During Trial, New Details Emerge on DuPuy Hip

When Johnson & Johnson announced the appointment in 2011 of an executive to head the troubled orthopedics division whose badly flawed artificial hip had been recalled, the company billed the move as a fresh start.

But that same executive, it turns out, had supervised the implant’s introduction in the United States and had been told by a top company consultant three years before the device was recalled that it was faulty.

In addition, the executive also held a senior marketing position at a time when Johnson & Johnson decided not to tell officials outside the United States that American regulators had refused to allow sale of a version of the artificial hip in this country.

The details about the involvement of the executive, Andrew Ekdahl, with the all-metal hip implant emerged Wednesday in Los Angeles Superior Court during the trial of a patient lawsuit against the DePuy Orthopaedics division of Johnson & Johnson. More than 10,000 lawsuits have been filed against DePuy in connection with the device — the Articular Surface Replacement, or A.S.R. — and the Los Angeles case is the first to go to trial.

The information about the depth of Mr. Ekdahl’s involvement with the implant may raise questions about DePuy’s ability to put the A.S.R. episode behind it.

Asked in an e-mail why the company had promoted Mr. Ekdahl, a DePuy spokeswoman, Lorie Gawreluk, said the company “seeks the most accomplished and competent people for the job.”

On Wednesday, portions of Mr. Ekdahl’s videotaped testimony were shown to jurors in the Los Angeles case. Other top DePuy marketing executives who played roles in the A.S.R. development are expected to testify in coming days. Mr. Ekdahl, when pressed in the taped questioning on whether DePuy had recalled the A.S.R. because it was unsafe, repeatedly responded that the company had recalled it “because it did not meet the clinical standards we wanted in the marketplace.”

Before the device’s recall in mid-2010, Mr. Ekdahl and those executives all publicly asserted that the device was performing extremely well. But internal documents that have become public as a result of litigation conflict with such statements.

In late 2008, for example, a surgeon who served as one of DePuy’s top consultants told Mr. Ekdahl and two other DePuy marketing officials that he was concerned about the cup component of the A.S.R. and believed it should be “redesigned.” At the time, DePuy was aggressively promoting the device in the United States as a breakthrough and it was being implanted into thousands of patients.

“My thoughts would be that DePuy should at least de-emphasize the A.S.R. cup while the clinical results are studied,” that consultant, Dr. William Griffin, wrote.

A spokesman for Dr. Griffin said he was not available for comment.

The A.S.R., whose cup and ball components were both made of metal, was first sold by DePuy in 2003 outside the United States for use in an alternative hip replacement procedure called resurfacing. Two years later, DePuy started selling another version of the A.S.R. for use here in standard hip replacement that used the same cup component as the resurfacing device. Only the standard A.S.R. was sold in the United States; both versions were sold outside the country.

Before the device recall in mid-2010, about 93,000 patients worldwide received an A.S.R., about a third of them in this country. Internal DePuy projections estimate that it will fail in 40 percent of those patients within five years; a rate eight times higher than for many other hip devices.

Mr. Ekdahl testified via tape Wednesday that he had been placed in charge of the 2005 introduction of the standard version of the A.S.R. in this country. Within three years, he and other DePuy executives were receiving reports that the device was failing prematurely at higher than expected rates, apparently because of problems related to the cup’s design, documents disclosed during the trial indicate.

Along with other DePuy executives, he also participated in a meeting that resulted in a proposal to redesign the A.S.R. cup. But that plan was dropped, apparently because sales of the implant had not justified the expense, DePuy documents indicate.

In the face of growing complaints from surgeons about the A.S.R., DePuy officials maintained that the problems were related to how surgeons were implanting the cup, not from any design flaw. But in early 2009, a DePuy executive wrote to Mr. Ekdahl and other marketing officials that the early failures of the A.S.R. resurfacing device and the A.S.R. traditional implant, known as the XL, were most likely design-related.

“The issue seen with A.S.R. and XL today, over five years post-launch, are most likely linked to the inherent design of the product and that is something we should recognize,” that executive, Raphael Pascaud wrote in March 2009.

Last year, The New York Times reported that DePuy executives decided in 2009 to phase out the A.S.R. and sell existing inventories weeks after the Food and Drug Administration asked the company for more safety data about the implant.

The F.D.A. also told the company at that time that it was rejecting its efforts to sell the resurfacing version of the device in the United States because of concerns about “high concentration of metal ions” in the blood of patients who received it.

DePuy never disclosed the F.D.A. ruling to regulators in other countries where it was still marketing the resurfacing version of the implant.

During a part of that period, Mr. Ekdahl was overseeing sales in Europe and other regions for DePuy. When The Times article appeared last year, he issued a statement, saying that any implication that the F.D.A. had determined there were safety issues with the A.S.R. was “simply untrue.” “This was purely a business decision,” Mr. Ekdahl stated at that time.

This article has been revised to reflect the following correction:

Correction: February 1, 2013

A headline on Thursday about a patient lawsuit against DePuy Orthopaedics, a unit of Johnson & Johnson, misstated the start of the trial in some copies. It began last week, not on Wednesday.

Read More..

During Trial, New Details Emerge on DuPuy Hip

When Johnson & Johnson announced the appointment in 2011 of an executive to head the troubled orthopedics division whose badly flawed artificial hip had been recalled, the company billed the move as a fresh start.

But that same executive, it turns out, had supervised the implant’s introduction in the United States and had been told by a top company consultant three years before the device was recalled that it was faulty.

In addition, the executive also held a senior marketing position at a time when Johnson & Johnson decided not to tell officials outside the United States that American regulators had refused to allow sale of a version of the artificial hip in this country.

The details about the involvement of the executive, Andrew Ekdahl, with the all-metal hip implant emerged Wednesday in Los Angeles Superior Court during the trial of a patient lawsuit against the DePuy Orthopaedics division of Johnson & Johnson. More than 10,000 lawsuits have been filed against DePuy in connection with the device — the Articular Surface Replacement, or A.S.R. — and the Los Angeles case is the first to go to trial.

The information about the depth of Mr. Ekdahl’s involvement with the implant may raise questions about DePuy’s ability to put the A.S.R. episode behind it.

Asked in an e-mail why the company had promoted Mr. Ekdahl, a DePuy spokeswoman, Lorie Gawreluk, said the company “seeks the most accomplished and competent people for the job.”

On Wednesday, portions of Mr. Ekdahl’s videotaped testimony were shown to jurors in the Los Angeles case. Other top DePuy marketing executives who played roles in the A.S.R. development are expected to testify in coming days. Mr. Ekdahl, when pressed in the taped questioning on whether DePuy had recalled the A.S.R. because it was unsafe, repeatedly responded that the company had recalled it “because it did not meet the clinical standards we wanted in the marketplace.”

Before the device’s recall in mid-2010, Mr. Ekdahl and those executives all publicly asserted that the device was performing extremely well. But internal documents that have become public as a result of litigation conflict with such statements.

In late 2008, for example, a surgeon who served as one of DePuy’s top consultants told Mr. Ekdahl and two other DePuy marketing officials that he was concerned about the cup component of the A.S.R. and believed it should be “redesigned.” At the time, DePuy was aggressively promoting the device in the United States as a breakthrough and it was being implanted into thousands of patients.

“My thoughts would be that DePuy should at least de-emphasize the A.S.R. cup while the clinical results are studied,” that consultant, Dr. William Griffin, wrote.

A spokesman for Dr. Griffin said he was not available for comment.

The A.S.R., whose cup and ball components were both made of metal, was first sold by DePuy in 2003 outside the United States for use in an alternative hip replacement procedure called resurfacing. Two years later, DePuy started selling another version of the A.S.R. for use here in standard hip replacement that used the same cup component as the resurfacing device. Only the standard A.S.R. was sold in the United States; both versions were sold outside the country.

Before the device recall in mid-2010, about 93,000 patients worldwide received an A.S.R., about a third of them in this country. Internal DePuy projections estimate that it will fail in 40 percent of those patients within five years; a rate eight times higher than for many other hip devices.

Mr. Ekdahl testified via tape Wednesday that he had been placed in charge of the 2005 introduction of the standard version of the A.S.R. in this country. Within three years, he and other DePuy executives were receiving reports that the device was failing prematurely at higher than expected rates, apparently because of problems related to the cup’s design, documents disclosed during the trial indicate.

Along with other DePuy executives, he also participated in a meeting that resulted in a proposal to redesign the A.S.R. cup. But that plan was dropped, apparently because sales of the implant had not justified the expense, DePuy documents indicate.

In the face of growing complaints from surgeons about the A.S.R., DePuy officials maintained that the problems were related to how surgeons were implanting the cup, not from any design flaw. But in early 2009, a DePuy executive wrote to Mr. Ekdahl and other marketing officials that the early failures of the A.S.R. resurfacing device and the A.S.R. traditional implant, known as the XL, were most likely design-related.

“The issue seen with A.S.R. and XL today, over five years post-launch, are most likely linked to the inherent design of the product and that is something we should recognize,” that executive, Raphael Pascaud wrote in March 2009.

Last year, The New York Times reported that DePuy executives decided in 2009 to phase out the A.S.R. and sell existing inventories weeks after the Food and Drug Administration asked the company for more safety data about the implant.

The F.D.A. also told the company at that time that it was rejecting its efforts to sell the resurfacing version of the device in the United States because of concerns about “high concentration of metal ions” in the blood of patients who received it.

DePuy never disclosed the F.D.A. ruling to regulators in other countries where it was still marketing the resurfacing version of the implant.

During a part of that period, Mr. Ekdahl was overseeing sales in Europe and other regions for DePuy. When The Times article appeared last year, he issued a statement, saying that any implication that the F.D.A. had determined there were safety issues with the A.S.R. was “simply untrue.” “This was purely a business decision,” Mr. Ekdahl stated at that time.

This article has been revised to reflect the following correction:

Correction: February 1, 2013

A headline on Thursday about a patient lawsuit against DePuy Orthopaedics, a unit of Johnson & Johnson, misstated the start of the trial in some copies. It began last week, not on Wednesday.

Read More..

Syria’s Confirmation of Airstrike May Undercut Israel’s Strategy of Silence

Jim Hollander/European Pressphoto Agency

In East Jerusalem, Israelis distributed gas masks on Wednesday as worries about security spread. More Photos »

JERUSALEM — Israeli officials remained stone silent on Thursday about their airstrike in Syrian territory the day before, a tactic that experts said was part of a longstanding strategy to give targeted countries face-saving opportunities to avoid conflict escalation. But Syria’s own confirmation of the attack, followed by harsh condemnation not only by Israel’s enemies Iran and Hezbollah but also by Russia, may have undercut that effort, analysts said, increasing the likelihood of retaliation, which could prompt further Israeli attacks.

“From the moment they chose to say Israel did something, it means someone has to do something after that,” said Giora Eiland, a former head of Israel’s National Security Council and a longtime military leader. “Contrary to what I could hope and believe yesterday, that this round of events would end soon, now I am much less confident.”

The Iranian deputy foreign minister warned Thursday that Israel’s strike would lead to “grave consequences for Tel Aviv,” while the Russian Foreign Ministry issued a statement saying that the strike “blatantly violates the United Nations Charter and is unacceptable and unjustified, whatever its motives.”

Israel has not acknowledged the attack, which American officials say hit a convoy before dawn Wednesday that was ferrying sophisticated antiaircraft missiles called SA-17s to Lebanon. The Syrians and their allies said the target was actually a scientific research facility in the Damascus suburbs. It remained unclear Thursday whether there was in fact one strike or two, and what involvement the research outpost might have had in weapons production or storage for Syria or Hezbollah, the militant Lebanese Shiite organization that has long battled with Israel.

Most experts agree that Syria, Hezbollah and Israel each have strong reasons to want to avoid a new active conflict right now: the Syrian president, Bashar al-Assad, is fighting for his survival in a violent and chaotic civil war; Hezbollah is struggling for political legitimacy at home and battling its label as a terrorist organization internationally; and Israel is trying to keep its head down in an increasingly volatile region.

But it is equally clear that Hezbollah — backed by Syria and Iran — wants desperately to upgrade its arsenal in hopes of changing the parameters for any future engagement with the powerful Israeli military, and that Israel is determined to stop it. And Hezbollah is perhaps even more anxious to gird itself for future challenges to its primacy in Lebanon, especially if a Sunni-led revolution triumphs next door in Syria.

Benjamin Netanyahu, the Israeli prime minister, and his deputies said loud and clear in the days leading up to the strike that they saw any transfer of Syria’s extensive cache of chemical weapons, or of sophisticated conventional weapons systems, as a “red line” that would prompt action. Now that it has followed through on that threat, even without admitting it, analysts expect Israel — perhaps backed by its Western allies — to similarly target any future convoys attempting the same feat.

“Once this red line has been crossed, it’s definitely going to be crossed time and again from now on, especially as the situation of the Assad regime will deteriorate,” said Boaz Ganor, head of the International Institute for Counterterrorism at the Interdisciplinary Center in Herzliya, Israel. “They will do the utmost to gain control of those weapons. In that case, I don’t see why Israel wouldn’t have the same type of calculation that Israel had two days ago into the future.”

Mr. Ganor said the United States and Europe should be as concerned as Israel, because Syria’s chemical weapons could end up in the hands not of Hezbollah but of jihadist organizations like Al Qaeda or its proxies. “If one organization will put their hands on this arsenal, then it will change hands in no time and we’ll see it all over the world,” he said. “We, the international community, are marching into a new era of terrorism.”

Eyal Zisser, a historian at Tel Aviv University who specializes in Syria and Lebanon, said that if there was no retaliation to Wednesday’s airstrike, “Why not repeat it? For Israel it’s going to be the practice.” The question, Professor Zisser said, “is what they will try to do next, Syria and Hezbollah, if there is another Israeli attack, whether they will avoid any retaliation the next time as well.”Israel’s steadfast silence on the airstrike was reminiscent of its posture after it destroyed a Syrian nuclear reactor in 2007 — an attack it has never acknowledged, though many officials discuss it with winks and nods. But in that case, President Assad bought into the de-escalation strategy by saying the attack had hit an unused — and implicitly unimportant — military building, relieving the pressure for a response.

Syria and Israel are technically at war, though there has long been a wary calm along the decades-old armistice line. Though Wednesday’s strike was on Syrian soil, analysts said its actual goal was to send a strong signal to Hezbollah — something the Lebanese organization tried to deflect in its own statement after the attack, which expressed “solidarity with Syria’s leadership, army and people.”

Reporting was contributed by Irit Pazner Garshowitz from Jerusalem, Ellen Barry from Moscow, Thomas Erdbrink from Tehran and Anne Barnard from Beirut, Lebanon.

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Chinese Hackers Infiltrate New York Times Computers

SAN FRANCISCO — For the last four months, Chinese hackers have persistently attacked The New York Times, infiltrating its computer systems and getting passwords for its reporters and other employees.

The New York Times published an article in October about the wealth of the family of China's prime minister, Wen Jiabao, in both English and Chinese.

After surreptitiously tracking the intruders to study their movements and help erect better defenses to block them, The Times and computer security experts have expelled the attackers and kept them from breaking back in.

The timing of the attacks coincided with the reporting for a Times investigation, published online on Oct. 25, that found that the relatives of Wen Jiabao, China’s prime minister, had accumulated a fortune worth several billion dollars through business dealings.

Security experts hired by The Times to detect and block the computer attacks gathered digital evidence that Chinese hackers, using methods that some consultants have associated with the Chinese military in the past, breached The Times’s network. They broke into the e-mail accounts of its Shanghai bureau chief, David Barboza, who wrote the reports on Mr. Wen’s relatives, and Jim Yardley, The Times’s South Asia bureau chief in India, who previously worked as bureau chief in Beijing.

“Computer security experts found no evidence that sensitive e-mails or files from the reporting of our articles about the Wen family were accessed, downloaded or copied,” said Jill Abramson, executive editor of The Times.

The hackers tried to cloak the source of the attacks on The Times by first penetrating computers at United States universities and routing the attacks through them, said computer security experts at Mandiant, the company hired by The Times. This matches the subterfuge used in many other attacks that Mandiant has tracked to China.

The attackers first installed malware — malicious software — that enabled them to gain entry to any computer on The Times’s network. The malware was identified by computer security experts as a specific strain associated with computer attacks originating in China. More evidence of the source, experts said, is that the attacks started from the same university computers used by the Chinese military to attack United States military contractors in the past.

Security experts found evidence that the hackers stole the corporate passwords for every Times employee and used those to gain access to the personal computers of 53 employees, most of them outside The Times’s newsroom. Experts found no evidence that the intruders used the passwords to seek information that was not related to the reporting on the Wen family.

No customer data was stolen from The Times, security experts said.

Asked about evidence that indicated the hacking originated in China, and possibly with the military, China’s Ministry of National Defense said, “Chinese laws prohibit any action including hacking that damages Internet security.” It added that “to accuse the Chinese military of launching cyberattacks without solid proof is unprofessional and baseless.”

The attacks appear to be part of a broader computer espionage campaign against American news media companies that have reported on Chinese leaders and corporations.

Last year, Bloomberg News was targeted by Chinese hackers, and some employees’ computers were infected, according to a person with knowledge of the company’s internal investigation, after Bloomberg published an article on June 29 about the wealth accumulated by relatives of Xi Jinping, China’s vice president at the time. Mr. Xi became general secretary of the Communist Party in November and is expected to become president in March. Ty Trippet, a spokesman for Bloomberg, confirmed that hackers had made attempts but said that “no computer systems or computers were compromised.”

Signs of a Campaign

The mounting number of attacks that have been traced back to China suggest that hackers there are behind a far-reaching spying campaign aimed at an expanding set of targets including corporations, government agencies, activist groups and media organizations inside the United States. The intelligence-gathering campaign, foreign policy experts and computer security researchers say, is as much about trying to control China’s public image, domestically and abroad, as it is about stealing trade secrets.

This article has been revised to reflect the following correction:

Correction: January 31, 2013

An earlier version of this article misstated the year that the United States and Israel were said to have started a cyber attack that caused damage at Iran’s main nuclear enrichment plant, and the article misstated the specific type of attack. The attack was a computer worm, not a virus, and it started around 2008, not 2012.

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Well: Waiting for Alzheimer's to Begin

My gray matter might be waning. Then again, it might not be. But I swear that I can feel memories — as I’m making them — slide off a neuron and into a tangle of plaque. I steel myself for those moments to come when I won’t remember what just went into my head.

I’m not losing track of my car keys, which is pretty standard in aging minds. Nor have I ever forgotten to turn off the oven after use, common in menopausal women. I can always find my car in the parking lot, although lots of “normal” folk can’t.

Rather, I suddenly can’t remember the name of someone with whom I’ve worked for years. I cover by saying “sir” or “madam” like the Southerner I am, even though I live in Vermont and grown people here don’t use such terms. Better to think I’m quirky than losing my faculties. Sometimes I’ll send myself an e-mail to-do reminder and then, seconds later, find myself thrilled to see a new entry pop into my inbox. Oops, it’s from me. Worse yet, a massage therapist kicked me out of her practice for missing three appointments. I didn’t recall making any of them. There must another Nancy.

Am I losing track of me?

Equally worrisome are the memories increasingly coming to the fore. Magically, these random recollections manage to circumnavigate my imagined build-up of beta-amyloid en route to delivering vivid images of my father’s first steps down his path of forgetting. He was the same age I am now, which is 46.

“How old are you?” I recall him asking me back then. Some years later, he began calling me every Dec. 28 to say, “Happy birthday,” instead of on the correct date, Dec. 27. The 28th had been his grandmother’s birthday.

The chasms were small at first. Explainable. Dismissible. When he crossed the street without looking both ways, we chalked it up to his well-cultivated, absent-minded professor persona. But the chasms grew into sinkholes, and eventually quicksand. When we took him to get new pants one day, he kept trying on the same ones he wore to the store.

“I like these slacks,” he’d say, over and over again, as he repeatedly pulled his pair up and down.

My dad died of Alzheimer’s last April at age 73 — the same age at which his father succumbed to the same disease. My dad ended up choosing neurology as his profession after witnessing the very beginning of his own dad’s forgetting.

Decades later, grandfather’s atrophied brain found its way into a jar on my father’s office desk. Was it meant to be an ever-present reminder of Alzheimer’s effect? Or was it a crystal ball sent to warn of genetic fate? My father the doctor never said, nor did he ever mention, that it was his father’s gray matter floating in that pool of formaldehyde.

Using the jarred brain as a teaching tool, my dad showed my 8-year-old self the difference between frontal and temporal lobes. He also pointed out how brains with Alzheimer’s disease become smaller, and how wide grooves develop in the cerebral cortex. But only after his death — and my mother’s confession about whose brain occupied that jar — did I figure out that my father was quite literally demonstrating how this disease runs through our heads.

Has my forgetting begun?

I called my dad’s neurologist. To find out if I was in the earliest stages of Alzheimer’s, he would have to look for proteins in my blood or spinal fluid and employ expensive neuroimaging tests. If he found any indication of onset, the only option would be experimental trials.

But documented confirmation of a diseased brain would break my still hopeful heart. I’d walk around with the scarlet letter “A” etched on the inside of my forehead — obstructing how I view every situation instead of the intermittent clouding I currently experience.

“You’re still grieving your father,” the doctor said at the end of our call. “Sadness and depression affect the memory, too. Let’s wait and see.”

It certainly didn’t help matters that two people at my father’s funeral made some insensitive remarks.

“Nancy, you must be scared to death.”

“Is it hard knowing the same thing probably will happen to you?”

Maybe the real question is what to do when the forgetting begins. My dad started taking 70 supplements a day in hopes of saving his mind. He begged me to kill him if he wound up like his father. He retired from his practice and spent all day in a chair doing puzzles. He stopped making new memories in an all-out effort to preserve the ones he already had.

Maybe his approach wasn’t the answer.

Just before his death — his brain a fraction of its former self — my father managed to offer up a final lesson. I was visiting him in the memory-care center when he got a strange look on his face. I figured it was gas. But then his eyes lit up and a big grin overtook him, and he looked right at me and said, “Funny how things turn out.”

An unforgettable moment?

I can only hope.

---

Nancy Stearns Bercaw is a writer in Vermont. Her book, “Brain in a Jar: A Daughter’s Journey Through Her Father’s Memory,” will be published in April 2013 by Broadstone.

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Well: Waiting for Alzheimer's to Begin

My gray matter might be waning. Then again, it might not be. But I swear that I can feel memories — as I’m making them — slide off a neuron and into a tangle of plaque. I steel myself for those moments to come when I won’t remember what just went into my head.

I’m not losing track of my car keys, which is pretty standard in aging minds. Nor have I ever forgotten to turn off the oven after use, common in menopausal women. I can always find my car in the parking lot, although lots of “normal” folk can’t.

Rather, I suddenly can’t remember the name of someone with whom I’ve worked for years. I cover by saying “sir” or “madam” like the Southerner I am, even though I live in Vermont and grown people here don’t use such terms. Better to think I’m quirky than losing my faculties. Sometimes I’ll send myself an e-mail to-do reminder and then, seconds later, find myself thrilled to see a new entry pop into my inbox. Oops, it’s from me. Worse yet, a massage therapist kicked me out of her practice for missing three appointments. I didn’t recall making any of them. There must another Nancy.

Am I losing track of me?

Equally worrisome are the memories increasingly coming to the fore. Magically, these random recollections manage to circumnavigate my imagined build-up of beta-amyloid en route to delivering vivid images of my father’s first steps down his path of forgetting. He was the same age I am now, which is 46.

“How old are you?” I recall him asking me back then. Some years later, he began calling me every Dec. 28 to say, “Happy birthday,” instead of on the correct date, Dec. 27. The 28th had been his grandmother’s birthday.

The chasms were small at first. Explainable. Dismissible. When he crossed the street without looking both ways, we chalked it up to his well-cultivated, absent-minded professor persona. But the chasms grew into sinkholes, and eventually quicksand. When we took him to get new pants one day, he kept trying on the same ones he wore to the store.

“I like these slacks,” he’d say, over and over again, as he repeatedly pulled his pair up and down.

My dad died of Alzheimer’s last April at age 73 — the same age at which his father succumbed to the same disease. My dad ended up choosing neurology as his profession after witnessing the very beginning of his own dad’s forgetting.

Decades later, grandfather’s atrophied brain found its way into a jar on my father’s office desk. Was it meant to be an ever-present reminder of Alzheimer’s effect? Or was it a crystal ball sent to warn of genetic fate? My father the doctor never said, nor did he ever mention, that it was his father’s gray matter floating in that pool of formaldehyde.

Using the jarred brain as a teaching tool, my dad showed my 8-year-old self the difference between frontal and temporal lobes. He also pointed out how brains with Alzheimer’s disease become smaller, and how wide grooves develop in the cerebral cortex. But only after his death — and my mother’s confession about whose brain occupied that jar — did I figure out that my father was quite literally demonstrating how this disease runs through our heads.

Has my forgetting begun?

I called my dad’s neurologist. To find out if I was in the earliest stages of Alzheimer’s, he would have to look for proteins in my blood or spinal fluid and employ expensive neuroimaging tests. If he found any indication of onset, the only option would be experimental trials.

But documented confirmation of a diseased brain would break my still hopeful heart. I’d walk around with the scarlet letter “A” etched on the inside of my forehead — obstructing how I view every situation instead of the intermittent clouding I currently experience.

“You’re still grieving your father,” the doctor said at the end of our call. “Sadness and depression affect the memory, too. Let’s wait and see.”

It certainly didn’t help matters that two people at my father’s funeral made some insensitive remarks.

“Nancy, you must be scared to death.”

“Is it hard knowing the same thing probably will happen to you?”

Maybe the real question is what to do when the forgetting begins. My dad started taking 70 supplements a day in hopes of saving his mind. He begged me to kill him if he wound up like his father. He retired from his practice and spent all day in a chair doing puzzles. He stopped making new memories in an all-out effort to preserve the ones he already had.

Maybe his approach wasn’t the answer.

Just before his death — his brain a fraction of its former self — my father managed to offer up a final lesson. I was visiting him in the memory-care center when he got a strange look on his face. I figured it was gas. But then his eyes lit up and a big grin overtook him, and he looked right at me and said, “Funny how things turn out.”

An unforgettable moment?

I can only hope.

---

Nancy Stearns Bercaw is a writer in Vermont. Her book, “Brain in a Jar: A Daughter’s Journey Through Her Father’s Memory,” will be published in April 2013 by Broadstone.

Read More..

Syrian Opposition Leader Softens Position on Talks with Assad

Goran Tomasevic/Reuters

Free Syrian Army fighters ran for cover as a tank shell exploded against a wall. More Photos »

BEIRUT, Lebanon — Syria’s top political opposition leader on Wednesday expressed willingness for the first time to talk with representatives of President Bashar al-Assad, softening what had been an absolute refusal to negotiate with the government in an increasingly chaotic civil war.

The opposition leader, Sheik Ahmad Moaz al-Khatib, coupled his offer with two demands: the release of what he described as 160,000 prisoners held by Mr. Assad’s government, and the renewal of all expired passports held by Syrians abroad — a gesture apparently aimed at disaffected expatriates and exiled opposition figures who could not return home even if they wanted to.

Sheik Khatib’s offer, published in Arabic on his Facebook page, quickly provoked sharp criticism from others in the Syrian opposition coalition, with some distancing themselves and complaining that the leader had not consulted with colleagues in advance. The sheik later clarified in a second statement that he was expressing his personal opinion, while he chided critics in among his colleagues who he described as “those sitting down on their couches and then saying ‘Attack — don’t negotiate.’ ”

The mutual criticisms reflected the fractiousness that has plagued the Syrian opposition movement since its struggle to depose Mr. Assad began as a peaceful political movement nearly two years ago. Nonetheless, the offer still represented a potential opening for dialogue in the conflict, which has threatened to destabilize the Middle East.

Sheik Khatib made the offer as the United Nations was scrambling to raise money to manage the humanitarian crisis caused by the conflict, which has sent at least 700,000 Syrians into neighboring countries and left more than one million displaced inside Syria. A donor conference under way in Kuwait has produced commitments for about $1 billion of the $1.5 billion that the United Nations is seeking.

“I announce that I am willing to sit down with representatives of the Syrian regime in Cairo or Tunisia or Istanbul,” Sheik Khatib said in the offer. His motivation to make such an offer, he said, was “to search for a political resolution to the crisis, and to arrange matters for the transitional phase that could prevent more blood.”

There was no immediate Syrian government response to Sheik Khatib, a respected Sunni cleric who once had been the imam of the historic Umayyad mosque in Damascus. His unified Syrian opposition coalition, created at a meeting in Qatar two months ago, has been formally recognized by the Arab League, the European Union and the United States.

Sheik Khatib’s offer was made less than a day after the peace envoy for Syria from the United Nations and Arab League, Lakhdar Brahimi, gave the United Nations Security Council a pessimistic prognosis for negotiations.

It also followed a grisly massacre discovered on Tuesday in the contested northern city of Aleppo, from which anti-Assad activists posted videos online of scores of bound victims who had been shot in the head and dumped in a river. Some insurgents said the death toll exceeded 100, mostly abducted men in their 20s and 30s.

Both sides in the conflict blamed the other for those killings, just as they have traded accusations for other atrocities, including two major explosions a few weeks ago that killed more than 80 people at the University of Aleppo. Outside assessments based on video of the university blasts have suggested that a Syrian military missile was responsible.

Sheik Khatib did not hide his contempt for Mr. Assad’s government in his statement, saying, “One can’t trust a regime that kills children and attacks bakeries and shells universities and destroys Syria’s infrastructure and commits massacres against innocents, the last of which won’t be the Aleppo massacre, which is unprecedented in its savagery.”

But he decided to reach out, he wrote, partly because the Syrian government had publicly invited political opposition leaders this week to return to Damascus for what it called a dialogue.

Three weeks ago, Mr. Assad said in a speech that he was open to reconciliation talks but not with political opponents he described as terrorists, the government’s generic term for armed insurgents. At the time, most members of the political opposition dismissed Mr. Assad’s speech as meaningless.

The opposition’s longstanding position has been that Mr. Assad must resign as a precondition for any talks and that he cannot be part of any transitional government. Mr. Assad and his aides have said he has no intention of resigning and may even run for another term in elections next year.

Hania Mourtada reported from Beirut, and Rick Gladstone from New York. Reporting was contributed by Anne Barnard and Hwaida Saad from Beirut.

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State of the Art: The BlackBerry, Rebuilt, Lives to Fight Another Day

I’m sorry. I was wrong.

This apology is for the bespectacled student at my talk in Cleveland, and the lady in the red dress in Florida, and anyone else who’s recently asked me about the future of the BlackBerry. I told all of them the same thing: that it’s doomed.

That wasn’t an outrageous opinion. The BlackBerry’s share of the smartphone market is a dismal 2.9 percent, down from 85 percent a few years ago. Its stock has crashed almost 90 percent from its 2008 peak. In the last two years, the BlackBerry’s maker, Research in Motion, released a disastrous tablet, laid off thousands of employees and fired its C.E.O.’s. The whole operation seemed to be one gnat-sneeze away from total collapse.

The company — which changed its name on Wednesday to simply BlackBerry — kept saying that it had a miraculous new BlackBerry in the wings with a new operating system called BlackBerry 10. But it was delayed and delayed and delayed. Nobody believed anything the company said anymore. Besides — even if there were some great phone, what prayer did BlackBerry have of catching up to the iPhone and Android phones now? Even Microsoft, with its slick, quick Windows Phone, hasn’t managed that trick.

Well, BlackBerry’s Hail Mary pass, its bet-the-farm phone, is finally here. It’s the BlackBerry Z10, and guess what? It’s lovely, fast and efficient, bristling with fresh, useful ideas.

And here’s the shocker — it’s complete. The iPhone, Android and Windows Phone all entered life missing important features. Not this one; BlackBerry couldn’t risk building a lifeboat with leaks. So it’s all here: a well-stocked app store, a music and movie store, Mac and Windows software for loading files, speech recognition, turn-by-turn navigation, parental controls, copy and paste, Find My Phone (with remote-control lock and erase) and on and on.

The hardware is all here, too. The BlackBerry’s 4.2-inch screen is even sharper than the iPhone’s vaunted Retina display (356 pixels per inch versus 326). Both front and back cameras can film in high definition (1080p back, 720p front).

The thin, sleek, black BlackBerry has 16 gigabytes of storage, plus a memory card slot for expansion. Its textured back panel pops off easily so that you can swap batteries. It will be available from all four major carriers — Verizon, AT&T, Sprint and T-Mobile — and Verizon said it would charge $200 with a two-year contract.

Some of BlackBerry 10’s ideas are truly ingenious. A subtle light blinks above the screen to indicate that something — a text, an e-mail message, voice mail, a Facebook post — is waiting for you. Without even pressing a physical button, you swipe up the screen; the Lock screen lifts like a drape as you slide your thumb, revealing what’s underneath. It’s fast and cool.

There are no individual app icons for Messages or Mail. Instead, all communication channels (including Facebook, Twitter and phone calls) are listed in the Hub — a master in-box list that appears at the left edge when you swipe inward. Each reveals how many new messages await and offers a one-tap jump into the corresponding app. It’s a one-stop command center that makes eminent sense.

The BlackBerry’s big selling point has always been its physical keyboard. The company says it will, in fact, sell a model with physical keys (and a smaller screen) called the Q10.

But you might not need it. On the all-touch-screen model, BlackBerry has come up with a mind-bogglingly clever typing system. Stay with me here:

As you type a word, tiny, complete words appear over certain on-screen keys — guesses as to the word you’re most likely to want. If you’ve typed “made of sil,” for example, the word “silicone” appears over the letter I key, “silver” over the V, and “silk” over the K. You can fling one of these words into your text by flicking upward from the key — or ignore it and keep typing.

How well does it work? In this passage, the only letters I actually had to type are shown in bold. The BlackBerry proposed the rest: “I’m going to have to cancel for tonight. There is a really good episode of Dancing With the Stars on.”

I type 20 characters; it typed 61 for me.

But wait, there’s more. The more you use the BlackBerry, the more it learns your way of writing. When I tried that same passage later, I typed only one letter: the I in “I’m.” Thereafter, the phone predicted each successive word in those sentences, requiring no letter-key presses at all. Freaky and brilliant and very, very fast.

There’s speech recognition, too. Hold in the Play/Pause key to get the Z10’s Siri-like assistant. Siri-like in concept, that is — you can say “send an e-mail to Harvey Smith,” “schedule an appointment” and a few other things — but it’s slower, less accurate and far narrower in scope. You can also speak to type, but the accuracy is so bad, you won’t use it.

This article has been revised to reflect the following correction:

Correction: January 30, 2013

An earlier version of this column reported incorrect information on the amount that cellphone carriers would charge for the new BlackBerry Z10. AT&T, Sprint and T-Mobile said they would announce pricing information in the future; they have not announced they will charge $200 with a two-year contract (as Verizon has).    

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BlackBerry 10’s Debut Is a Critical Day for Research in Motion

OTTAWA — Research in Motion’s introduction on Wednesday of a new BlackBerry phone will be the most important event in the company’s history since 1996, when its founders showed investors a small block of wood and promised that a wireless e-mail device shaped like that would change business forever.

Now with just 4.6 percent of the global market for smartphones in 2012, according to IDC, RIM long ago exchanged dominance for survival mode. On Wednesday, the company will introduce a new line of smartphones called the BlackBerry 10 and an operating system of the same name that Thorsten Heins, the president and chief executive of RIM, says will restore the company to glory.

But Frank Mersch, who became one of RIM’s earliest investors after seeing the block of wood, is far less excited by what he sees this time around.

“You’re in a very, very competitive market and you’re not the leader,” Mr. Mersch, now the chairman and a vice president at Front Street Capital in Toronto, said of RIM. “You have to ask: ‘At the end of the day are we really going to win?’ I personally think the jury’s out on that.”

The main elements of the new phones and their operating system are already well known. Mr. Heins and other executives at RIM have been demonstrating the units for months to a variety of audiences. App developers received prototype versions as far back as last spring.

While analysts and app developers may be divided about the future of RIM, there is a consensus that BlackBerry 10, which arrives more than year behind schedule, was worth the wait.

Initially RIM will release two variations of the BlackBerry 10, one a touch-screen model that resembles many other phones now on the market. The other model is a hybrid with a keyboard similar to those now found on current BlackBerrys as well as a small touch screen.

The real revolution, though, may be in the software that manages a person’s business and personal information. It is clearly designed with an eye toward retaining and, more important, luring back, corporate users.

Corporate and government information technology managers will be able to segregate business-related apps and data on BlackBerry 10 handsets from users’ personal material through a system known as BlackBerry Balance. It will enable an I.T. manager to, among other things, remotely wipe corporate data from fired employees’ phones while leaving the newly jobless workers’ personal photos, e-mails, music and apps untouched. The system can also block users from forwarding or copying information from the work side of the phone.

Messages generated by e-mail, Twitter, Facebook, instant messaging and LinkedIn accounts are automatically consolidated into a single in-box that RIM calls BlackBerry Hub.

Charles Golvin, an analyst with Forrester Research, called the new phones “beautiful” and described the operating system as “a giant leap forward” from RIM’s current operating system. Ray Sharma, who followed RIM’s glory years as a financial analyst but who now runs XMG Studio, a mobile games developer in Toronto, has been similarly impressed.

But both men are among many analysts who question the ability of BlackBerry 10, whatever its merits, to revive RIM’s fallen fortunes.

“If it’s good, it will help inspire the upgrade cycle,” Mr. Sharma said. “But it has to be great in order to inspire touch-screen users to come back. If it’s good, not great, I will be concerned.”

Mr. Golvin was more blunt. “They’ll need to prove themselves in the face of a simultaneous onslaught of marketing from Microsoft, not to mention the continued push from Apple plus Google and its Android partners,” he wrote. “This is a gargantuan challenge for a company of RIM’s size.”

In the year since he took over from the founders, Jim Balsillie and Mike Lazaridis, Mr. Heins has certainly remade RIM. He cut 5,000 jobs in a program to reduce operating costs by about $1 billion a year. Along the way, he also replaced RIM’s senior management and straightened out its balance sheet. While unprofitable, RIM remains debt-free and holds $2.9 billion in cash.

With BlackBerry 10, RIM not only started over with its operating system, it also rebuilt the company through acquisitions. Its core operating system comes from QNX Software Systems, the design of the user interface is largely the work of the Astonishing Tribe in Sweden while other main components, like the touch-screen technology, came from smaller companies that are now part of RIM.

Integrating all of those acquisitions, analysts and former RIM employees say, added to the delays that plagued BlackBerry 10.

Now that the new phones are finally here, Mr. Heins is counting on RIM’s remaining base of 79 million users globally to eagerly upgrade. But where those customers reside may be as important in their numbers in determining the success of that plan.

In the United States, which leads the world in setting smartphone trends, about 11 million BlackBerry users switched to other phones between 2009 and the middle of last year, according to an analysis by Horace Dediu on Asymco, a wireless industry blog he founded.

Until the final months of 2012, RIM continued to increase its subscriber base through sales of low-cost handsets to less developed countries like Nigeria and Indonesia. Although BlackBerry 10 will be made available worldwide, the initial phones will be too expensive for a majority of BlackBerry fans in those regions.

RIM may also have confused its loyalists, particularly in North America and Europe, in the run-up to the BlackBerry 10 debut. Many of those users stuck with BlackBerrys because of their physical keyboards. But public demonstrations for BlackBerry 10 were centered on the touch-screen-only version and its virtual keyboard.

While some corporations have remained loyal to BlackBerry, RIM not only has to sell them on the new handsets, it also must persuade them to upgrade server software to accommodate the new operating system, a costly and time-consuming process. Companies whose employees continue to use older BlackBerrys will have to run two separate BlackBerry servers.

Mr. Heins’s pitch to those corporations is that the BlackBerry 10 server software will also allow them to manage and control data on employees’ Android phones and iPhones. But any corporation or organization that allows those phones to connect with its systems long ago installed mobile device management software from other companies, including Good Technology and SAP. RIM is likely to find that the competition in device management software is as severe as it is in the handset business.

This article has been revised to reflect the following correction:

Correction: January 30, 2013

An earlier version of this story incorrectly stated that Frank Mersh is the chairman and a vice president at First Street Capital in Toronto. Mr. Mersh is the chairman and a vice president at Front Street Capital in Toronto.

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Well: Helmets for Ski and Snowboard Safety

Recently, researchers from the department of sport science at the University of Innsbruck in Austria stood on the slopes at a local ski resort and trained a radar gun on a group of about 500 skiers and snowboarders, each of whom had completed a lengthy personality questionnaire about whether he or she tended to be cautious or a risk taker.

The researchers had asked their volunteers to wear their normal ski gear and schuss or ride down the slopes at their preferred speed. Although they hadn’t informed the volunteers, their primary aim was to determine whether wearing a helmet increased people’s willingness to take risks, in which case helmets could actually decrease safety on the slopes.

What they found was reassuring.

To many of us who hit the slopes with, in my case, literal regularity — I’m an ungainly novice snowboarder — the value of wearing a helmet can seem self-evident. They protect your head from severe injury. During the Big Air finals at the Winter X Games in Aspen, Colo., this past weekend, for instance, 23-year-old Icelandic snowboarder Halldor Helgason over-rotated on a triple back flip, landed head-first on the snow, and was briefly knocked unconscious. But like the other competitors he was wearing a helmet, and didn’t fracture his skull.

Indeed, studies have concluded that helmets reduce the risk of a serious head injury by as much as 60 percent. But a surprising number of safety experts and snowsport enthusiasts remain unconvinced that helmets reduce overall injury risk.

Why? A telling 2009 survey of ski patrollers from across the country found that 77 percent did not wear helmets because they worried that the headgear could reduce their peripheral vision, hearing and response times, making them slower and clumsier. In addition, many worried that if they wore helmets, less-adept skiers and snowboarders might do likewise, feel invulnerable and engage in riskier behavior on the slopes.

In the past several years, a number of researchers have attempted to resolve these concerns, for or against helmets. And in almost all instances, helmets have proved their value.

In the Innsbruck speed experiment, the researchers found that people whom the questionnaires showed to be risk takers skied and rode faster than those who were by nature cautious. No surprise.

But wearing a helmet did not increase people’s speed, as would be expected if the headgear encouraged risk taking. Cautious people were slower than risk-takers, whether they wore helmets or not; and risk-takers were fast, whether their heads were helmeted or bare.

Interestingly, the skiers and riders who were the most likely, in general, to don a helmet were the most expert, the men and women with the most talent and hours on the slopes. Experience seemed to have taught them the value of a helmet.

Off of the slopes, other new studies have brought skiers and snowboarders into the lab to test their reaction times and vision with and without helmets. Peripheral vision and response times are a serious safety concern in a sport where skiers and riders rapidly converge from multiple directions.

But when researchers asked snowboarders and skiers to wear caps, helmets, goggles or various combinations of each for a 2011 study and then had them sit before a computer screen and press a button when certain images popped up, they found that volunteers’ peripheral vision and reaction times were virtually unchanged when they wore a helmet, compared with wearing a hat. Goggles slightly reduced peripheral vision and increased response times. But helmets had no significant effect.

Even when researchers added music, testing snowboarders and skiers wearing Bluetooth-audio equipped helmets, response times did not increase significantly from when they wore wool caps.

So why do up to 40 percent of skiers and snowboarders still avoid helmets?

“The biggest reason, I think, is that many people never expect to fall,” says Dr. Adil H. Haider, a trauma surgeon and associate professor of surgery at Johns Hopkins University in Baltimore and co-author of a major new review of studies related to winter helmet use. “That attitude is especially common in people, like me, who are comfortable on blue runs but maybe not on blacks, and even more so in beginners.”

But a study published last spring detailing snowboarding injuries over the course of 18 seasons at a Vermont ski resort found that the riders at greatest risk of hurting themselves were female beginners. I sympathize.

The takeaway from the growing body of science about ski helmets is in fact unequivocal, Dr. Haider said. “Helmets are safe. They don’t seem to increase risk taking. And they protect against serious, even fatal head injuries.”

The Eastern Association for the Surgery of Trauma, of which Dr. Haider is a member, has issued a recommendation that “all recreational skiers and snowboarders should wear safety helmets,” making them the first medical group to go on record advocating universal helmet use.

Perhaps even more persuasive, Dr. Haider has given helmets to all of his family members and colleagues who ski or ride. “As a trauma surgeon, I know how difficult it is to fix a brain,” he said. “So everyone I care about wears a helmet.”

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