In Soldier’s Hearing, Afghans Tell of Horror

JOINT BASE LEWIS-McCHORD, Wash. — Through a live video feed from half a world away in Afghanistan, in an extraordinary night court session, descriptions of chaos and horror poured into a military courtroom here as if from an open spigot.

Lois Silver/FR 170774 Associated Press, via Associated Press

In a courtroom sketch, Staff Sgt. Robert Bales, lower right, is shown during testimony on Friday.

Reuters

Sergeant Bales, left, during a 2011 training exercise in Fort Irwin, California.

“Their brains were still on the pillows,” said Mullah Khamal Adin, 39, staring into the camera with his arms folded on the table, describing the 11 members of his cousin’s family he found dead in the family compound — most of the bodies burned in a pile in one room.

Mr. Adin, in a hearing that started here late Friday, was asked about the smell. Was there an odor of gasoline or kerosene?

Just bodies and burned plastic, he replied through a translator.

The Army’s preliminary hearing in the case against Staff Sgt. Robert Bales, accused of killing 16 Afghan civilians in Kandahar Province this year, unfolded last week mostly in the bustling daylight of a working military base an hour south of Seattle. But to accommodate witnesses in Afghanistan, and the 12-and-a-half-hour time difference, the schedule was shifted at week’s end, with testimony through cameras and uplinks in Afghanistan and here at Lewis-McChord starting at 7:30 p.m. Pacific time on Friday and running until shortly after 2 a.m. Saturday.

The attacks, which occurred on March 11 in a deeply poor rural region while most of the victims were asleep, were the deadliest war crime attributed to a single American soldier in the decade of war that has followed the terrorist attacks of Sept. 11, 2001, and they further frayed the relationship between the American and Afghan governments.

The military says Sergeant Bales, 39, was serving his fourth combat tour overseas when he walked away from his remote outpost in southern Afghanistan and shot and stabbed members of several families in a nighttime ambush on two villages. At least nine of the people he is accused of killing were children, and others were women. After the victims were shot, some of the bodies were dragged into a pile and burned.

“ ‘What are you doing? What are you doing?’ ” one witness, a farmer named Haji Naim, said he had shouted to the American soldier, whom he described as wearing a blindingly bright headlamp in a house that, without electricity, was pitch black. The gunman said nothing, Mr. Naim said, and simply kept firing.

“He shot me right here, right here, and right here,” he said, indicating wounds from which he has apparently recovered.

Most of the testimony, however graphic, was circumstantial, pointing to a lone American gunman but not directly implicating Sergeant Bales. The villagers testified on the fifth day of a military proceeding known as an Article 32 investigation, held to establish whether there is enough evidence to bring Sergeant Bales before a court-martial. If a court-martial is ordered and the Army decides to continue the prosecution as a capital case, the sergeant could face the death penalty.

Sergeant Bales, a decorated veteran of three tours in Iraq before being sent to Afghanistan last December, was deployed from Joint Base Lewis-McChord. He was held at the military prison at Fort Leavenworth in Kansas before being brought here for the hearing.

Witnesses earlier in the week talked about the blood-soaked clothes that Sergeant Bales was seen wearing when he returned to his base in Kandahar and his comments to fellow soldiers about having done “the right thing.” There was also testimony about the test for steroids in his system that came back positive three days after the killings.

The hearing’s night sessions, which were scheduled to continue on Saturday, were all about the violence that unfolded the night of March 11. Mr. Adin, who was summoned to his cousin’s compound by a telephone call early the next morning, told of boot prints that were on some bodies, including the head of a child who had apparently been shot and stomped or kicked. Mr. Adin talked about a small child who he said appeared to have been “grabbed from her bed and thrown on the fire.” But Mr. Adin never saw the gunman, arriving after the fact.

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Bits Blog: On Twitter, Steve Jobs Is Immortal

Steve Jobs is gone, but on Twitter his @name lives on. And on.

The chief executive of Apple, who died in 2011, is memorialized on Twitter by about a thousand fans, parodists, traffic seekers, unrepentant haters and crypto-historians, among others. The accounts use his name as either as a title or, with many variations, as an address.

The copycats include @FakeSteveJobs, @FauxSteve and @SteveJobsFalso, a collection of admitted imposters who are following in the footsteps of a parody Web site that was active from 2006 to 2011. Other versions include @RememberSteve, @PulseonJobs and @RealSteveJobs. There are a couple of @BlackSteveJobs, plus Twitter accounts by various articles of clothing and body parts.

Several of the accounts are operated by start-ups hoping to generate attention for themselves. Their tweets contain links to corporate Web pages. Some of the accounts are in languages like Arabic, Thai or Japanese. Many others use Mr. Jobs’s name for the account but have a different address.

Searching the name “Steve Jobs” on Twitter yields about 1,080 accounts, some of which are unrelated to the Apple co-founder; there are people on Twitter who are really named Steve Jobs.

Twitter does not keep score of how many of its 140 million accounts are fakes, but it generally supports the idea of parody accounts. “It’s very helpful for political dissidents, who can’t write under their own name,” said Rachael Horwitz, a company spokeswoman. She also noted that Dick Costolo, Twitter’s chief executive, has a parody account. Jack Dorsey, the chairman of the company’s board, is likewise roasted.

Possibly for his close identification with technology, Mr. Jobs does appear to be the most popular identity on Twitter to leverage. President Obama has about 600 versions of his name, either through the “@” address, or in the name of the account. Given much of the venom of the recent election, several of these accounts are remarkably ugly, certainly worse than the treatment afforded Mr. Jobs. Michelle Obama, who like the president has an official and verified Twitter account, has about 500 copycats.

Bill Gates, Mr. Jobs’s longtime nemesis and eventual frenemey, does better than the president and first lady, with about 840 imitators and parodists. There is also a Klingon version of him, which to date Mr. Jobs’s name does not appear to share. There also appear to be a lot more people on Twitter who are simply named “Bill Gates,” a characteristic that must fill their lives with a lot of predictable humor.

Justin Beiber gets a mere 240 people hoping for a bit of his lustre. John Lennon, Mr. Jobs’ idol, has fewer than 100.

Twitter will take down parody accounts, but usually when it is not clear that they are parodies. That is not a problem in the case of most public figures. “It’s a form of speech,” Ms. Horwitz said. On the Internet, everyone needs a thicker skin. The situation does come up enough that the company has published formal policies on acceptable parody and fan accounts , along with impersonation.

There are parody accounts for Oracle’s chief executive, Larry Ellison; for Larry Page, the chief executive and co-founder of Google; and for Mark Zuckerberg, the chief of Facebook. With so many parody accounts around, some technology chief executives may worry if they are not being parodied.

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The New Old Age Blog: The Emotional Aftermath of Hurricane Sandy

Let’s talk about the emotional aftermath of the storm that left tens of thousands of older people on the East Coast without power, bunkered down in their homes, chilled to the bone and out of touch with the outside world.

Let’s name the feelings they may have experienced. Fear. Despair. Hopelessness. Anxiety. Panic.

Linda Leest and her staff at Services Now for Adult Persons in Queens heard this in the voices of the older people they had been calling every day, people who were homebound and at risk because of medical conditions that compromise their physical functioning.

“They’re afraid of being alone,” she said in a telephone interview a few days after the storm. “They’re worried that if anything happens to them, no one is going to know. They feel that they’ve lost their connection with the world.”

What do we know about how older adults fare, emotionally, in a disaster like that devastating storm, which destroyed homes and businesses and isolated older adults in darkened apartment buildings, walk-ups and houses?

Most do well — emotional resilience is an underappreciated characteristic of older age — but those who are dependent on others, with pre-existing physical and mental disabilities, are especially vulnerable.

Most will recover from the disorienting sense that their world has been turned upside down within a few weeks or months. But some will be thrown into a tailspin and will require professional help. The sooner that help is received, the more likely it is to prevent a significant deterioration in their health.

The best overview comes from a November 2008 position paper from the American Association for Geriatric Psychiatry that reviewed the effects of Hurricane Katrina and other disasters. After Katrina, “the elderly had the highest mortality rates, health decline and suicide rates of any subgroup,” that document notes. “High rates of psychosomatic problems were seen, with worsening health problems and increased mortality and disability.”

This is an important point: Emotional trauma in older adults often is hard to detect, and looks different from what occurs in younger people. Instead of acknowledging anxiety or depression, for instance, older people may complain of having a headache, a bad stomachache or some other physical ailment.

“This age group doesn’t generally feel comfortable talking about their feelings; likely, they’ll mask those emotions or minimize what they’re experiencing,” said Dr. Mark Nathanson, a geriatric psychiatrist at Columbia University Medical Center.

Signs that caregivers should watch out for include greater-than-usual confusion in an older relative, a decline in overall functioning and a disregard for “self care such as bathing, eating, dressing properly and taking medication,” Dr. Nathanson said.

As an example, he mentioned an older man who had “been sitting in a cold house for days and decided to stop taking his water pill because he felt it was just too much trouble.” Being distraught or distracted and forgetting or neglecting to take pills for chronic conditions like diabetes or heart disease can have immediate harmful effects.

Especially at risk of emotional disturbances are older adults who are frail and advanced in age, those who have cognitive impairments like Alzheimer’s disease, those with serious mental illnesses like schizophrenia or major depression, and those with chronic medical conditions or otherwise in poor physical health, according to the geriatric psychiatry association’s position paper.

A common thread in all of the above is the depletion of physical and emotional reserves, which impairs an older person’s ability to adapt to adverse circumstances.

“In geriatrics, we have this idea of the ‘geriatric cascade’ that refers to how a seemingly minor thing can set in motion a functional, cognitive and psychological downward spiral” in vulnerable older adults, said Dr. Mark Lachs, chief of the division of geriatrics at Weill Cornell Medical College. “Well, the storm was a major thing — a very large disequilibrating event — and its impact is an enormous concern.”

Of special concern are older people who may be in the early stages of Alzheimer’s disease or other types of dementia who are living alone. For this group, the maintenance of ordinary routines and the sense of a dependable structure in their lives is particularly important, and “a situation like Sandy, which causes so much disruption, can be a tipping point,” Dr. Lachs said.

Also of concern are older people who may have experienced trauma in the past, and who may suffer a reignition of post-traumatic stress symptoms because of the disaster.

Most painful of all, for many older adults, is the sense of profound isolation that can descend on those without working phones, electricity or relatives who can come by to help.

“That isolation, I can’t tell you how disorienting that can be,” said Bobbie Sackman, director of public policy for the Council of Senior Centers and Services of New York City. “They’re scared, but they won’t tell you because they’re too proud and ashamed to ask for help.”

The best remedy, in the short run, is the human touch.

“Now is the time for people to reach out to their neighbors in high-rises or in areas where seniors are clustered, to knock on doors and ask people how they are doing,” said Dr. Gary Kennedy, director of the division of geriatric psychiatry at Montefiore Medical Center in the Bronx.

Don’t make it a one-time thing; let the older person know you’ll call or come by again, and set up a specific time so “there’s something for them to look forward to,” Dr. Kennedy said. So-called naturally occurring retirement communities with large concentrations of older people should be organizing from within to contact residents who may not be connected with social services and find out how they’re doing, he recommended.

In conversations with older adults, offer reassurance and ask open-ended questions like “Are you low on pills?” or “Can I run out and get you something?” rather than trying to get them to open up, experts recommended. Focusing on problem-solving can make people feel that their lives are being put back in order and provide comfort.

Although short-term psychotherapy has positive outcomes for older adults who’ve undergone a disaster, it’s often hard to convince a senior to seek out mental health services because of the perceived stigma associated with psychological conditions. Don’t let that deter you: Keep trying to connect them with services that can be of help.

Be mindful of worrisome signs like unusual listlessness, apathy, unresponsiveness, agitation or confusion. These may signal that an older adult has developed delirium, which can be extremely dangerous if not addressed quickly, Dr. Nathanson said. If you suspect that’s the case, call 911 or make sure you take the person to the nearest hospital emergency room.

This is a safe place to talk about all kinds of issues affecting older adults. Would you be willing to share what kinds of mental health issues you or family members are dealing with since the storm so readers can learn from one another?

Read More..

The New Old Age Blog: The Emotional Aftermath of Hurricane Sandy

Let’s talk about the emotional aftermath of the storm that left tens of thousands of older people on the East Coast without power, bunkered down in their homes, chilled to the bone and out of touch with the outside world.

Let’s name the feelings they may have experienced. Fear. Despair. Hopelessness. Anxiety. Panic.

Linda Leest and her staff at Services Now for Adult Persons in Queens heard this in the voices of the older people they had been calling every day, people who were homebound and at risk because of medical conditions that compromise their physical functioning.

“They’re afraid of being alone,” she said in a telephone interview a few days after the storm. “They’re worried that if anything happens to them, no one is going to know. They feel that they’ve lost their connection with the world.”

What do we know about how older adults fare, emotionally, in a disaster like that devastating storm, which destroyed homes and businesses and isolated older adults in darkened apartment buildings, walk-ups and houses?

Most do well — emotional resilience is an underappreciated characteristic of older age — but those who are dependent on others, with pre-existing physical and mental disabilities, are especially vulnerable.

Most will recover from the disorienting sense that their world has been turned upside down within a few weeks or months. But some will be thrown into a tailspin and will require professional help. The sooner that help is received, the more likely it is to prevent a significant deterioration in their health.

The best overview comes from a November 2008 position paper from the American Association for Geriatric Psychiatry that reviewed the effects of Hurricane Katrina and other disasters. After Katrina, “the elderly had the highest mortality rates, health decline and suicide rates of any subgroup,” that document notes. “High rates of psychosomatic problems were seen, with worsening health problems and increased mortality and disability.”

This is an important point: Emotional trauma in older adults often is hard to detect, and looks different from what occurs in younger people. Instead of acknowledging anxiety or depression, for instance, older people may complain of having a headache, a bad stomachache or some other physical ailment.

“This age group doesn’t generally feel comfortable talking about their feelings; likely, they’ll mask those emotions or minimize what they’re experiencing,” said Dr. Mark Nathanson, a geriatric psychiatrist at Columbia University Medical Center.

Signs that caregivers should watch out for include greater-than-usual confusion in an older relative, a decline in overall functioning and a disregard for “self care such as bathing, eating, dressing properly and taking medication,” Dr. Nathanson said.

As an example, he mentioned an older man who had “been sitting in a cold house for days and decided to stop taking his water pill because he felt it was just too much trouble.” Being distraught or distracted and forgetting or neglecting to take pills for chronic conditions like diabetes or heart disease can have immediate harmful effects.

Especially at risk of emotional disturbances are older adults who are frail and advanced in age, those who have cognitive impairments like Alzheimer’s disease, those with serious mental illnesses like schizophrenia or major depression, and those with chronic medical conditions or otherwise in poor physical health, according to the geriatric psychiatry association’s position paper.

A common thread in all of the above is the depletion of physical and emotional reserves, which impairs an older person’s ability to adapt to adverse circumstances.

“In geriatrics, we have this idea of the ‘geriatric cascade’ that refers to how a seemingly minor thing can set in motion a functional, cognitive and psychological downward spiral” in vulnerable older adults, said Dr. Mark Lachs, chief of the division of geriatrics at Weill Cornell Medical College. “Well, the storm was a major thing — a very large disequilibrating event — and its impact is an enormous concern.”

Of special concern are older people who may be in the early stages of Alzheimer’s disease or other types of dementia who are living alone. For this group, the maintenance of ordinary routines and the sense of a dependable structure in their lives is particularly important, and “a situation like Sandy, which causes so much disruption, can be a tipping point,” Dr. Lachs said.

Also of concern are older people who may have experienced trauma in the past, and who may suffer a reignition of post-traumatic stress symptoms because of the disaster.

Most painful of all, for many older adults, is the sense of profound isolation that can descend on those without working phones, electricity or relatives who can come by to help.

“That isolation, I can’t tell you how disorienting that can be,” said Bobbie Sackman, director of public policy for the Council of Senior Centers and Services of New York City. “They’re scared, but they won’t tell you because they’re too proud and ashamed to ask for help.”

The best remedy, in the short run, is the human touch.

“Now is the time for people to reach out to their neighbors in high-rises or in areas where seniors are clustered, to knock on doors and ask people how they are doing,” said Dr. Gary Kennedy, director of the division of geriatric psychiatry at Montefiore Medical Center in the Bronx.

Don’t make it a one-time thing; let the older person know you’ll call or come by again, and set up a specific time so “there’s something for them to look forward to,” Dr. Kennedy said. So-called naturally occurring retirement communities with large concentrations of older people should be organizing from within to contact residents who may not be connected with social services and find out how they’re doing, he recommended.

In conversations with older adults, offer reassurance and ask open-ended questions like “Are you low on pills?” or “Can I run out and get you something?” rather than trying to get them to open up, experts recommended. Focusing on problem-solving can make people feel that their lives are being put back in order and provide comfort.

Although short-term psychotherapy has positive outcomes for older adults who’ve undergone a disaster, it’s often hard to convince a senior to seek out mental health services because of the perceived stigma associated with psychological conditions. Don’t let that deter you: Keep trying to connect them with services that can be of help.

Be mindful of worrisome signs like unusual listlessness, apathy, unresponsiveness, agitation or confusion. These may signal that an older adult has developed delirium, which can be extremely dangerous if not addressed quickly, Dr. Nathanson said. If you suspect that’s the case, call 911 or make sure you take the person to the nearest hospital emergency room.

This is a safe place to talk about all kinds of issues affecting older adults. Would you be willing to share what kinds of mental health issues you or family members are dealing with since the storm so readers can learn from one another?

Read More..

Black Friday Deals Will Start Earlier This Year

There was an outcry last year when some retailers opened at midnight on Thanksgiving, with workers and shoppers saying the holiday should be reserved for family, not spent lining up for the start of the Christmas shopping season.

This year, retailers are responding to the criticism by opening even earlier on Thanksgiving evening — and a handful are even planning to be open all day.

The lesson of 2011 was clear: earlier shopping hours were good for the top line. Retailers said their midnight openings drew a younger crowd who wanted to party — and shop — late rather than get up early. At Macy’s Herald Square store in Manhattan, for instance, about 9,000 people were in line as it opened, compared with 7,000 for an early Friday opening the previous year.

“We got customer feedback that says, ‘I like to shop earlier so I can go to bed earlier,’ so as we looked at the balance of being competitive in the marketplace and being customer-centric,” said Duncan Mac Naughton, chief merchandising and marketing officer for Wal-Mart, which will put its first doorbuster items on sale at 8 p.m. on Thanksgiving.

Just a few years ago, most major stores opened about 5 a.m. on the Friday after Thanksgiving, usually the busiest shopping day of the year. This year, not only are the openings scattered across two days, but several retailers are offering staggered deals — some items at a certain time, other items a few hours later, still others over the weekend.

“We had Black Friday pretty cleanly teed up, with, here are the ads, here are the stores opening Friday morning, pick a retailer and go,” said Brad Wilson, who lists Black Friday ads at BradsDeals. “Now you have this multiday affair, and you can go at different times.”

Kmart has perhaps the most confusing hours. Like last year, it will open at 6 a.m. on Thanksgiving. It will then stay open until 4 p.m., close from 4 to 8 p.m., reopen at 8, stay open until 3 a.m. on Friday, close from 3 to 5 a.m., reopen at 5, and then stay open until 11 p.m. on Friday.

Sears, which was closed on Thanksgiving last year, will open at 8 p.m. on Thursday night.

Sears Holdings, which owns both Sears and Kmart, said in a news release that customers wanted “more flexible Black Friday in-store shopping times.”

Lord & Taylor was closed last year on Thanksgiving, but this year it will be open from 10 a.m. to 7 p.m.

Walmart, which is generally open 24 hours anyway, is offering the first deals on Thanksgiving two hours earlier than last year. Mr. Mac Naughton said customer feedback and competitiveness with other retailers were factors.

Target, which last year got angry feedback from employees when it opened at midnight on Thanksgiving, this year moved it up three hours to 9 p.m., according to a holiday circular posted online on Friday.

Some workers object to Thanksgiving Day holiday openings, saying it cuts into family time. It shows “disregard for all of our families,” said Mary Pat Tifft, a Walmart employee in Kenosha, Wis., who is part of the union-backed OUR Walmart group, in a statement. But in many cases, it can also mean a higher hourly pay rate for holiday duty.

Now, the handful of retailers who are holding off until midnight on Thanksgiving suddenly look like the respectful ones.

“We believe that Thanksgiving Day is a time to spend and celebrate with family, and we want our associates to do so,” said Jim Sluzewski, a spokesman for Macy’s, which will open at midnight. Kohl’s will also open at midnight Thanksgiving, as will Best Buy, according to a circular posted online Friday.

Companies are also sprinkling sales throughout the weekend in an effort to keep traffic coming.

After its initial 8 p.m. sale, Walmart will put another set of items on sale at 10, and a third group at 5 a.m. Friday. “Whether they like to start early, stay up late, or go to bed early and get up early, we’re going to have three different events that will meet their needs,” Mr. Mac Naughton said. Then, Walmart will “kick off a weekend full of savings with more specialty offers” on items like jewelry, sewing machines and tools.

Target, after its 9 p.m. doorbuster special, will offer a free gift card for purchases made between 4 a.m. and noon on Friday, according to the circular posted on Mr. Wilson’s site and elsewhere. (Target declined to confirm the authenticity of the circular, saying it had not yet publicly announced holiday details.)

Sears will do a second wave of promotions at 4 a.m. on Friday, eight hours after it opens. Sports Authority will do some doorbusters at its midnight opening, then put numerous others on sale over the weekend. And Ace Hardware is offering different percentages or dollars off, on Friday, Saturday and Sunday.

Mr. Wilson of BradsDeals says the retailers may be intentionally trying to confuse shoppers. “They’re trying to introduce more variables,” he said, to make it harder to figure out exactly which is the best deal.

All of the twists and turns, though, may just end up frustrating consumers.

Only 6 percent of shoppers plan to hit stores on Thanksgiving night, and just under one-fifth will go to stores on Black Friday, according to a new survey from Ipsos and Offers.com, accurate within three percentage points.

At least one major retailer is going against the grain. Sam’s Club, which last year opened at 5 a.m. on Black Friday, this year is opening two hours later, at 7 a.m., and offering coffee and pastries to shoppers.

“If they want to chill out on Thanksgiving day and not go out and get into the rat race of everything, they can do that,” said Todd Harbaugh, executive vice president for operations at Sam’s Club. “Our members said they want hassle-free shopping.”

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A Transfer of Power Begins in China

Military delegates arrived for the 18th Communist Party Congress at the Great Hall of the People in Beijing on Thursday. The weeklong meeting precedes the naming of China’s top leader, who will replace Hu Jintao. The meeting also introduces a new generation of party leaders.

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Groupon Earnings Miss Expectations on Weakness in Europe

SAN FRANCISCO (Reuters) — Groupon reported financial results late Thursday that fell short of Wall Street’s already cautious expectations, as the daily-deal company failed to turn around its struggling European business.

Groupon also confirmed that it had laid off about 80 employees, mainly in sales, as part of an effort to automate the way it handles its deals.

The company’s shares fell as low as $3.21 in after-hours trading, down as much as 18 percent from their closing price of $3.92. Groupon was the darling of investors during last year’s consumer dot-com boom in initial public offerings, but now it has shed more than 80 percent of its value since making its public debut at $20 a share.

Wall Street has grown uneasy about Groupon’s prospects as daily-deals fever wanes among consumers and merchants, and as growth rates sputter. Adding to the difficulties, the S.E.C. has been looking into Groupon’s accounting and disclosures, an area of controversy during its initial public offering.

Groupon reported third-quarter revenue of $568.6 million, compared with $430.2 million a year earlier. Analysts had expected revenue of $590 million, according to Thomson Reuters.

The company posted a quarterly net loss of $3 million, or break-even on a per-share basis, compared with a net loss of $54.2 million, or 18 cents a share, in the third quarter of 2011.

Andrew Mason, chief executive of Groupon, said a “solid performance” in North America was offset by weakness in Europe. International revenue, including Europe, grew 3 percent to $277 million; North American revenue surged 80 percent to $292 million.

Europe has been a particular problem for Groupon, partly because the sovereign debt crisis there has hurt demand for higher-price deals. Groupon was also offering steeper discounts, disappointing some merchants.

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Malaria Vaccine Candidate Produces Disappointing Results in Clinical Trial

The latest clinical trial of the world’s leading malaria vaccine candidate produced disappointing results on Friday. The infants it was given to had only about a third fewer infections than a control group.

But researchers said they wanted to press on, assuming they keep getting financial support, because the number of children who die of malaria is so great that even an inefficient vaccine can save thousands of lives.

Three shots of the vaccine, known as RTS, S or Mosquirix and produced by GlaxoSmithKline, gave babies fewer than 12 weeks old 31 percent protection against detectable malaria and 37 percent protection against severe malaria, according to an announcement by the company at a vaccines conference in Cape Town.

Last year, in a trial in children up to 17 months old, the same vaccine gave 55 percent protection against detectable malaria and 47 percent against severe malaria.

The new trial “is less than we’d hoped for,” Moncef Slaoui, Glaxo’s chairman of research and development said in a telephone interview. “But if a million babies were vaccinated, we would prevent 260,000 cases of malaria a year. This is a disease that kills 655,000 babies a year — 31 percent of that is a very large number.”

The company, which has already spent more than $300 million on the vaccine, wants to keep forging ahead, he said, “but it is not just our decision.”

It also depends on the PATH Malaria Vaccine Initiative, which has put more than $200 million of its Bill and Melinda Gates Foundation financing into the vaccine, and on the World Health Organization, which has helped talk seven African countries into allowing the vaccine to be tested on their children.

The Gates Foundation declined to say how much money it was ultimately prepared to spend on an imperfect vaccine; this set of trials is set to go into 2014.

“The efficacy came back lower than we had hoped, but developing a vaccine against a parasite is a very hard thing to do,” Bill Gates said in a prepared statement. “The trial is continuing, and we look forward to getting more data to help determine whether and how to deploy this vaccine.”

All the families in the trial were given insecticide-impregnated mosquito nets and encouraged to use them; 86 percent did, so the vaccine worked despite other anti-malaria measures.

RTS, S contains a protein found on the parasite’s surface that provokes an immune reaction. It was first identified decades ago by two New York University scientists, Ruth and Victor Nussenzweig. The vaccine was developed by Glaxo in Belgium and initially tested on American volunteers by the Walter Reed Army Institute of Research. When the Gates Foundation began focusing on global health in the early part of this century, it was one of the first projects the foundation adopted. Different ways to make the vaccine more effective, including adding different boosters and giving more shots, are being experimented with. Other vaccines using different ways to provoke an immune reaction exist, but none are as far along in clinical trials.

Like an H.I.V. vaccine, one against malaria has proved an elusive goal. The parasite morphs several times, exhibiting different surface proteins as it goes from mosquito saliva into blood and then into and out of the liver. Also, even the best natural “vaccine” — catching the disease itself — is not very effective. While one bout of measles immunizes a child for life, it usually takes several bouts of malaria to confer even partial immunity. Pregnancy can cause women to stop being immune, and immunity can fade out if someone moves away from a malarial area — presumably because they no longer get “boosters” from repeated mosquito bites.

Read More..

Malaria Vaccine Candidate Produces Disappointing Results in Clinical Trial

The latest clinical trial of the world’s leading malaria vaccine candidate produced disappointing results on Friday. The infants it was given to had only about a third fewer infections than a control group.

But researchers said they wanted to press on, assuming they keep getting financial support, because the number of children who die of malaria is so great that even an inefficient vaccine can save thousands of lives.

Three shots of the vaccine, known as RTS, S or Mosquirix and produced by GlaxoSmithKline, gave babies fewer than 12 weeks old 31 percent protection against detectable malaria and 37 percent protection against severe malaria, according to an announcement by the company at a vaccines conference in Cape Town.

Last year, in a trial in children up to 17 months old, the same vaccine gave 55 percent protection against detectable malaria and 47 percent against severe malaria.

The new trial “is less than we’d hoped for,” Moncef Slaoui, Glaxo’s chairman of research and development said in a telephone interview. “But if a million babies were vaccinated, we would prevent 260,000 cases of malaria a year. This is a disease that kills 655,000 babies a year — 31 percent of that is a very large number.”

The company, which has already spent more than $300 million on the vaccine, wants to keep forging ahead, he said, “but it is not just our decision.”

It also depends on the PATH Malaria Vaccine Initiative, which has put more than $200 million of its Bill and Melinda Gates Foundation financing into the vaccine, and on the World Health Organization, which has helped talk seven African countries into allowing the vaccine to be tested on their children.

The Gates Foundation declined to say how much money it was ultimately prepared to spend on an imperfect vaccine; this set of trials is set to go into 2014.

“The efficacy came back lower than we had hoped, but developing a vaccine against a parasite is a very hard thing to do,” Bill Gates said in a prepared statement. “The trial is continuing, and we look forward to getting more data to help determine whether and how to deploy this vaccine.”

All the families in the trial were given insecticide-impregnated mosquito nets and encouraged to use them; 86 percent did, so the vaccine worked despite other anti-malaria measures.

RTS, S contains a protein found on the parasite’s surface that provokes an immune reaction. It was first identified decades ago by two New York University scientists, Ruth and Victor Nussenzweig. The vaccine was developed by Glaxo in Belgium and initially tested on American volunteers by the Walter Reed Army Institute of Research. When the Gates Foundation began focusing on global health in the early part of this century, it was one of the first projects the foundation adopted. Different ways to make the vaccine more effective, including adding different boosters and giving more shots, are being experimented with. Other vaccines using different ways to provoke an immune reaction exist, but none are as far along in clinical trials.

Like an H.I.V. vaccine, one against malaria has proved an elusive goal. The parasite morphs several times, exhibiting different surface proteins as it goes from mosquito saliva into blood and then into and out of the liver. Also, even the best natural “vaccine” — catching the disease itself — is not very effective. While one bout of measles immunizes a child for life, it usually takes several bouts of malaria to confer even partial immunity. Pregnancy can cause women to stop being immune, and immunity can fade out if someone moves away from a malarial area — presumably because they no longer get “boosters” from repeated mosquito bites.

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Preparing to Step Aside in China, Hu Jintao Warns of Challenges

Changing of the Guard in China:
The New York Times’s Beijing correspondents discuss the challenges ahead for China as the country begins its once-in-a-decade leadership transition.

BEIJING — Capping 10 careful years at the helm of the Communist Party, China’s top leader, Hu Jintao, on Thursday boasted of successes during his tenure while issuing a blunt warning against unrest and political reform.

Mr. Hu, 69, is to step down as the party’s general secretary next week, handing over power to his designated successor, Xi Jinping. His speech at the opening here in Beijing of the Communist Party’s 18th Congress was likely to be his last major address — a chance to write his own eulogy while also setting the course for Mr. Xi.

“He’s worried about how history will view him,” said Qian Gang, who works with the China Media Project of Hong Kong University. “On the whole, he is against reform.”

Formally, Mr. Hu nodded to almost every manner of reform: economic, social, political and environmental. But, in the fashion of his predecessors, this was balanced with warnings of the need to guard against a rise in unrest. It was an unusual admission for a man whose signature slogan is creating for China a “harmonious society.”

“Social contradictions have clearly increased,” said the formal 64-page document issued at the congress. (Mr. Hu’s speech, even at 100 minutes, was only a summary.)

“There are many problems concerning the public’s immediate interests in education, employment, social security, health care, housing, the environment, food and drug safety, workplace safety, public security and law enforcement.”

The solution, Mr. Hu said, was “reform and opening up,” a policy initiated by the man who chose him for the job nearly two decades ago, the paramount leader Deng Xiaoping.

Mr. Hu also lauded his own contribution to Communist Party ideology: “Scientific Development.” Most of his predecessors have had their own ideologies enshrined as guiding state doctrines. His repetition of the phrase — which means that the party should be pragmatic and follow policies that are demonstrably effective — implied that he, too, would be so honored.

But his caveats to reform were many.

According to Mr. Qian, a leading expert on textual analysis of Chinese leaders’ speeches, Mr. Hu’s speech hit on almost every anti-reform phrase used by Chinese Communist leaders.

He referred to Communist China’s founder three times with the phrase “Mao Zedong Thought,” and said the party must “resolutely not follow Western political systems,” something not mentioned at the last party congress five years ago.

“They don’t say these terms lightly,” Mr. Qian said. “When they mention it, it matters.”

Mr. Hu also coined a new term, pledging that the party will not to follow the “wicked way” of changing the party’s course.

Mr. Hu’s speech is thought to have been drawn up in cooperation with his successor, Mr. Xi. While Mr. Xi is widely thought to be consulting with liberal members of China’s intelligentsia, he either did not oppose Mr. Hu’s direction or was not able to change it.

That is important, observers say, because Mr. Xi will not exercise unrestrained power when he takes over. Besides the other half-dozen members on the Standing Committee of the party’s Politburo, he will also have to listen to the advice of Mr. Hu, Mr. Hu’s own predecessor, Jiang Zemin, and an estimated 20 other “senior leaders.” As if to emphasize their role, these men were seated on the dais next to Mr. Hu. Many of them are in their 70s and 80s and have exercised power for decades.

“Xi Jinping certainly won’t be a Gorbachev,” said Yao Jianfu, a former official and researcher who closely follows Chinese politics and advocates democratic change. “Every aspect of reform has an important precondition — that the Communist Party remains in charge.”

Even though Mr. Hu’s speech was broadcast live on national television and on screens in Beijing subway cars, gauging popular opinion was difficult.

Microbloggers, who are mostly urban and fairly well educated, at times cast scorn on the rhetoric. One blogger listed the Marxist terminology that Mr. Hu used and wrote simply “madness.” Others used laughing emoticons, while some delved closely into the speech for clues to new policies — some noted his fleeting mention of China’s unpopular single-child policy.

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Vermont School Cut Off From Technology Faces Its Intrusion

VERSHIRE, Vt. — Past the chicken coop and up a hill, in a spot on campus where the wooden buildings of the Mountain School can seem farther away than the mountains of western New Hampshire, there sometimes can be found a single bar, sometimes two, of cellphone reception.

The spot, between the potato patch and a llama named Nigel, is something of an open secret at the school in this remote corner of Vermont where simplicity is valued over technology. “We’re at the periphery of civilization here,” said Doug Austin, a teacher.

But that is about to change.

The school offers high school juniors, many from elite private institutions in the Northeast, a semester to immerse themselves in nature. The students make solo camping trips to a nearby mountain for a day or two of reflection, and practice orienteering skills without a GPS device. Between English and environmental science classes, they care for farm animals, chop wood and read the works of Robert Frost. And in the process, many say, they stop scouring the campus for its sparse bars of reception and lose the habit of checking their Facebook pages at every opportunity.

As the rest of the country has gotten high-speed Internet, Vershire (population 730) has lagged, relying on land lines shared among neighbors, with dial-up and (for homes that face the right way) satellite Internet service that cuts out when the weather is rough. But cellphone signals have been seeping in, and soon there will be more.

This fall, technicians will start laying fiber-optic cable to bring high-speed Internet to the town. Cellphone coverage is expected soon after. “Right now we’re the third-world country of Vermont,” said Gene Craft, the town clerk. “We’d like to be in touch.”

That presents a challenge for the Mountain School: how to regulate the use of smartphones and other devices that serve as a constant distraction for 21st-century teenagers, who are here to engage with the rural setting and with one another.

True to its mission of encouraging “collaborative learning and shared work,” the school asked its students and alumni to develop a technology policy that will determine whether to ban phones, allow them in a limited way or leave the decision whether to disconnect to students.

Many students, alumni and teachers have asked Alden Smith, the school’s director, to declare a ban. But the school has always held that its students can be trusted to make good choices, he said. “We have to figure out the balance between how to preserve the values we have,” Mr. Smith said. “But I tend to think that adolescents, particularly the ones we get here, when mentored, will rise to the occasion when trusted with real responsibility.”

To make phone calls from the 300-acre campus, students must take turns, using prepaid calling cards, at small phone closets in each dormitory. At the recommendation of alumni, there is no Internet service in the dorms, only in the academic building, and incoming students are strongly discouraged from bringing DVDs or loading videos on their laptops. (Even where there is Internet service, any online activity that requires significant bandwidth — watching a video on YouTube, for example — means a loss of signal to others because the town’s fair access policy limits bandwidth to the school.)

At first, Andy Sharp, 17, from nearby Thetford Academy, missed participating in his friends’ fantasy football league online. But after most of a semester at the school, he said, he uses his laptop only for doing homework and checking Facebook occasionally. “I didn’t think that was going to happen to me, but it did,” he said. “Your focus shifts to things that are in front of you.”

That is not to say that students cut themselves off from the outside world altogether. Many were keeping up with new music, including Julia Christensen, a 16-year-old from the Lakeside School in Seattle. She planned to wake up before 7 a.m. recently to download Taylor Swift’s new album before the morning Internet rush hour. But that was an exception.

“Here, if you spent a lot of time on your computer, people would think that’s lame,” said Calais Larson, 17, of Phillips Exeter Academy, who believes that cellphones should not be used on campus.

Students say they are ambivalent about returning to a world where they can be reached at any moment.

After a short break last month, several students said it was a relief when they returned and were not expected to respond immediately to text messages or did not have to worry about which party to attend. As they split firewood and dug potatoes, the discussion was instead about heading to Garden Hill to watch the stars, or reading Frost and hiking in the New England countryside.

The school says students have agreed on a draft policy: students will hand over their phones to the faculty when they arrive and will get them back on off-campus trips; they can also choose to get them back a month into the semester.

Mr. Smith and other longtime teachers say their goal is not to encourage their students to live without technology, but to make them think more carefully about their use of it.

“The idea is not to be going back to a time where things were better,” Mr. Smith said, “but where the richness of each day is defined by the food you eat, the company you keep, the work you do.”

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Well: The Presidential Health Quiz

Whether it’s George Washington’s teeth or Bill Clinton’s former hamburger habit, Americans have always been fascinated by the health of the president and presidential candidates.

With help from the Web site DoctorZebra, which has compiled an exhaustive list of the medical history of American presidents, we’ve created an Election Day quiz to test your knowledge of presidential fitness and health.

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Well: The Presidential Health Quiz

Whether it’s George Washington’s teeth or Bill Clinton’s former hamburger habit, Americans have always been fascinated by the health of the president and presidential candidates.

With help from the Web site DoctorZebra, which has compiled an exhaustive list of the medical history of American presidents, we’ve created an Election Day quiz to test your knowledge of presidential fitness and health.

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Shares on Wall St. Slide Lower

Shares on Wall Street edged lower on Thursday as investors continued to adjust for upcoming negotiations over the so-called fiscal cliff, overshadowing a batch of positive economic data.

Investors worry that if no deal is reached in Congress over the fiscal cliff — some $600 billion in spending cuts and tax increases set to kick in early next year — it could derail the American economic recovery.

Data showed that the United States trade deficit narrowed in September as exports increased, suggesting that the economy expanded more than previously estimated in the third quarter.

Also on Thursday, the government reported than fewer Americans than expected filed new claims for unemployment benefits last week. The jobs data was distorted by the effects from Hurricane Sandy, though it was not clear if the storm increased or decreased claims.

“We’ve seen a big spike in the trend of the jobs market in the past few months,” said Adam Sarhan, chief executive of Sarhan Capital in New York. “We should react positively to this.”

In afternoon trading, Standard & Poor’s 500-stock index was down 0.3 percent, as was the Dow Jones industrial average. The Nasdaq composite was 0.5 percent lower.

On Wednesday, equities slumped more than 2 percent, as investor focus returned to Europe’s economic troubles and the looming tax hikes and budget cuts in the United States.

McDonald’s shares dropped 1.4 percent after the company reported a 1.8 percent drop in October sales at established restaurants around the world, its first monthly sales fall since March 2003.

Qualcomm reported quarterly revenue late Wednesday that beat expectations, sending shares up more than 6 percent.

Whole Foods Market reported earnings that met expectations, but its shares were down 4.9 percent.

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Obama’s Other ‘Cliff’ Is in Foreign Policy

For all the talk of a “fiscal cliff” threatening the nation’s finances, President Obama also faces a foreign policy cliff of sorts, with a welter of national security issues that he put on the back burner during the campaign now clamoring for his attention.

Atop that list, administration officials and foreign policy experts say, is the bloody civil war in Syria and the standoff with Iran over its nuclear program. The United States is likely to engage the Iranian government in direct negotiations over the next few months, in perhaps a last-ditch diplomatic effort to head off a military strike on its nuclear facilities.

Administration officials said that they had not set a date for talks and that they did not know if Iran’s supreme leader, Ayatollah Ali Khamenei, would give his blessing. But with Iran’s uranium centrifuges spinning and Israel threatening its own military action, the need to avoid a war may make this high-risk diplomatic effort Mr. Obama’s No. 1 priority.

Syria, too, will demand a pressing response, given the high human toll of the violence and the danger of a spreading regional conflict. Mr. Obama, however, remains leery of being dragged into the conflict, rejecting calls to supply weapons to rebel groups. His reluctance has been partly political, experts say, but he also has strategic qualms.

“At a time when he was running on a platform of ending wars in the Middle East, he did not want to be seen as starting one,” said Martin S. Indyk, a former American ambassador to Israel.

“But if he doesn’t try to intervene in a way that gives him a way to shape a post-Assad regime on the ground,” Mr. Indyk continued, referring to the Syrian president, Bashar al-Assad, “there’s a high risk of descent into chaos in Syria, and a sectarian war that spreads to Lebanon, Bahrain and eventually Saudi Arabia.”

Beyond those flash points, the president will have to grapple with Pakistan, an unstable nuclear state whose relationship with Washington has eroded during his presidency. And he will have to oversee an orderly exit from Afghanistan, where the waning American role threatens to throw the country back into chaos and Islamic militancy.

As he does so, some question whether he will rethink his administration’s heavy reliance on drone strikes to kill people suspected of being extremists, a policy that has proved lethally efficient but has sown deep resentment in Pakistan and Afghanistan.

More broadly, Mr. Obama will face Russia under the aggressive leadership of President Vladimir V. Putin and China with the opposite problem — negotiating a tumultuous change in power after a scandal that tainted the top ranks of its Communist leadership.

None of these problems are new, but many were effectively shelved over the past year as the president waged a bitter re-election battle dominated by his stewardship of the economy. Foreign policy played such a bit part in the election that even in the debate ostensibly devoted to it, Mr. Obama and Mitt Romney detoured into a discussion of high school test scores in Massachusetts.

For reasons of history and political reality, a re-elected Mr. Obama is likely to devote more time to foreign affairs. From Richard M. Nixon to Bill Clinton, presidents have tended to make their bid for statesman status in their second terms. The prospect of continuing gridlock — with the Republicans still controlling the House — gives Mr. Obama all the more reason to favor diplomacy over domestic legislation.

There is also some unfinished business from the past four years, not least Mr. Obama’s frustrated efforts to broker a peace agreement between Israel and the Palestinians. But several experts cast doubt on whether the president would throw himself into the role of Middle East peacemaker, as Mr. Clinton did in his second term.

The Israeli prime minister, Benjamin Netanyahu, who has had a fraught relationship with Mr. Obama, faces his own voters early next year, but he seems likely to stay in power with a right-wing government. Such an arrangement could make peacemaking difficult.

“Because he got his fingers burned and was outmaneuvered by Netanyahu, he will wait to see the outcome in the Israeli election,” said Mr. Indyk, who wrote a book about Mr. Obama’s foreign policy, “Bending History.” He added that the president is “going to think long and hard about trying again.”

The added wrinkle for the United States: the Palestinian Authority is likely to petition for nonstate membership in the United Nations next month, a step it had put off until after the election. If the United Nations were to grant it, that would trigger Congress to cut off aid not only to the Palestinian Authority but also to the United Nations itself.

The mere fact of Mr. Obama’s victory does not ease these problems. But as the president himself famously said to Russia’s former president, Dmitri A. Medvedev, at a nuclear conference in South Korea, he may have more room to maneuver in dealing with them.

Ask foreign policy experts for wild cards in a second Obama term and two countries come up: India and Cuba. Little progress was made in opening the door to Havana during the past four years, but hope springs eternal for those who advocate an end to the half-century-old trade embargo. Mr. Obama also is likely to build on his ties to India.

India figures into the biggest geopolitical bet of Mr. Obama’s presidency: the American pivot from the Middle East to China and Asia. With four more years, experts said, Mr. Obama can put meat on the bones of an ambitious, but incomplete, policy.

Here, however, is where the fiscal cliff meets foreign policy. To be credible in reasserting an American presence in Asia, experts said, will require a robust military presence from the Yellow Sea to the South China Sea. But unless the White House and Congress can strike some kind of fiscal deal, the Pentagon will face deep automatic cuts in its budget, depriving it of the ability to project power as it once did.

For Mr. Obama to realize his grandest visions abroad, then, he will still have to work with the same House Republicans who thwarted him on the home front in his first term.

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Facebook Cancels Shortcut Over Concern for Security

SAN FRANCISCO — What was supposed to be a shortcut for Facebook users to log into their pages ended up exposing their e-mail addresses — and, in some cases, potentially allowing access to their accounts as well.

A Facebook spokesman said on Friday that the company had created the shortcut, called auto login, to let some users go directly to their pages by clicking on a Web link sent to their e-mail addresses. Once they clicked on the link, they could get into their accounts, rather than having to go to Facebook.com and log in.

Some of the links required users to type their passwords, while others did not, the company said.

On the Web site Hacker News, a technology discussion board, Matt Jones, an engineer at Facebook, said the company had offered the service for “ease of use” and never made the Web addresses “publicly available.”

But they did become publicly available, as the discussion on Hacker News revealed on Friday.

The Facebook spokesman, Frederic Wolens, said some users may have posted the links on the Web, allowing anyone to search for them. Those links could give a stranger access to the Facebook pages connected to them, as well as the e-mail addresses of those users. Mr. Wolens said he had no explanation why someone would post the links.  

When Facebook found the problem, it discontinued the shortcut.

The Hacker News thread said over one million Facebook accounts had been affected. Facebook could not confirm that figure on Friday afternoon.

TrendMicro, a private security company that offers safety tools for Facebook users, said Web address shortcuts were inherently dangerous because they could ultimately end up on the Web.

“Many, many hackers are targeting these portals because of the ubiquitous trust and use of them,” said Tom Kellermann, vice president for cybersecurity at TrendMicro. He added, “You don’t take shortcuts through the woods in cyberspace.”

The news of the security hole comes a week after a Bulgarian blogger, Bogomil Shopov, said he had bought 1.1 million Facebook users’ names and e-mail addresses on the Web for $5. He found the information for sale on a marketplace site, gigbucks.com. The items are no longer available.

Mr. Wolens of Facebook said the data had been acquired and compiled by someone who took whatever information Facebook users made public on their pages — and from other publicly available data about those users.

Mr. Kellermann of TrendMicro said the problem with the shortcut could explain how the names and e-mail addresses that Mr. Shopov had found became public. Facebook said the security flaw and the user data for sale had nothing to do with each another.

“We have no reason whatsoever to believe that these two incidents are related,” Mr. Wolens said.

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Alarm Over India’s Dengue Fever Epidemic

Enrico Fabian for The New York Times

A man at the Yamuna River, an ideal breeding ground for mosquitoes. Filthy standing water abounds in New Delhi. More Photos »

NEW DELHI — An epidemic of dengue fever in India is fostering a growing sense of alarm even as government officials here have publicly refused to acknowledge the scope of a problem that experts say is threatening hundreds of millions of people, not just in India but around the world.

India has become the focal point for a mosquito-borne plague that is sweeping the globe. Reported in just a handful of countries in the 1950s, dengue (pronounced DEN-gay) is now endemic in half the world’s nations.

“The global dengue problem is far worse than most people know, and it keeps getting worse,” said Dr. Raman Velayudhan, the World Health Organization’s lead dengue coordinator.

The tropical disease, though life-threatening for a tiny fraction of those infected, can be extremely painful. Growing numbers of Western tourists are returning from warm-weather vacations with the disease, which has reached the shores of the United States and Europe. Last month, health officials in Miami announced a case of locally acquired dengue infection.

Here in India’s capital, where areas of standing water contribute to the epidemic’s growth, hospitals are overrun and feverish patients are sharing beds and languishing in hallways. At Kalawati Saran Hospital, a pediatric facility, a large crowd of relatives lay on mats and blankets under the shade of a huge banyan tree outside the hospital entrance recently.

Among them was Neelam, who said her two grandchildren were deathly ill inside. Eight-year-old Sneha got the disease first, followed by Tanya, 7, she said. The girls’ parents treated them at home but then Sneha’s temperature rose to 104 degrees, a rash spread across her legs and shoulders, and her pain grew unbearable.

“Sneha has been given five liters of blood,” said Neelam, who has one name. “It is terrible.”

Officials say that 30,002 people in India had been sickened with dengue fever through October, a 59 percent jump from the 18,860 recorded for all of 2011. But the real number of Indians who get dengue fever annually is in the millions, several experts said.

“I’d conservatively estimate that there are 37 million dengue infections occurring every year in India, and maybe 227,500 hospitalizations,” said Dr. Scott Halstead, a tropical disease expert focused on dengue research.

A senior Indian government health official, who agreed to speak about the matter only on the condition of anonymity, acknowledged that official figures represent a mere sliver of dengue’s actual toll. The government only counts cases of dengue that come from public hospitals and that have been confirmed by laboratories, the official said. Such a census, “which was deliberated at the highest levels,” is a small subset that is nonetheless informative and comparable from one year to the next, he said.

“There is no denying that the actual number of cases would be much, much higher,” the official said. “Our interest has not been to arrive at an exact figure.”

The problem with that policy, said Dr. Manish Kakkar, a specialist at the Public Health Foundation of India, is that India’s “massive underreporting of cases” has contributed to the disease’s spread. Experts from around the world said that India’s failure to construct an adequate dengue surveillance system has impeded awareness of the illness’s vast reach, discouraged efforts to clean up the sources of the disease and slowed the search for a vaccine.

“When you look at the number of reported cases India has, it’s a joke,” said Dr. Harold S. Margolis, chief of the dengue branch at the Centers for Disease Control and Prevention in Atlanta.

Neighboring Sri Lanka, for instance, reported nearly three times as many dengue cases as India through August, according to the World Health Organization, even though India’s population is 60 times larger.

Hari Kumar contributed reporting.

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Alarm Over India’s Dengue Fever Epidemic

Enrico Fabian for The New York Times

A man at the Yamuna River, an ideal breeding ground for mosquitoes. Filthy standing water abounds in New Delhi. More Photos »

NEW DELHI — An epidemic of dengue fever in India is fostering a growing sense of alarm even as government officials here have publicly refused to acknowledge the scope of a problem that experts say is threatening hundreds of millions of people, not just in India but around the world.

India has become the focal point for a mosquito-borne plague that is sweeping the globe. Reported in just a handful of countries in the 1950s, dengue (pronounced DEN-gay) is now endemic in half the world’s nations.

“The global dengue problem is far worse than most people know, and it keeps getting worse,” said Dr. Raman Velayudhan, the World Health Organization’s lead dengue coordinator.

The tropical disease, though life-threatening for a tiny fraction of those infected, can be extremely painful. Growing numbers of Western tourists are returning from warm-weather vacations with the disease, which has reached the shores of the United States and Europe. Last month, health officials in Miami announced a case of locally acquired dengue infection.

Here in India’s capital, where areas of standing water contribute to the epidemic’s growth, hospitals are overrun and feverish patients are sharing beds and languishing in hallways. At Kalawati Saran Hospital, a pediatric facility, a large crowd of relatives lay on mats and blankets under the shade of a huge banyan tree outside the hospital entrance recently.

Among them was Neelam, who said her two grandchildren were deathly ill inside. Eight-year-old Sneha got the disease first, followed by Tanya, 7, she said. The girls’ parents treated them at home but then Sneha’s temperature rose to 104 degrees, a rash spread across her legs and shoulders, and her pain grew unbearable.

“Sneha has been given five liters of blood,” said Neelam, who has one name. “It is terrible.”

Officials say that 30,002 people in India had been sickened with dengue fever through October, a 59 percent jump from the 18,860 recorded for all of 2011. But the real number of Indians who get dengue fever annually is in the millions, several experts said.

“I’d conservatively estimate that there are 37 million dengue infections occurring every year in India, and maybe 227,500 hospitalizations,” said Dr. Scott Halstead, a tropical disease expert focused on dengue research.

A senior Indian government health official, who agreed to speak about the matter only on the condition of anonymity, acknowledged that official figures represent a mere sliver of dengue’s actual toll. The government only counts cases of dengue that come from public hospitals and that have been confirmed by laboratories, the official said. Such a census, “which was deliberated at the highest levels,” is a small subset that is nonetheless informative and comparable from one year to the next, he said.

“There is no denying that the actual number of cases would be much, much higher,” the official said. “Our interest has not been to arrive at an exact figure.”

The problem with that policy, said Dr. Manish Kakkar, a specialist at the Public Health Foundation of India, is that India’s “massive underreporting of cases” has contributed to the disease’s spread. Experts from around the world said that India’s failure to construct an adequate dengue surveillance system has impeded awareness of the illness’s vast reach, discouraged efforts to clean up the sources of the disease and slowed the search for a vaccine.

“When you look at the number of reported cases India has, it’s a joke,” said Dr. Harold S. Margolis, chief of the dengue branch at the Centers for Disease Control and Prevention in Atlanta.

Neighboring Sri Lanka, for instance, reported nearly three times as many dengue cases as India through August, according to the World Health Organization, even though India’s population is 60 times larger.

Hari Kumar contributed reporting.

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Egyptian Vigilantes Crack Down on Abuse of Women

Tara Todras-Whitehill for The New York Times

A self-appointed citizens patrol that tries to protect women on Cairo’s streets spray-painted a youth for identification last month.

CAIRO — The young activists lingered on the streets around Tahrir Square, scrutinizing the crowds of holiday revelers. Suddenly, they charged, pushing people aside and chasing down a young man. As the captive thrashed to get away, the activists pounded his shoulders, flipped him around and spray-painted a message on his back: “I’m a harasser.”

Egypt’s streets have long been a perilous place for women, who are frequently heckled, grabbed, threatened and violated while the police look the other way. Now, during the country’s tumultuous transition from authoritarian rule, more and more groups are emerging to make protecting women — and shaming the do-nothing police — a cause.

“They’re now doing the undoable?” a police officer joked as he watched the vigilantes chase down the young man. The officer quickly went back to sipping his tea.

The attacks on women did not subside after the uprising. If anything, they became more visible as even the military was implicated in the assaults, stripping female protesters, threatening others with violence and subjecting activists to so-called virginity tests. During holidays, when Cairenes take to the streets to stroll and socialize, the attacks multiply.

But during the recent Id al-Adha holiday, some of the men were surprised to find they could no longer harass with impunity, a change brought about not just out of concern for women’s rights, but out of a frustration that the post-revolutionary government still, like the one before, was doing too little to protect its citizens.

At least three citizens groups patrolled busy sections of central Cairo during the holiday. The groups’ members, both men and women, shared the conviction that the authorities would not act against harassment unless the problem was forced into the public debate. They differed in their tactics: some activists criticized others for being too quick to resort to violence against suspects and encouraging vigilantism.  One group leader compared the activists to the Guardian Angels in the United States.

“The harasser doesn’t see anyone who will hold him accountable,” said Omar Talaat, 16, who joined one of the patrols.

The years of President Hosni Mubarak’s rule were marked by official apathy, collusion in the assaults on women, or empty responses to the attacks, including police roundups of teenagers at Internet cafes for looking at pornography.

“The police did not take harassment seriously,” said Madiha el-Safty, a sociology professor at the American University in Cairo. “People didn’t file complaints. It was always underreported.”

Mr. Mubarak’s wife, Suzanne, who portrayed herself as a champion of women’s rights, pretended the problem hardly existed. As reports of harassment grew in 2008, she said, “Egyptian men always respect Egyptian women.”

Egypt’s new president, Mohamed Morsi, has presided over two holidays, and many activists say there is no sign that the government is paying closer attention to the problem. But the work by the citizens groups may be having an effect: Last week, after the Id al-Adha holiday, Mr. Morsi’s spokesman announced that the government had received more than 1,000 reports of harassment, and said that the president had directed the Interior Ministry to investigate them.

“Egypt’s revolution cannot tolerate these abuses,” the spokesman quoted Mr. Morsi as saying.

Azza Soliman, the director of the Center for Egyptian Women’s Legal Assistance, dismissed the president’s words as “weak.” During the holiday, she said, one of her sons was beaten on the subway after he tried to stop a man who was groping two foreign women. The police tried to stop him from filing a complaint. “The whole world is talking about harassment in our country,” Ms. Soliman said. “The Interior Ministry takes no action.”

For years, anti-harassment activists have worked to highlight the problems in Egypt, but the uprising seemed to give the effort more energy and urgency.

Asmaa Al Zohairy contributed reporting.

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South Carolina Tax Hacking Puts Other States on Alert

The theft of tax information from a South Carolina computer system appears to have been the largest cyberattack ever on a state government and has put other states on high alert, computer security experts say.

The state announced late last month that an international hacker had stolen 3.6 million Social Security numbers and 387,000 credit and debit card numbers. Now tax departments across the country are inspecting their own security systems.

“When one employee’s laptop gets stolen, it’s a big deal,” said Verenda Smith, the deputy director of the National Federation of Tax Administrators. “So you can imagine the reverberations when this news came out.”

Since 2005, at least 11 state tax agencies have faced security breaches, according to the Privacy Rights Clearinghouse, a consumer rights group. But most were caused by internal accidents, not attacks, and none were on this scale.

“As a cyberattack, this appears to be in a league of its own,” said Beth Givens, the group’s director.

The hacking has raised questions about whether South Carolina was unprotected or simply unlucky. Most of the stolen credit cards were encrypted, but the Social Security numbers were not. The computer system that was hacked did not have a free layer of security monitoring offered to all South Carolina agencies, according to the State Budget and Control Board.

In a lawsuit filed last Wednesday, a former state senator, John Hawkins, said the state had failed to protect taxpayers and had not reported the attack promptly. The tax agency detected the attack on Oct. 10 and, after notifying federal authorities, alerted the public on Oct. 26.

“Obviously these hackers picked South Carolina because it was vulnerable,” Mr. Hawkins said. “I equate it to a burglar going into a neighborhood. He’s going to break into the house with no alarms and the door open.”

But South Carolina is hardly the first state to suffer a large-scale security breach. In Texas last year, Social Security records for 3.5 million people were inadvertently disclosed to the public on a computer server.

In Georgia in 2007, a computer disk containing personal information on 2.9 million people disappeared. At the federal Veterans Affairs Department in 2006, an employee lost a laptop and an external hard drive containing the Social Security records of 26.5 million active-duty troops and veterans.

Gov. Nikki R. Haley said that South Carolina had a state-of-the-art security system but that the hacker nevertheless found a way around it. Her office said on Friday that it was encrypting all tax files to reduce the harm if any were stolen, and that the process would be completed within 90 days. The state is paying up to $12 million to provide a free year of credit monitoring and identity theft prevention to anyone affected.

Last Wednesday, the state disclosed that tax records for 657,000 businesses had also been hacked.

Anyone who has filed a tax return since 1998 has been urged to contact state law enforcement officials. By last Thursday, 653,000 people had called the state’s emergency hot line, and 521,000 had signed up for identity protection.

Within state governments, tax agencies face the highest risk for hacking, said Larry Ponemon, the founder of a security research firm, the Ponemon Institute. If stolen, their data can be used for tax fraud, credit card fraud and identity theft.

“This is the crown jewel for a cyberattacker: having the Social Security numbers, personal information and credit card for the same person,” he said.

After the attack, state tax agencies, including in California, said they were monitoring their security particularly closely.

Michael Hicks, the director of the Maryland Cybersecurity Center at the University of Maryland, said states needed a clearer understanding of the attack in South Carolina.

“The only way states can raise the level of vigilance,” Mr. Hicks said, “is if they really get to the bottom of what really happened in this attack.”

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Vital Signs: Limits to Resveratrol as a Metabolism Aid

Resveratrol, the red wine component shown to be helpful in improving metabolic function in obese or diabetic people, has no discernible effect on healthy women who are not obese, a new experiment has found.

In a small 12-week randomized, double-blinded trial, researchers gave 29 normal weight postmenopausal women either 75 milligrams a day of resveratrol or a placebo, testing their metabolic function at the start and end of the study.

Blood concentrations of resveratrol increased in the group given the supplements, but the scientists found no difference between them and those given the placebo in body composition, resting metabolic rate or glucose tolerance (a test for insulin resistance and diabetes).

The study, to be published in this week’s issue of the journal Cell Metabolism, found that blood pressure, heart rate, C-reactive protein levels (a measure of inflammation), LDL, HDL and total cholesterol were unaffected by resveratrol. In other words, resveratrol blood concentrations were associated with no quantifiable changes, beneficial or otherwise, in any measure of metabolic function.

Does this mean that resveratrol offers no benefits? Not necessarily, said the senior author, Dr. Samuel Klein, a professor of medicine at Washington University in St. Louis. “We only show that metabolically healthy people get no benefits to begin with,” he said. “We have no way of knowing whether it will prevent future metabolic complications.”

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Vital Signs: Limits to Resveratrol as a Metabolism Aid

Resveratrol, the red wine component shown to be helpful in improving metabolic function in obese or diabetic people, has no discernible effect on healthy women who are not obese, a new experiment has found.

In a small 12-week randomized, double-blinded trial, researchers gave 29 normal weight postmenopausal women either 75 milligrams a day of resveratrol or a placebo, testing their metabolic function at the start and end of the study.

Blood concentrations of resveratrol increased in the group given the supplements, but the scientists found no difference between them and those given the placebo in body composition, resting metabolic rate or glucose tolerance (a test for insulin resistance and diabetes).

The study, to be published in this week’s issue of the journal Cell Metabolism, found that blood pressure, heart rate, C-reactive protein levels (a measure of inflammation), LDL, HDL and total cholesterol were unaffected by resveratrol. In other words, resveratrol blood concentrations were associated with no quantifiable changes, beneficial or otherwise, in any measure of metabolic function.

Does this mean that resveratrol offers no benefits? Not necessarily, said the senior author, Dr. Samuel Klein, a professor of medicine at Washington University in St. Louis. “We only show that metabolically healthy people get no benefits to begin with,” he said. “We have no way of knowing whether it will prevent future metabolic complications.”

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Facing Protests, China’s Business Investment May Be Cooling

SHIFANG, China — Local leaders were all smiles this summer at a groundbreaking ceremony for a vast copper smelting project that seemed like the answer to the chronic unemployment that has plagued this city in northern Sichuan ever since a devastating earthquake in 2008.

Reuters

A protest against plans to expand a petrochemical plant in Ningbo, China, last month. More investment projects are running into opposition from a growing Chinese middle class concerned about environmental damage.

But within days, the tree-lined plaza at the heart of the city was packed with thousands of youths, protesting that the $1.6 billion factory would pose a pollution hazard. After two nights of street battles pitting youths against the riot police, city leaders canceled the smelter.

“The environment is more important” than new investments or jobs, said a young woman sitting on a recent afternoon at the cafe across the street from the plaza, now empty except for a clutch of retirees gathered under the clock tower.

China’s economic boom over the last three decades has depended overwhelmingly on a build-at-all-costs investment strategy in which pollution concerns, the preservation of neighborhoods and other such questions have been swept aside. But that approach is starting to backfire, posing one of the biggest challenges for the new generation of Chinese policy makers who will take over at the Communist Party Congress, which starts on Thursday.

New investment projects used to be seen as the best way to keep the Chinese public happy with jobs and rising incomes, assuring social stability — a paramount goal of the Communist Party — while frequently enriching local politicians as well.

But from Shifang in the west to the port of Ningbo in the east, where a week of sometimes violent protests forced the suspension on Oct. 28 of plans to expand a chemical plant, more projects are running into public hostility.

In many cases, they are running into opposition not just from farmers who do not want their houses and fields confiscated, but also from a growing middle class fearful that new factories will lead to more environmental damage.

In response to this and other worries about the economy, a number of influential officials and business leaders in China have stepped up their calls for changes aimed at increasing the efficiency of investment and simultaneously shifting the country toward a greater reliance on consumption.

But China’s leaders, including the outgoing prime minister, Wen Jiabao, have been talking about such a transformation for years with little sign of success, as state-controlled banks continue to lend huge sums to politically powerful state-owned enterprises and local governments.

Frenzied construction of roads, bridges, tunnels and rail lines over the last decade has left China with world-class infrastructure. But it has also produced deeply indebted local governments that are struggling to finance more projects.

At the same time, vast unused capacity in practically every industrial sector has crippled profitability and left manufacturing companies straining to repay their borrowings, a problem that has been partly masked by banks in the habit of simply rolling over loans rather than recognizing losses.

“All Chinese industries are like that — can you dig out which area of Chinese industry is not in overcapacity?” said Li Junfeng, a longtime director general for energy at China’s top economic planning agency.

Investment reached 46 percent of China’s economic output last year. By comparison, Japan’s investment rate peaked at 36 percent, which it reached in the early 1970s; South Korea topped out at 39 percent in the late 1980s.

Growth in Japan and South Korea started to slow and eventually tumbled after investment peaked. The big question now is when China will run into the same limits, and how rapidly change will take place, said Diana Choyleva, an economist at Lombard Street Research in Hong Kong. “The potential for a big crisis is always there,” she said.

Even experts who strongly favor fundamental policy changes, like moving to a more market-oriented system for allocating bank loans and setting interest rates, doubt that China’s leaders are preparing to move quickly. Conversations at senior levels of the Communist Party appear to have focused so far on reducing the state’s role in the day-to-day management of many state-owned enterprises rather than selling them or breaking them up.

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