Research links acute malnutrition to gut microbes

WASHINGTON: A dearth of calories may not be the only reason some children face acute malnutrition, according to a new study out this week that says the microbes living in our guts may also be to blame.

Within hunger-stricken communities, not all children fare the same. Some develop acute malnutrition, while others, even their brothers and sisters, may stay healthy.

And some children respond well to treatment -- generally a peanut-based nutrient-rich supplement -- while for others, the benefits cease when the treatment does.

To figure out why this happens, researchers studied more than 300 sets of twins in Malawi, where malnutrition is a common childhood ailment, during their first three years of life.

Among half the twin pairs, one or both twins became malnourished over the course of the study.

Even among identical twins, there were cases where one twin -- but not the other -- developed a form of malnutrition called kwashiorkor, associated with swollen bellies, liver damage, skin ulcerations and loss of appetite, in addition to wasting.

That ruled out human genetics as a factor in the disorder, since identical twins share identical genomes.

But the researchers found something else at play: the microbes in the gut that extract nutrients and calories from the diet synthesise vitamins and nutrients and help shape the immune system.

When any of the twins became malnourished, both received treatment to limit food sharing.

In the healthy twin, the gut microbes thrived with the extra food and continued to mature after the treatment ended. But in the severely malnourished twin, the gut microbes stalled out or even regressed by four weeks after the treatment ended.

The findings were further bolstered when the researchers implanted into mice the gut microbes of the healthy and malnourished twins.

Both groups of mice were fed the same diet -- one similar to the nutrient-deficient diet common in Malawi -- but the ones who were transplanted with the malnourished children's microbes dropped weight, while the others did not.

"The gut microbes of malnourished children and malnourished mice do not appear to mature along a normal, healthy trajectory," said senior author Jeffrey Gordon of Washington University's Centre for Genome Sciences and Systems Biology.

"Our results suggest we need to devise new strategies to repair gut microbial communities so these children can experience healthy growth and reach their full potential."

Gordon said the new findings could be a crucial step towards finding better treatment for severely malnourished children.

"It may be that earlier or longer treatment with existing or next-generation therapeutic foods will enhance our ability to repair or prevent the problems associated with malnutrition," he said.

"We are also exploring whether it is possible to supplement the therapeutic food with beneficial gut bacteria from healthy children, as a treatment to repair the gut microbiome," he added.

"We hope that these studies will provide a new way of understanding how the gut microbiome and food interact to affect the health and recovery of malnourished children."

Their study is to be published Thursday in the US journal "Science".

According to UNICEF, a person dies of starvation every 3.6 seconds, and most of the deaths are among children under five.

"Some 300 million children go to bed hungry every day. Of these only eight percent are victims of famine or other emergency situations. More than 90 per cent are suffering long-term malnourishment and micronutrient deficiency," the UN agency says on its website.

-AFP/fl

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'Destroyed' owner of burned club attempts suicide

STORY HIGHLIGHTS

• NEW: A lawyer for the owner blames the fire department


• The club owner who attempted suicide is "emotionally destroyed," police say


• New patients are arriving at hospitals with respiratory symptoms


• The fire department says club was in the process of renewing its license

iReport: Are you there? Share your story.

Santa Maria, Brazil (CNN) -- One of the owners of the Brazilian nightclub that burned down this week, killing 235, tried to take his own life while in custody, police said Wednesday.

Elissandro Spohr is one of four arrested in the aftermath of Sunday's deadly blaze at the Kiss nightclub in Santa Maria, Brazil.

The suicide attempt happened while he was interned and under police guard at a hospital, where he is being treated for smoke inhalation, Santa Maria Police Chief Lylian Carus said.

While taking a shower, Spohr removed the shower hose and tied it to a window, but police discovered him before he placed the other end around his neck, Carus said.

"Everything indicates he was going to commit suicide by hanging," she said. "He's emotionally destroyed."

The residents of Santa Maria, in southern Brazil, have also suffered an emotional toll from the tragedy.

Opinon: We haven't learned from past mistakes

It seems to be all that people in the town talk about, and protestors have taken to the streets demanding justice.

In addition to Spohr, police arrested another owner of the club, Mauro Hoffman. Also in custody are the vocalist for the band performing that night, Marcelo de Jesus dos Santos, and show producer Luciano Bonilha.

During their performance, the band Gurizada Fandangueira used pyrotechnics that they knew were for outdoor use only, police have said. They opted to buy this particular firework because it was cheaper than the indoor-use kind, police said.

Kiss was filled well beyond its legal capacity with the crowd of 2,000 people, who packed the club to hear the band play.

When the pyrotechnics were set off, the ceiling caught fire, state officials said, and the flames spread quickly.

The crowd panicked, breaking into a stampede, and it hit a bottleneck -- the only exit was the front door, down a dark, narrow hallway.

More than 100 of the victims were students at the local Federal University of Santa Maria, the school said.

In addition to the ongoing criminal investigation, Santa Maria's public prosecutor announced that there will be a separate investigation to establish civil liability.

"The introduction of the civil investigation allows us to request documents and produce evidence to establish that kind of responsibility," public prosecutor Cesar Carlan said, according to state media. "We are, at this moment, watching the police work, where the evidence produced will be useful for our own inquiry."

Eerie sounds of cell phones amid disaster

New patients

In the days after the fire, about 20 more people who were at the club sought health services because of symptoms such as tiredness and breathlessness, Brazil's state-run Agencia Brasil news agency reported.

These new patients were hospitalized for observation and may require breathing aids.

Some 82 people remained in intensive care units, with 75 in critical condition, health officials said.

Club was renewing its license

Investigators said they found evidence of faulty and fake fire extinguishers at the club, which had expired fire and municipal licenses. The club's original license permitted just 691 people inside.

However, fire officials said that because the club was in the process of renewing its license, it was not required to be shut down.

Last September, the fire department notified the owners of the club about their expired permit, and in November, the club requested inspection for a renewal, fire official Sergio Roberto de Abreu said, according to Agencia Brasil.

The renewal request was pending at the time of the fire.

A lawyer for Spohr, the owner, not only said the club was operating legally, but also blamed the fire department for the mass casualties.

"It was a disastrous and poor operation by the fire department," attorney Jader Marques said, according to Agencia Brasil.

The firefighters weren't wearing proper masks and lacked proper equipment, he said. "Worse than that, the firefighters, feeling powerless, used civilians" to assist in the rescue.

Deadly blazes: Nightclub tragedies in recent history

Shasta Darlington reported from Santa Maria, and Mariano Castillo and Umaro Djau from Atlanta. CNN's Helena de Moura contributed from Santa Maria

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Obama: "No doubt" Congress will pass immigration, gun bills

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Obama: "No doubt" gun, immigration bills will pass in coming months

There's more bipartisan support in Congress for comprehensive immigration reform than gun control legislation, President Obama said tonight during an interview with Univision, but qualified that even under his proposal, illegal immigrants shouldn't be harboring expectations that they'll be granted citizenship "manana."

"Even under our proposal, this is not a situation where overnight, suddenly people all find themselves as citizens," Mr. Obama told the Spanish-language television network. "They're going to have to go to the back of the line. We're going to have to clear out the existing line, backlogs we have in terms of illegal immigrants, because they did it the right way. We shouldn't punish them for breaking the law.

"...What we don't want to do is to create some vague prospect in the future that somehow comprehensive immigration reform that includes a pathway to citizenship will happen manana," he continued, chuckling softly at the somewhat awkward injection of the Spanish word for "tomorrow." "But we have to put that in place at the outset, and make sure people are clear that this pathway is real and not just a fantasy for the future."

Asked whether he was in a standoff with Sen. Marco Rubio, R-Fla., the son of Cuban immigrants who has said he will not support a bill that does not put border control ahead of a path to citizenship, Mr. Obama said no, but pointed out that the number of people crossing the border illegally has dropped "about 80 percent since 2000."

On Tuesday, the president delivered a speech in Las Vegas outlining his immigration plan and applauding a bipartisan group of eight senators that has offered up proposals as well. In an interview today with another Spanish language network, Telemundo, he specified that he's hoping immigration reform that includes a pathway to citizenship can be passed in the next six months, but "certainly this year."

Meanwhile, despite facing more resistance from the right on tightening gun laws, he said he has "no doubt" that Congress will be able to put through legislation on gun control, as well as immigration.

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Obama: Legalization for illegal immigrants won't happen "ma?ana"

"On the gun issue, you're starting to see gun owners, people who traditionally have opposed gun control, saying, 'You know what, when 20 of our children are shot by somebody who is disturbed, and when it is that easy to get these high-clip magazines that can fire off hundreds of shots in a few minutes, then it's time for us to do better job on background checks, to get control of these magazine clips, to really crack down on gun trafficking," Mr. Obama said in the Univision interview.

The Senate Judiciary Committee today held the first congressional hearing on gun violence since last month's massacre at a Newtown, Conn., elementary school, that left 20 children and six adults dead. Star witnesses included former Rep. Gabrielle Giffords, D-Ariz., who survived a shot to the head two years ago during an assassination attempt that left six people dead, and her husband on one side, and NRA CEO Wayne LaPierre on the other.

Both gun control and immigration "will end up generating some opposition," the president said. "There will be passions on both sides. But I'm generally encouraged that the Senate seems to be having a serious conversation about these issues."

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Obama Confident Immigration Reform Will Pass

President Barack Obama expressed confidence on Wednesday that he would sign comprehensive immigration reform into law by the end of this year.

In an interview with Univision's Maria Elena Salinas, Obama explained that significant details of a bill still must be worked out by lawmakers, including the structure of a pathway to citizenship for many of the 11 million undocumented immigrants. But Obama said that the progress made by a bipartisan group of lawmakers in the Senate has given him hope that a deal can get done.

See Also: What Will Be Obama's Immigration Legacy?

When asked by Salinas if we will have immigration reform by the end of the year, Obama said, "I believe so."

"You can tell our audience, 'Sí, se puede?'" Salinas asked.

"Sí, se puede," Obama responded.

Later in the interview, Obama said that he hopes a bill could be passed as early as this summer.

But cognizant of deep divisions a topic like immigration has sewn in the past, Obama said that's contingent on bipartisan negotiations continuing to proceed well.

"The only way this is going to get done is if the Republicans continue to work with Democrats in Congress, in both chambers, to get a bill to my desk," he said. "And I'm going to keep on pushing as hard as I can. I believe that the mood is right."

Although the president threatened to introduce his own bill if negotiations in Congress stall during his speech in Las Vegas, Nevada, on Tuesday, he said he is content to let lawmakers hash out the details among themselves for the time being.

"If they are on a path as they have already said, where they want to get a bill done by March, then I think that's a reasonable timeline and I think we can get that done. I'm not going to lay down a particular date because I want to give them a little room to debate," he said. "If it slips a week, that's one thing. If it starts slipping three months, that's a problem."

The president's principles and the Senate's principles on immigration broadly align with one another, but there are still thorny issues that could spark a division between Obama and Republicans, such as the pathway to citizenship.

The Senate's path to citizenship would allow many undocumented immigrants to obtain legal status immediately upon passage of the law. But their ability to then seek legal permanent residency would be contingent upon the U.S.-Mexico border being deemed secure. Sen. Marco Rubio (R-Fla.), a member of the bipartisan "Gang of Eight" on immigration, has been particularly vocal in stating that border security is a precondition for gaining legal permanent residence, and then citizenship.

While the White House has said that it is withholding judgment on that plan until actual legislative language is drafted, Obama said that he wants a bill that makes it clear from the outset that undocumented immigrants eligible to earn their way to citizenship can eventually obtain it.

"What we don't want to do is create some kind of vague prospect in the future that somehow comprehensive immigration reform that includes a pathway to citizenship will happen, you know, mañana," Obama said. "We want to make sure we are very clear this legislation provides a real pathway."

The president said that enhancing border security measures and workplace enforcement provisions are a part of his plan, as well as the Senate's, and cited his administration's efforts to bulk up border security during the past four years, saying that illegal crossings have dropped 80 percent since 2000.

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Is the U.S. getting Egypt wrong again?

Egyptian riot police stand guard as people protest against Egypt's President Mohamed Morsy in Cairo on December 29, 2012.

STORY HIGHLIGHTS

• National protests against Morsy set for second anniversary of Egypt's revolution


• Cynthia Schneider: U.S. out of step, underestimates the anti-Morsy sentiment


• She says proponents of secular democracy think the U.S. backs Muslim Brotherhood


• She says massive protests will show U.S. needs to align itself with the popular will

Editor's note: Cynthia Schneider is a professor in the practice of diplomacy at Georgetown University; dean at the School of Diplomacy, Dubrovnik International University; and a senior nonresident fellow at Brookings Institution. She is also a former U.S. ambassador to the Netherlands.

(CNN) -- Protests planned around Egypt -- particularly in Cairo's Tahrir Square -- on the second anniversary of the January 25 revolution are expected to be an explosion of dissent, revealing the deep divisions in the country between President Mohamed Morsy and the Egyptian people.

Opposition to Morsy's authoritarianism is broader than the world recognizes. In making accommodations for Morsy's government, the United States is -- once again -- out of step with the Egyptian people.

Cynthia P. Schneider

Egyptians may not know exactly what they want, but they know what they don't want. Although an effective political opposition has yet to coalesce, Egyptians from all sectors of society are united in their refusal to accept another repressive regime.

Egypt is on a collision course. An ever growing, if periodically discouraged, portion of the population opposes the government and Morsy's Muslim Brotherhood, and supports the revolution's goals of social and economic justice, accountable government, and basic freedoms, including freedom of expression and protection of minorities. Yet the government is moving in exactly the opposite direction, with its authoritarian control over political, social, and religious life.

The government's investigation of the wildly popular "Egyptian Jon Stewart" Bassem Youssef -- charged with insulting Morsy and undermining his command -- and the forced "retirement" of respected journalist Hani Shukrallah, editor of state-owned Al-Ahram's English-language website, are just two very public examples of the vice tightening on freedom of expression.

In fact, the Arab Network for Human Rights says about 24 lawsuits for insulting Morsy have been filed against journalists and activists since his election in June.

The regime is trying to put the revolution genie back in the bottle. But it is clamping down on a population that has discovered its voice. In opposition to this repression, Egyptians at all levels are increasingly engaged in politics.

A Cairo cab driver -- ever the measure of popular sentiment -- recently debated the failings of the Constitution with a passenger. After reaching the destination, the driver leapt out, grabbed a dogeared copy of the Constitution he kept in the front seat, and pointed to a passage to prove his point to his passenger.

The December demonstrations against President Morsy and the Muslim Brotherhood-backed Constitution, which attracted an even broader segment of the population than those who stood in Tahrir Square in 2011, revealed the broadening chasm between the regime and the people in Egypt.

Assembled outside the Presidential Palace were old and young, veiled and unveiled, rich and poor. Whether they arrived in chauffeur-driven cars or whether they marched from Cairo's outlying shantytowns, the hundreds of thousands joined together in their refusal to accept a state that squashed the dreams of the revolution and dictated political, social, and religious behavior.

Many call the second wave of the revolution in the fall of 2012 the "Mothers' Revolution." Parents and grandparents went into the streets to protest the divided loyalties in their families between the Islamists (Brotherhood or Salafis) and those supporting a democratic, secular Egypt. In Egypt, secular means freedom from state control of religion, not nonreligious.

The clash between these two visions of Egypt -- secular with freedom and social justice, or a religious state run by the Brotherhood with its version of Sharia law -- played out inside families and on the streets.

Soldiers protecting the Presidential Palace during the December demonstrations were moved to tears when an Egyptian woman, referring to Morsy, shouted at them, "Why are you protecting this man who is pitting Egyptians against each other?"

Mohamed El Gindy, a successful businessman who opposes Morsy and spent much of December camping in Tahrir with the young revolutionaries, has experienced this division within families firsthand. A relative who had joined the Salafis informed him that the extreme Islamist group had put El Gindy at No. 5 on its "hit list," which is widely believed by Egyptians to exist. The relative was unapologetic until El Gindy told him that he might as well put El Gindy's mother on the list, too, since the octogenarian also had joined the street protests.

Egypt and its families may be divided, but on one subject, all are united -- in the belief that the United States is supporting the Muslim Brotherhood-dominated government.

Visible in the throngs at the December demonstrations were signs opposing Qatar and the United States -- yes, the U.S. and Qatar were lumped together as supporters of the Muslim Brotherhood regime.

"This is such a historic opportunity to restore the image of the U.S., but instead it is putting itself in the same position as Qatar. ... And this from President Obama -- so disappointing," Riham Bahi, a professor at American University in Cairo, said, reflecting views heard repeatedly last December in Egypt.

Opposition leader and blogger Bassem Sabry was even more blunt: "With the Constitution in play, you are subsidizing an Islamist state." Sabry said he was always pro-U.S. "until the revolution."

In addition, the Pentagon plans to proceed with the delivery of 20 F-16 jets to Egypt, a step that looks to Egyptians like a vote of confidence in Morsy. Unchanged since the revolution, U.S. aid policy toward Egypt still makes the military alliance its priority.

Two years after the Egyptian Revolution, the U.S. government finds itself again backing an authoritarian regime against the popular will. As January 25 approaches, with massive protests planned against Morsy's government, this is a precarious position for both the U.S. and Egypt.

In his second term, Obama should adopt a more agile and informed policy toward Egypt, one that matches the words often heard from the White House -- "The United States always has stood with the Egyptian people" -- with action.

Follow @CNNOpinion on Twitter.

Join us at Facebook/CNNOpinion.

The opinions expressed in this commentary are solely those of Cynthia Schneider.

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Tibetans in India launch drive against China

NEW DELHI: The Tibetan government-in-exile in India on Tuesday announced plans for a four-day campaign to bring global pressure on China in a bid to end a string of self-immolations in their Himalayan homeland.

Penpa Tsering, speaker of the exiled Tibetan parliament based in the northern Indian town of Dharamshala, said the drive would include rallies and meetings and begin in New Delhi on Wednesday.

"The situation is getting more and more grim," Tsering said at a joint news conference with Lobsang Sangay, who in 2011 took over political duties from revered Buddhist spiritual leader, the Dalai Lama, and was named prime minister.

The two leaders said 99 Tibetans had set themselves on fire between 2009 and January 22 this year in protest against Chinese rule in Tibet. Of that number, the government-in-exile says 83 have died.

"Instead of trying to address the main causes as to why self-immolations are taking place, as to why Tibetans are protesting in various other forms, the Chinese government has resorted to a blame game," Sangay said.

The Havard-educated scholar said India, home to tens of thousands of Tibetan exiles, "ought to speak out forcefully on Tibet".

The four-day campaign will call for visits to Tibet by UN fact-finding teams and the publication of details of human rights discussions between Beijing and foreign powers, Sangay said.

He said the Tibetan government as well as the parliament, which has been based in Dharamshala since the Dalai Lama fled after a failed uprising against China in 1959, were determined to highlight "repression of Tibetans in Tibet".

Both the Dalai Lama and the prime minister have appealed to Tibetans not to resort to self-immolation.

"We are against drastic action but we must highlight it (the situation in Tibet) to the international community," Sangay said.

Many Tibetans in China accuse the government of religious repression and eroding their culture, as the country's majority Han ethnic group increasingly moves into historically Tibetan areas.

China rejects that, saying Tibetans enjoy religious freedom. Beijing also points to the huge ongoing investment that it says has brought modernisation and a better standard of living to Tibet.

-AFP/fl

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Tearful Newtown dad: No new gun laws

By David Ariosto, CNN

updated 8:09 PM EST, Tue January 29, 2013

STORY HIGHLIGHTS

• Mark Mattioli, a parent of a Sandy Hook victim, says there are more than enough gun laws


• "The time is now" to strengthen gun laws, says Veronique Pozner, another parent


• Crowd interrupts the statement of a parent of a slain child


• Connecticut has some of the nation's strictest gun laws

(CNN) -- His voice wavering, Mark Mattioli wiped away tears as he recalled the day his 6-year-old son died when a man wielding an AR-15 semi-automatic rifle broke into Sandy Hook Elementary School and began shooting.

His son, James, was among the 20 children and seven adults killed by Adam Lanza on December 14 in Newtown, Connecticut -- an event so horrific that it has since spawned a federal task force and kick-started a national conversation about gun control.

But unlike the handful of other parents who testified Monday at the emotionally charged hearing in Hartford, Connecticut, Mattioli said there are more than enough gun laws on the books. He called instead for a closer look at mental health policies.

Why new laws could miss America's bigger gun problem

"I don't care if you named it 'James' law,' I don't want (another law)," he said during the first of a series of meetings set up by a legislative task force assigned to review the state's gun laws.

Reaction to Newtown school killings

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"I think there's much more promise for a solution in identifying, researching and creating solutions along the lines of mental health."

Connecticut's medical examiner said he was told that Lanza, 20, had Asperger's syndrome. Research has not shown a link between that condition and violence.

The hearing drew hundreds to the Connecticut state house and revealed the sharp divide in public opinion over what should happen next in the massacre's aftermath.

"The time is now," said Veronique Pozner, whose son, Noah, was also killed, referring to a strengthening of the nation's gun laws.

Sandy Hook probe to extend until summer

With a framed photo of her slain 6-year-old propped up beside her, Pozner called on Connecticut to become "an agent for change" across the country.

During her testimony, she held up a crayon drawing that Noah once scrawled on Thanksgiving.

"I am thankful for the life I live," he wrote.

At one point during the hearing, Neil Heslin, father of a 6-year-old boy named Jesse who was also gunned down that day, asked why the public needed assault weapons and high-capacity magazines.

Some people in the crowd then interrupted his statement and shouted the "Second Amendment shall not be infringed."

"We're not living in the Wild West. We're not a Third World nation," Heslin continued. "We have the strongest military in the world. We don't need to defend our homes with weapons like that."

Connecticut already has some of the nation's strictest gun laws.

Gov. Dannel Malloy, a first-term Democrat, has also vowed to address the factors that led to last month's massacre and set up a 16-member panel of experts to come up with recommendations. It includes experts who reviewed policies after mass shootings in Colorado and at Virginia Tech.

The panel must meet a March 15 deadline for its initial report, which Malloy is expected to use in drafting initiatives aimed at reducing gun violence.

Newtown parents learn comforting details about son's death

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Grandson of oil tycoon T. Boone Pickens dies in Texas

Updated 8:35 PM ET

FORT WORTH, Texas A 21-year-old grandson of Texas oil tycoon T. Boone Pickens died Tuesday after being rushed to a hospital in Fort Worth, according to police and a family spokesman.

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Thomas Boone Pickens IV, who went by Ty, was a junior at Texas Christian University. Pickens' spokesman, Jay Rosser, called the death an "unspeakable family tragedy" and asked that the family be allowed to grieve in private.

Neither Rosser nor Fort Worth police have said what may have caused the death.

Officers were dispatched after getting a report of a dead person at an off-campus location around 9:30 a.m. Tuesday, police spokeswoman Cpl. Tracey Knight said. Police said Ty Pickens was transported to a hospital, where he was pronounced dead.

Knight said the Tarrant County medical examiner would determine the cause of death. She declined further comment.

T. Boone Pickens appears on "CBS This Morning," Aug. 23, 2012.

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CBS News

The elder Pickens made much of his fortune in oil drilling but has since become an advocate for alternative energy. The 84-year-old also is active in politics and has donated millions of dollars to his alma mater, Oklahoma State University, and various other causes.

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Jodi Arias Borrowed Gas Cans Before Killing Ex

Accused murderer Jodi Arias borrowed two five-gallon gas cans from a former boyfriend the day before she drove to Arizona to kill another ex, Travis Alexander, according to testimony in Arias' murder trial today.

In cross examination, prosecutors also forced Arias' former live-in boyfriend Darryl Brewer to describe his sex life with Arias as "pretty aggressive."

Brewer, 52, dated Arias for four years and shared a home with her in California for two years. He told the court today that Arias called him in May 2008, asking to borrow gas cans, but would not explain why. She called him again at least two more times, and arrived at his house on June 2008, to borrow the cans.

On the day she picked up the gas cans she told Brewer that she was going to visit friends in California and Arizona.

Prosecutors argue that Arias then drove to Mesa, Ariz., where she allegedly had sex with Alexander, took nude photos of him, and then stabbed him 27 times, slashed his throat, and shot him twice in the head. She is charged with murder and could face the death penalty if convicted.

Arias, who claims she killed Alexander in self defense, had approached prosecutors two years ago offering to plea to a second degree murder charge, which could carry a 25 year term, but the state rejected the offer, Nancy Grace reported on Good Morning America today.

Brewer said that Arias never returned the gas cans. The pair had been broken up two years earlier and they had only spoken "sporadically," he said.

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Prosecutors also showed receipts from Arias' trip from her California home to Alexander's home in Mesa, showing that she purchased a 10 gallons of gas at one gas station the night before she drove to Arizona, and then another 10 gallons from a different gas station 10 minutes later. Prosecutors are expected to argue she brought the gas with her to fill up her car secretly on the way to Alexander's home, showing premeditation for the murder.

Arias' attorneys called Brewer as one of their first witnesses as they began mounting their case that Arias killed Alexander in self defense, arguing that Alexander was controlling and abusive toward Arias.

They asked Brewer to explain how he and Arias had been in a stable relationship for four years, from 2002 to 2006, and had bought a home together before Arias met Alexander at a business conference and began to change.

"I saw a lot of changes in Jodi. She became a different person than I had known previously," Brewer said, describing how Arias' behavior changed in May 2006 when she joined a company called Pre-Paid Legal. There, she met Alexander and began seeing him. She continued to live with Brewer.

"She had continued to pay the mortgage, but she was not paying other household bills, she began getting into debt or financial trouble," Brewer said. "For me it seemed she was not as rational or logical."

Arias also converted to Mormonism while living with Brewer, telling him that he could no longer curse and she would no longer have sex with him because she was saving herself for marriage.

The pair had previously had an "enthusiastic" and "aggressive" sex life, Brewer admitted to prosecutors. They had engaged in anal sex, Arias had taken nude photos of Brewer, and Arias had purchased breast implants in 2006, he testified.

Brewer said that after Arias began to change, he made arrangements to move closer to his son from his first marriage, and he and Arias broke up.

They kept in touch with occasional phone calls until Arias asked to borrow the gas cans in June 2008, and then called him a week after borrowing the cans to say that her friend had been killed.

Martinez, reading notes from an interview Brewer gave to authorities during the investigation into Alexander's death, asked if Arias had ever mentioned needing an "alibi." Brewer said he did not recall any conversation about alibis.

"After this date of June 4, 2008," Martinez asked, "you received a call from Jodi Arias, and she was very agitated?"

"She was sad," Brewer said.

"Did she tell you that her friend had been killed and she did not have an alibi?"

"I don't remember that," Brewer said.

Arias was arrested a month after Alexander was found dead, in July 2008.

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Why haven't we learned from fires?

STORY HIGHLIGHTS

• Pyrotechnics, overcrowding, poor exits have contributed to tragic fires in recent years


• You would think the world would have learned from past incidents, John Barylick says


• Concertgoers have to be their own fire marshals, he says

Editor's note: John Barylick, author of "Killer Show," a book on the 2003 Station nightclub fire in Rhode Island, is an attorney who represented victims in wrongful death and personal injury cases arising from the fire.

(CNN) -- Sunday morning we awoke to breaking news of another tragic nightclub fire, this time in Brazil. At last report the death toll exceeded 230.

This tragedy is not without precedent. Next month will mark the 10th anniversary of a similar nightclub fire in Rhode Island. At this sad time, it's appropriate to reflect on what we've learned from club fires -- and what we haven't.

Rhode Island's Station nightclub fire of 2003, in which 100 concertgoers lost their lives, began when fireworks set off by Great White, an 80s heavy metal band, ignited flammable packing foam on the club's walls.

Deadly blazes: Nightclub tragedies in recent history

John Barylick

Panicked patrons stampeded toward the club's main exit, and a fatal pileup ensued. Contributing to the tragedy were illegal use of pyrotechnics, overcrowding and a wall covering that would have failed even the most rudimentary flammability tests.

Video images of the Station fire were broadcast worldwide: A concert begins; the crowd's mood changes from merry, to curious, to concerned, to horrified -- in less than a minute. You'd think the world would have learned from it. You would be wrong.

The following year, the Republica Cromanon nightclub in Argentina went up in flames, killing 194 people. The club was made to hold about 1,000 people, but it was estimated that more than 3,000 fans were packed inside the night of the fire, which began when fans began lighting flares that caught the roof on fire.

Echoes of the past: Rhode Island victims 'can't help but watch'

Then, in January 2009, at least 64 New Year's revelers lost their lives in a nightclub in Bangkok, Thailand, after fire ignited its ceiling. Many were crushed in a rush to get out of the club. In December of that same year, a fire in a Russian nightclub, ignited by pyrotechnics, killed 156 people. Overcrowding, poor exits, and indoor fireworks all played roles in these tragedies; yet no one bothered to learn from mistakes of the past.

While responsibility for concert disasters unquestionably lies with venue operators, performers and promoters, ultimately, we, as patrons of clubs and concerts, can enhance our own safety by taking a few simple steps. The National Fire Protection Association urges concertgoers to:

• Be observant. Is the concert venue rundown or well-maintained? Does the staff look well-trained?

• As you proceed to your seat, observe how long the process takes. Could you reverse it in a hurry? Do you pass through pinch points? Is furniture in the way?

• Once seated, take note of the nearest exit. (In an emergency, most people try to exit by the door they entered, which is usually not the closest, and is always overcrowded.) Then, share the location of that nearest exit with your entire party. Agree that at the first sign of trouble, you will all proceed to it without delay.

• Once the show begins, remain vigilant. If you think there's a problem, LEAVE IMMEDIATELY. Do not stay to "get your money's worth" despite concerns about safety. Do not remain to locate that jacket or bag you placed somewhere. No concert is worth your life. Better to read about an incident the next day than be counted as one of its statistics.

Read more: How to protect yourself in a crowd

To be sure, all fire codes must be vigorously enforced, and club and concert hall operators must be held to the highest standards. A first step is banning indoor pyrotechnics in all but the largest, stadium-type venues.

But, ultimately, we are our own best "fire marshals" when it comes to avoiding, and escaping, dangerous situations. We can still enjoy shows. But it is up to us to look out for our own safety.

In coming days, Rhode Islanders will follow the unfolding news from Brazil with a sense of queasy deja vu -- the rising body counts, the victim identification process, the grieving families, and the assigning (and dodging) of blame. If only they had learned from our tragedy.

The opinions expressed in this commentary are solely those of John Barylick.

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