she says. “Looking back at my first pregnancy, there are certain things that I wore and I have no idea why. I looked horrible and I won’t do that again!”

Originally from Pittsburgh, the expectant mama is thrilled to have settled down with her growing family on the West Coast. Her only wish? That her children will one day enjoy a winter wonderland.

“I don’t miss the East Coast at all — especially the humidity,” she explains. “The one thing I do want my children to experience from an early age is snow. There is nothing like being a kid playing in the snow.”

– Anya Leon

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FDA approves new targeted breast cancer drug

WASHINGTON (AP) — The Food and Drug Administration has approved a first-of-a-kind breast cancer medication that targets tumor cells while sparing healthy ones.

The drug Kadcyla from Roche combines the established drug Herceptin with a powerful chemotherapy drug and a third chemical linking the medicines together. The chemical keeps the cocktail intact until it binds to a cancer cell, delivering a potent dose of anti-tumor poison.

Cancer researchers say the drug is an important step forward because it delivers more medication while reducing the unpleasant side effects of chemotherapy.

"This antibody goes seeking out the tumor cells, gets internalized and then explodes them from within. So it's very kind and gentle on the patients — there's no hair loss, no nausea, no vomiting," said Dr. Melody Cobleigh of Rush University Medical Center. "It's a revolutionary way of treating cancer."

Cobleigh helped conduct the key studies of the drug at the Chicago facility.

The FDA approved the new treatment for about 20 percent of breast cancer patients with a form of the disease that is typically more aggressive and less responsive to hormone therapy. These patients have tumors that overproduce a protein known as HER-2. Breast cancer is the second most deadly form of cancer in U.S. women, and is expected to kill more than 39,000 Americans this year, according to the National Cancer Institute.

The approval will help Roche's Genentech unit build on the blockbuster success of Herceptin, which has long dominated the breast cancer marketplace. The drug had sales of roughly $6 billion last year.

Genentech said Friday that Kadcyla will cost $9,800 per month, compared to $4,500 per month for regular Herceptin. The company estimates a full course of Kadcyla, about nine months of medicine, will cost $94,000.

FDA scientists said they approved the drug based on company studies showing Kadcyla delayed the progression of breast cancer by several months. Researchers reported last year that patients treated with the drug lived 9.6 months before death or the spread of their disease, compared with a little more than six months for patients treated with two other standard drugs, Tykerb and Xeloda.

Overall, patients taking Kadcyla lived about 2.6 years, compared with 2 years for patients taking the other drugs.

FDA specifically approved the drug for patients with advanced breast cancer who have already been treated with Herceptin and taxane, a widely used chemotherapy drug. Doctors are not required to follow FDA prescribing guidelines, and cancer researchers say the drug could have great potential in patients with earlier forms of breast cancer

Kadcyla will carry a boxed warning, the most severe type, alerting doctors and patients that the drug can cause liver toxicity, heart problems and potentially death. The drug can also cause severe birth defects and should not be used by pregnant women.

Kadcyla was developed by South San Francisco-based Genentech using drug-binding technology licensed from Waltham, Mass.-based ImmunoGen. The company developed the chemical that keeps the drug cocktail together and is scheduled to receive a $10.5 million payment from Genentech on the FDA decision. The company will also receive additional royalties on the drug's sales.

Shares of ImmunoGen Inc. rose 2 cents to $14.32 in afternoon trading. The stock has ttraded in a 52-wek range of $10.85 to $18.10.

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Bell jury is handed the fates of six onetime civic leaders

Before jurors left the courtroom to deliberate, the prosecutor took a final shot at the six former City Council members accused of corruption.

"The one-percenters of Bell," he called them, a band of small-town politicians who had "apparently forgotten who they are and where they live."

After four weeks of testimony, a jury of seven women and five men was handed the fates of six onetime civic leaders accused of raiding the small town's treasury with huge salaries.

Jurors now must decide whether it was legal for Luis Artiga, Victor Bello, George Cole, Oscar Hernandez, Teresa Jacobo and George Mirabal to receive salaries as high as $100,000 a year, spiked by pay for serving on city boards that the prosecution insisted seldom met and did little work.

If convicted, the former officials — one a preacher in town, another a retired steelworker — could be sentenced to prison.

The huge salaries in Bell were exposed in 2010, an era when the town's finances were sagging, workers were being cut from the city payroll and a long-promised sports park remained fenced off.

While the prosecution cast the six as thieves who thought more of their own wallets than their constituents' needs, defense attorneys argued their clients were tireless advocates in a town that had been forced to weather the misdeeds of a scheming, ruthless city manager.

They stressed to jurors that the prosecution failed to prove criminal negligence — that their clients knew what they were doing was wrong or that a reasonable person should have known.

Throughout the trial, the defense maintained that their clients relied on experts to tell them if their salaries were illegal. Stanley L. Friedman pointed out that his client, Hernandez, had only an elementary school education and was elected for his heart, not his intellect.

"There's a lot of elected officials who we have quite a bit of respect for who maybe, maybe, weren't the most scholarly," Hernandez said, mentioning former Gov. Arnold Schwarzenegger.

Cole, Jacobo and Mirabal, the only defendants to take the stand, said independent auditors and former City Atty. Edward Lee never raised concerns about their paychecks. Although Lee was on the prosecution's witness list, neither side called him to the stand.

The defense pinned much of the blame on a culture where City Administrator Robert Rizzo ruled with a strong hand, drafting resolutions for salary increases and manipulating council members to take city money. Cole testified that he voted in 2008 for a 12% annual pay raise because he feared Rizzo would gut the community programs he helped develop.

"We're here for Mr. Rizzo's sins," said defense attorney George Mgdesyan.

His client, Artiga, a pastor at Bell Community Church, said people around the country were praying for him. "I believe God already has set in motion that I will be found not guilty," said Artiga, who days before his arrest described his bountiful salary as "a trap from the devil."

At the center of much of the trial was Bell's charter, which was passed in a 2005 special election in which fewer than 400 people voted. The charter allowed Bell greater flexibility in governing itself than if it had remained a general law city.

However, Miller argued that the charter limited council members' annual pay to what state law dictated a city of a similar size could receive. That amount — $8,076 — was paid to Lorenzo Velez, the lone sitting council member in 2010 who was not charged with a crime. Velez said he was unaware how much his colleagues were making until the salaries were revealed by The Times.

Velez's salary, as well as the council's refusal to answer a resident who asked during a 2008 meeting how much they were being paid, was proof that defendants knew their pay was illegal, Miller said.

"They knew they were in trouble," he said.

The defense insisted that the charter allowed their clients to be paid extra for city boards, such as the Surplus Property Authority, and that those raises were voted on in open session.

Defense attorneys also urged jurors to take into consideration the character of their clients, who multiple witnesses had testified were so dedicated to their community that they often put residents ahead of their own family.

Miller cautioned that a person who is well-liked can still commit a crime.

"A liquor store robber's weapon is a gun," he said. "The weapon of the white-collar criminal is the trust he or she has gained over a number of years that allows them to occupy positions of elevated trust where they can steal a large amount of money."

corina.knoll@latimes.com

jeff.gottlieb@latimes.com

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India Ink: Classes Warfare

NEW DELHI — It was a widely awaited verdict: Tens of thousands of parents seeking admission for their children to nursery schools in New Delhi were hoping for some remedy against a system that rewards inherited privilege and access to political power. But the High Court of Delhi upheld the status quo on Tuesday.

Most parents have little or no choice over which school their children will attend.

Two years ago the India blog for The Wall Street Journal ran a piece entitled “Delhi’s Nursery Schools Still Tougher to Crack Than Harvard?” The catchy headline was only partly true: New Delhi’s top private nursery schools are perhaps as competitive as an Ivy League college, but that’s not saying much about the means required to get in.

I should know: I spent the last month filling in application forms to 10 private schools for my three-year-old son, and he wasn’t admitted to any.

The Indian public school system is too dysfunctional to be a serious choice for most middle-class parents. As a result, the total number of applicants to the top 20 private nursery schools in New Delhi is well over 50,000 for about 1,500 slots. (This is my rough estimate.) Most parents have little or no choice over which school their children will attend. Rather, the question is which school, if any, will admit their children.

A few years ago, worried about the growing pressure to which children no more than four years of age were being subjected, the city government forbade entrance exams and interviews for nursery schools, as well as the screening of parents’ educational background. Before then, New Delhi schools openly sought out candidates whose parents were affluent, spoke English fluently and mattered in the city’s power hierarchy. A privileged class kept replicating itself.

In theory, the new norms suggested a more egalitarian process: They prescribed a point system, and a lottery would be drawn among candidates who were tied. In practice, this favored the old elite. A school could attribute points to a child who lived nearby, whose siblings were pupils or whose parents were alumni. The residency requirement benefited the rich because the best schools are in affluent parts of the city, and the legacy criteria only served those already entrenched in the system.

Some schools also went out of their way to bypass the law by creating subjective criteria for assigning points to applicants. One top school I sent an application to has a special category for the “Promotion of Indian heritage/Exceptional achievement/Significant inspirational work for the nation/Any other, please specify.” I have asked them to clarify what this means.

The new norms also created two sets of restricted seats. All schools were required to set aside 25 percent of seats for students from poor families, which in New Delhi are defined as having annual incomes of less than $2,500. Perhaps to compensate for the attending monetary loss — poorer students pay reduced fees — the city government also allowed schools to allot 20 percent of the total seats under a management quota free of any regulation.

While I have had no direct access to any school official who decides on such quotas, anecdotal evidence I’ve gleaned from other parents suggests that some schools are trading admission for donations of $40,000 or more — unless, of course, applicants are backed by ministers or powerful bureaucrats. Even schools that are less sought-after are asking between $2,000 and $3,000 just to register students who have been admitted. No receipts are being issued.

The Indian middle class, especially in a city like New Delhi, is a substantial and growing presence. But very few of its members have the means or the connections to secure seats in good schools for their children.

The new admissions system is only a pretense at nondiscrimination. As much as the old, it ensures that rich or well-connected Indians will continue to corner most seats in the country’s top schools.

---

Hartosh Singh Bal is political editor of Open Magazine and co-author of “A Certain Ambiguity.’’

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American Idol: Sudden-Death Round Begins for Men

TV Watch

By Steve Helling

02/21/2013 at 11:00 PM EST

From left: Randy Jackson, Mariah Carey, Ryan Seacrest, Nicki Minaj and Keith Urban

George Holz/FOX

On Wednesday, 10 women sang for five spots on American Idol's live shows. On Thursday, it was the remaining guys' turn.

The judges have their own euphemisms when they don't like a performance – it's usually easy to read between the lines: If they compliment a singer on his shoes, he won't advance. On Thursday, Nicki Minaj actually told a contestant, "Kudos to you for being really freshly, nicely groomed." They might as well have had a stagehand pull him offstage with an oversized vaudeville hook.

After several weeks of good behavior by the judges, Thursday's episode showed a spark of life when Nicki – who was wearing her very best Jan Brady wig – began rolling her eyes whenever Randy Jackson spoke. At one point, Ryan Seacrest even tried to get them to kiss and make up. There was talk about lipstick, and Mariah Carey did her best to look at anything other than the awkward air kiss that followed.

But the theatrics did not eclipsed some solid singers – and a few performances that just weren't good enough for the competition.

The Good: Curtis Finch Jr. wowed judges with his version of Luther Vandross's "Superstar." It was oversung. But there was no denying Finch's vocal talent. Charlie Askew's rendition of Elton John's "Rocketman" was interesting and well-suited to his voice. And Devin Velez pleased the crowd when he infused Spanish lyrics into Beyoncé's "Listen." The three of them advanced easily.

The Okay: Elijah Liu chose Bruno Mars's "Talking to the Moon," a song that felt current and new. Paul Jolley sang Keith Urban's "Tonight I'm Gonna Cry." Generally, it's a risky move to sing a song made popular by one of the judges, but Jolley's performance was pleasant, if a little shaky. Both advanced, although the judges were split on their assessment of Jolley.

The Others: Johnny Keiser, Kevin Harris, Chris Watson and Jimmy Smith sang unspectacular versions of various songs that everyone knows. Each of them had a decent voice, but none of their performances were all that unique, and none of them advanced. On the other side of the spectrum, J'DA performed an over-the-top rendition of Adele's "Rumor Has It." It wasn't enough for him to advance, but his performance – at one point he collapsed on the floor but continued singing – was by far the most memorable of the night.

There are ten contestants – five men and five women – who have made it to the next round. Next week, the remaining 20 contestants will complete for the remaining 10 spots – and all will hope the judges don't compliment what they're wearing.

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APNewsBreak: Govs to hear Oregon health care plan

SALEM, Ore. (AP) — Oregon Gov. John Kitzhaber will brief other state leaders this weekend on his plan to lower Medicaid costs, touting an overhaul that President Barack Obama highlighted in his State of the Union address for its potential to lower the deficit even as health care expenses climb.

The Oregon Democrat leaves for Washington, D.C., on Friday to pitch his plan that changes the way doctors and hospitals are paid and improves health care coordination for low income residents so that treatable medical problems don't grow in severity or expense.

Kitzhaber says his goal is to win over a handful of other governors from each party.

"I think the politics have been dialed down a couple of notches, and now people are willing to sit down and talk about how we can solve the problem" of rising health care costs, Kitzhaber told The Associated Press in a recent interview.

Kitzhaber introduced the plan in 2011 in the face of a severe state budget deficit, and he's been talking for two years about expanding the initiative beyond his state. Now, it seems he's found people ready to listen.

Hospital executives from Alabama visited Oregon last month to learn about the effort. And the U.S. Department of Health and Human Services announced Thursday that it's giving Oregon a $45 million grant to help spread the changes beyond the Medicaid population and share information with other states, making it one of only six states to earn a State Innovation Model grant.

Kitzhaber will address his counterparts at a meeting of the National Governors Association. His talk isn't scheduled on the official agenda, but a spokeswoman confirmed that Kitzhaber is expected to present.

"The governors love what they call stealing from one another — taking the good ideas and the successes of their colleagues and trying to figure out how to apply that in their home state," said Matt Salo, director of the National Association of Medicaid Directors.

There's been "huge interest" among other states in Oregon's health overhaul, Salo said, not because the concepts are brand new, but because the state managed to avoid pitfalls that often block health system changes.

Kitzhaber persuaded state lawmakers to redesign the system of delivering and paying for health care under Medicaid, creating incentives for providers to coordinate patient care and prevent avoidable emergency room visits. He has long complained that the current financial incentives encourage volume over quality, driving costs up without making people healthier.

Obama, in his State of the Union address this month, suggested that changes such as Oregon's could be part of a long-term strategy to lower the federal debt by reigning in the growing cost of federally funded health care.

"We'll bring down costs by changing the way our government pays for Medicare, because our medical bills shouldn't be based on the number of tests ordered or days spent in the hospital — they should be based on the quality of care that our seniors receive," Obama said.

The Obama administration has invested in the program, putting up $1.9 billion to keep Oregon's Medicaid program afloat over the next five years while providers make the transition to new business models and incorporate new staff and technology.

In exchange, though, the state has agreed to lower per-capita health care cost inflation by 2 percentage points without affecting quality.

The Medicaid system is unique in each state, and Kitzhaber isn't suggesting that other states should adopt Oregon's specific approach, said Mike Bonetto, Kitzhaber's health care policy adviser. Rather, he wants governors to buy into the broad concept that the delivery system and payment models need to change.

That's not a new theory. But Oregon has shown that under the right circumstances massive changes to deeply entrenched business models can gain wide support.

What Oregon can't yet show is proof the idea is working — that it's lowering costs without squeezing on the quality or availability of care. The state is just finishing compiling baseline data that will be used as a basis of comparison.

One factor driving the Obama administration's interest in Oregon's success is the president's health care overhaul. Under the Affordable Care Act, millions more Americans will join the Medicaid rolls after Jan. 1, and the health care system will have to be able to absorb the influx of patients in a logistically and financially sustainable way.

The federal government will pay 100 percent of the costs for those additional patients in the first three years before scaling back to 90 percent in 2020 and beyond.

"There are a lot of governors who are facing the same challenges we're facing in Oregon," Kitzhaber said. "They recognize that the cost of health care is something they're going to have to get their arms around."

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Garcetti and Greuel in duel for funds

Wendy Greuel and Eric Garcetti remain locked in a tight fundraising battle, with the front-runners in Los Angeles' mayoral contest each raising just under a half-million dollars in recent weeks and both showing ample cash reserves to wage a vigorous effort in the closing days of the primary campaign, according to disclosure reports filed with the City Ethics Commission on Thursday.

Greuel has a razor-blade edge — the city controller raised $473,582 and spent more than $1.7 million in the latest reporting period between Jan. 20 and Feb. 16. She enters the final days before the March 5 contest with nearly $1.7 million cash on hand, according to the reports.

Noting that nearly three-quarters of her recent contributions came from first-time donors and more than half were from contributors who gave $250 and under, Greuel said the figures signified the momentum behind her campaign.

"It's amazing that so many Angelenos from every corner of the city are coming together to join our grassroots campaign," Greuel said in a statement. "In this election, we can fight together to change our city. We can build a stronger economy that creates jobs, a seamless public transportation system and better schools. We can crack down on waste in government so Angelenos can get the services they deserve. Today's report shows that people across L.A. are joining together to make this vision a reality."

Greuel's main rival, City Councilman Garcetti, raised $452,819 and spent nearly $2.5 million during the same time frame, ending the filing period with $1.5 million cash on hand, according to campaign filings. He noted that with more than 10,000 donors, he leads the field in grassroots support.

"I'm proud that our campaign's momentum is growing every day as more people learn about my plans to create jobs and solve problems for L.A. residents," Garcetti said in a statement. "You can see our grassroots strength through our fundraising, our energized volunteer corps and our thriving online network."

Overall, fundraising by the mayoral candidates has topped $11 million. Greuel and Garcetti are saturating the television and radio airwaves and have started attacking one another in voters' mailboxes. They have been fairly even in their fundraising efforts for many months, allowing them both to run a robust advertising campaign. But while Garcetti spent more during the filing period, Greuel has a steep advantage in outside efforts on her behalf. Of the $1.7 million spent by independent committees, more than $1.2 million has been spent to boost her bid, largely by labor.

Voters typically only see the candidates' ads and mailers, or clips of them on the nightly news. Under the radar, the candidates are spending significant time raising the kind of money it takes to campaign in a city as sprawling as Los Angeles. On Wednesday night, Garcetti held a fundraiser at the Petersen Automotive Museum with some of the city's hottest chefs — turning out a young and stylish crowd who sampled craft beers and delicacies such as braised and crispy pork with salted oats, house mostarda and toasted broccoli. On the same night, Greuel held a fundraiser with U.S. Sen. Barbara Boxer (D-Calif.) at the Beverly Hills manse of billionaire media mogul Haim Saban. But unlike Garcetti, her campaign did not allow the media to attend.

Greuel's ads have highlighted her efforts as controller to root out "waste, fraud and abuse" — claims her opponents say she has exaggerated. On Thursday, Garcetti launched two new 15-second ads featuring his endorsement by the Los Angeles Times. Those followed two introductory spots in English and Spanish. The councilman is spending more than $600,000 this week airing ads, according to a Democratic media consultant who is not working for any candidate. Greuel and the efforts on her behalf, which are not allowed to legally coordinate with her campaign, spent about $1.3 million in the same period, according to the media consultant.

Councilwoman Jan Perry, who has been waging a blistering mail campaign against Greuel, continues to lag behind. She raised nearly $68,000 in the filing period, and spent nearly $809,000, leaving her with less than a half-million dollars for the remainder of the race. Emanuel Pleitez, the former technology executive who has never held elected office, reported raising nearly $20,000 and spending nearly $194,000 during the period, leaving him with nearly $146,000 cash on hand.

Kevin James, the sole Republican in the race, has been the beneficiary of nearly $500,000 in outside spending. He has had difficulties raising money, but his campaign has claimed that the numbers were improving. They did not file a disclosure report by press time, but his campaign manager said James had raised $52,000 and had spent $181,000 during the filing period, leaving the former entertainment attorney with about $25,000 cash on hand.

seema.mehta@latimes.com

maeve.reston@latimes.com

Times staff writer Maloy Moore contributed to this report.

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Police Detective in Pistorius Case Faces Attempted Murder Charges

PRETORIA, South Africa — In a remarkable twist in the case of Oscar Pistorius, the double amputee track star accused of murdering his girlfriend, the South African police said on Thursday that the officer leading the investigation against the athlete is himself facing attempted murder charges.

Stephane De Sakutin/Agence France-Presse — Getty Images

Police detective Hilton Botha arrived at court for the bail hearing of Oscar Pistorius on Wednesday.

The disclosure deepened questions surrounding the detective, Hilton Botha, who, under cross-examination at a bail hearing on Wednesday, was forced to concede that he could not rule out Mr. Pistorius’s own version of events based on the existing evidence.

While the prosecution has accused Mr. Pistorius, 26, of the premeditated murder of his girlfriend Reeva Steenkamp, 29, a week ago, the track star himself said he opened fire thinking there was an intruder in his home in a gated community and had no intention of killing her.

In a development that seemed as bewildering as it was sensational on Thursday, Police Brig. Neville Malila said that Mr. Botha is himself set to appear in court in May facing attempted murder charges relating to an incident in Oct. 2011, when Mr. Botha and two other police officers were accused of firing at a minivan carrying seven people.

The case had initially been dropped but was reinstated on Wednesday at the insistence of the state prosecutor, even as Mr. Botha was appearing as the lead police witness in the prosecution’s attempt to prevent Mr. Pistorius from securing bail.

“Botha and two other policemen allegedly tried to stop a mini bus taxi with seven people. They fired shots," Brigadier Malila told Reuters.

“We were informed yesterday that the charges will be reinstated," he said. “At this stage there are no plans to take him off the Pistorius case.”

Mr. Pistorius returned to court on Thursday for further arguments about whether he should be granted bail in a case that has riveted South Africa and fascinated a wider audience, reflecting Mr. Pistorius’s status as one of the world’s most renowned athletes, whose distinctive carbon-fiber running blades have given him the nickname Blade Runner.

On Wednesday, what was supposed to be a simple bail hearing took on the proportions of a full-blown trial, with sharp questions from the presiding magistrate, Desmond Nair, and a withering cross-examination that left Detective Botha grasping for answers that did not contradict his earlier testimony.

Initially, Detective Botha explained how preliminary ballistic evidence supported the prosecution’s assertion that Mr. Pistorius had been wearing prosthetic legs when he shot at a bathroom door early on Feb. 14. Ms. Steenkamp, a model and law school graduate, was hiding behind it at the time.

Mr. Pistorius said in an affidavit read to the court on Tuesday that he had hobbled over from his bed on his stumps and had felt extremely vulnerable to a possible intruder as a result.

But when questioned by Barry Roux, Mr. Pistorius’s lawyer, Detective Botha was forced to acknowledge sloppy police work, and he eventually conceded that he could not rule out Mr. Pistorius’s version of events based on the existing evidence. Mr. Roux accused the prosecution of selectively taking “every piece of evidence” and trying “to extract the most possibly negative connotation and present it to the court.”

Lydia Polgreen reported from Pretoria, South Africa, and Alan Cowell from London.

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American Idol: Women Face Sudden-Death Round

American Idol

By Jamie Bufalino

02/20/2013 at 11:00 PM EST

Mariah Carey

Mario Anzuoni/Reuters/Landov

American Idol threw yet another new twist at its 40 remaining contestants: a sudden-death round.

"One song, one chance, no mercy," Ryan Seacrest said as the first group of 10 female contestants gathered in Las Vegas to try to finally sing their way – in front of a boisterous studio audience – through to the "America votes" phase of the competition.

Five women moved on, five went home.

Kentucky high school junior Jenny Beth Willis, whose rendition of a Trisha Yearwood song earned mixed reviews from the judges, was the first up. Although Keith Urban appreciated her "effortless confidence," Nicki Minaj said her performance lacked excitement (a comment that elicited the first audience boos of the season). Final result: It was the end of the road for Willis.

Tenna Torres, 28, – who attended Mariah Carey's camp for kids as a youngster – took the stage next and impressed the judges with her take on the Natasha Bedingfield's "Soulmate." But she lost style points with Minaj, who didn't like one particular aspect of her look. "Lose the hair," said Minaj, who felt the contestant's coif aged her. Final result: She made it through to the Top 20.

The three most powerful performances of the night all made it to the next round: Nashville's Kree Harrison, who despite taking a decidedly plain-Jane approach to styling, wowed the judges with her version of Patty Griffin's "Up to the Mountain." "You sang the hell out of that song," said Carey.

Angela Miller, 18, of Massachusetts, belted out Jessie J's hit "Nobody's Perfect." But she pretty much was.

And Amber Holcomb, an assistant teacher from Texas, closed the show with a rousing (and well received) rendition of "My Funny Valentine."

For the final spot of the night, it came down to Anchorage, Alaska, resident Adriana Latonio, 17, who tackled Aretha Franklin's "Ain't No Way," and Shubha Vedula, a Michigan high school senior who sang Lady Gaga's "Born This Way."

Although the judges saw potential in both contestants, they ultimately picked Lantonio's powerhouse vocals in a final emotional moment.

Thursday will bring out the guys. The first round of 10 will take the stage to try to make the top 20 – but once again, five will go home.

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Doc groups issue list of overused tests, therapies

WASHINGTON (AP) — Don't be afraid to question your doctor and ask, "Do I really need that?"

That's the advice from leading medical groups who came up dozens of tests and treatments that physicians too often prescribe when they shouldn't.

No worrisome stroke signs? Then don't screen a healthy person for a clogged neck artery, the family physicians say. It could lead to risky surgery for a blockage too small to matter.

Don't routinely try heartburn medicine for infants with reflux, the pediatric hospitalists say. It hasn't been proven to work in babies, and could cause side effects.

Don't try feeding tubes in people with advanced dementia, say the hospice providers. Helping them eat is a better option.

These are examples of potentially needless care that not only can waste money and time, but sometimes can harm, says the warning being issued Thursday from medical specialty groups that represent more than 350,000 doctors.

Too many people "think that more is better, that more treatment, more testing somehow results in better health care," said Dr. Glen Stream, former president of the American Academy of Family Physicians, which contributed to the list. "That really is not true."

The recommendations are part of a coalition called Choosing Wisely, formed by the American Board of Internal Medicine Foundation. Participating medical societies were asked to identify five tests or treatments that are commonly overused in their specialty. The list is aimed at doctors and includes references to published studies. Consumers Reports and other consumer groups are publicizing the information in more patient-friendly terms.

Last year, the coalition listed 45 overused tests and treatments. It included some of the best known examples, such as too much imaging for back pain and repeating colonoscopies too frequently.

This year's list adds 90 more overused kinds of care. Some are the result of doctors' habits, hard to overcome despite new evidence, Stream said. Others come about because patients demand care they think they need.

Some other examples:

—Don't use opioid painkillers for migraines except as a last resort, say the neurologists. There are better, more migraine-specific drugs available without the addictive risk of narcotics. Plus, frequent use of opioids actually can worsen migraines, a concept known as rebound headache.

—Just because a pregnant woman misses her due date, don't race to induce labor if mom and baby are doing fine, say the obstetricians. Inducing before the cervix is ready often fails, leading to an unneeded C-section. "Just being due by the calendar doesn't mean your body says you're due," Stream notes.

—Don't automatically give a child a CT scan after a minor head injury, say the pediatricians. About half of children who go to the ER with head injuries get this radiation-heavy scan, and clinical observation first could help some who don't really need a CT avoid it.

—And don't leave an implanted heart-zapping defibrillator turned on when a patient is near death, say the hospice providers. This technology clearly saves lives by guarding against an irregular heartbeat. But if someone is dying of something else, or is in the terminal stages of heart disease, it can issue repeated painful shocks, to no avail. Yet fewer than 10 percent of hospices have formal policies on when to switch off the implants.

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