Bank of Japan Moves to Fight Deflation

TOKYO — The Bank of Japan set an ambitious 2 percent inflation target and pledged to ease monetary policy “decisively” by introducing open-ended asset purchases, following intense pressure from the country’s audacious new prime minister, Shinzo Abe, who has made beating deflation a national priority.

In a joint statement Tuesday with the government, the central bank said it was doubling its inflation target to 2 percent and said it would “pursue monetary easing and aim to achieve this target at the earliest possible time.”

The Bank of Japan also said that it intended to purchase assets indefinitely, promising to stick to a program that has allowed the bank to pump funds into the Japanese economy, even with interest rates at virtually zero. The bank’s board voted to keep its benchmark rate at a range of zero to 0.1 percent.

Mr. Abe immediately hailed the bank’s moves, telling the Bank of Japan governor, Masaaki Shirakawa, that the measures were “groundbreaking,” according to Kyodo News. Analysts, however, said the details of the bank’s policy were less impressive than the headlines and said they had expected more.

The central bank, for example, will only begin its open-ended asset purchases in 2014, and estimates that its asset purchase fund will increase by just 10 trillion yen in 2014, remaining unchanged after that. With such a paltry increase, it was unlikely Japan would achieve 2 percent inflation, analysts said. The consumer price index for 2012 fell 0.5 percent, according to government statistics.

The Bank of Japan’s announcement “will likely disappoint those who expected the policy board to answer Abe’s call for a ‘different kind of B.O.J. policy,’ or significantly ramp up its pace of easing,” Izumi Devalier, an economist with HSBC, said in a note to clients.

“This means pressure will remain in place for the B.O.J. to ease policy further, as the 2 percent inflation target remains ever out of reach,” Ms. Devalier and her colleagues said.

Masaaki Kanno, Japan economist for JPMorgan, also called the details of the asset purchase program disappointing. “That said, this is not the end of the game,” he said. “We should expect further easing” including an increase in asset purchases as well as purchases of longer-term assets, once Gov. Shirakawa’s term is up in April and a successor is appointed, Mr. Kanno said.

Since last year, when Mr. Abe was still opposition leader, he has urged the central bank to do more to end deflation, the all-around fall in prices, profit and incomes that has plagued Japan’s economy since the late 1990s. He stepped up the pressure on the bank after a landslide victory by his Liberal Democratic Party in parliamentary elections in December, which catapulted him to office for the second time since a short-lived stint in 2006-07.

Mr. Abe’s call for the Bank of Japan to increase the monetary supply, among other things, has weakened the yen, a boon to the competitiveness of exporters, which make up much of Japan’s growth. Earlier this month, Mr. Abe also announced a 12 trillion yen emergency stimulus, providing even more tailwind for the Japanese economy. That bright outlook has pushed the Nikkei stock index 20 percent higher since mid-November, when Mr. Abe first campaigned on his expansionary platform.

Mr. Abe’s critics, however, warn that the central bank, which will buy up more government bonds as part of its asset purchase program, will become a printing press for profligate government spending — spending that carries great risks for a country whose public debt is already twice the size of its economy. Critics also say that before flooding a broken system with money, Japan must first tackle structural problems that hurt economic efficiency.

Mr. Abe maintains that deflation will undermine any efforts to grow, and that the government and central bank must act together to get prices rising again. But in a nod to critics, the joint statement said the government would also promote “all possible decisive policy actions for reforming the economic structure” and establish “a sustainable fiscal structure.”

“I believe we are firmly on the path toward bold monetary easing,” Mr. Abe told reporters following the bank’s announcement.

Mr. Shirakawa, who has long argued that the bank alone cannot spark inflation or economic growth, called on the government to do its part to bolster the Japanese economy.

“Various actors need to put in considerable effort along with the Bank of Japan,” Mr. Shirakawa told a press conference late Tuesday. “Those efforts are going to have to be quite drastic,” he said.

Market reaction was mixed. The Nikkei index average rose 0.8 percent in anticipation of the bank’s announcement, before giving up its gains to end 0.4 percent lower, at 10,709.93. The index has risen over 20 percent, however, since Mr. Abe started his monetarist push. The dollar briefly rose above 90 yen, near the 2-year high of 90.25 it hit on Monday, but had slipped to 88.67 yen late afternoon in Tokyo.

Yields on 10-year Japanese government bonds were largely unchanged, with a benchmark issue ending trading at 0.730 percent, down 0.005 percentage points from Monday’s close.

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The Week: A Roundup of This Week’s Science News

“Science,” a colleague once said at a meeting, “is a mighty enterprise, which is really rather quite topical.” He was so right: as we continue to enhance our coverage of the scientific world, we always aim to keep the latest news front and center.

His observation seemed like a nice way to introduce this column, which will highlight the week’s developments in health and science news and glance at what’s ahead. This past week, for instance, the mighty enterprise of science addressed itself to such newsy topics as the flu (there’s still time to get vaccinated!), and mental illness and gun control.

In addition to the big-headline stories that invite wisdom from scientists, each week there is a drumbeat of purely scientific and medical news that emerges from academic journals, fieldwork and elsewhere. These developments, from the quirky to the abstruse, often make their way into the daily news cycle, depending on the strength of the research behind them. (Well, that’s how we judge them, anyway.)

Many discoveries are hard to unravel. “In a way, science is antithetical to everything that has to do with a newspaper,” the same colleague observed. “You couldn’t imagine anything less consumer-friendly.”

Let’s aim to fix that. Below, a selection of the week’s stories.

DEVELOPMENTS

Health

Strange, but Effective

People with a bacterial infection called Clostridium difficile — which kills 14,000 Americans a year — have a startling cure: a transplant of someone else’s feces into their digestive system, which introduces good bacteria that the gut needs to fight off the bad. For some people, antibiotics don’t fix this problem, but an infusion of diluted stool from a healthy person seems to do the trick.

Genetics

Dig We Must

Hillery Metz and Hopi Hoekstra/Harvard University

Evolutionary biologists at Harvard took a tiny species of deer mice, known for building elaborate burrows with long tunnels, and bred it with another species of deer mice, which builds short-tunneled burrows. Comparing the DNA of the original mice with their offspring, the biologists pinpointed four regions of genetic code that help tell the mice what kind of burrow to construct.

Aerospace

Launch, Then Inflate

Uncredited/Bigelow Aerospace, via Associated Press

NASA signed a contract for an inflatable space habitat — roughly pineapple-shaped, with walls of floppy cloth — that will ideally be appended to the International Space Station in 2015. NASA aims to use the pod to test inflatable technology in space, but the company that builds these things, Bigelow Aerospace, has bigger ambitions: think of a 12-person apartment and laboratory in the sky, with two months’ rent at north of $26 million.

Biology

What’s Green and Flies?

Jodi Rowley/Australian Museum

National Geographic reported on an Australian researcher working in Vietnam who discovered a great-looking new species of flying frog. Described as having flappy forearms (the better for gliding), the three-and-a-half-inch-long frog likes to “parachute” from tree to tree, Jodi Rowley, an amphibian biologist at the Australian Museum in Sydney, told the magazine. She named it Helen’s Flying Frog, for her mother.

Privacy

That’s Joe’s DNA!

People who volunteer their genetic information for the betterment of science — and are assured anonymity — may find that their privacy is not a slam dunk. A researcher who set out to crack the identities of a few men whose genomes appeared in a public database was able to do so using genealogical Web sites (where people upload parts of their genomes to try to find relatives) as well as some simple search tools. He was trying to test the database’s security, but even he did not expect it to be so easy.

Genetics

An On/Off Switch for Disease

Geneticists have long puzzled over what it is that activates a disease in one person but not in another — even in identical twins. Now researchers from Johns Hopkins and the Karolinska Institute in Sweden who studied people with rheumatoid arthritis have identified a pattern of chemical tags that tell genes whether to turn on or not. In rheumatoid arthritis, the immune system attacks the body, and it is thought the tags enable the attack.

Planetary Science

That Red Planet

Everybody loves Mars, and we’re all secretly hoping that NASA’s plucky little rover finds evidence of life there. Meanwhile, a separate NASA craft — the Mars Reconnaissance Orbiter, which has been looping the planet since 2006 — took some pictures of a huge crater that looks as if it once held a lake fed by groundwater. It is too soon to say if the lake held living things, but NASA’s news release did include the happy phrase “clues to subsurface habitability.”

COMING UP

Animal Testing

Retiring Chimps

Emily Wabitsch/European Pressphoto Agency

A lot of people have strong feelings about the use of chimpanzees in biomedical and behavioral experiments, and the National Institutes of Health has been listening. On Tuesday, the agency is to release its recommendations for curtailing chimp research in a big way. This will be but a single step in a long process and it will apply only to the chimps the agency owns, but it may well stir big reactions from many constituencies.

Read More..

The Week: A Roundup of This Week’s Science News

“Science,” a colleague once said at a meeting, “is a mighty enterprise, which is really rather quite topical.” He was so right: as we continue to enhance our coverage of the scientific world, we always aim to keep the latest news front and center.

His observation seemed like a nice way to introduce this column, which will highlight the week’s developments in health and science news and glance at what’s ahead. This past week, for instance, the mighty enterprise of science addressed itself to such newsy topics as the flu (there’s still time to get vaccinated!), and mental illness and gun control.

In addition to the big-headline stories that invite wisdom from scientists, each week there is a drumbeat of purely scientific and medical news that emerges from academic journals, fieldwork and elsewhere. These developments, from the quirky to the abstruse, often make their way into the daily news cycle, depending on the strength of the research behind them. (Well, that’s how we judge them, anyway.)

Many discoveries are hard to unravel. “In a way, science is antithetical to everything that has to do with a newspaper,” the same colleague observed. “You couldn’t imagine anything less consumer-friendly.”

Let’s aim to fix that. Below, a selection of the week’s stories.

DEVELOPMENTS

Health

Strange, but Effective

People with a bacterial infection called Clostridium difficile — which kills 14,000 Americans a year — have a startling cure: a transplant of someone else’s feces into their digestive system, which introduces good bacteria that the gut needs to fight off the bad. For some people, antibiotics don’t fix this problem, but an infusion of diluted stool from a healthy person seems to do the trick.

Genetics

Dig We Must

Hillery Metz and Hopi Hoekstra/Harvard University

Evolutionary biologists at Harvard took a tiny species of deer mice, known for building elaborate burrows with long tunnels, and bred it with another species of deer mice, which builds short-tunneled burrows. Comparing the DNA of the original mice with their offspring, the biologists pinpointed four regions of genetic code that help tell the mice what kind of burrow to construct.

Aerospace

Launch, Then Inflate

Uncredited/Bigelow Aerospace, via Associated Press

NASA signed a contract for an inflatable space habitat — roughly pineapple-shaped, with walls of floppy cloth — that will ideally be appended to the International Space Station in 2015. NASA aims to use the pod to test inflatable technology in space, but the company that builds these things, Bigelow Aerospace, has bigger ambitions: think of a 12-person apartment and laboratory in the sky, with two months’ rent at north of $26 million.

Biology

What’s Green and Flies?

Jodi Rowley/Australian Museum

National Geographic reported on an Australian researcher working in Vietnam who discovered a great-looking new species of flying frog. Described as having flappy forearms (the better for gliding), the three-and-a-half-inch-long frog likes to “parachute” from tree to tree, Jodi Rowley, an amphibian biologist at the Australian Museum in Sydney, told the magazine. She named it Helen’s Flying Frog, for her mother.

Privacy

That’s Joe’s DNA!

People who volunteer their genetic information for the betterment of science — and are assured anonymity — may find that their privacy is not a slam dunk. A researcher who set out to crack the identities of a few men whose genomes appeared in a public database was able to do so using genealogical Web sites (where people upload parts of their genomes to try to find relatives) as well as some simple search tools. He was trying to test the database’s security, but even he did not expect it to be so easy.

Genetics

An On/Off Switch for Disease

Geneticists have long puzzled over what it is that activates a disease in one person but not in another — even in identical twins. Now researchers from Johns Hopkins and the Karolinska Institute in Sweden who studied people with rheumatoid arthritis have identified a pattern of chemical tags that tell genes whether to turn on or not. In rheumatoid arthritis, the immune system attacks the body, and it is thought the tags enable the attack.

Planetary Science

That Red Planet

Everybody loves Mars, and we’re all secretly hoping that NASA’s plucky little rover finds evidence of life there. Meanwhile, a separate NASA craft — the Mars Reconnaissance Orbiter, which has been looping the planet since 2006 — took some pictures of a huge crater that looks as if it once held a lake fed by groundwater. It is too soon to say if the lake held living things, but NASA’s news release did include the happy phrase “clues to subsurface habitability.”

COMING UP

Animal Testing

Retiring Chimps

Emily Wabitsch/European Pressphoto Agency

A lot of people have strong feelings about the use of chimpanzees in biomedical and behavioral experiments, and the National Institutes of Health has been listening. On Tuesday, the agency is to release its recommendations for curtailing chimp research in a big way. This will be but a single step in a long process and it will apply only to the chimps the agency owns, but it may well stir big reactions from many constituencies.

Read More..

Media Decoder: Pew Survey Finds Reliance on Libraries for Computers and Internet

Free access to computers and the Internet is now nearly as important to library patrons as borrowing books, according to a new survey.

The survey, released Tuesday by the Pew Research Center’s Internet & American Life Project, found that 80 percent of Americans said book borrowing was a “very important” library service, but 77 percent said the same thing about computers and the Internet.

The study also found that library patrons were open to having even more technological options.

“In the past generation, public libraries have reinvented themselves to become technology hubs in order to help their communities access information in all its new forms,” Kathryn Zickuhr, a research analyst with Pew and a co-author of a report on the survey’s findings, said in a written statement.

Pew questioned 2,252 Americans ages 16 and older via cellphones and landlines from Oct. 15 to Nov. 10 last year, in both English and Spanish. More than half of those surveyed said that they wanted more e-book selections in their public libraries, and would be likely to check out e-readers already loaded with books — a significant increase from a survey a year ago.

Roughly 69 percent said they would like to be able to try new technology devices through libraries, and 63 percent said they would like to receive customized book and music recommendations from their libraries as they do from online retailers like Amazon.com.

Some library users seemed willing to support even more changes. When asked whether libraries “should move some printed books and stacks out of public locations to free up space for tech centers, reading rooms, meeting rooms, and cultural events,” 20 percent of respondents said yes and 39 percent said maybe.

Still, of the 53 percent of respondents who had actually visited a library or mobile book location in the last year, 73 percent said they went in order to borrow print books, and only 49 percent said they visit libraries “to sit, read, and study, or watch or listen to media.”

As a result of these conflicting messages, Ms. Zickuhr said, “Many libraries are torn between expanding their digital offerings on the latest platforms and still providing quality resources for patrons who may lack experience with technology or the means to own the latest devices.”

Read More..

British Woman Sentenced to Death in Bali Drug Case

JAKARTA — A British woman was sentenced to death Tuesday by an Indonesian court after she was caught smuggling $2.5 million worth of cocaine onto the island of Bali.

The woman, Lindsay June Sandiford, 56, had claimed that she was forced to take the drugs into the country by a gang that had threatened to hurt one of her children. Her death sentence came even though prosecutors had only recommended a 15-year sentence, and television footage shooting Mr. Sandiford, a grandmother, sobbing at word of the verdict.

Investigators said that customs officials found that she brought in 8.4 pounds of cocaine to Bali’s airport, which was hidden in the lining of her travel bag.

Indonesia is known for its tough treatment of people who commit drug offenses and other crimes, having put five foreigners to death in drug cases since 1998, and 40 foreigners are currently on death row for drug and other offenses.

In a statement issued after the sentence was delivered, the British embassy said that “Britain remains strongly opposed to the death penalty in all circumstances.”

President Susilo Bambang Yudhoyono has granted clemency to four prisoners on death row for narcotics crimes. A decision to reduce the sentences of 19 drug convicts last October stirred a public backlash from critics who accused him of softening Indonesia’s anti-drug policy.

“It’s possible that could have influenced the thinking of the judges,” said David McRae, a research fellow at Australia’s Lowy Institute for International Policy, said in an email. “On the other hand, it’s not unheard of for sentences to exceed, even significantly exceed, the prosecutor's sentencing request.”

Ms. Sandiford’s alleged accomplice, Anthony Pounder, also of Britain, is expected to be sentenced Wednesday.

In handing down its verdict, a judicial panel at the Denpasar District Court found that Ms. Sandiford, by ferrying in the drugs, had damaged the image of Bali as a tourism destination and weakened the government’s drug prevention program.

Douglas Ramage, an analyst with Bower Group Asia, called the sentence fair by Indonesian standards.

“Foreigners and Indonesians alike have been regularly sentenced to the death penalty, so in a sense, Lindsay was not treated appreciably different than others who have come before Indonesian courts on drug trafficking charges,” he said.

Gerry Mullany contributed reporting from Hong Kong.

Read More..

Media Decoder: News Outlets Take to Washington for Inauguration Coverage

If he squints hard enough, President Obama will be able to see CNN from his perch on the inaugural podium on Monday.

The cable news channel has set up an elaborate studio on the National Mall — one of the four locations where its anchors will be leading coverage of Mr. Obama’s second inaugural celebration.

“The goal is to put our anchors in the middle of all the activity,” said Sam Feist, CNN’s Washington bureau chief. So in the morning, Wolf Blitzer will start out by the Capitol building and Anderson Cooper by the Mall, moving to new spots along the parade route in the afternoon. Other anchors will be at the inaugural balls at night.

The coverage might seem more subdued on other major television networks, reflecting the fact that there is generally less enthusiasm for presidential inaugurations the second time around. Still, the ceremony and the spectacle that accompanies it will take over the networks and news channels beginning with their morning shows, some of which are relocating to Washington for the day.

CBS has built a studio on the Mall beside CNN’s. Its one-year-old morning show, “CBS This Morning,” will be broadcast from there and expand to three hours for the day. NBC’s “Today” show will have all of its hosts in Washington, as well.

ABC’s “Good Morning America” is doing it a bit differently, sending George Stephanopoulos and Josh Elliott to Washington and having the show’s other hosts stay in New York.

The bulk of the festivities will be anchored by the same correspondents who handled election night for their networks. There has been a last-minute change at PBS, though: Judy Woodruff is away from Washington because of a family illness, a spokeswoman said, so the senior correspondent Jeffrey Brown will anchor with Gwen Ifill, instead.

Most Americans will watch the inauguration on television, just as they did in 2009, the first time Mr. Obama was inaugurated. But there will also be a panoply of Web sites live-streaming the event, including that of the Presidential Inauguration Committee.

Read More..

Well: A Check on Physicals

“Go Beyond Your Father’s Annual Physical. Live Longer, Feel Better”

This sales pitch for the Princeton Longevity Center’s “comprehensive exam” promises, for $5,300, to take “your health beyond the annual physical.” But it is far from certain whether this all-day checkup, and others less inclusive, make a meaningful difference to health or merely provide reassurance to the worried well.

Among physicians, researchers and insurers, there is an ongoing debate as to whether regular checkups really reduce the chances of becoming seriously ill or dying of an illness that would have been treatable had it been detected sooner.

No one questions the importance of regular exams for well babies, children and pregnant women, and the protective value of specific exams, like a Pap smear for sexually active women and a colonoscopy for people over 50. But arguments against the annual physical for all adults have been fueled by a growing number of studies that failed to find a medical benefit.

Some experts note that when something seemingly abnormal is picked up during a routine exam, the result is psychological distress for the patient, further testing that may do more harm than good, and increased medical expenses.

“Part of the problem of looking for abnormalities in perfectly well people is that rather a lot of us have them,” Dr. Margaret McCartney, a Scottish physician, wrote in The Daily Mail, a British newspaper. “Most of them won’t do us any harm.”

She cited the medical saga of Brian Mulroney, former prime minister of Canada. A CT scan performed as part of a checkup in 2005 revealed two small lumps in Mr. Mulroney’s lungs. Following surgery, he developed an inflamed pancreas, which landed him in intensive care. He spent six weeks in the hospital, then was readmitted a month later for removal of a cyst on his pancreas caused by the inflammation.

The lumps on his lungs, by the way, were benign. But what if, you may ask, Mr. Mulroney’s lumps had been cancer? Might not the discovery during a routine exam have saved his life?

Logic notwithstanding, the question of benefits versus risks from routine exams can be answered only by well-designed scientific research.

Defining the value of a routine checkup — determining who should get one and how often — is especially important now, because next year the Affordable Care Act will add some 30 million people to the roster of the medically insured, many of whom will be eligible for government-mandated preventive care through an annual exam.

Dr. Ateev Mehrotra of the University of Pittsburgh School of Medicine, who directed a study of annual physicals in 2007, reported that an estimated 44.4 million adults in the United States undergo preventive exams each year. He concluded that if every adult were to receive such an exam, the health care system would be saddled with 145 million more visits every year, consuming 41 percent of all the time primary care doctors spend with patients.

There is already a shortage of such doctors and not nearly enough other health professionals — physician assistants and nurse practitioners — to meet future needs. If you think the wait to see your doctor is too long now, you may want to stock up on some epic novels to keep you occupied in the waiting room in the future.

Few would challenge the axiom that an ounce of prevention is worth a pound of cure. Lacking incontrovertible evidence for the annual physical, this logic has long been used to justify it:

¶ If a thorough exam and conversation about your well-being alerts your doctor to a health problem that is best addressed sooner rather than later, isn’t that better than waiting until the problem becomes too troublesome to ignore?

¶ What if you have a potentially fatal ailment, like heart disease or cancer, that may otherwise be undetected until it is well advanced or incurable?

¶ And wouldn’t it help to uncover risk factors like elevated blood sugar or high cholesterol that could prevent an incipient ailment if they are reversed before causing irreparable damage?

Even if there is no direct medical benefit, many doctors say that having their patients visit once a year helps to maintain a meaningful relationship and alert doctors to changes in patients’ lives that could affect health. It is also an opportunity to give patients needed immunizations and to remind them to get their eyes, teeth and skin checked.

But the long-sacrosanct recommendation that everyone should have an annual physical was challenged yet again recently by researchers at the Nordic Cochrane Center in Copenhagen.

The research team, led by Dr. Lasse T. Krogsboll, analyzed the findings of 14 scientifically designed clinical trials of routine checkups that followed participants for up to 22 years. The team found no benefit to the risk of death or serious illness among seemingly healthy people who had general checkups, compared with people who did not. Their findings were published in November in BMJ (formerly The British Medical Journal).

In introducing their analysis, the Danish team noted that routine exams consist of “combinations of screening tests, few of which have been adequately studied in randomized trials.” Among possible harms from health checks, they listed “overdiagnosis, overtreatment, distress or injury from invasive follow-up tests, distress due to false positive test results, false reassurance due to false negative test results, adverse psychosocial effects due to labeling, and difficulties with getting insurance.”

Furthermore, they wrote, “general health checks are likely to be expensive and may result in lost opportunities to improve other areas of health care.”

In summarizing their results, the team said, “We did not find an effect on total or cause-specific mortality from general health checks in adult populations unselected for risk factors or disease. For the causes of death most likely to be influenced by health checks, cardiovascular mortality and cancer mortality, there were no reductions either.”

What, then, should people do to monitor their health?

Whenever you see your doctor, for any reason, make sure your blood pressure is checked. If a year or more has elapsed since your last blood test, get a new one.

Keep immunizations up to date, and get the screening tests specifically recommended based on your age, gender and known risk factors, including your family and personal medical history.

And if you develop a symptom, like unexplained pain, shortness of breath, digestive problems, a lump, a skin lesion that doesn’t heal, or unusual fatigue or depression, consult your doctor without delay. Seek further help if the initial diagnosis and treatment fails to bring relief.

Read More..

Well: A Check on Physicals

“Go Beyond Your Father’s Annual Physical. Live Longer, Feel Better”

This sales pitch for the Princeton Longevity Center’s “comprehensive exam” promises, for $5,300, to take “your health beyond the annual physical.” But it is far from certain whether this all-day checkup, and others less inclusive, make a meaningful difference to health or merely provide reassurance to the worried well.

Among physicians, researchers and insurers, there is an ongoing debate as to whether regular checkups really reduce the chances of becoming seriously ill or dying of an illness that would have been treatable had it been detected sooner.

No one questions the importance of regular exams for well babies, children and pregnant women, and the protective value of specific exams, like a Pap smear for sexually active women and a colonoscopy for people over 50. But arguments against the annual physical for all adults have been fueled by a growing number of studies that failed to find a medical benefit.

Some experts note that when something seemingly abnormal is picked up during a routine exam, the result is psychological distress for the patient, further testing that may do more harm than good, and increased medical expenses.

“Part of the problem of looking for abnormalities in perfectly well people is that rather a lot of us have them,” Dr. Margaret McCartney, a Scottish physician, wrote in The Daily Mail, a British newspaper. “Most of them won’t do us any harm.”

She cited the medical saga of Brian Mulroney, former prime minister of Canada. A CT scan performed as part of a checkup in 2005 revealed two small lumps in Mr. Mulroney’s lungs. Following surgery, he developed an inflamed pancreas, which landed him in intensive care. He spent six weeks in the hospital, then was readmitted a month later for removal of a cyst on his pancreas caused by the inflammation.

The lumps on his lungs, by the way, were benign. But what if, you may ask, Mr. Mulroney’s lumps had been cancer? Might not the discovery during a routine exam have saved his life?

Logic notwithstanding, the question of benefits versus risks from routine exams can be answered only by well-designed scientific research.

Defining the value of a routine checkup — determining who should get one and how often — is especially important now, because next year the Affordable Care Act will add some 30 million people to the roster of the medically insured, many of whom will be eligible for government-mandated preventive care through an annual exam.

Dr. Ateev Mehrotra of the University of Pittsburgh School of Medicine, who directed a study of annual physicals in 2007, reported that an estimated 44.4 million adults in the United States undergo preventive exams each year. He concluded that if every adult were to receive such an exam, the health care system would be saddled with 145 million more visits every year, consuming 41 percent of all the time primary care doctors spend with patients.

There is already a shortage of such doctors and not nearly enough other health professionals — physician assistants and nurse practitioners — to meet future needs. If you think the wait to see your doctor is too long now, you may want to stock up on some epic novels to keep you occupied in the waiting room in the future.

Few would challenge the axiom that an ounce of prevention is worth a pound of cure. Lacking incontrovertible evidence for the annual physical, this logic has long been used to justify it:

¶ If a thorough exam and conversation about your well-being alerts your doctor to a health problem that is best addressed sooner rather than later, isn’t that better than waiting until the problem becomes too troublesome to ignore?

¶ What if you have a potentially fatal ailment, like heart disease or cancer, that may otherwise be undetected until it is well advanced or incurable?

¶ And wouldn’t it help to uncover risk factors like elevated blood sugar or high cholesterol that could prevent an incipient ailment if they are reversed before causing irreparable damage?

Even if there is no direct medical benefit, many doctors say that having their patients visit once a year helps to maintain a meaningful relationship and alert doctors to changes in patients’ lives that could affect health. It is also an opportunity to give patients needed immunizations and to remind them to get their eyes, teeth and skin checked.

But the long-sacrosanct recommendation that everyone should have an annual physical was challenged yet again recently by researchers at the Nordic Cochrane Center in Copenhagen.

The research team, led by Dr. Lasse T. Krogsboll, analyzed the findings of 14 scientifically designed clinical trials of routine checkups that followed participants for up to 22 years. The team found no benefit to the risk of death or serious illness among seemingly healthy people who had general checkups, compared with people who did not. Their findings were published in November in BMJ (formerly The British Medical Journal).

In introducing their analysis, the Danish team noted that routine exams consist of “combinations of screening tests, few of which have been adequately studied in randomized trials.” Among possible harms from health checks, they listed “overdiagnosis, overtreatment, distress or injury from invasive follow-up tests, distress due to false positive test results, false reassurance due to false negative test results, adverse psychosocial effects due to labeling, and difficulties with getting insurance.”

Furthermore, they wrote, “general health checks are likely to be expensive and may result in lost opportunities to improve other areas of health care.”

In summarizing their results, the team said, “We did not find an effect on total or cause-specific mortality from general health checks in adult populations unselected for risk factors or disease. For the causes of death most likely to be influenced by health checks, cardiovascular mortality and cancer mortality, there were no reductions either.”

What, then, should people do to monitor their health?

Whenever you see your doctor, for any reason, make sure your blood pressure is checked. If a year or more has elapsed since your last blood test, get a new one.

Keep immunizations up to date, and get the screening tests specifically recommended based on your age, gender and known risk factors, including your family and personal medical history.

And if you develop a symptom, like unexplained pain, shortness of breath, digestive problems, a lump, a skin lesion that doesn’t heal, or unusual fatigue or depression, consult your doctor without delay. Seek further help if the initial diagnosis and treatment fails to bring relief.

Read More..

How M.I.T. Ensnared a Hacker, Bucking a Freewheeling Culture

Months earlier, the mysterious visitor had used the school’s computer network to begin copying millions of research articles belonging to Jstor, the nonprofit organization that sells subscription access to universities.

The visitor was clever — switching identifications to avoid being blocked by M.I.T.’s security system — but eventually the university believed it had shut down the intrusion, then spent weeks reassuring furious officials at Jstor that the downloading had been stopped.

However, on Jan. 3, 2011, according to internal M.I.T. documents obtained by The New York Times, the university was informed that the intruder was back — this time downloading documents very slowly, with a new method of access, so as not to alert the university’s security experts.

“The user was now not using any of the typical methods to access MITnet to avoid all usual methods of being disabled,” concluded Mike Halsall, a senior security analyst at M.I.T., referring to the university’s computer network.

What the university officials did not know at the time was that the intruder was Aaron Swartz, one of the shining lights of the technology world and a leading advocate for open access to information, with a fellowship down the road at Harvard.

Mr. Swartz’s actions presented M.I.T. with a crucial choice: the university could try to plug the weak spot in its network or it could try to catch the hacker, then unknown.

The decision — to treat the downloading as a continuing crime to be investigated rather than a security threat that had been stopped — led to a two-day cat-and-mouse game with Mr. Swartz and, ultimately, to charges of computer and wire fraud. Mr. Swartz, 26, who faced a potentially lengthy prison term and whose trial was to begin in April, was found dead of an apparent suicide in his Brooklyn apartment on Jan. 11.

Mr. Swartz’s supporters called M.I.T.’s decision a striking step for an institution that prides itself on operating an open computer network and open campus — the home of a freewheeling programming culture. M.I.T.’s defenders viewed the intrusion as a computer crime that needed to be taken seriously.

M.I.T. declined to confirm any of these details or comment on its actions during the investigation. The university’s president, L. Rafael Reif, said last week, “It pains me to think that M.I.T. played any role in a series of events that have ended in tragedy.” He appointed a professor, Hal Abelson, to analyze M.I.T.’s conduct in the investigation. To comment now, a spokeswoman for the university said, would be “to get ahead of that investigation.”

Early on Jan. 4, at 8:08 a.m., according to Mr. Halsall’s detailed internal timeline of the events, a security expert was able to locate that new method of access precisely — the wiring in a network closet in the basement of Building 16, a nondescript rectangular structure full of classrooms and labs that, like many buildings on campus, is kept unlocked.

In the closet, Mr. Halsall wrote, there was a netbook, or small portable computer, “hidden under a box,” connected to an external hard drive that was receiving the downloaded documents.

At 9:44 a.m. the M.I.T. police were called in; by 10:30 a.m., the Cambridge police were en route, and by 11 a.m., Michael Pickett, a Secret Service agent and expert on computer crime, was on the scene. On his recommendation, a surveillance camera was installed in the closet and a second laptop was connected to the network switch to track the traffic.

There may have been a reason for the university’s response. According to the timeline, the tech team detected brief activity from China on the netbook — something that occurs all the time but still represents potential trouble.

E-mails among M.I.T. officials that Tuesday in January 2011 highlight the pressures university officials felt over a problem they thought they had solved. Ann J. Wolpert, the director of libraries, wrote to Ellen Finnie Duranceau, the official who was receiving Jstor’s complaints: “Has there ever been a situation similar to this when we brought in campus police? The magnitude, systematic and careful nature of the abuses could be construed as approaching criminal action. Certainly, that’s how Jstor views it.”

Some of Mr. Swartz’s defenders argue that collecting and providing evidence to the government without a warrant may have violated federal and state wiretapping statutes.

John Schwartz contributed reporting.

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Insurgents Attack Police Unit in Kabul

KABUL, Afghanistan — In the second brazen attack on the capital in less than a week, five Taliban suicide bombers stormed the headquarters of the traffic police early on Monday, setting off a fierce nine-hour gun battle that raged into the afternoon and claimed the lives of at least three traffic officers.

The attack began around 5 a.m., when insurgents shot and killed officers manning the checkpoint in front of the headquarters, which is on the same road as the Parliament building.

After the firefight began, insurgents wearing suicide vests remotely detonated a huge car bomb and rushed into the compound. Throughout the day, rocket explosions and gunfire erupted in intermittent bursts, as an array of Afghan security forces attempt to dislodge the insurgents.

The battle ended shortly after 2 p.m. with all of the insurgents dead. Only two of the bombers detonated their vests, officials said at the scene. The other three fighters were gunned down by the security forces.

In addition to the three dead officers, six security members of the security forces were wounded in the attack, said Gen. Abdul Rahman Rahman, a deputy minister at the Interior Ministry. At least eight civilians were also wounded, mostly from the bombing.

The Taliban claimed responsibility for the assault, the second it has carried out in less than a week. On Wednesday, heavily armed bombers blew up the gate to an Afghan intelligence facility, killing at least one security officer and injuring numerous civilians.

The consecutive attacks have rattled the relative security Kabul has experienced compared with other areas of the country. The group has promised to continue its fight against government targets in Kabul and elsewhere, creating unease among many Afghans as they prepare for coalition forces to withdraw troops from the country by 2014 or sooner.

“Our target was a special police training unit where foreign instructors and trainers train,” said a Taliban spokesman, Zabiullah Mujahid. “We inflicted heavy casualties to the enemy so far and that is a part of our routine operations against the enemy.”

Unlike the facilities of the security services, which are heavily armed and protected by mountainous blast walls and coils of razor wire, the traffic police headquarters offered a softer target. Traffic police are not typically armed in the streets of Kabul, and the headquarters doesn’t have the same level of security as the intelligence installations.

Still, within half an hour of the blast, the area was cordoned off by an array of Afghan security forces, as onlookers listened to the firefight from beyond the security perimeter. Periodically, debris from rocket-propelled grenades rained down on the street.

Jawad Sukhanyar contributed reporting.

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