Personal Health: Keeping Firearms Away From Children

I doubt that our forebears who ratified the Second Amendment in 1791 ever imagined how carelessly and callously firearms would be used centuries later. Witness the senseless slaughter of 20 innocent children and 6 adults last month in Newtown, Conn. As a mother of two and grandmother of four, I can’t imagine a more painful loss.

If you are as concerned as I am about the safety of your children and grandchildren, consider that it may be time for a grass-roots movement, comparable to Mothers Against Drunk Driving, to help break the stranglehold the National Rifle Association seems to have on our elected officials. Do you really want, as the association proposed, an armed guard in every school?

The Connecticut massacre occurred just two months after the American Academy of Pediatrics issued a new policy statement on firearm-related injuries to children. Murder and accidental shootings were not the academy’s only concerns. “Suicides among the young are typically impulsive,” the statement noted, “and easy access to lethal weapons largely determines outcome.”

In an article published online last month in The New England Journal of Medicine, Dr. Judith S. Palfrey, a pediatrician at Boston Children’s Hospital, and her husband, Dr. Sean Palfrey, also a pediatrician in Boston, highlighted the shocking statistics.

Every day in the United States, 18 children and young adults between the ages of 1 and 24 die from gun-related injuries. That makes guns the second leading cause of death in young people — twice the number of deaths from cancer, five times the deaths from heart disease and 15 times the deaths from infections.

Dr. Judith S. Palfrey has seen this heartbreak up close. “My niece, who was sad about something, might be alive today if she hadn’t had such easy access to a handgun at age 18,” she told me.

The United States has the dubious distinction of leading high-income countries in firearm homicides, suicides and unintentional deaths among young people. Among American children ages 5 to 14, an international study showed that firearm suicide rates were six times higher, and death rates from unintentional firearm injuries 10 times higher, than in other high-income countries.

Innocent Victims

The Palfreys said they were haunted by the death of one of their patients, a 12-year-old boy who went on an errand for his mother and was caught in the cross-fire of a gun battle. The boy had shortly before written a letter to his mother expressing his desire to become a doctor.

And Dr. Sean Palfrey recalls “with horror” picking up a loaded .22-caliber rifle, at age 11 or 12, and threatening his baby sitter with it. “This scared the hell out of me and remains seared in my memory. I could have killed this person.”

In explaining why he had a gun, he said, “I’m a great-grandson of Theodore Roosevelt, who was a hunter as well as a naturalist, and when I grew up guns were an acceptable part of youth. I took target practice and was an N.R.A. member myself as a child. We had guns for hunting, not automatic weapons that can shoot hundreds of rounds within seconds.”

Now, he said, “I do all my shooting with a camera. This is not the same world it was when the Second Amendment was written. Guns have to be removed so that they can’t be accessed by those who are immature, impulsive or mentally ill.”

In their article, the Palfreys pointed out that “little children explore their worlds without understanding danger, and in one unsupervised moment, an encounter with a gun can end in fatality.” School-age children who see guns used on television, in movies or video games “don’t necessarily understand that people who are really shot may really die,” they said.

Among teenagers, who may fight over girlfriends or sneakers, or have their judgment impaired by drugs or alcohol, “a fistfight may cause transient injuries, but a gunfight can kill rivals, friends, or innocent bystanders,” the pediatricians wrote. Among depressed adolescents, they said, “less than 5 percent of suicide attempts involving drugs are lethal, but 90 percent of those involving guns are.”

Preventing Access

In a 2006 study of gun-owning Americans with children under age 18, 21.7 percent stored a gun loaded, 31.5 percent stored one unlocked, and 8.3 percent stored at least one gun unlocked and loaded. And in households with adolescents ages 13 to 17, firearms were left unlocked 41.7 percent of the time.

These are accidents, or worse, waiting to happen, and the pediatrics academy reiterated its earlier recommendations that pediatricians talk to parents about guns in the home and their safe storage, and follow up by distributing cable locks.

To limit unauthorized access to guns, the academy recommended the use of trigger locks, lockboxes, personalized safety mechanisms, and trigger pressures that are too high for young children.

Still, the academy emphasized, “the safest home for a child or adolescent is one without firearms.”

The Palfreys said that when one of their colleagues asked a mother about guns in her home, she responded, “Why, yes, I have a loaded gun in the drawer of my bedside table.” It was only then the woman realized that this could be a danger to her child, Dr. Judith Palfrey said.

The academy also called for restoring the federal ban, in effect from 1994 to 2004, on the sale of assault weapons to the general public. None of the many attempts to renew it have succeeded in Congress.

The Supreme Court ruled in 2010, in the case of McDonald v. the City of Chicago, that the due process clause of the Fourteenth Amendment applied to provisions of the Second Amendment, and prevented states and localities from restricting citizens’ right to bear arms. The academy stated that the ruling “set the stage for Second Amendment legal challenges to local and state gun laws, including laws requiring the safe storage of firearms and trigger locks, as well as laws aimed at protecting children from firearms.”

In 2011, Florida passed legislation that raised First Amendment questions by forbidding doctors to ask families about guns in the home. Although a permanent injunction against the law was issued, Gov. Rick Scott has appealed the ruling. At the federal level, wording introduced into the Affordable Care Act restricts collection of data on guns in the home.

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This post has been revised to reflect the following correction:

Correction: January 11, 2013

The Personal Health column on Tuesday, about firearms and children, using information from The New England Journal of Medicine, misstated the number of children and young adults between the ages of 1 and 24 who die each day in the United States from gun-related injuries. Eighteen people between the ages of 1 and 24 die every day — not seven people between those ages. (Seven deaths a day is the number for children and young adults between the ages of 1 and 19.) And the article misstated part of a Supreme Court ruling. In the case of McDonald v. the City of Chicago in 2010, the court ruled that the due process clause of the Fourteenth Amendment — not the equal protection clause — applied to provisions of the Second Amendment, which guarantees the right to keep and bear arms.

This post has been revised to reflect the following correction:

Correction: January 11, 2013

A chart posted with an earlier version of this article also misstated the number of children and young adults between the ages of 1 and 24 killed every day in the United States by gun injuries. It is 18, not seven.

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DealBook: Wells Fargo Profit Jumps 24% in Quarter, Driven by Mortgage Gains

8:46 a.m. | Updated

Wells Fargo reported $5.1 billion in profit for the fourth quarter on Friday, a 24 percent increase, driven by the bank’s lucrative mortgage business.

Seizing on low-interest rates that have spurred a flurry of refinancing activity, the bank again notched record profits. For the last 12 quarters, profits at the bank have increased.

In this latest quarter, Wells Fargo, based in San Francisco, reported earnings of 91 cents a share, which exceeded analysts’ expectations. Ahead of the report, analysts polled by Thomson Reuters estimated that the bank would report earnings of 89 a share.

Wells Fargo, unlike many of its rivals, has been able to steadily increase its revenue. The first bank to release fourth-quarter earnings, Wells Fargo reported $21.95 billion in revenue in the fourth quarter, up 7 percent from a year earlier.

Much of the revenue gains stemmed from the bank’s consumer lending business, as borrowers jumped on record low interest rates to refinance their mortgages. Wells Fargo, which dominates the market as the nation’s largest mortgage lender, notched $125 billion in mortgage originations, up from $120 billion in the fourth quarter of 2011. Refinancing applications accounted for nearly 75 percent of that total.

The big profit in the group came from the extra money that Wells Fargo makes bundling the mortgages into bonds and selling them to the government. In the fourth quarter, the bank reported $2.8 billion of so-called net gains on its mortgages activities, up 51 percent from the previous year.

The question is whether those gains are sustainable. Refinancing activity shows signs of tapering off. And the housing recovery is far from robust, which means it may be tough to make new mortgages.

Investors seemed to look beyond the strong profits to the potential challenges. Shares of the Wells Fargo were down modestly on Friday, as the bank reported a drop in its net interest margin.

Under the tenure of its chief executive, John G. Stumpf, Wells Fargo has aggressively expanded into the mortgage market, a strategy that might help the bank surpass its rivals in profits, notably JPMorgan Chase.

Wells Fargo’s net interest margin, a closely watched profit metric that measures the difference between the interest the bank collects and the interest it pays on its own borrowings, was down slightly to 3.56 percent, from 3.89 percent a year earlier.

Profit in the community banking division, which spans Wells Fargo’s retail branches and mortgage business, increased 14 percent to $2.9 billion.

The bank successfully courted more cash from depositors, adding $72 billion in total core checking and savings deposits than a year earlier.

“The company’s underlying results were driven by solid loan growth, improved credit quality, and continued success in improving efficiency,” Wells Fargo’s chief financial officer, Tim Sloan, said in a statement.

The bank has benefited from sweeping federal stimulus initiatives that have buoyed the mortgage business. The Treasury Department has helped spur Americans to refinance their mortgages.

Wells Fargo is the reigning titan in the mortgage industry, generating roughly a third of all the mortgages across the United States. Mortgage originations continued to climb, up 4 percent to $125 billion.

Adding to its mortgage-related profit, Wells Fargo reported a $926 million profit from its servicing business, in which the bank collects payments from homeowners. That’s up roughly 6 percent from a year earlier.

Alongside the consumer loan business, Wells Fargo had gains in its wealth management business, a particular focus for the bank to defray the impact of federal regulations that dragged down profits elsewhere.

Still, Wells Fargo’s profit from residential mortgages could wane this year if the Federal Reserve halts its extensive bond buying spree.

Working to move beyond the mortgage crisis woes that have dogged the bank, Wells Fargo has been brokering deals with federal regulators. Wells Fargo was one of 10 banks that signed onto an $8.5 billion settlement this week with the Comptroller of the Currency and the Federal Reserve over claims that shoddy foreclosure practices may have led to the wrongful eviction of homeowners.

The sweeping federal pact ends a deeply flawed review of millions of loans in foreclosure that was mandated by federal regulators in 2011. The review, which was ended this week, began in November 2011 amid mounting public fury that bank employees were churning through hundreds of foreclosure filings without reviewing them for accuracy.

In addition to the settlement, the bank set aside $1.2 billion to prevent foreclosures.

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Jimmy Dushku: The 25-year-old who is North Korea’s one true Twitter friend

Mother Jones takes a look at a globetrotting young investor who’s the only American — and the only human being — Pyongyang follows

Google Chairman Eric Schmidt capped a controversial four-day visit to North Korea on Thursday with a call for the country’s censorship-happy communist government to give its people access to the internet, or face further economic decline due to the country’s global isolation. It was a strong message from one of the web’s most powerful figures, although North Korea watchers seem pretty confident the country’s young leader, Kim Jong Un, will ignore it. There’s one American, however, Pyongyang does appear to listen to. That would be Jimmy Dushku, a young investor who is one of exactly three Twitter users Kim’s government follows on Twitter. What’s the story behind this unlikely online bromance? Here, a guide:

Who is Jimmy Dushku?
He’s a 25-year-old financial whiz kid from Austin, Texas. Dushku, who also goes by the nicknames “Jimmer” and “Jammy,” started a website development business when he was 14, according to Mother Jones, and he parlayed his early earnings into investments that now include everything from construction projects in Europe to real estate in Texas to mines in South America. He’s also a rabid Coldplay fan, and when he isn’t jetting around the world, he says he likes to play Rachmaninoff on his piano and zoom around on his Ducati Monster motorcycle.

SEE MORE: North Korea’s rocket launch: 3 consequences

So how did he become buddies with North Korea?
Dushku tells Asawin Suebsaeng at Mother Jones he’s not really sure. “People always ask me how it happened, and I honestly can’t remember,” he says. “It started sometime back in 2010. I was initially surprised.” North Korea followed him, he followed North Korea “out of courtesy.” He tweeted back, “Hello my friend,” and a relationship was born. Then, the North Korean government, which has piled up some 11,000 followers in two-and-a-half years on Twitter, abruptly whittled down the number of accounts it follows, leaving just three. Dushku made the cut (along with a Vietnam account and another official North Korean handle).

What has Dushku gotten from the relationship?
Death threats, for one thing. Not long after he linked up with North Korea’s account, which goes by @uriminzok (or “our nation”), Dushku says he started getting angry messages from exiles and South Koreans. Since then, he has mostly kept a low profile, just to be safe, although he does occasionally grant interviews to foreign publications. For its part, North Korea gets a rare glimpse at the outside world through Dushku, as his is the only account North Korea follows that is regularly updated — the other two haven’t tweeted in months. He’s also the only human being in the bunch.

Will @JimmyDushku and @uriminzok ever meet in real life?
That’s always the question for acquaintances who meet online, isn’t it? Dushku says his friendly relationship has won him a standing offer to visit North Korea. Casual observers, however, advise him to proceed with caution. “Am I the only one thinking they picked some random guy so they can lure him into North Korea and use him as a political prisoner/bargaining chip?” one commenter at Gizmodo said. Another suggests that Dushku play it cool, without making Pyongyang angry, saying, “Never unfollow anybody with nuclear weapons.”

Sources: Austinist, CNN, Gizmodo, Mother Jones

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German Bishops Cancel Study Into Sexual Abuse by Priests

PARIS (Reuters) — Germany’s Roman Catholic bishops on Wednesday canceled a study into the sexual abuse of minors by priests, prompting the investigator to accuse them of trying to censor what was to be a major report on the scandals.

The independent study, examining church files that sometimes date to 1945, was meant to shed light on undiscovered cases after about 600 people filed claims against priests in 2010 following a wave of revelations of sexual abuse. The German scandals were part of a series of abuse scandals that also shook the Catholic Church in Ireland, Belgium, the Netherlands and the United States, forcing Pope Benedict XVI to issue a public apology.

Bishop Stephan Ackermann, a spokesman on abuse issues for the German Bishops’ Conference, said that the hierarchy had lost confidence in the researcher, Christian Pfeiffer, a criminologist, and that it would look for another specialist for the study.

“We will have to find a new partner,” Bishop Ackermann said in a statement that blamed Mr. Pfeiffer’s “communications behavior with church officials” for the breakdown.

Mr. Pfeiffer told German Radio that the bishops wanted to change previously agreed-upon guidelines for the project to include a final veto over publishing its results, which he could not accept.

Officials made “an attempt to turn the whole contract towards censorship and stronger control by the church,” said Mr. Pfeiffer, head of the Criminological Research Institute of Lower Saxony.

One lay Catholic organization, known as the International Movement We Are Church, called the decision “a devastating signal for the credibility of the church leadership” that showed the bishops could not accept an independent inquiry into the scandals. The German justice minister, Sabine Leutheusser-Schnarrenberger, said that the church’s effort to clear up the scandals should not end in “a halfhearted inventory.”

“It’s high time that the Catholic Church opened up and let outside experts look at its archives,” she told the Sueddeutsche Zeitung newspaper.

Investigations into the records of priests accused of molesting children have been conducted in recent years in other countries, sometimes with devastating results for the reputation of the church involved.

Ireland was shocked when several inquiries conducted by the government revealed widespread abuse and a pattern of secrecy to cover them up. Three bishops resigned as a result. An official Dutch report said that up to 20,000 children had been sexually abused in Catholic orphanages, boarding schools and seminaries between 1945 and 2010.

A commission set up by the Belgian church received 475 reports of abuse before its premises were raided in 2010 by the police seeking evidence for possible criminal cases against predator priests. It reported 13 victims had been driven to suicide.

Revelations of sexual abuse cases in the United States starting in the 1990s led to a wave of court cases, costing the church $2 billion in settlements.

Speaking to German Radio, Bishop Ackermann said the bishops feared that Mr. Pfeiffer would publish results without their permission. “We weren’t trying to hold things back,” he said. “We want a similar project to go ahead.”

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Researchers: NFL's Seau had from brain disease

When he ended his life last year by shooting himself in the chest, Junior Seau had a degenerative brain disease often linked with repeated blows to the head.

Researchers from the National Institutes of Health said Thursday the former NFL star's abnormalities are consistent with chronic traumatic encephalopathy, or CTE.

The hard-hitting linebacker played for 20 NFL seasons with San Diego, Miami and New England before retiring in 2009. He died at age 43 of a self-inflicted gunshot in May, and his family requested the analysis of his brain.

"We saw changes in his behavior and things that didn't add up with him," his ex-wife, Gina, told The Associated Press. "But (CTE) was not something we considered or even were aware of. But pretty immediately (after the suicide) doctors were trying to get their hands on Junior's brain to examine it."

The NIH, based in Bethesda, Md., studied three unidentified brains, one of which was Seau's, and said the findings on Seau were similar to autopsies of people "with exposure to repetitive head injuries."

"It was important to us to get to the bottom of this, the truth," Gina Seau added, "and now that it has been conclusively determined from every expert that he had obviously had CTE, we just hope it is taken more seriously. You can't deny it exists, and it is hard to deny there is a link between head trauma and CTE. There's such strong evidence correlating head trauma and collisions and CTE."

In the final years of his life, Seau had wild behavioral swings, according to Gina and to 23-year-old son, Tyler, along with signs of irrationality, forgetfulness, insomnia and depression.

"He emotionally detached himself and would kind of 'go away' for a little bit," Tyler Seau said. "And then the depression and things like that. It started to progressively get worse."

He hid it well in public, they said, but not when he was with family or close friends.

Seau joins a list of several dozen football players who were found to have CTE. Boston University's center for study of the disease reported last month that 34 former pro players and nine who played only college football suffered from CTE.

The NFL faces lawsuits by thousands of former players who say the league withheld information on the harmful effects of concussions. According to an AP review of 175 lawsuits, 3,818 players have sued. At least 26 Hall of Famer members are among the players who have done so.

The National Football League, in an email to the AP, said: "We appreciate the Seau family's cooperation with the National Institutes of Health. The finding underscores the recognized need for additional research to accelerate a fuller understanding of CTE.

"The NFL, both directly and in partnership with the NIH, Centers for Disease Control and other leading organizations, is committed to supporting a wide range of independent medical and scientific research that will both address CTE and promote the long-term health and safety of athletes at all levels."

NFL teams have given a $30 million research grant to the NIH.

The players' union called the NIH report on Seau "tragic."

"The only way we can improve the safety of players, restore the confidence of our fans and secure the future of our game is to insist on the same quality of medical care, informed consent and ethical standards that we expect for ourselves and for our family members," the NFLPA said in a statement.

"This is why the players have asked for things like independent sideline concussion experts, the certification and credentialing of all professional football medical staff and a fairer workers compensation system in professional football," it said.

Seau is not the first former NFL player who killed himself and later was found to have had CTE. Dave Duerson and Ray Easterling are the others.

Before shooting himself, Duerson, a former Chicago Bears defensive back, left a note asking that his brain be studied for signs of trauma. His family filed a wrongful-death suit against the NFL, claiming the league didn't do enough to prevent or treat the concussions that severely damaged his brain.

Easterling played safety for the Falcons in the 1970s. After his career, he suffered from dementia, depression and insomnia, according to his wife, Mary Ann. He committed suicide last April.

Mary Ann Easterling is among the plaintiffs who have sued the NFL.

Tyler Seau played football through high school and for two years in college. He says he has no symptoms of brain trauma.

"I was not surprised after learning a little about CTE that he had it," Tyler said. "He did play so many years at that level. I was more just kind of angry I didn't do something more and have the awareness to help him more, and now it is too late."

Gina Seau's son Jake, now a high school junior, played football for two seasons but has switched to lacrosse and has been recruited to play at Duke.

"Lacrosse is really his sport and what he is passionate about," she said. "He is a good football player and probably could continue. But especially now watching what his dad went through, he says, 'Why would I risk lacrosse for football?'

"I didn't have to have a discussion with him after we saw what Junior went through."

Her 12-year-old son Hunter has shown no interest in playing football.

"That's fine with me," she said.

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Flu Widespread, Leading a Range of Winter’s Ills

It is not your imagination — more people you know are sick this winter, even people who have had flu shots.

The country is in the grip of three emerging flu or flulike epidemics: an early start to the annual flu season with an unusually aggressive virus, a surge in a new type of norovirus, and the worst whooping cough outbreak in 60 years. And these are all developing amid the normal winter highs for the many viruses that cause symptoms on the “colds and flu” spectrum.

Influenza is widespread, and causing local crises. On Wednesday, Boston’s mayor declared a public health emergency as cases flooded hospital emergency rooms.

Google’s national flu trend maps, which track flu-related searches, are almost solid red (for “intense activity”) and the Centers for Disease Control and Prevention’s weekly FluView maps, which track confirmed cases, are nearly solid brown (for “widespread activity”).

“Yesterday, I saw a construction worker, a big strong guy in his Carhartts who looked like he could fall off a roof without noticing it,” said Dr. Beth Zeeman, an emergency room doctor for MetroWest Medical Center in Framingham, Mass., just outside Boston. “He was in a fetal position with fever and chills, like a wet rag. When I see one of those cases, I just tighten up my mask a little.”

Massachusetts General Hospital in Boston started asking visitors with even mild cold symptoms to wear masks and to avoid maternity wards. The hospital has treated 532 confirmed influenza patients this season and admitted 167, even more than it did by this date during the 2009-10 swine flu pandemic.

At Brigham and Women’s Hospital, 100 patients were crowded into spaces licensed for 53. Beds lined halls and pressed against vending machines. Overflow patients sat on benches in the lobby wearing surgical masks.

“Today was the first time I think I was experiencing my first pandemic,” said Heidi Crim, the nursing director, who saw both the swine flu and SARS outbreaks here. Adding to the problem, she said, many staff members were at home sick and supplies like flu test swabs were running out.

Nationally, deaths and hospitalizations are still below epidemic thresholds. But experts do not expect that to remain true. Pneumonia usually shows up in national statistics only a week or two after emergency rooms report surges in cases, and deaths start rising a week or two after that, said Dr. Gregory A. Poland, a vaccine specialist at the Mayo Clinic in Minnesota. The predominant flu strain circulating is an H3N2, which typically kills more people than the H1N1 strains that usually predominate; the relatively lethal 2003-4 “Fujian flu” season was overwhelmingly H3N2.

No cases have been resistant to Tamiflu, which can ease symptoms if taken within 48 hours, and this year’s flu shot is well-matched to the H3N2 strain, the C.D.C. said. Flu shots are imperfect, especially in the elderly, whose immune systems may not be strong enough to produce enough antibodies.

Simultaneously, the country is seeing a large and early outbreak of norovirus, the “cruise ship flu” or “stomach flu,” said Dr. Aron J. Hall of the C.D.C.’s viral gastroenterology branch. It includes a new strain, which first appeared in Australia and is known as the Sydney 2012 variant.

This week, Maine’s health department said that state was seeing a large spike in cases. Cities across Canada reported norovirus outbreaks so serious that hospitals were shutting down whole wards for disinfection because patients were getting infected after moving into the rooms of those who had just recovered. The classic symptoms of norovirus are “explosive” diarrhea and “projectile” vomiting, which can send infectious particles flying yards away.

“I also saw a woman I’m sure had norovirus,” Dr. Zeeman said. “She said she’d gone to the bathroom 14 times at home and 4 times since she came into the E.R. You can get dehydrated really quickly that way.”

This month, the C.D.C. said the United States was having its biggest outbreak of pertussis in 60 years; there were about 42,000 confirmed cases, the highest total since 1955. The disease is unrelated to flu but causes a hacking, constant cough and breathlessness. While it is unpleasant, adults almost always survive; the greatest danger is to infants, especially premature ones with undeveloped lungs. Of the 18 recorded deaths in 2012, all but three were of infants under age 1.

That outbreak is worst in cold-weather states, including Colorado, Washington, Wisconsin, Minnesota and Vermont.

Although most children are vaccinated several times against pertussis, those shots wear off with age. It is possible, the authorities said, that a new, safer vaccine introduced in the 1990s gives protection that does not last as long, so more teenagers and adults are vulnerable.

And, Dr. Poland said, if many New Yorkers are catching laryngitis, as has been reported, it is probably a rhinovirus. “It’s typically a sore, really scratchy throat, and you sometimes lose your voice,” he said.

Though flu cases in New York City are rising rapidly, the city health department has no plans to declare an emergency, largely because of concern that doing so would drive mildly sick people to emergency rooms, said Dr. Jay K. Varma, deputy director for disease control. The city would prefer people went to private doctors or, if still healthy, to pharmacies for flu shots. Nursing homes have had worrisome outbreaks, he said, and nine elderly patients have died. Homes need to be more alert, vaccinate patients, separate those who fall ill and treat them faster with antivirals, he said.

Dr. Susan I. Gerber of the C.D.C.’s respiratory diseases branch, said her agency has not seen any unusual spike of rhinovirus, parainfluenza, adenovirus, coronavirus or the dozens of other causes of the “common cold,” but the country is having its typical winter surge of some, like respiratory syncytial virus “that can mimic flulike symptoms, especially in young children.”

The C.D.C. and the local health authorities continue to advocate getting flu shots. Although it takes up to two weeks to build immunity, “we don’t know if the season has peaked yet,” said Dr. Joseph Bresee, chief of prevention in the agency’s flu division.

Flu shots and nasal mists contain vaccines against three strains, the H3N2, the H1N1 and a B. Thus far this season, Dr. Bresee said, H1N1 cases have been rare, and the H3N2 component has been a good match against almost all the confirmed H3N2 samples the agency has tested.

About a fifth of all flus this year thus far are from B strains. That part of the vaccine is a good match only 70 percent of the time, because two B’s are circulating.

For that reason, he said, flu shots are being reformulated. Within two years, they said, most will contain vaccines against both B strains.

Joanna Constantine, 28, a stylist at the Guy Thomas Hair Salon on West 56th Street in Manhattan, said she recently was so sick that she was off work and in bed for five days — and silenced by laryngitis for four of them.

She did not have the classic flu symptoms — a high fever, aches and chills — so she knew it was probably something else.

Still, she said, it scared her enough that she will get a flu shot next year. She had not bothered to get one since her last pregnancy, she said. But she has a 7-year-old son and a 5-year-old daughter, “and my little guys get theirs every year.”

Jess Bidgood contributed reporting.

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Media Decoder Blog: With 'Daisy,' Beats Electronics Bets on Digital Music

Memo to Spotify: Beats Electronics is coming for you.

Beats, whose success with the Beats by Dr. Dre line of high-end headphones transformed a hobbyist niche into a huge mainstream market, has been planning its entry into the streaming music world since at least last year, when it bought the digital service, Mog.

Beats has been slow to reveal its plans, and the streaming market has been growing steadily without it. But two recently announced hires should signal to Spotify, Rhapsody and others that Beats is serious about challenging them.

On Thursday, Beats — whose founders are the hip-hop star Dr. Dre and the music executive Jimmy Iovine — announced that Ian Rogers of Topspin Media would be the chief executive of its digital service, which is code-named Daisy. Last month, a profile in The New Yorker of the musician Trent Reznor (Nine Inch Nails, “The Social Network”) revealed that he was acting as creative director.

The announcement on Thursday offered few details about what music fans (and current Mog subscribers) can expect. Daisy will be based on Mog’s technology to some degree, although executives suggested some changes, like the ability for artists to interact with their fans.

Mr. Rogers, a veteran of digital music well known by music executives and musicians alike, has been a longtime critic of existing digital music services; in 2006 he called iTunes “a spreadsheet that plays music.” On Tuesday, Mr. Iovine characterized the appeal of existing services as, “Give me your credit card, here are 12 million songs, and good luck.”

All digital services have to some degree or other been struggling with that perception. Last month, for example, Spotify introduced a number of features to help users find music on the service, like the ability to follow favorite artists and cellphone alerts for new songs.

A bigger challenge, however, is growth. Spotify has five million paying subscribers, Rhapsody about one million, and other American services are believed to be far behind. While Pandora has built a huge audience offering a free digital alternative to radio, and Sirius XM has gotten nearly 24 million paying subscribers for its version of radio, so-called on-demand services like Spotify and Rhapsody — which let consumers pick exactly what songs to listen to — have been slow to penetrate the mainstream.

Beats, however, has a major advantage in reaching everyday consumers: its headphones, which have become popular enough to be fashion accessories. The company is estimated to have more than $1 billion in sales, and says that it has nearly two-thirds of the premium headphone market. Beats headphones range from $100 earbuds to a $400 “pro” model.

Mr. Rogers, 40, got his start in the music business when the Beastie Boys spotted the fan site he had made in college, and hired him to run its Web operation. He later worked for Yahoo Music before joining Topspin, which offers online tools to musicians and record companies to help them market and sell music. (The Beastie Boys and Nine Inch Nails are two of its most prominent clients.)

“This is the gig I’ve been training for my whole career,” Mr. Rogers said.

Beats also made an investment in Topspin, which will continue with Jeremy Bellinghausen as its chief executive and Mr. Rogers as its executive chairman.

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Ben Sisario writes about the music industry. Follow @sisario on Twitter.

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Men and Women of (Limited) Letters: Must-Follow Twitter Accounts of 2013

Scientific American editors voted in recent weeks on the 20 most informative Twitter accounts to stay abreast of the latest ideas, issues and developments in science and technology. We weeded through hundreds of lists and feeds to select the most brilliant and engaging, as well as the quirkiest of the bunch.Our picks are often witty, sometimes eccentric and occasionally silly, but each brings valuable insights to his or her area of expertise. For the latest, greatest tweets on science, technology, journalism, astronomy, physics, mathematics and more, check out these top 20 Twitter accounts of 2013, listed here in alphabetical order.

Must-Follow Twitter Accounts of 2013

Next » BBC Science @BBCscience

 Pay attention to BBC Science for breaking science and environmental news from a global perspective. Tweets are most often serious, with the occasional story about whether a toilet seat really is the dirtiest item in the house. The BBC offers variety suitable to both the casual consumer and the diehard nerd.

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Must-Follow Twitter Accounts of 2013

Next » Deborah Blum @DeborahBlum

Deborah Blum’s tweets about poison, murder and other interesting articles and quips aren’t all that make her Twitter feed unique. It also stands out for her insights into science journalism. Blum often posts jobs, tips and tricks of the trade that will motivate any aspiring science blogger to break out the laptop and start posting.
By day, Sean Carroll is a theoretical physicist. By night he’s a “truth vigilante.” The Caltech researcher writes lofty pieces about eternity and dark matter, and tweets fascinating facts about his field.

 This NASA Twitter account gained notoriety when the car-size rover Curiosity landed on Mars in August 2012. With its witty persona, pop culture references and updates on its forays across the surface of the Red Planet, @MarsCuriosity is a must-follow for 2013—and the rest of its multiyear tour. Also check out the “Curiosity Explorer” badge on Foursquare and watch the rover’s New Year’s Eve message on YouTube
David Dobbs is an accomplished science journalist who is big on audience engagement in the new media milieu. His Twitter feed is punctuated with responses to readers weighing in on a wide variety of topics, especially cognitive science. Dobbs also tweets sporadically about his personal life and his work for Wired. He’s working on his fifth book.
Maryn McKenna, a specialist on food policy, public health and infectious disease, has built and cultivated a dedicated online following. Her tweets and posts are smart, quirky and highly informative. A seasoned science journalist, she uses social media to nerd out on a daily basis, so join in the geeky fun.
Former Scientific American special projects guru Christopher Mims isn’t shy. Opinionated and straightforward, the technology and sustainability journalist, now at QuartzNews, stays ahead of the pack. Mims frequently engages with his audience and uses crowd-sourcing to gather material for many of his stories.
Scientific American editors enjoy checking in on Nature News‘s hard-nosed, clever twitter feed.  One might suspect that our favor for it derives from the fact that Scientific American is also part of Nature Publishing Group, but we actually operate as editorially independent units. Follow Nature News especially for investigative reporting on science scandals and international science policy, as well as the latest important biomedical and physics news.

 Founder and CEO of O’Reilly Media Tim O’Reilly reports technology trends and comments on advocacy issues. His Twitter feed is dominated by references to Silicon Valley and e-book deals. Follow his tweets for insightful coverage of the technical world.
John Allen Paulos is a PhD with character. He’s wearing a bow tie in his profile picture, and his favored emoticon is a winking smiley face. Paulos’s tweets can be a tad cryptic for the layperson, but the mathematician has such a great sense of humor that you’re sure to laugh out loud at some point—even if you don’t quite understand the joke.
Accomplished blogger Phil Plait has just migrated his popular “Bad Astronomy” blog to Slate. The author, skeptic, father and punster primarily covers the ins and outs of the solar system. The best part about Plait’s Twitter feed is his daily #BAFact, wherein he throws strange-but-true scraps of science to his curious followers.

 Veteran science journalist Paul Raeburn has turned his eye in recent years to good-natured meta-media, covering science reporting itself for the Knight Science Journalism Tracker while also covering reseach on fatherhood. Raeburn takes reporters to task for sloppy thinking, points out inaccuracies and addresses ethical dilemmas. Follow his account just to read the back-and-forth between him and his targets.
Andy Revkin is a leader in the environmental reporting field, covering everything from fracking to global warming. Check out Revkin’s DotEarth blog in The New York Times too for his breaking news coverage—it’s all the environmental news that’s fit to cover.

 Science Friday, part of National Public Radio’s Talk of the Nation radio program, packs its Twitter feed with tantalizing links that just beg to be clicked on. @SciFri looks at daily news through a scientific lens, including live tweets to provide context during the weekly broadcast. The result is an entertaining bundle of scientific discoveries, intrigues and debunkings.
Scientific American‘s contributors are a brilliant group of reporters, bloggers and commentators, if you’ll pardon this moment of pride. Creativity, skepticism and authoritative context are a big part of what makes our coverage so engaging and worthwhile. Check out this Twitter list and follow your favorites.
Nate Silver, the most celebrated political statistician of the 2012 election, started out as a forecaster of baseball player performance. When he turned his attention to U.S. presidential elections, using statistical models to accurately predict what was thought to be unpredictable, he became a sensation. Although this past year’s electoral frenzy is behind us, Silver is still at work making predictions we’d be foolish to ignore.
Steven Strogatz holds the esteem of math wunderkinds as well as those who are iffy on formulas. He’s hardly a typical numbers-cruncher. The Cornell University professor has a knack for taking on complex topics and making them interesting, even to full-on mathphobes. In his recent book, The Joy of X, discussions range from the number of people one should date before settling down to how HBO’s The Sopranos can help us understand calculus. His Twitter account is similarly entertaining.
Not following Neil DeGrasse Tyson on Twitter? Beware: science nerds who don’t wake up each morning to the rational witticisms of NGT in their feed risk losing all geek cred. If you fit this description, please remedy that situation—now.
Blogger Ed Yong diligantly weaves a love of data into his prose, while still managing to craft posts that are accessible to readers with little to no science background. By covering new findings skeptically and tweeting prolifically, he has built a readership that relies on him for science news. Join the club.
A self-described “champion of underappreciated life-forms,” Carl Zimmer tends to tackle stories about parasites, viruses and quantum earthworms. Follow his feed, probably the most followed of any science writer, for solid reporting and captivating writing.

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Must-Follow Twitter Accounts of 2013

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Follow Scientific American on Twitter @SciAm and @SciamBlogs.Visit ScientificAmerican.com for the latest in science, health and technology news.
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The Lede Blog: Saudi Arabia Executes Sri Lankan Maid

A Sri Lankan woman who was employed as a domestic worker in Saudi Arabia was beheaded by the Saudi authorities on Wednesday after she was accused of murdering an infant in her charge and then sentenced to death in a case that the Sri Lankan government and human rights groups said was flawed.

The Saudi Interior Ministry announced in a brief statement released by the official Saudi news agency that the woman, Rizana Nafeek, had been executed. It said she strangled the infant because of differences between her and the baby’s mother. She was detained and interrogated and was sentenced after trial, the Saudi ministry reported.

Sri Lanka’s Ministry of External Affairs said Wednesday in a statement on its Web site that Ms. Nafeek had been beheaded. She had been on the job for only six weeks before the accusation was made against her in 2005.

Sri Lanka’s president, Mahinda Rajapaksa, had made several appeals to the Saudi government to halt the execution. Sri Lanka also sent ministers to the kingdom on similar appeals and arranged for the woman’s parents to visit their daughter in prison in 2008 and 2011, the Sri Lanka statement said.

“President Rajapaksa and the Government of Sri Lanka deplore the execution of Miss Rizana Nafeek despite all efforts at the highest level of the government and the outcry of the people locally and internationally over the death sentence of a juvenile housemaid,” it said.

Ms. Nafeek’s case has been shrouded in controversy. Human Rights Watch, which along with other rights organizations had urged the Saudi government to halt the execution, said that she should have been treated as a minor in Saudi Arabia’s judicial system, and it also questioned whether she had been given a fair trial:

Though she was arrested in 2005, she did not have access to legal counsel until after a court in Dawadmi sentenced her to death in 2007. Nafeek has also retracted a confession that she said was made under duress, and says that the baby died in a choking accident while drinking from a bottle.

#Saudi executed Rizana today – she was 17 when baby she looked after died; she had no lawyer, incompetent interpretor during her trial.

— Liesl Gerntholtz (@LieslHRW) 9 Jan 13

Human Rights Watch said that Ms. Nafeek’s birth certificate showed that she was 17 at the time of her arrest, but that a recruitment agency in Sri Lanka had altered the birth date on her passport to present her as 23 so she could migrate for work. Her birth certificate says she was born in 1988, said Nisha Varia, senior women’s rights researcher at Human Rights Watch, said in an interview, adding that she has a scanned image of the document.

The High Court in Colombo, Sri Lanka, sentenced two recruitment agents to two years in prison for falsifying her travel documents, she said.

In a statement that was released this week and updated on Wednesday when the sentence was carried out, Human Rights Watch said that international law prohibits the death penalty for crimes committed before the age of 18.

“Saudi Arabia is one of just three countries that executes people for crimes they committed as children,” Ms. Varia said. The others are Iran and Yemen, she said.

Amnesty International said in a statement that as a state party to the Convention on the Rights of the Child, Saudi Arabia is prohibited from imposing the death penalty on people under the age of 18 at the time of the alleged offense, and that if there was doubt, the courts were required to treat the suspect as a juvenile until the prosecution can confirm the age.

After the sentence was handed down in 2007, Amnesty International and Human Rights Watch had called on the Saudi authorities for clemency, but the sentence was appealed and then later ratified by the country’s Supreme Court. King Abdullah signed off on it this week, Amnesty International said.

According to information gathered by Amnesty International, Ms. Nafeek said she was not allowed to present her birth certificate or other evidence of her age to the Court of First Instance in 2007. Amnesty International said it also appeared that the man who translated her statement to the court might not have been able adequately to go between Tamil and Arabic.

She also had no access to lawyers either during her pretrial interrogation or at her trial in 2007. Amnesty International said that although she initially confessed to the baby’s murder during her interrogation, “she later retracted and denied it was true, saying she had been forced to make the ‘confession’ under duress following a physical assault.”

Ms. Varia said she had spoken on Wednesday to the Sri Lankan ambassador in Riyadh, who told her that Ms. Nafeek was unaware she was to be executed. Ms. Nafeek, a Muslim, is from an impoverished family. Her father is a woodcutter. “In cases where girls are migrating so young it shows how desperate families are for income,” she said.

The news of the execution came on the same day that the United Nations’ International Labor Organization issued a report saying that of the 52 million domestic workers worldwide, only 10 percent are covered by labor laws to the same extent as other workers, and more than one-quarter are completely excluded from national labor legislation. It called on countries to extend protections to such workers.

Saudi Arabia in particular was not keeping up with the international trend to improve protections for domestic workers, Ms. Varia said.

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Bonds, Clemens rejected; no one elected to BB Hall

NEW YORK (AP) — Steroid-tainted stars Barry Bonds, Roger Clemens and Sammy Sosa were denied entry to baseball's Hall of Fame, with voters failing to elect any candidates for only the second time in four decades.

In a vote that keeps the game's career home run leader and one of its greatest pitchers out of Cooperstown — at least for now — Bonds received just 36.2 percent of the vote and Clemens 37.6 in totals announced Wednesday by the Hall and the Baseball Writers' Association of America, both well short of the 75 percent necessary. Sosa, eighth on the career home run list, got 12.5 percent.

"Curt Schilling made a good point, everyone was guilty. Either you used PEDs, or you did nothing to stop their use," Hall of Famer Mike Schmidt said in an email to The Associated Press. "This generation got rich. Seems there was a price to pay."

Bonds, Clemens and Sosa were eligible for the first time and have up to 14 more years on the writers' ballot to gain baseball's highest honor.

"After what has been written and said over the last few years I'm not overly surprised," Clemens said in a statement he posted on Twitter.

Craig Biggio, 20th on the career list with 3,060 hits, topped the 37 candidates with 68.2 percent of the 569 ballots, 39 shy of election. Among other first-year eligibles, Mike Piazza received 57.8 percent and Schilling 38.8.

Jack Morris led holdovers with 67.7 percent. He will make his final ballot appearance next year, when fellow pitchers Greg Maddux and Tom Glavine along with slugger Frank Thomas are eligible for the first time.

Two-time NL MVP Dale Murphy received 18.6 percent in his 15th and final appearance.

"With 53 percent you can get to the White House, but you can't get to Cooperstown," BBWAA secretary-treasurer Jack O'Connell said. "It's the 75 percent that makes it difficult."

It was the eighth time the BBWAA failed to elect any players. There were four fewer votes than last year and five members submitted blank ballots.

"It's a tough period for evaluation, that's what this chalks up to," Hall President Jeff Idelson said. "Honestly, I think that any group you put this to would have the same issues. ... There's always going to be discussion and concern about players who didn't get in, but at the end of the day it's a process and again, a snapshot in time isn't one year, it's 15 with this exercise."

Bonds, baseball's only seven-time Most Valuable Player, hit 762 home runs, including a record 73 in 2001.

"It is unimaginable that the best player to ever play the game would not be a unanimous first-ballot selection," said Jeff Borris of the Beverly Hills Sports Council, Bonds' longtime agent.

Clemens, the only seven-time Cy Young Award winner, is third in career strikeouts and ninth in wins.

"To those who did take the time to look at the facts," Clemens said, "we very much appreciate it."

Since 1961, the only years the writers didn't elect a candidate were when Yogi Berra topped the 1971 vote by appearing on 67 percent of the ballots cast and when Phil Niekro headed the 1996 ballot at 68 percent. Both were chosen the following years when they achieved the 75 percent necessary for election.

The other BBWAA elections without a winner were in 1945, 1946, 1950, 1958 and 1960.

"Next year, I think you'll have a rather large class and this year, for whatever reasons, you had a couple of guys come really close," Commissioner Bud Selig said at the owners' meetings in Paradise Valley, Ariz. "This is not to be voted to make sure that somebody gets in every year. It's to be voted on to make sure that they're deserving. I respect the writers as well as the Hall itself. This idea that this somehow diminishes the Hall of baseball is just ridiculous in my opinion."

Players' union head Michael Weiner called the vote "unfortunate, if not sad."

"To ignore the historic accomplishments of Barry Bonds and Roger Clemens, for example, is hard to justify. Moreover, to penalize players exonerated in legal proceedings — and others never even implicated — is simply unfair. The Hall of Fame is supposed to be for the best players to have ever played the game. Several such players were denied access to the Hall today. Hopefully this will be rectified by future voting."

Three inductees were chosen last month by the 16-member panel considering individuals from the era before integration in 1947: Yankees owner Jacob Ruppert, umpire Hank O'Day and barehanded catcher Deacon White. They will be enshrined during a ceremony in Cooperstown on July 28, when the Hall also will honor Lou Gehrig and Rogers Hornsby among a dozen players who never received formal inductions because of restrictions during World War II.

Bonds has denied knowingly using performance-enhancing drugs and was convicted of one count of obstruction of justice for giving an evasive answer in 2003 to a grand jury investigating PEDs. Clemens was acquitted of perjury charges stemming from congressional testimony during which he denied using PEDs.

Sosa, who finished with 609 home runs, was among those who tested positive in MLB's 2003 anonymous survey, The New York Times reported in 2009. He told a congressional committee in 2005 that he never took illegal performance-enhancing drugs.

The BBWAA election rules say "voting shall be based upon the player's record, playing ability, integrity, sportsmanship, character, and contributions to the team(s) on which the player played."

An Associated Press survey of 112 eligible voters conducted in late November after the ballot was announced indicated Bonds, Clemens and Sosa would fall well short of 50 percent. The big three drew even less support than that as the debate raged over who was Hall worthy.

Voters are writers who have been members of the BBWAA for 10 consecutive years at any point.

BBWAA president Susan Slusser of the San Francisco Chronicle said she didn't vote for Bonds, Clemens or Sosa.

"The evidence for steroid use is too strong," she said.

As for Biggio, "I'm surprised he didn't get in."

MLB.com's Hal Bodley, the former baseball columnist for USA Today, said Biggio and others paid the price for other players using PEDs.

"They got caught in the undertow of the steroids thing," he said.

Bodley said this BBWAA vote was a "loud and clear" message on the steroids issue. He said he couldn't envision himself voting for stars linked to drugs.

"We've a forgiving society, I know that," he said. "But I have too great a passion for the sport."

Mark McGwire, 10th on the career home run list, received 16.9 percent on his seventh try, down from 19.5 last year. He received 23.7 percent in 2010 — a vote before he admitted using steroids and human growth hormone.

Rafael Palmeiro, among just four players with 500 homers and 3,000 hits along with Hank Aaron, Willie Mays and Eddie Murray, received 8.8 percent in his third try, down from 12.6 percent last year. Palmeiro received a 10-day suspension in 2005 for a positive test for performance-enhancing drugs, claiming it was due to a vitamin vial given to him by teammate Miguel Tejada.

While there are exhibits about the Steroids Era at the Hall, the plaque room will remain without Bonds and Clemens, who join career hits leader Pete Rose on the outside looking in. There were four write-in votes for Rose, who never appeared on the ballot because of his lifetime ban that followed an investigation of his gambling while manager of the Cincinnati Reds.

Morris increased slightly from his 66.7 percent last year, when Barry Larkin was elected. Morris could become the player with the highest-percentage of the vote who is not in the Hall, a mark currently held by Gil Hodges at 63 percent in 1983.

Several players who fell just short in the BBWAA balloting later were elected by either the Veterans Committee or Old-Timers' Committee: Nellie Fox (74.7 percent on the 1985 BBWAA ballot), Jim Bunning (74.2 percent in 1988), Orlando Cepeda (73.6 percent in 1994) and Frank Chance (72.5 percent in 1945).

The ace of three World Series winners, Morris had 254 victories and was the winningest pitcher of the 1980s. His 3.90 ERA, however, is higher than that of any Hall of Famer.

___

AP Sports Writers Mike Fitzpatrick, John Marshall and Ben Walker contributed to this report.

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