Drug overdose deaths up for 11th consecutive year

CHICAGO (AP) — Drug overdose deaths rose for the 11th straight year, federal data show, and most of them were accidents involving addictive painkillers despite growing attention to risks from these medicines.

"The big picture is that this is a big problem that has gotten much worse quickly," said Dr. Thomas Frieden, head of the Centers for Disease Control and Prevention, which gathered and analyzed the data.

In 2010, the CDC reported, there were 38,329 drug overdose deaths nationwide. Medicines, mostly prescription drugs, were involved in nearly 60 percent of overdose deaths that year, overshadowing deaths from illicit narcotics.

The report appears in Tuesday's Journal of the American Medical Association.

It details which drugs were at play in most of the fatalities. As in previous recent years, opioid drugs — which include OxyContin and Vicodin — were the biggest problem, contributing to 3 out of 4 medication overdose deaths.

Frieden said many doctors and patients don't realize how addictive these drugs can be, and that they're too often prescribed for pain that can be managed with less risky drugs.

They're useful for cancer, "but if you've got terrible back pain or terrible migraines," using these addictive drugs can be dangerous, he said.

Medication-related deaths accounted for 22,134 of the drug overdose deaths in 2010.

Anti-anxiety drugs including Valium were among common causes of medication-related deaths, involved in almost 30 percent of them. Among the medication-related deaths, 17 percent were suicides.

The report's data came from death certificates, which aren't always clear on whether a death was a suicide or a tragic attempt at getting high. But it does seem like most serious painkiller overdoses were accidental, said Dr. Rich Zane, chair of emergency medicine at the University of Colorado School of Medicine.

The study's findings are no surprise, he added. "The results are consistent with what we experience" in ERs, he said, adding that the statistics no doubt have gotten worse since 2010.

Some experts believe these deaths will level off. "Right now, there's a general belief that because these are pharmaceutical drugs, they're safer than street drugs like heroin," said Don Des Jarlais, director of the chemical dependency institute at New York City's Beth Israel Medical Center.

"But at some point, people using these drugs are going to become more aware of the dangers," he said.

Frieden said the data show a need for more prescription drug monitoring programs at the state level, and more laws shutting down "pill mills" — doctor offices and pharmacies that over-prescribe addictive medicines.

Last month, a federal panel of drug safety specialists recommended that Vicodin and dozens of other medicines be subjected to the same restrictions as other narcotic drugs like oxycodone and morphine. Meanwhile, more and more hospitals have been establishing tougher restrictions on painkiller prescriptions and refills.

One example: The University of Colorado Hospital in Aurora is considering a rule that would ban emergency doctors from prescribing more medicine for patients who say they lost their pain meds, Zane said.

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Stobbe reported from Atlanta.

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Online:

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

CDC: http://www.cdc.gov

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

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Asian shares hit 18-month high on growth hopes

TOKYO (Reuters) - Asian shares rose to their highest since August 2011 on Wednesday after an improving global economic outlook boosted world equities overnight, encouraging investors to take on risk.

The MSCI's broadest index of Asia-Pacific shares outside Japan <.miapj0000pus> added 0.7 percent, rose for a third day in a row, led by a 1.7 percent gain in its technology sector <.miapjit00pus>. The index has risen 4 percent so far this year.

Asian shares have been on an uptrend as risks from the euro zone debt crisis the U.S. fiscal crisis abated and signs of tepid recovery emerged in major economies including China. Corporate earnings have also been generally positive.

"A shift to cyclicals from defensives has come to a full circle and investors are now looking at sector-specific factors within an asset class, selecting those with a tight supply/demand outlook," said Naohiro Niimura, a partner at research and consulting firm Market Risk Advisory.

News of possible fresh mergers boosted U.S. stocks on Tuesday, pinning the benchmark Standard & Poor's 500 Index <.spx> near a five-year high, while a stronger-than-expected rise in the German ZEW investor sentiment index to a three-year high supported European stocks.

Australian shares rose 0.4 percent, extending a rally that has taken the market to 4-1/2 year highs, with financials and retailers supporting prices. The Australian market has risen nearly 10 percent this year.

"There's a few good earnings reports but I think it's this hunt for yield that continues to push our market higher," Weston said. "I think that's keeping the support; the market doesn't want to go down and you just don't want to be missing out."

South Korean shares <.ks11> outperformed with a 1.5 percent jump to hit a one-month high, as foreigners stepped up buying and a pause in the yen's falling trend soothed sentiment.

"The KOSPI had decoupled with global equities in January because of currency moves and foreign selling. But this is changing with the pace of currency changes easing," Shawn Oh, an analyst at Daishin Securities, said of Seoul shares.

Positive growth in Southeast Asia has drawn foreign investors, keeping regional stocks robust. The Philippines stock market <.psi> extended gains to a record high while Bangkok's SET index <.seti> hit a fresh 18-year high.

The rise in equities weighed on assets perceived as safe-haven, such U.S. Treasuries and gold on Tuesday. Spot gold inched up 0.2 percent to $1,607.94 an ounce, but hovered near a six-month low hit the day before.

London copper climbed 0.6 percent to $8,095 a metric ton, off Tuesday's three-week lows.

Tokyo's Nikkei stock average <.n225> added 0.7 percent, after touching a 52-month high. <.t/>

The yen remained jittery, swinging in narrow ranges on concerns Japan may not be able to pursue as strong a reflationary policy mix as previously thought.

A week-long delay in the government nominating a new Bank of Japan governor fuelled talk of friction between the prime minister and the finance minister over who should run a central bank charged with taking bold action to reignite the economy.

The dollar eased 0.1 percent to 93.49 yen, still near its highest since May 2010 of 94.465 hit on February 11. The euro was up 0.1 percent to 125.36 yen. It touched a peak since April 2010 of 127.71 yen on February 6.

Sterling was under pressure on growing speculation the UK could soon lose its prized triple-A credit rating. Sterling traded at $1.5444, having plumbed a seven-month low at $1.5414 in New York.

"Markets continued to consolidate while reallocation trades helped risky assets to outperform and the USD to come under some pressure," said Sebastien Galy, strategist at Societe Generale, said in a note to clients.

"Fears regarding the UK are steadily rising, reinforcing a bearish tendency...We remain short GBP, CHF, JPY and AUD," he said, adding that the market will use any bearish excuse to sell the yen.

Japan logged its biggest monthly trade deficit on record in January, underscoring the country's deteriorating trade balances and accenting the yen's weak fundamental trend.

Investors remained wary of the possible U.S. federal spending cuts and outcome of the upcoming Italian election, limiting losses in sovereign bonds.

The ZEW report was a positive sign ahead of the more important euro zone flash PMIs on Thursday and Germany's IFO business sentiment on Friday, said Vassili Serebriakov, a strategist at BNP Paribas.

U.S. crude steadied around $96.70 a barrel but Brent eased 0.2 percent to $117.34.

(Additional reporting by Thuy Ong in Sydney and Hyunjoo Jin in Seoul; Edting by Eric Meijer)

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IHT Rendezvous: Concerns Grow About 'Severely Polluted' Water in China's Cities

HONG KONG — The recent headlines about China’s pollution problems — many are now calling it a crisis — have focused on the worsening air pollution in Beijing and other major Chinese cities, drawing worldwide attention to the issue.

But another peril, potentially just as dangerous, lurks — one that is also drawing increasing notice: the poor condition of China’s water supplies. On Tuesday, a report underscored just how widespread the problem is: an official with the China Geological Survey was quoted as saying that the groundwater of 90 percent of Chinese cities is polluted, with two-thirds of those cities having “severely polluted” water.

Danwei, a Web site that tracks the Chinese media, noted that the Strait Times newspaper in Fujian Province on Tuesday devoted its full front page to the issue, another example of mainland Chinese media being more aggressive in tackling environmental degradation. The newspaper also notes that another official from a Beijing research center describes the intractable nature of the problem: the polluted water is often contaminated with heavy metals whose organic byproducts are difficult to filter out through traditional water treatment systems.

The concerns about China’s water supply come in myriad forms. As my colleague Didi Kirsten Tatlow pointed out last week, the thirst that the Chinese coal and chemical industries have for water risks drying up key rivers, with a quarter of the flow in China’s Yellow River threatened by 2015. India and other nations are worried about China’s “hydro-supremacy” on the continent, particularly plans to build huge new dams on rivers that flow across international borders. These dams, the Indian author Brahma Chellaney asserts, “are designed to pump electricity into China’s southern electricity grid” as nations downstream bear “the environmental and social costs.” Some see such conflicts, with the potential for “water wars,” as among the most delicate challenges to Asian diplomacy in coming decades as water supplies get scarcer.

China, of course, is not alone as it struggles to balance economic growth with growing concern about water supply quality. The debate about whether to allow gas hydrofracking in the United States has pitted environmentalists against energy extraction companies and others who see such technology as a way to finally wean the nation away from dependence on foreign energy supplies.

As with the air pollution problem, bloggers and others have grown more vigilant in calling attention to water degradation throughout China. Caixin Online recently ran a troubling photo of what locals have called “Orange Juice River” — the Daqubang River in Zhejiang Province that has turned to a rust color because of pollution. Another in the series of pictures shows a woman drawing water from Luoyang River in Henan Province after it had been discolored by red dye from an illegal workshop upstream that had been dumping the substance from sewage pipes.

The issue is not just environmental. Where there is scarcity of precious resources, the opportunity to make money is not far behind. China Water Risk, a privately financed Web portal that examines the nation’s growing water supply problems, takes a realistic look at the long-term challenges the Chinese face — and the opportunities for investors.

“At the global level, investors have responded to the threat of water scarcity by investing in specialist water funds,” the site notes. But with China expected to spend roughly $150 billion over the next 12 years to deal with water shortage issues, “increasing attention is being paid to investment opportunities in water supply infrastructure, water treatment facilities and demand management technologies.”

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The U.S. Postal Service Is Getting into the ‘Wearable Electronics’ Business?

Yes, you read that headline right. Strapped for cash and obviously desperate, the United States Postal Service is launching a new line of “‘smart apparel,’ — also known as wearable electronics.” The mailmen-turned-fashionistas will call the new line Rain Heat & Snow, first for men and later for women, and while it’s unclear exactly how smart the apparel gets, reports suggest that you’ll  be able to plug your iPod into your new Postal Service jacket. The agency’s licensing manager, Steven Mills, says that the new line “will put the Postal Service on the cutting edge of functional fashion.” Which is basically true. When was the last time you plugged your iPod into your jacket? That said, when was the last time you used an iPod? Or the U.S. Postal Service?

RELATED: Snail Mail Is Still Too Fast for the U.S. Postal Service

It’s hard to not to give the old USPS a slow clap for this one. It would be one thing if the Postal Service wanted to sell some t-shirts and Dad ties with pictures of stamps on them — they actually tried that back in the 80s, and it didn’t work — but it sounds like they’re actually going after serious outerwear brands like North Face and Burton Snowboards with this one. It’s unclear if the Postal Service can keep up, though. Burton, for one, has a head start, since it partnered with Motorola and released a Bluetooth-enabled snowboarding jacket with a matching, headphone studded beanie back in 2005. The geeks at the Consumer Electronics Show (CES) loved it, called it “space age.” The Postal Service, by contrast, opted not to take the fancy brand-name strategy, instead teaming up with the Cleveland-based Wahconah Group. You might know them from their Legends line of men’s clothing, but you probably don’t.

RELATED: The U.S. Postal Service Lost $ 3.3 Billion Last Quarter

The big question remains: Will it work? The Postal Service lost $ 16 billion last year and plans to halt Saturday mail service in an attempt to cut costs and dig itself out of debt. Unfortunately, the drastic measure will cut 22,000 jobs, but it will only save the agency $ 2 billion a year. Suffice it to say that the Postal Service needed to get creative with their revenue streams — and you can’t get much more creative than cyborg jackets. After all, the new ad campaign last year didn’t work, and the Simpson’s stamp venture definitely didn’t work. So why not get into the outdoor gear business? If anybody knows anything about being outside, it’s those letter carriers, right? You know the riff: “Neither snow nor rain nor heat nor gloom of night stay these couriers from the swift completion of their appointed rounds.”

RELATED: Your Pants Are Lying to You

Here’s a little bit of encouraging news. Other companies have tried the apparel route in the past, albeit without the whole sexy wearable electronics angle. Apple released its own clothing line in 1986, and look at where the company is now!

Gadgets News Headlines – Yahoo! News

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Mindy McCready: Under Police Scrutiny at Time of Suicide?

By Steve Helling and Mike Fleeman

02/18/2013 at 06:00 PM EST

Mindy McCready and David Wilson

Courtesy Mindy McCready

When Mindy McCready talked to police in recent weeks, her account of how her boyfriend came to be found with a fatal gunshot wound to the head concerned police, a law enforcement source tells PEOPLE.

"At first, she said she hadn't heard the gunshot because the TV was too loud. Then she said she had heard the gunshot," the source says. "So obviously there were a lot of questions, and the Sheriff was asking for clarification."

But before investigators could re-interview her, the long-troubled country singer also would die under eerily similar circumstances, her body discovered at the same Heber Springs, Ark., house just feet away from where David Wilson died.

McCready's death was blamed on what "appears to be a single self-inflicted gunshot wound," the Cleburne County Sheriff's Office said in a statement.

This differed from how the sheriff characterized Wilson's case. His cause and manner of death still have not been established by the coroner. It was McCready's publicist, and not a law enforcement official, who announced that Wilson had died of a self-inflicted gunshot wound.

After Wilson's death, McCready, 37, spoke to investigators three times, but they didn't feel as if they were through with her.

"At no point did [police] tell her she was a suspect, and she wasn't officially one," says the source. "But she knew that some of her answers didn't stand up to questioning. She was very cooperative, but she just wasn't making a lot of sense."

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Hip implants a bit more likely to fail in women

CHICAGO (AP) — Hip replacements are slightly more likely to fail in women than in men, according to one of the largest studies of its kind in U.S. patients. The risk of the implants failing is low, but women were 29 percent more likely than men to need a repeat surgery within the first three years.

The message for women considering hip replacement surgery remains unclear. It's not known which models of hip implants perform best in women, even though women make up the majority of the more than 400,000 Americans who have full or partial hip replacements each year to ease the pain and loss of mobility caused by arthritis or injuries.

"This is the first step in what has to be a much longer-term research strategy to figure out why women have worse experiences," said Diana Zuckerman, president of the nonprofit National Research Center for Women & Families. "Research in this area could save billions of dollars" and prevent patients from experiencing the pain and inconvenience of surgeries to fix hip implants that go wrong.

Researchers looked at more than 35,000 surgeries at 46 hospitals in the Kaiser Permanente health system. The research, published Monday in JAMA Internal Medicine, was funded by the U.S. Food and Drug Administration.

After an average of three years, 2.3 percent of the women and 1.9 percent of the men had undergone revision surgery to fix a problem with the original hip replacement. Problems included instability, infection, broken bones and loosening.

"There is an increased risk of failure in women compared to men," said lead author Maria Inacio, an epidemiologist at Southern California Permanente Medical Group in San Diego. "This is still a very small number of failures."

Women tend to have smaller joints and bones than men, and so they tend to need smaller artificial hips. Devices with smaller femoral heads — the ball-shaped part of the ball-and-socket joint in an artificial hip — are more likely to dislocate and require a surgical repair.

That explained some, but not all, of the difference between women and men in the study. It's not clear what else may have contributed to the gap. Co-author Dr. Monti Khatod, an orthopedic surgeon in Los Angeles, speculated that one factor may be a greater loss of bone density in women.

The failure of metal-on-metal hips was almost twice as high for women than in men. The once-popular models were promoted by manufacturers as being more durable than standard plastic or ceramic joints, but several high-profile recalls have led to a decrease in their use in recent years.

"Don't be fooled by hype about a new hip product," said Zuckerman, who wrote an accompanying commentary in the medical journal. "I would not choose the latest, greatest hip implant if I were a woman patient. ... At least if it's been for sale for a few years, there's more evidence for how well it's working."

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Online:

Journal: http://www.jamainternalmed.com

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Asian shares listless, yen firmer but near lows

TOKYO (Reuters) - Most Asian shares barely moved on Tuesday as a holiday in the U.S. overnight and a lack of catalysts kept many investors on the sidelines.

Concerns about the euro zone economy, U.S. fiscal talks and Chinese appetite limited gains in commodities and also weighed on the euro.

The dollar's strength against a basket of currencies <.dxy> also weighed on commodities and capped gains in gold.

"Markets have become top-heavy after rallying through early February on signs of economic recovery in the United States and Europe, and investors now await fresh factors to push prices higher from here," said Tomomichi Akuta, senior economist at Mitsubishi UFJ Research and Consulting in Tokyo.

"The broad sentiment is underpinned by a lack of tail risks, but investors are turning to some potentially worrying elements such as Italian elections and U.S. budget talks," he said.

The MSCI's broadest index of Asia-Pacific shares outside Japan <.miapj0000pus> was flat after briefly touching a 18-1/2-month high. The index has gained 3.5 percent this year.

Disappointing earnings pushed European shares lower on Monday for a third straight session while U.S. markets were closed for the President's Day holiday.

The risk of an inconclusive outcome in Italy's election this weekend added to concerns while investors kept eyes on Washington where policymakers are discussing a package of budget cuts set to kick in March 1, which analysts warn could hurt the economy.

"We didn't have a lead from Wall St overnight, we also had weakness coming through from European markets overnight, so we were never expecting a strong day," said Juliette Saly, stock market analyst at Commonwealth Securities in Sydney.

Australian shares <.axjo> edged up 0.1 percent as investors focused on local corporate earnings for direction after a three-month rally that has taken the market to 4-1/2 year highs.

The Nikkei stock average <.n225> eased 0.2 percent, after closing up 2.1 percent on Monday to approach its highest level since September 2008 of 11,498.42 tapped on February 6. <.t/>

Spot gold was up 0.3 percent at $1,614.01 an ounce.

London copper inched up 0.3 percent to $8,144 a tonne as Monday's three-week low drew bargain hunting given prospects for a slowly improving global economic recovery. Unease over China's limp return to the market from a week-long break held back upside momentum, however.

U.S. crude fell 0.3 percent to $95.59 a barrel while Brent inched up 0.1 percent to $117.48.

The euro was steady around $1.3344. The currency eased slightly on Monday after European Central Bank President Mario Draghi said in a speech at the European Parliament that "the exchange rate is not a policy target but is important for growth and price stability" and that its rise is "a risk."

YEN JITTERY

The yen remained near recent lows on Tuesday, as attention turned to the appointment of a new Bank of Japan governor.

The yen, which has dropped 20 percent against the dollar since mid-November, fell further at the start of the week after financial leaders from the G20 promised not to devalue their currencies to boost exports and avoided singling out Japan for any direct criticism.

The choice of the next BOJ governor and two deputies has drawn attention as a gauge of how strongly Prime Minister Shinzo Abe is committed to reflating the economy. The G20's message was that as long as Japan pursues aggressive monetary easing to achieve that goal, a weaker yen as a result of such domestic monetary policy will be tolerated, analysts say.

"But that means that some other economy's monetary conditions have been tightened," said Barclays Capital in a note.

"Japan hasn't even changed its policy stance thus far, and the effect of expectations of a looser setting have led to limited moves in domestic interest rates, but the sell-off of the JPY has been marked and has clearly caused unease in other economies," the note said.

Market reaction was muted to the release of the minutes of the BOJ's January 21-22 meeting, when the bank set a 2 percent inflation target and pledged an open-ended quantitative easing from 2014. But the yen was bought when Finance Minister Taro Aso told reporters Japan has no plans to buy foreign currency bonds as part of monetary easing, a trader said.

The dollar was down 0.2 percent to 93.73 yen, but remained near its highest since May 2010 of 94.465 hit on February 11. The euro also eased 0.3 percent to 125.05 yen, below its peak since April 2010 of 127.71 yen touched on February 6.

(Additional reporting by Maggie Lu Yueyang and Thuy Ong in Sydney; Editing by Richard Borsuk)

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India Ink: Kalyan Anand, the Sadhu From Madhya Pradesh

Why do millions of Indians, sometimes entire villages, brave the crowds to attend the Kumbh Mela? India Ink interviewed some of the estimated 100 million pilgrims who traveled to this year’s Kumbh Mela at Allahabad, Uttar Pradesh, a 55-day pilgrimage during which Hindus take a holy dip in the Ganges River to wash away their sins.

Kalyan Anand, 46, a sadhu from Chitrakoot town of Madhya Pradesh was one among them. This is what he had to say.

Why did you come to the Kumbh Mela this year? Is this your first time?

I have been coming to the Kumbh for 20 years now. I have gone everywhere there is a Kumbh – Ujjain, Nashik, Haridwar and Allahabad. The purity of River Ganges never ceases to fascinate me. I come to each Kumbh to try and make myself as pure as Mother Ganges.

How have you found it so far?

This one is particularly crowded. They have significantly restricted the bathing area for the sadhus to accommodate the common folk. That is a disappointment. But otherwise, the energy in a Kumbh is always infectious.

Describe your journey to the Kumbh. Did you travel alone? How long did it take?

I travel with my ashram wherever I go.

What does religion mean to you? Do you consider yourself a religious person?

Internal cleansing – that is the basis of religion. Our ancestors strived for it. We should all too. It becomes our inherent responsibility. When everyone on this earth is conscious of his sins, imagine how pure the world will become? Just the mere knowledge will ensure you don’t err in the future.

Who do you think is going to win the 2014 election? Have you ever cast a vote?

We are people who are beyond these things. I haven’t cast a vote all my life.

(The interview was translated from Hindi.)

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Pirate Bay reports anti-piracy group to Finnish police for alleged copyright infringement

Give the Pirate Bay this much — they certainly have a refined sense of irony. TorrentFreak reports that the Pirate Bay has asked the Economic Crime division of Finland’s police department to investigate an anti-piracy organization for allegedly copying several of the Pirate Bay’s design aspects for its own website. According to TorrentFreak, the Pirate Bay is upset that the Copyright Information and Anti-Piracy Centre (CIAPC) has allegedly “copied the site’s homepage and the CSS file,” which “is a direct violation of The Pirate Bay’s usage policy which specifically prohibits organizations’ use of any site material without permission.” And yes, for those wondering, the Pirate Bay does understand the irony of what it’s doing.

[More from BGR: Broadband ISPs put to the test: Real data speeds vs. advertised speeds charted by FCC]

“While The Pirate Bay may have a positive view on copying, it will not stand by and watch copyright enforcing organizations disrespect copyright,” writes Pirate Bay blogger Winston. “CIAPC is like an ugly high school bully without friends. It’s time to take a stand. Cyber bullying is a serious matter to us all.”

[More from BGR: We’ll be live from HTC’s press conference tomorrow at 10:00AM!]

For those who don’t recall, CIAPC last year took some heat for pushing Finnish police to raid the home of a 9-year-old Pirate Bay user and seize her “Winnie the Poor” laptop. CIAPC eventually decided to drop charges against the girl and her father, who had allegedly ignored the organization’s request to pay a €600 fine to settle copyright violations.

This article was originally published on BGR.com

Wireless News Headlines – Yahoo! News

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Downton Abbey's Season 3 Finale: Shocking, Says PEOPLE's TV Critic

Downton Abbey

By Tom Gliatto

02/17/2013 at 10:00 PM EST

Downton Abbey season 3 cast

Carnival Film & Television/PBS

Downton Abbey's third season finale on PBS's Masterpiece was, to say the least, a spoiler's paradise. The episode, which saw the Granthams and servants going on holiday in the Scottish Highlands, started on a joyful note – Lady Mary was pregnant! – and ended with a shock that would have knocked the hat off Lady Violet wobbling head.

SPOLIER ALERT: Major plot points to be revealed immediately.

Cousin Matthew (Dan Stevens) died in a car accident. He was driving back to Downton, so happy he was practically whistling, just after Lady Mary (Michelle Dockery) had given birth to their son – the male Downton heir everyone has been so obsessed with since Season 1.

Many viewers probably saw this coming: For one thing, Stevens had said he was thinking of decamping before season 4 started shooting. And after the finale had its premiere broadcast in Britain in December, he blabbed all about it, including for an interview posted online by The New York Times.

Even so, the death was almost sadistically abrupt and arbitrary, especially after the soft tenderness and growing love between Mary and Matthew in recent episodes. Now we saw dead poor Matthew dumped on the cold mossy ground, eyes wide open.

You can never be sure Downton writer-creator Julian Fellowes won't pull some shameless stunt to kick-start a story – in season 2 Matthew, paralyzed during the war, suddenly leaped out of his wheelchair – but he seemed to want us to be sure that Matthew was 100% gone. I wouldn't have been surprised if the car backed over the corpse.

So ended a terribly sad season of Downton.

We already suffered the loss in childbirth of Lady Sybil (Jessica Brown Findlay). Her deathbed scene was unflinching and deeply moving as she gasped for breath and called for help. Her poor mother (Elizabeth McGovern) sobbed in despair, and the doctors couldn't agree on what to do.

Millions of viewers cried, too, and sighed for a long time afterward. Those who didn't are probably evil.

That scene was the heart of the season: Sybil was so beautiful and kind and gracious and spirited, and so different from her fractious sisters. It was if one were to discover a rare, transcendent soul among the Kardashians. Her death robbed the show of a lovely presence, and also brought out the best moments yet from McGovern and Maggie Smith, as Lady Violet.

It never ceases to annoy me, to be honest, that Lady Violet's feeble witticisms are treated as if they were Oscar Wilde one-liners on loan, like Harry Winston jewels. If you want real witticisms, try any contemporary American sitcom, including FX's Archer.

But this season, as Violet grieved, we saw how much depth Smith can invest in a single moment. At one point in the finale, she looked up as dinner was announced, and in her enormous eyes you saw a woman who wished she could just chuck the whole damn thing and dwell on her memories.

I wish I could say I will miss Matthew, but all in all an unattached Lady Mary is better than a married one. She was never sexier than in the first season, when she sneaked off to bed with velvety, sensual Mr. Pamuk, who unfortunately kicked the bucket while they made love.

Mary is a wonderful creation – the show's most original, complex character – capable of bouncing from romance to sorrow to sarcasm. You could say her love for Matthew transformed her, but it also had the potential to dull her.

Matthew was blandly handsome and good and patient and full of improving notions, but not terribly exciting. He was like a Bachelor from a much earlier period.

There isn't much else to say about the finale. Fellowes worked through a number of plots with his usual tangy glibness. The performances were all delightful, tart, full of emotion, humor and regret.

For now, we can look forward to Lady Mary at her most beautiful, because most woeful, in season 4.

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