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Back surgery, hip and knee replacements, and prostate removal were among the operations performed more often in rural Medicare patients, the study found. Emergency surgeries and elective operations alike were more common among rural residents.

The results seem to challenge the idea that city dwellers have better access to medical care, but experts say the research raises more questions than it answers.

“When I first saw the result, I looked at it and said maybe I got it backwards,” said lead author Dr. Mark Francis, a researcher at Texas Tech University Health Sciences Center in El Paso. The study doesn’t indicate where rural residents had surgery. It’s likely many had to travel some distance, which would be risky when urgent surgery is needed.

The study didn’t report on how the patients fared after their operations. Nor did it say whether rural residents had worse health overall than city dwellers, although some previous research has suggested that is generally true.

HAWAII

Case over anonymity at school nixed

HONOLULU — The U.S. Supreme Court has declined to hear a dispute over whether to identify students challenging a private school system’s admissions policy that gives preference to those of Hawaiian ancestry.

The court on Monday left in place lower court rulings against four non-Hawaiian students who object to the Kamehameha Schools’ policy.

The challengers, who applied for admission to Kamehameha in the 2008-09 school year, wanted to file their lawsuit anonymously because of concerns about public humiliation and retaliation if they were identified. It wasn’t immediately clear Monday if their names would be released; an attorney for the students previously said they likely would drop the suit if they couldn’t remain anonymous.

The students contended in their lawsuit that the private school system’s preference for Native Hawaiians is at odds with federal civil rights laws. Only a few non-Hawaiians have ever been admitted to Kamehameha Schools.

The system teaches preschool through 12th grade and operates several campuses on Oahu, Maui and the Big Island.

NEVADA

Sahara hotel-casino closes on Vegas Strip

LAS VEGAS — The venerable Sahara hotel-casino on the Las Vegas Strip, where Elvis Presley stayed while filming “Viva Las Vegas” and the Beatles stayed when they performed in Sin City, dealt to its final gamblers and checked out its last guests Monday after six decades.

Visitors streamed through the casino before officials planned to shut the doors at 2 p.m., picking up souvenirs at a near-empty gift shop, playing $10 blackjack and visiting with dealers and bartenders one last time.

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