Asperger's dropped from revised diagnosis manual

CHICAGO (AP) — The now familiar term "Asperger's disorder" is being dropped. And abnormally bad and frequent temper tantrums will be given a scientific-sounding diagnosis called DMDD. But "dyslexia" and other learning disorders remain.

The revisions come in the first major rewrite in nearly 20 years of the diagnostic guide used by the nation's psychiatrists. Changes were approved Saturday.

Full details of all the revisions will come next May when the American Psychiatric Association's new diagnostic manual is published, but the impact will be huge, affecting millions of children and adults worldwide. The manual also is important for the insurance industry in deciding what treatment to pay for, and it helps schools decide how to allot special education.

This diagnostic guide "defines what constellations of symptoms" doctors recognize as mental disorders, said Dr. Mark Olfson, a Columbia University psychiatry professor. More important, he said, it "shapes who will receive what treatment. Even seemingly subtle changes to the criteria can have substantial effects on patterns of care."

Olfson was not involved in the revision process. The changes were approved Saturday in suburban Washington, D.C., by the psychiatric association's board of trustees.

The aim is not to expand the number of people diagnosed with mental illness, but to ensure that affected children and adults are more accurately diagnosed so they can get the most appropriate treatment, said Dr. David Kupfer. He chaired the task force in charge of revising the manual and is a psychiatry professor at the University of Pittsburgh.

One of the most hotly argued changes was how to define the various ranges of autism. Some advocates opposed the idea of dropping the specific diagnosis for Asperger's disorder. People with that disorder often have high intelligence and vast knowledge on narrow subjects but lack social skills. Some who have the condition embrace their quirkiness and vow to continue to use the label.

And some Asperger's families opposed any change, fearing their kids would lose a diagnosis and no longer be eligible for special services.

But the revision will not affect their education services, experts say.

The new manual adds the term "autism spectrum disorder," which already is used by many experts in the field. Asperger's disorder will be dropped and incorporated under that umbrella diagnosis. The new category will include kids with severe autism, who often don't talk or interact, as well as those with milder forms.

Kelli Gibson of Battle Creek, Mich., who has four sons with various forms of autism, said Saturday she welcomes the change. Her boys all had different labels in the old diagnostic manual, including a 14-year-old with Asperger's.

"To give it separate names never made sense to me," Gibson said. "To me, my children all had autism."

Three of her boys receive special education services in public school; the fourth is enrolled in a school for disabled children. The new autism diagnosis won't affect those services, Gibson said. She also has a 3-year-old daughter without autism.

People with dyslexia also were closely watching for the new updated doctors' guide. Many with the reading disorder did not want their diagnosis to be dropped. And it won't be. Instead, the new manual will have a broader learning disorder category to cover several conditions including dyslexia, which causes difficulty understanding letters and recognizing written words.

The trustees on Saturday made the final decision on what proposals made the cut; recommendations came from experts in several work groups assigned to evaluate different mental illnesses.

The revised guidebook "represents a significant step forward for the field. It will improve our ability to accurately diagnose psychiatric disorders," Dr. David Fassler, the group's treasurer and a University of Vermont psychiatry professor, said after the vote.

The shorthand name for the new edition, the organization's fifth revision of the Diagnostic and Statistical Manual, is DSM-5. Group leaders said specifics won't be disclosed until the manual is published but they confirmed some changes. A 2000 edition of the manual made minor changes but the last major edition was published in 1994.

Olfson said the manual "seeks to capture the current state of knowledge of psychiatric disorders. Since 2000 ... there have been important advances in our understanding of the nature of psychiatric disorders."

Catherine Lord, an autism expert at Weill Cornell Medical College in New York who was on the psychiatric group's autism task force, said anyone who met criteria for Asperger's in the old manual would be included in the new diagnosis.

One reason for the change is that some states and school systems don't provide services for children and adults with Asperger's, or provide fewer services than those given an autism diagnosis, she said.

Autism researcher Geraldine Dawson, chief science officer for the advocacy group Autism Speaks, said small studies have suggested the new criteria will be effective. But she said it will be crucial to monitor so that children don't lose services.

Other changes include:

—A new diagnosis for severe recurrent temper tantrums — disruptive mood dysregulation disorder. Critics say it will medicalize kids' who have normal tantrums. Supporters say it will address concerns about too many kids being misdiagnosed with bipolar disorder and treated with powerful psychiatric drugs. Bipolar disorder involves sharp mood swings and affected children are sometimes very irritable or have explosive tantrums.

—Eliminating the term "gender identity disorder." It has been used for children or adults who strongly believe that they were born the wrong gender. But many activists believe the condition isn't a disorder and say calling it one is stigmatizing. The term would be replaced with "gender dysphoria," which means emotional distress over one's gender. Supporters equated the change with removing homosexuality as a mental illness in the diagnostic manual, which happened decades ago.

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner .

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Geithner on averting cliff: 'I actually think we're going to get there'

Boehner, Geithner (AP/Getty)

With the fiscal cliff looming--and Republicans, like House Speaker John Boehner, slamming the White House's latest proposal--U.S. Treasury Secretary Timothy Geithner hit the Sunday morning talk show circuit, saying the partisan posturing is a necessary part of "political theater" but that he's hopeful a deal will get done before the end of the year.

"I actually think that we're gonna get there," Geithner said on ABC's "This Week With George Stephanopoulos." "I mean, inevitably [there is] gonna be a little political theater in this context--sometimes that's a sign of progress. I think we're actually making a little bit of progress, but we're still some distance apart."

Geithner said the GOP lawmakers need to realize that the burden is now on them to work with Democrats--and that the ball is in their court.

"There's just no reason why 98 percent of Americans have to see their taxes go up because some members of Congress on the Republican side want to block tax rate increases for 2 percent of the wealthiest Americans," the treasury secretary said.

"They really are in a difficult position," he added. "And they're going to have to figure out their politics of what they do next."

On CNN's "State of the Union With Candy Crowley," Geithner dismissed Boehner's contention that debt talks were at a "stalemate."

"I think we're far apart still, but I think we're moving closer together," Geithner said. "Republicans have said for the first time in decades, if I'm not mistaken, that they are prepared to raise taxes as part of a deal that helps reduce our long-term deficits. Now, what they haven't said to us is how far they're willing to go both on rates and revenues. And that's something we're going to need to see from them if we're going to have an agreement."

He added: "There's going to be a lot of political theater between now and when we get there."

On "Meet The Press," Geithner said he thinks a deal will get done by the end of the year.

"The only thing standing in the way of that would be a refusal by Republicans to accept that rates are going to have to go up on the wealthiest Americans," he said. "And I don't really see them doing that."

Geithner's Sunday talk show tour was met with immediate criticism from the GOP.

"The president and the White House have had three weeks and this is the best we've got?" Boehner asked on "Fox News Sunday." "We are nowhere."

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Lone Chinese home destroyed; farmer accepts deal

BEIJING (AP) — Authorities have demolished a five-story home that stood incongruously in the middle of a new main road and had become the latest symbol of resistance by Chinese homeowners against officials accused of offering unfair compensation.

Xiayangzhang village chief Chen Xuecai told The Associated Press the house was bulldozed Saturday after its owners, duck farmer Luo Baogen and his wife, agreed to accept compensation of 260,000 yuan ($41,000).

There was no immediate confirmation from Luo, whose cellphone was turned off Saturday.

The couple had been the lone holdouts from a neighborhood that was demolished to make way for the main thoroughfare heading to a newly built railway station on the outskirts of the city of Wenling in Zhejiang province.

The razing comes a week after images of the house circulated widely online in China, triggering a flurry of domestic and foreign media reports about the latest "nail house," as buildings that remain standing as their owners resist development are called.

Luo, 67, had just completed his house at a cost of about 600,000 yuan ($95,000) when the government approached him with their standard offer of 220,000 ($35,000) to move out — which he refused, Chen has previously said. The offer then went up to 260,000 yuan ($41,000) last week.

It was not immediately clear why Luo accepted the compensation in a meeting with officials Friday afternoon when the amount of money offered was the same as a week ago.

Village chief Chen said Luo was tired of all the media attention and voluntarily consented to the deal. "Luo Baogen received dozens of people from the media every day and his house stands in the center of the road. So he decided to demolish the house," Chen said.

Authorities commonly pressure residents to agree to make way for development with sometimes extreme measures, such as cutting off utilities or moving in to demolish when residents are out for the day. In Luo's case, however, he had told local reporters last week his electricity and water were still flowing.

Real estate is one of the big drivers of China's runaway growth in recent decades. But the rapid development has run into objections from many of the hundreds of thousands of residents who have been forced out to make way for new housing, factories and other business ventures, creating a major source of unrest.

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Sony’s radical PlayStation 4 controller concept: A motion-control device you can split in half

While Nintendo (NTDOY) has been busy innovating with unique controllers on the Wii and Wii U, Sony’s (SNE) DualShock controller for its PlayStation, PlayStation 2 and PlayStation 3 has remained virtually the same since 1997. A newly discovered patent reveals Sony might be planning on a radical overhaul of the DualShock for the PlayStation 4 that’s rumored to arrive next year. U.S. patent 20120302347A1 details a “hybrid separable motion controller” that resembles a DualShock controller with two PlayStation Move sensor balls attached to it. Much like how the Wii Remote and Nunchuk controller combo separated the left and right hand input, the Sony controller patent goes one step further by allowing the two halves to be split and combined at any time – all without reducing the amount of buttons available.

The patent also highlights the inclusion of a “connection sensor for determining whether the controller is in a connected configuration or a disconnected configuration.”

One of the PlayStation Move’s biggest disadvantages is that it’s a separate controller and not the default one. As a result, most developers either saw it as merely a Wii Remote clone or as a niche controller with a limited install base not worth programming special controls for. If Sony were to include proper 1:1 motion controls within the default PS4 controller without turning its back on the “core” controller, it could greatly appeal to casual and core gamers.

Such a controller can be considered a natural evolution of the current DualShock 3 controller that sports limited motion controls using its three-axis accelerometer and gyroscope.

Of course, the controller is only a patent that may never make it to market, so don’t get your hopes up if it doesn’t happen.

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JLo tones down concert in Indonesia

JAKARTA, Indonesia (AP) — Jennifer Lopez wowed thousands of fans in Indonesia, but they didn't see as much of her as concertgoers in other countries — the American pop star toned down both her sexy outfits and her dance moves during her show in the world's most populous Muslim country, promoters said Saturday.

Lopez's "Dance Again World Tour" was performed in the country's capital, Jakarta, on Friday in line with promises Lopez made to make her show more appropriate for the audience, said Chairi Ibrahim from Dyandra Entertainment, the concert promoter.

"JLo was very cooperative ... she respected our culture," Ibrahim said, adding that Lopez's managers also asked whether she could perform her usual sexy dance moves, but were told that "making love" moves were not appropriate for Indonesia.

"Yes, she dressed modestly ... she's still sexy, attractive and tantalizing, though," said Ira Wibowo, an Indonesian actress who was among more than 7,000 fans at the concert.

Another fan, Doddy Adityawarman, was a bit disappointed with the changes.

"She should appear just the way she is," he said, "Many local artists dress even much sexy, much worse."

Lopez changed several times during her 90-minute concert along with several dancers, who also dressed modestly without revealing their chests or cleavage.

Most Muslims in Indonesia, a secular country of 240 million people, are moderate. But a small extremist fringe has become more vocal in recent years.

They have pushed through controversial laws — including an anti-pornography bill — and have been known to attack anything perceived as blasphemous, from transvestites and bars to "deviant" religious sects.

Lady Gaga was forced to cancel her sold-out show in Indonesia in May following threats by Islamic hard-liners, who called her a "devil worshipper."

Lopez will also perform in Muslim-majority Malaysia on Sunday.

"Thank you Jakarta for an amazing night," the 43-year-old diva tweeted to her 13 million followers Saturday.

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South Africa makes progress in HIV, AIDS fight

JOHANNESBURG (AP) — In the early '90s when South Africa's Themba Lethu clinic could only treat HIV/AIDS patients for opportunistic diseases, many would come in on wheelchairs and keep coming to the health center until they died.

Two decades later the clinic is the biggest anti-retroviral, or ARV, treatment center in the country and sees between 600 to 800 patients a day from all over southern Africa. Those who are brought in on wheelchairs, sometimes on the brink of death, get the crucial drugs and often become healthy and are walking within weeks.

"The ARVs are called the 'Lazarus drug' because people rise up and walk," said Sue Roberts who has been a nurse at the clinic , run by Right to Care in Johannesburg's Helen Joseph Hospital, since it opened its doors in 1992. She said they recently treated a woman who was pushed in a wheelchair for 3 kilometers (1.8 miles) to avoid a taxi fare and who was so sick it was touch and go. Two weeks later, the woman walked to the clinic, Roberts said.

Such stories of hope and progress are readily available on World AIDS Day 2012 in sub-Saharan Africa where deaths from AIDS-related causes have declined by 32 percent from 1.8 million in 2005 to 1.2 million in 2011, according to the latest UNAIDS report.

As people around the world celebrate a reduction in the rate of HIV infections, the growth of the clinic, which was one of only a few to open its doors 20 years ago, reflects how changes in treatment and attitude toward HIV and AIDS have moved South Africa forward. The nation, which has the most people living with HIV in the world at 5.6 million, still faces stigma and high rates of infection.

"You have no idea what a beautiful time we're living in right now," said one of the doctors at the clinic, Dr. Kay Mahomed, over the chatter of a crowd of patients outside her door.

President Jacob Zuma's government decided to give the best care, including TB screening and care at the clinic, and not to look at the cost, she said. South Africa has increased the numbers treated for HIV by 75 percent in the last two years, UNAIDS said, and new HIV infections have fallen by more than 50,000 in those two years. South Africa has also increased its domestic expenditure on AIDS to $1.6 billion, the highest by any low-and middle-income country, the group said.

Themba Lethu clinic, with funding from the government, the United States Agency for International Development and the United States President's Emergency Plan for AIDS Relief, is now among some 2,500 anti-retroviral therapy facilities in the country that treat approximately 1.9 million people.

"Now, you can't not get better. It's just one of these win-win situations. You test, you treat and you get better, end of story," Mahomed said.

But it hasn't always been that way.

In the 1990s South Africa's problem was compounded by years of misinformation by President Thabo Mbeki, who questioned the link between HIV and AIDS, and his health minister, Manto Tshabalala-Msimang, who promoted a "treatment" of beets and garlic.

Christinah Motsoahae first found out she was HIV positive in 1996, and said she felt nothing could be done about it.

"I didn't understand it at that time because I was only 24, and I said, 'What the hell is that?'" she said.

Sixteen years after her first diagnosis, she is now on anti-retroviral drugs and her life has turned around. She says the clinic has been instrumental. To handle the flow of patients, they're electronically checked in at reception, several nursing stations with partitions are set up to check vital signs and a new machine even helps dispense medicine to the pharmacists.

"My status has changed my life, I have learned to accept people the way they are. I have learned not to be judgmental. And I have learned that it is God's purpose that I have this," the 40-year-old said.

She works with a support group of "positive ladies" in her hometown near Krugersdorp. She travels to the clinic as often as needed and her optimism shines through her gold eye shadow and wide smile. "I love the way I'm living now."

Motsoahae credits Nelson Mandela's family for inspiring her to face up to her status. The anti-apartheid icon galvanized the AIDS community in 2005 when he publicly acknowledged his son died of AIDS.

Motsoahae is among about a hundred people waiting in a room to see one of about 10 doctors or to collect medications. A woman there rises up, slings her baby behind her back in a green fleece blanket, and tries to leave by zigzagging through the intercrossing legs of those seated.

None of Motsoahae's children was born with HIV. The number of children newly infected with HIV has declined significantly. In six countries in sub-Saharan Africa — South Africa, Burundi, Kenya, Namibia, Togo and Zambia —the number of children with HIV declined by 40 to 59 percent between 2009 and 2011, the UNAIDS report said.

But the situation remains dire for those over the age of 15, who make up the 5.3 million of those infected in South Africa. Fear and denial lend to the high prevalence of HIV for that age group in South Africa, said the clinic's Kay Mahomed.

About 3.5 million South Africans still are not getting therapy, and many wait too long to come in to clinics or don't stay on the drugs, said Dr. Dave Spencer, who works at the clinic .

"People are still afraid of a stigma related to HIV," he said, adding that education and communication are key to controlling the disease.

Themba Lethu clinic reaches out to the younger generation with a teen program.

Tshepo Hoato, 21, who helps run the program found out he was HIV positive after his mother died in 2000. He said he has been helped by the program in which teens meet one day a month.

"What I've seen is a lot people around our ages, some commit suicide as soon as they find out they are HIV. That's a very hard stage for them so we came up with this program to help one another," he said. "We tell them our stories so they can understand and progress and see that no, man, it's not the end of the world."

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Two dead after bus crash at Miami airport

MIAMI (AP) — A bus carrying more than 30 people hit a concrete overpass at Miami International Airport, killing two people on board and leaving three others critically injured, officials said Saturday.

The large, white bus was too tall for the 8-foot-6-inch entrance to the arrivals area, said airport spokesman Greg Chin. Buses are supposed to go through the departures area, which has a higher ceiling, he said.

Two large signs warn drivers of large vehicles not to enter beneath the concrete overpass. One attached to the top of the concrete barrier reads: "High Vehicle STOP Turn Left." The other, placed to the left of the driveway several feet in front of the barrier, says all vehicles higher than the 8-foot-6 threshold must turn left.

Three people were at hospitals in critical condition. The other 27 passengers had been hurt, but their injuries were less extensive, authorities said.

Osvaldo Lopez, an officer with Miami-Dade aviation, said he first heard a loud noise Saturday morning and was certain it was some sort of car wreck.

He said he went inside the bus to help and found several passengers thrown into the center aisle. He said the passengers, many of whom were elderly, remained calm after the wreck.

"It was just very bloody," he said of the scene.

After helping the passengers, Lopez suffered some injuries of his own — his left arm and a finger on his right hand were both bandaged.

The body of one dead passenger was pulled from the bus late Saturday morning; the second person died after being taken to a hospital, police said.

Fire trucks and police cars swarmed the area Saturday morning, and the bus was blocked off by yellow police tape. A white cooler that had been filled with water bottles was on its side behind the bus, the front of which remained wedged beneath the overpass Saturday.

The bus was privately owned and typically used for tours, though police believe all the passengers were local residents, not tourists, said Miami-Dade police Lt. Rosanna Cordero-Stutz. The bus' ultimate destination was not yet known, but the driver was unfamiliar with the area near the airport and did not intend to wind up at the arrivals area, Cordero-Stutz said. The driver was being interviewed by investigators, she said.

The bus was going about 20 mph when it hit the overpass Saturday morning, Chin said.

The bus resembles others commonly used for charters and tours, with the driver seated low to the ground and passenger seats in an elevated area behind the driver's seat.

Markings on the bus showed it was owned by Miami Bus Service Corp. Federal Motor Carrier Safety Administration records found online show the company has had no violations for unsafe driving or controlled substances and alcohol. It also has not reported any crashes in the two years before Oct. 26, 2012.

The records show it did receive three citations related to fatigued driving in April 2011.

The company owns three motorcoaches, according to the records. Miami Bus Service Corp. officials did not immediately respond to a phone message Saturday.

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Pakistan agrees to free more Taliban prisoners

ISLAMABAD (AP) — Pakistan agreed on Friday to free more Taliban prisoners in the future, a move considered a key step to coaxing the militant group into peace negotiations to end the 11-year-old war in Afghanistan.

The decision was announced in a statement by the foreign ministry in Islamabad after a one-day visit by Afghan Foreign Minister Zalmay Rasoul, who held talks with his Pakistani counterpart, Hina Rabbani Khar.

The statement gave no details on when the prisoners would be released, how many would go free or whether the militant group's former deputy leader, Mullah Abdul Ghani Baradar, would be among them.

Earlier this month, Pakistan decided to release nine Taliban prisoners in a move that Kabul welcomed as a positive first step and an indication that Islamabad supports the stalled Afghan peace process.

The cooperation of Pakistan, which has longstanding ties to the Taliban, is seen as key to jumpstarting an Afghan peace process that has made little headway since it began several years ago, hobbled by distrust among the major players, including the United States. The Afghan and U.S. governments accuse Islamabad of backing insurgents — an allegation Pakistan denies — and say many militant leaders are hiding in the country.

With Afghan presidential elections and the withdrawal of most foreign combat troops looming in 2014, Afghanistan and its international allies are trying to push a peace process with the Taliban to bring an end to the conflict.

The foreign ministry statement after Rasoul's meeting with Khar said both sides agreed to the "release of more prisoners," but gave no further details.

Rasoul was expected to press Pakistan to free more Taliban prisoners, including Baradar, whom Afghanistan considers to be key to the reconciliation process, said an Afghan official who spoke on condition of anonymity ahead of the talks.

Baradar was captured in Pakistan in 2010 because he reportedly was having secret talks with the Afghans.

Khar, the Pakistani foreign minister, said during a joint news conference earlier Friday that the release of prisoners was "discussed thoroughly" and that the two countries had "operationalized" a joint commission to address the issue.

Pakistan also shared with Afghanistan a draft of a strategic partnership agreement the two countries hope to negotiate over the next year, Khar said. Afghanistan signed a similar agreement with Pakistan's archenemy India last year, causing consternation in Islamabad.

The Afghan foreign minister welcomed Pakistan's efforts.

"We want all Afghan Taliban to return to their country, join the constitutional political process there and play their part in furthering the construction and development of our nation," Rasoul said.

The Taliban prisoners released earlier by Pakistan, including some senior leaders, are believed to still be in the country, said the Afghan official who spoke ahead of Rasoul's visit.

While it's unclear whether the Taliban are interested in negotiating peace, the official maintained that there are indeed key Taliban figures who support a political process to end the violence, but that some of them are afraid to establish direct contact with the Afghan government because some of those who did in the past were killed or detained.

Afghanistan wants Pakistan to encourage Taliban leaders to join the Afghan-led peace process and allow Taliban negotiators to travel to third countries for talks without detaining them or putting pressure on their families, the official said.

Informal contacts have been established with Taliban officials in recent years, but so far no formal negotiations have begun.

Waheed Muzhda, a political analyst in Kabul and an expert on Taliban issues, told The Associated Press in a recent interview that he met informally about two months ago in Qatar with several Taliban figures, including Tayyab Agha, a personal emissary of Taliban leader Mullah Omar, and Sher Mohammad Abbas Stanekzai, a former deputy at two ministries during the Taliban regime.

Muzhda said the Taliban are interested in talks, but with the U.S. and not with the Afghan government. If any negotiations begin, they would be between the U.S. and the Taliban, he said.

"If there was a good result from that, then the Afghan government could be involved," Muzhda said.

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Riechmann reported from Kabul, Afghanistan. Associated Press Writer Rahim Faiez contributed to this report from Kabul.

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Study: DVRs now in half of US pay-TV homes

NEW YORK (AP) — A new survey finds that digital video recorders are now in more than half of all U.S. homes that subscribe to cable or satellite TV services.

Leichtman Research Group‘s survey of 1,300 households found that 52 percent of the ones that have pay-TV service also have a DVR. That translates to about 45 percent of all households and is up from 13.5 percent of all households surveyed five years ago by another firm, Nielsen.

The first DVRs came out in 1999, from TiVo Inc. and ReplayTV. Later, they were built into cable set-top boxes. The latest trend is “whole-home” DVRs that can distribute recorded shows to several sets.

Even with the spread of DVRs, live TV rules. Nielsen found last year that DVRs accounted for 8 percent of TV watching.

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No charges against Chris Brown in Fla. phone grab

MIAMI (AP) — Grammy-winning singer Chris Brown won't be charged with a crime after a woman claimed he snatched her cell phone when she tried to take his photo outside a Miami Beach club.

A memo released Friday by the Miami-Dade County State Attorney's office concludes there is no evidence that Brown intended to steal the phone in February or that he deleted the photo. One or the other is necessary for him to be charged.

Prosecutors say that Brown tossed the phone from his limo and that it was picked up by security.

A felony charge against the 24-year-old might have triggered a violation of his probation for his 2009 assault on singer Rihanna, who was his girlfriend at the time. The two have recently collaborated on a new duet.

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