Indian Prostitutes’ New Autonomy Imperils AIDS Fight

Kuni Takahashi for The New York Times

Sex workers in Mumbai’s long-established red-light district, where brothels are dwindling.

MUMBAI, India — Millions once bought sex in the narrow alleys of Kamathipura, a vast red-light district here. But prostitutes with inexpensive mobile phones are luring customers elsewhere, and that is endangering the astonishing progress India has made against AIDS.

Indeed, the recent closings of hundreds of ancient brothels, while something of an economic victory for prostitutes, may one day cost them, and many others, their lives.

“The place where sex happens turns out to be an important H.I.V. prevention point,” said Saggurti Niranjan, program associate of the Population Council. “And when we don’t know where that is, we can’t help stop the transmission.”

Cellphones, those tiny gateways to modernity, have recently allowed prostitutes to shed the shackles of brothel madams and strike out on their own. But that independence has made prostitutes far harder for government and safe-sex counselors to trace. And without the advice and free condoms those counselors provide, prostitutes and their customers are returning to dangerous ways.

Studies show that prostitutes who rely on cellphones are more susceptible to H.I.V. because they are far less likely than their brothel-based peers to require their clients to wear condoms.

In interviews, prostitutes said they had surrendered some control in the bedroom in exchange for far more control over their incomes.

“Now, I get the full cash in my hand before we start,” said Neelan, a prostitute with four children whose side business in sex work is unknown to her husband and neighbors. (Neelan is a professional name, not her real one.)

“Earlier, if the customer got scared and didn’t go all the way, the madam might not charge the full amount,” she explained. “But if they back out now, I say that I have removed all my clothes and am going to keep the money.”

India has been the world’s most surprising AIDS success story. Though infections did not appear in India until 1986, many predicted the nation would soon become the epidemic’s focal point. In 2002, the C.I.A.’s National Intelligence Council predicted that India would have as many as 25 million AIDS cases by 2010. Instead, India now has about 1.5 million.

An important reason the disease never took extensive hold in India is that most women here have fewer sexual partners than in many other developing countries. Just as important was an intensive effort underwritten by the World Bank and the Bill and Melinda Gates Foundation to target high-risk groups like prostitutes, gay men and intravenous drug users.

But the Gates Foundation is now largely ending its oversight and support for AIDS prevention in India, just as efforts directed at prostitutes are becoming much more difficult. Experts say it is too early to identify how much H.I.V. infections might rise.

“Nowadays, the mobility of sex workers is huge, and contacting them is very difficult,” said Ashok Alexander, the former director in India of the Gates Foundation. “It’s a totally different challenge, and the strategies will also have to change.”

An example of the strategies that had been working can be found in Delhi’s red-light district on Garstin Bastion Road near the old Delhi railway station, where brothels have thrived since the 16th century. A walk through dark alleys, past blind beggars and up narrow, steep and deeply worn stone staircases brings customers into brightly lighted rooms teeming with scores of women brushing each other’s hair, trying on new dresses, eating snacks, performing the latest Bollywood dances, tending small children and disappearing into tiny bedrooms with nervous men who come out moments later buttoning their trousers.

A 2009 government survey found 2,000 prostitutes at Garstin Bastion (also known as G. B.) Road who served about 8,000 men a day. The government estimated that if it could deliver as many as 320,000 free condoms each month and train dozens of prostitutes to counsel safe-sex practices to their peers, AIDS infections could be significantly reduced. Instead of broadcasting safe-sex messages across the country — an expensive and inefficient strategy commonly employed in much of the world — it encircled Garstin Bastion with a firebreak of posters with messages like “Don’t take a risk, use a condom” and “When a condom is in, risk is out.”

Surprising many international AIDS experts, these and related tactics worked. Studies showed that condom use among clients of prostitutes soared.

“To the credit of the Indian strategists, their focus on these high-risk groups paid off,” said Dr. Peter Piot, the former executive director of U.N.AIDS and now director of the London School of Hygiene and Tropical Medicine. A number of other countries, following India’s example, have achieved impressive results over the past decade as well, according to the latest United Nations report, which was released last week.

Sruthi Gottipati contributed reporting in Mumbai and New Delhi.

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M.I.T. Lab Hatches Ideas, and Companies, by the Dozens

HOW do you take particles in a test tube, or components in a tiny chip, and turn them into a $100 million company?

Dr. Robert Langer, 64, knows how. Since the 1980s, his Langer Lab at the Massachusetts Institute of Technology has spun out companies whose products treat cancer, diabetes, heart disease and schizophrenia, among other diseases, and even thicken hair.

The Langer Lab is on the front lines of turning discoveries made in the lab into a range of drugs and drug delivery systems. Without this kind of technology transfer, the thinking goes, scientific discoveries might well sit on the shelf, stifling innovation.

A chemical engineer by training, Dr. Langer has helped start 25 companies and has 811 patents, issued or pending, to his name. That’s not too far behind Thomas Edison, who had 1,093. More than 250 companies have licensed or sublicensed Langer Lab patents.

Polaris Venture Partners, a Boston venture capital firm, has invested $220 million in 18 Langer Lab-inspired businesses. Combined, these businesses have improved the health of many millions of people, says Terry McGuire, co-founder of Polaris.

Along the way, Dr. Langer and his lab, including about 60 postdoctoral and graduate students at a time, have found a way to navigate some slippery territory: the intersection of academic research and the commercial market.

Over the last 30 years, many universities — including M.I.T. — have set up licensing offices that oversee the transfer of scientific discoveries to companies. These offices have become a major pathway for universities seeking to put their research to practical use, not to mention add to their revenue streams.

In the sciences in particular, technology transfer has become a key way to bring drugs and other treatments to market. “The model of biomedical innovation relies on research coming out of universities, often funded by public money,” says Josephine Johnston, director of research at the Hastings Center, a bioethics research organization based in Garrison, N.Y.

Just a few of the products that have emerged from the Langer Lab are a small wafer that delivers a dose of chemotherapy used to treat brain cancer; sugar-sequencing tools that can be used to create new drugs like safer and more effective blood thinners; and a miniaturized chip (a form of nanotechnology) that can test for diseases.

The chemotherapy wafer, called the Gliadel, is licensed by Eisai Inc. The company behind the sugar-sequencing tools, Momenta Pharmaceuticals, raised $28.4 million in an initial public offering in 2004. The miniaturized chip is made by T2Biosystems,  which completed a $23 million round of financing in the summer of 2011.

“It’s inconvenient to have to send things to a lab,” so the company is trying to develop more sophisticated methods, says Dr. Ralph Weissleder, a co-founder, with Dr. Langer and others, of T2Biosystems and a professor at Harvard Medical School.

FOR Dr. Langer, starting a company is not the same as it was, say, for Mark Zuckerberg with Facebook. “Bob is not consumed with any one company,” says H. Kent Bowen, an emeritus professor of business administration at Harvard Business School who wrote a case study on the Langer Lab. “His mission is to create the idea.”

Dr. Bowen observes that there are many other academic laboratories, including highly productive ones, but that the Langer Lab’s combination of people, spun-out companies and publications sets it apart. He says Dr. Langer “walks into the great unknown and then makes these discoveries.”

Dr. Langer is well known for his mentoring abilities. He is “notorious for replying to e-mail in two minutes, whether it’s a lowly graduate school student or the president of the United States,” says Paulina Hill, who worked in his lab from 2009 to 2011 and is now a senior associate at Polaris Venture Partners. (According to Dr. Langer, he has corresponded directly with President Obama about stem cell research and federal funds for the sciences.)

Dr. Langer says he looks at his students “as an extended family,” adding that “I really want them to do well.”

And they have, whether in business or in academia, or a combination of the two. One former student, Ram Sasisekharan, helped found Momenta and now runs his own lab at M.I.T. Ganesh Venkataraman Kaundinya is Momenta’s chief scientific officer and senior vice president for research.

Hongming Chen is vice president of research at Kala Pharmaceuticals. Howard Bernstein is chief scientific officer at Seventh Sense Biosystems, a blood-testing company. Still others have taken jobs in the law or in government.

Dr. Langer says he spends about eight hours a week working on companies that come out of his lab. Of the 25 that he helped start, he serves on the boards of 12 and is an informal adviser to 4. All of his entrepreneurial activity, which includes some equity stakes, has made him a millionaire. But he says he is mainly motivated by a desire to improve people’s health.

Operating from the sixth floor of the David H. Koch Institute for Integrative Cancer Research on the M.I.T. campus in Cambridge, Mass., Dr. Langer’s lab has a research budget of more than $10 million for 2012, coming mostly from federal sources.

The research in labs like Dr. Langer’s is eyed closely by pharmaceutical companies. While drug companies employ huge research and development teams, they may not be as freewheeling and nimble, Dr. Langer says. The basis for many long-range discoveries has “come out of academia, including gene therapy, gene sequencing and tissue engineering,” he says.

He has served as a consultant to pharmaceutical companies. Their large size, he says, can end up being an impediment.

“Very often when you are going for real innovation,” he says, “you have to go against prevailing wisdom, and it’s hard to go against prevailing wisdom when there are people who have been there for a long time and you have some vice president who says, ‘No, that doesn’t make sense.’ ”

Pharmaceutical companies are eager to tap into the talent at leading research universities. In 2008, for example, Washington University in St. Louis announced a $25 million pact with Pfizer to collaborate more closely on biomedical research.

But in some situations, the close — critics might say cozy — ties between business and academia have the potential to create conflicts of interest.

There was a controversy earlier this year when it was revealed that the president of the University of Texas M.D. Anderson Cancer Center owned stock in Aveo Oncology, which had announced earlier that the university would be leading clinical trials of one of its cancer drugs.  Last month, the University of Texas announced that he would be allowed to keep his ties with three pharmaceutical companies, including Aveo Oncology; his holdings will be placed in a blind trust.

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New Zealand Wants a Hollywood Put on Its Map

WELLINGTON, New Zealand — Standing by his desk in New Zealand’s distinctive round Parliament building, known locally as the Beehive, Prime Minister John Key proudly brandished an ornately engraved sword. It was used, he said, by Frodo Baggins, the protagonist of the “Lord of the Rings” trilogy, and in the films it possesses magical powers that cause it to glow blue in the presence of goblins.

“This was given to me by the president of the United States,” said Mr. Key, marveling that President Obama’s official gift to New Zealand was, after all, a New Zealand product.

In Mr. Key’s spare blond-wood office — with no goblins in sight — the sword looked decidedly unmagical. But it served as a reminder that in New Zealand, the business of running a country goes hand in hand with the business of making movies.

For better or worse, Mr. Key’s government has taken extreme measures that have linked its fortunes to some of Hollywood’s biggest pictures, making this country of 4.4 million people, slightly more than the city of Los Angeles, a grand experiment in the fusion of film and government.

That union has been on enthusiastic display here in recent weeks as “The Hobbit: An Unexpected Journey,” the first of three related movies by the director Peter Jackson, approached its world premiere on Wednesday in Wellington (and on Dec. 14 in the United States). Anticipation in New Zealand has been building, and there are signs everywhere of the film’s integration into Kiwi life — from the giant replica of the movie’s Gollum creature suspended over the waiting area at Wellington Airport to the gift shops that are expanding to meet anticipated demand for Hobbit merchandise (elf ears, $14).

But the path to this moment has been filled with controversy. Two years ago, when a dispute with unions threatened to derail the “Hobbit” movies — endangering several thousand jobs and a commitment of some $500 million by Warner Brothers — Mr. Key persuaded the Parliament to rewrite its national labor laws.

It was a breathtaking solution, even in a world accustomed to generous public support of movie projects, and a substantial incentive package was included: the government agreed to contribute $99 million in production costs and add $10 million to the studio’s marketing budget. And its tourism office will spend about $8 million in its current fiscal year, and probably more in the future, as part of a promotional campaign with Time Warner that is marketing the country as a film-friendly fantasyland.

For a tiny nation like New Zealand, where plans to cut $35 million from the education budget set off national outrage earlier this year (and a backtrack from the government), the “Hobbit” concessions were difficult for many to swallow, especially since the country had already provided some $150 million in support for the three “Lord of the Rings” movies.

Now, even amid the excitement of the “Hobbit” opening, skepticism about the government’s film-centric strategy remains. And recently it has become entangled with new suspicions: that Mr. Key’s government is taking cues from America’s powerful film industry in handling a request by United States officials for the extradition of Kim Dotcom, the mogul whose given name was Kim Schmitz, so he can face charges of pirating copyrighted material.

New Zealand’s political scene erupted in September, as Mr. Key publicly apologized to Mr. Dotcom for what turned out to be illegal spying on him by the country’s Government Communications Security Bureau. The Waikato Times, a provincial paper, taunted Mr. Key, accusing him of making New Zealand the “51st state,” while others suggested that a whirlwind trip by Mr. Key to Los Angeles in early October was somehow tied to the Dotcom case.

“No studio executive raised it with me,” Mr. Key said in an interview last month. He spoke the day after a private dinner where he lobbied executives from Disney, Warner Brothers, Fox and other companies for still more New Zealand film work, with Mr. Jackson, a New Zealander, joining by video link.

Mr. Key has been sharply criticized for cozying up to Mr. Jackson in what some consider unseemly ways. Last year, a month before elections in which he and his National Party were fighting to keep control of the government, Mr. Key skipped an appointment with Queen Elizabeth II in Australia to visit the Hobbiton set. He also interviewed Mr. Jackson on a radio show, prompting an outcry from the opposition.

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Scientists See Advances in Deep Learning, a Part of Artificial Intelligence

Hao Zhang/The New York Times

A voice recognition program translated a speech given by Richard F. Rashid, Microsoft’s top scientist, into Mandarin Chinese.

Using an artificial intelligence technique inspired by theories about how the brain recognizes patterns, technology companies are reporting startling gains in fields as diverse as computer vision, speech recognition and the identification of promising new molecules for designing drugs.

The advances have led to widespread enthusiasm among researchers who design software to perform human activities like seeing, listening and thinking. They offer the promise of machines that converse with humans and perform tasks like driving cars and working in factories, raising the specter of automated robots that could replace human workers.

The technology, called deep learning, has already been put to use in services like Apple’s Siri virtual personal assistant, which is based on Nuance Communications’ speech recognition service, and in Google’s Street View, which uses machine vision to identify specific addresses.

But what is new in recent months is the growing speed and accuracy of deep-learning programs, often called artificial neural networks or just “neural nets” for their resemblance to the neural connections in the brain.

“There has been a number of stunning new results with deep-learning methods,” said Yann LeCun, a computer scientist at New York University who did pioneering research in handwriting recognition at Bell Laboratories. “The kind of jump we are seeing in the accuracy of these systems is very rare indeed.”

Artificial intelligence researchers are acutely aware of the dangers of being overly optimistic. Their field has long been plagued by outbursts of misplaced enthusiasm followed by equally striking declines.

In the 1960s, some computer scientists believed that a workable artificial intelligence system was just 10 years away. In the 1980s, a wave of commercial start-ups collapsed, leading to what some people called the “A.I. winter.”

But recent achievements have impressed a wide spectrum of computer experts. In October, for example, a team of graduate students studying with the University of Toronto computer scientist Geoffrey E. Hinton won the top prize in a contest sponsored by Merck to design software to help find molecules that might lead to new drugs.

From a data set describing the chemical structure of 15 different molecules, they used deep-learning software to determine which molecule was most likely to be an effective drug agent.

The achievement was particularly impressive because the team decided to enter the contest at the last minute and designed its software with no specific knowledge about how the molecules bind to their targets. The students were also working with a relatively small set of data; neural nets typically perform well only with very large ones.

“This is a really breathtaking result because it is the first time that deep learning won, and more significantly it won on a data set that it wouldn’t have been expected to win at,” said Anthony Goldbloom, chief executive and founder of Kaggle, a company that organizes data science competitions, including the Merck contest.

Advances in pattern recognition hold implications not just for drug development but for an array of applications, including marketing and law enforcement. With greater accuracy, for example, marketers can comb large databases of consumer behavior to get more precise information on buying habits. And improvements in facial recognition are likely to make surveillance technology cheaper and more commonplace.

Artificial neural networks, an idea going back to the 1950s, seek to mimic the way the brain absorbs information and learns from it. In recent decades, Dr. Hinton, 64 (a great-great-grandson of the 19th-century mathematician George Boole, whose work in logic is the foundation for modern digital computers), has pioneered powerful new techniques for helping the artificial networks recognize patterns.

Modern artificial neural networks are composed of an array of software components, divided into inputs, hidden layers and outputs. The arrays can be “trained” by repeated exposures to recognize patterns like images or sounds.

These techniques, aided by the growing speed and power of modern computers, have led to rapid improvements in speech recognition, drug discovery and computer vision.

Deep-learning systems have recently outperformed humans in certain limited recognition tests.

Last year, for example, a program created by scientists at the Swiss A. I. Lab at the University of Lugano won a pattern recognition contest by outperforming both competing software systems and a human expert in identifying images in a database of German traffic signs.

The winning program accurately identified 99.46 percent of the images in a set of 50,000; the top score in a group of 32 human participants was 99.22 percent, and the average for the humans was 98.84 percent.

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Scientists See Advances in Deep Learning, a Part of Artificial Intelligence

Hao Zhang/The New York Times

A voice recognition program translated a speech given by Richard F. Rashid, Microsoft’s top scientist, into Mandarin Chinese.

Using an artificial intelligence technique inspired by theories about how the brain recognizes patterns, technology companies are reporting startling gains in fields as diverse as computer vision, speech recognition and the identification of promising new molecules for designing drugs.

The advances have led to widespread enthusiasm among researchers who design software to perform human activities like seeing, listening and thinking. They offer the promise of machines that converse with humans and perform tasks like driving cars and working in factories, raising the specter of automated robots that could replace human workers.

The technology, called deep learning, has already been put to use in services like Apple’s Siri virtual personal assistant, which is based on Nuance Communications’ speech recognition service, and in Google’s Street View, which uses machine vision to identify specific addresses.

But what is new in recent months is the growing speed and accuracy of deep-learning programs, often called artificial neural networks or just “neural nets” for their resemblance to the neural connections in the brain.

“There has been a number of stunning new results with deep-learning methods,” said Yann LeCun, a computer scientist at New York University who did pioneering research in handwriting recognition at Bell Laboratories. “The kind of jump we are seeing in the accuracy of these systems is very rare indeed.”

Artificial intelligence researchers are acutely aware of the dangers of being overly optimistic. Their field has long been plagued by outbursts of misplaced enthusiasm followed by equally striking declines.

In the 1960s, some computer scientists believed that a workable artificial intelligence system was just 10 years away. In the 1980s, a wave of commercial start-ups collapsed, leading to what some people called the “A.I. winter.”

But recent achievements have impressed a wide spectrum of computer experts. In October, for example, a team of graduate students studying with the University of Toronto computer scientist Geoffrey E. Hinton won the top prize in a contest sponsored by Merck to design software to help find molecules that might lead to new drugs.

From a data set describing the chemical structure of 15 different molecules, they used deep-learning software to determine which molecule was most likely to be an effective drug agent.

The achievement was particularly impressive because the team decided to enter the contest at the last minute and designed its software with no specific knowledge about how the molecules bind to their targets. The students were also working with a relatively small set of data; neural nets typically perform well only with very large ones.

“This is a really breathtaking result because it is the first time that deep learning won, and more significantly it won on a data set that it wouldn’t have been expected to win at,” said Anthony Goldbloom, chief executive and founder of Kaggle, a company that organizes data science competitions, including the Merck contest.

Advances in pattern recognition hold implications not just for drug development but for an array of applications, including marketing and law enforcement. With greater accuracy, for example, marketers can comb large databases of consumer behavior to get more precise information on buying habits. And improvements in facial recognition are likely to make surveillance technology cheaper and more commonplace.

Artificial neural networks, an idea going back to the 1950s, seek to mimic the way the brain absorbs information and learns from it. In recent decades, Dr. Hinton, 64 (a great-great-grandson of the 19th-century mathematician George Boole, whose work in logic is the foundation for modern digital computers), has pioneered powerful new techniques for helping the artificial networks recognize patterns.

Modern artificial neural networks are composed of an array of software components, divided into inputs, hidden layers and outputs. The arrays can be “trained” by repeated exposures to recognize patterns like images or sounds.

These techniques, aided by the growing speed and power of modern computers, have led to rapid improvements in speech recognition, drug discovery and computer vision.

Deep-learning systems have recently outperformed humans in certain limited recognition tests.

Last year, for example, a program created by scientists at the Swiss A. I. Lab at the University of Lugano won a pattern recognition contest by outperforming both competing software systems and a human expert in identifying images in a database of German traffic signs.

The winning program accurately identified 99.46 percent of the images in a set of 50,000; the top score in a group of 32 human participants was 99.22 percent, and the average for the humans was 98.84 percent.

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Protests Erupt After Egypt’s Leader Seizes New Power

Tara Todras-Whitehill for The New York Times

Egyptians in central Cairo ran from tear gas during clashes with the police on Friday. Protesters took to the streets in several cities. More Photos »

CAIRO — Protests erupted across Egypt on Friday, as opponents of President Mohamed Morsi clashed with his supporters over a presidential edict that gave him unchecked authority and polarized an already divided nation while raising a specter, the president’s critics charged, of a return to autocracy.  

In an echo of the uprising 22 months ago, thousands of protesters chanted for the downfall of Mr. Morsi’s government in Cairo, while others ransacked the offices of the president’s former party in Suez, Alexandria and other cities.

Mr. Morsi spoke to his supporters in front of the presidential palace here, imploring the public to trust his intentions as he cast himself as a protector of the revolution and a fledgling democracy.

In a speech that was by turns defensive and conciliatory, he ultimately gave no ground to the critics who now were describing him as a pharaoh, in another echo of the insult once reserved for the deposed president, Hosni Mubarak.

“God’s will and elections made me the captain of this ship,” Mr. Morsi said.

The battles that raged on Friday — over power, legitimacy and the mantle of the revolution — posed a sharp challenge not only to Mr. Morsi but also to his opponents, members of secular, leftist and liberal groups whose crippling divisions have stifled their agenda and left them unable to confront the more popular Islamist movement led by the Muslim Brotherhood.

The crisis over his power grab came just days after the Islamist leader won international praise for his pragmatism, including from the United States, for brokering a cease-fire between Hamas and Israel.

On Friday, the State Department expressed muted concern over Mr. Morsi’s decision. “One of the aspirations of the revolution was to ensure that power would not be overly concentrated in the hands of any one person or institution,” said the State Department spokeswoman, Victoria Nuland.

She said, “The current constitutional vacuum in Egypt can only be resolved by the adoption of a constitution that includes checks and balances, and respects fundamental freedoms, individual rights and the rule of law consistent with Egypt’s international commitments.”

But the White House was notably silent after it had earlier this week extolled the emerging relationship between President Obama and Mr. Morsi and credited a series of telephone calls between the two men with helping to mediate the cease-fire in Gaza.

For Mr. Morsi, who seemed to be saying to the nation that it needed to surrender the last checks on his power in order to save democracy from Mubarak-era judges, the challenge was to convince Egyptians that the ends justified his means.

But even as he tried, thousands of protesters marched to condemn his decision. Clashes broke out between the president’s supporters and his critics, and near Tahrir Square, the riot police fired tear gas and bird shot as protesters hurled stones and set fires.

Since Thursday, when Mr. Morsi issued the decree, the president and his supporters have argued that he acted precisely to gain the power to address the complaints of his critics, including the families of protesters killed during the uprising and its aftermath.

By placing his decisions above judicial review, the decree enabled him to replace a public prosecutor who had failed to win convictions against senior officers implicated in the killings of protesters.

The president and his supporters also argued that the decree insulated the Constituent Assembly, which is drafting the constitution, from meddling by Mubarak-era judges.

Since Mr. Mubarak’s ouster, courts have dissolved Parliament, kept a Mubarak loyalist as top prosecutor and disbanded the first Assembly.

But by ending legal appeals, the decree also removed a safety valve for critics who say the Islamist majority is dominating the drafting of the constitution.

Mayy El Sheikh contributed reporting from Cairo, and Helene Cooper from Washington.

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Congress Looks at Ways to Raise Taxes

Stephen Crowley/The New York Times

President Obama met with Congressional leaders last week to talk about the fiscal crisis. Both parties said they were confident of a deal, but progress has slowed.

WASHINGTON — Congressional negotiators, trying to avert a fiscal crisis in January, are examining ideas that would allow effective tax rates to rise for the wealthy without technically raising the top tax rate of 35 percent. They hope the proposals will advance negotiations by allowing both parties to claim they stood their ground.

One possible change would tax the entire salary earned by those making more than a certain level — $400,000 or so — at the top rate of 35 percent rather than allowing them to pay lower rates before they reach the target, as is the standard formula. That plan would allow Republicans to say they did not back down in their opposition to raising marginal tax rates and Democrats to say they prevailed by increasing effective tax rates on the rich. At the same time, it would provide an initial effort to reduce the deficit, which the negotiators call a down payment, as Congressional tax-writing committees hash out a broad overhaul of the tax code.

That idea could be combined with the reinstatement of tax code provisions that once prevented the rich from taking personal exemptions or itemizing deductions. Those rules were eliminated by the tax cut of 2001. Reinstating them would tack an additional one to two percentage points onto the effective tax rates of high-income households without raising the 35 percent rate, but which households would be affected has not been decided. In all, tax experts say, families in the top tax bracket would find their effective tax rate jump to 41 percent, even though the top statutory rate would remain 35 percent.

The proposals have been floated as a way to speed up negotiations to avert a crisis in January when the tax cuts passed under President George W. Bush expire and across-the-board spending cuts on military and domestic programs automatically kick in. This “fiscal cliff” would squeeze hundreds of billions of dollars out of the fragile economy next year and, many economists say, send the country back into recession.

President Obama met a week ago with House Speaker John A. Boehner of Ohio; Representative Nancy Pelosi of California, the House minority leader; Senator Harry Reid of Nevada, the majority leader; and Mitch McConnell of Kentucky, the leader of the Senate Republicans, and both parties emerged confident a deal could be struck.

Since then, progress has slowed considerably. The Congressional leaders had said that aides would provide concrete ideas by Wednesday on deficit reduction targets through revenue increases and changes to social programs, especially Medicare. White House and Congressional staff members did meet early this week, but no such ideas were produced. Democrats want Republicans to first define what they mean by “structural changes” to Medicare and Medicaid. Republicans say Mr. Obama should make the first move, using what they say is the political capital gained by his re-election.

But aides involved in the negotiations said they remained confident, in part because many of the ideas that could break the impasse were fleshed out during successive but fruitless deficit negotiations between the president and Mr. Boehner and between Vice President Joseph R. Biden Jr. and Representative Eric Cantor of Virginia, the House majority leader, and during the deliberations of the Congressional “supercommittee” on deficit reduction formed during the 2011 impasse over raising the nation’s borrowing limit. One Republican aide involved in the current talks said both sides believe a deal can be reached before Christmas.

The supercommittee drafted a proposal that would have eliminated tax brackets lower than 35 percent for affluent families, taxing the first dollar of taxable earnings at the highest tax bracket. In the late 1980s, the tax code included a similar rule, which “clawed back” savings from lower tax rates for some rich families.

Under the existing tax code, the first $17,400 of adjusted gross income for a couple filing jointly is taxed at 10 percent. Above that level, up to $70,700, income is taxed at 15 percent. Income between $70,701 and $142,700 is taxed at 25 percent. Gross incomes up to $217,450 are taxed at 28 percent. The next bracket, 33 percent, ends at $388,350 for couples. The top bracket hits adjusted gross incomes only above $388,350.

All taxpayers get the advantage of the lower tax rates below the top threshold, whether they earn $40,000 or $40 million.

If Republicans insist that the top 35 percent rate cannot change while Congress tries to rewrite the tax code, negotiators could decide to technically keep all the Bush-era tax rates in place, but eliminate the lower tax rates for rich households.

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The New Old Age Blog: Home Health Care Help by the Hour

Here is a bright idea that ought to spread: You call your home care agency and say you will need your mother’s aide for the normal two hours on Monday and Wednesday, but for just half an hour (to drive her to a doctor’s office) on Tuesday, then 90 minutes on Thursday. And the agency says, “Sure.”

It sounds logical to hire someone to help — with bathing, dressing, errands, meal preparation, medication reminders – for only as many hours as an older adult needs assistance. But it is actually unusual for companies to offer such flexibility.

The majority of agencies require a four-hour minimum. Having to spend $80  — the national average cost for home care is $21 an hour — if you only need $40 worth of help is a big barrier for families trying to keep their elderly relatives living at home longer. A few agencies allow you to hire for fewer than four hours, but at higher rates.

But Mission Healthcare in San Diego, Calif., a three-year-old agency that began with Medicare-certified skilled home nursing and hospice care, expanded to general home care this summer and decided that clients should be able to specify how much help they want – in 15-minute increments — and will pay for.

“We’ll come for as long as they need us to,” said Mark Kimsey, one of Mission’s four directors. “In one hour, a well-trained caregiver can get the client bathed and dressed, prepare three meals and have them organized for the day.” (I have to think that is a speedy caregiver with a not-too-frail client, but still … )

Can Mission, which charges $19 to $20 an hour, actually make money this way? Though overall the agency serves 1,100 clients, its fledgling home care business is still small: 30 aides caring for just 60 clients. The aides can get benefits if they work enough hours, a bonus for them and for consumers (better employees, lower turnover), but an additional cost for the company.

The directors say they are profitable already, and that the approach will succeed because more people will like the flexibility and potential savings, and sign up. It is also true, let’s acknowledge, that a person who can get by with an hour or two a day for now may well need more help eventually, a boost for Mission’s bottom line.

Competitors are no doubt watching to see if this works. I’m curious, too, to see if the policy catches on. “Consumers can change the marketplace if they want to,” Mr. Kimsey said. It would be nice to think that is true.

Would you use this kind of hourly service, if it were available?

Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

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The Shrewd Shopper Carries a Smartphone

Tim Gruber for The New York Times

From left, Tara Niebeling, Sarah Schmidt, Bridget Jewell and Erin Vande Steeg are members of the social media team at the Mall of America in Bloomington, Minn.

Retailers are trying to lure shoppers away from the Internet, where they have increasingly been shopping to avoid Black Friday madness, and back to the stores. The bait is technological tools that will make shopping on the busiest day of the year a little more sane — and give shoppers an edge over their competition.

Those with smartphones in hand will get better planning tools, prices and parking spots. Walmart has a map that shows shoppers exactly where the top Black Friday specials can be found. A Mall of America Twitter feed gives advice on traffic and gifts, and the Macy’s app sends special deals for every five minutes a shopper stays in a store.

“The crazy mad rush to camp out and the crazy mad rush to hit the doorbusters have really made people think, ‘I’m just going to stay home on Black Friday,’ ” said Carey Rossi, editor in chief of ConsumerSearch.com, a review site. “This is going to invite some people back and say, ‘You know what? It doesn’t have to be that crazy.’ ”

Part of the retailers’ strategy is to slap back at online stores like Amazon.com, which last year used apps to pick off shoppers as they browsed in physical stores. But the stores are also recognizing that shopping on the Friday after Thanksgiving need not require an overnight wait in line, a helmet and elbow pads. A smartphone gives shoppers enough of an edge.

“This takes away that frantic Black Friday anxiety,” said Lawrence Fong, co-founder of BuyVia, an app that sends people price alerts and promotions. “While there’s a sport to it, life’s a little too short.”

Denise Fouts, 45, who works repairing fire and water damage in Chandler, Ariz., was already using apps, including Shopkick, Target’s app and one called Black Friday, before Thanksgiving to prepare for Black Friday. “There still are going to be the crowds, but at least I already know ahead of time what I’m going specifically for,” Ms. Fouts said.

Last week, Macy’s released an update to its app with about 300 Black Friday specials and their location. In the Herald Square store, for instance, the $49.99 cashmere sweater specials will be in the Broadway side of the fifth-floor women’s department.

“With the speed that people are shopping with on Black Friday, they need to be really efficient about how they’re spending their time,” said Jennifer Kasper, group vice president for digital media at Macy’s.

When shoppers keep the app open, Macy’s will start sending special deals to the phone every five minutes. The deals are not advertised elsewhere.

Walmart has had an app for several years, but recently introduced an in-store mode, which shows things like the current circular or food tastings when a shopper is near a certain location. Twelve percent of Walmart’s mobile revenue now comes from when a person is inside a store.

For Black Friday, the app will have a map of each store, with the precise location of the top sale items — so planners can determine the best way to run. “The blitz items are not where you think they would be, because for traffic reasons, maybe the hot game console is in the lawn and garden center,” said Gibu Thomas, senior vice president for mobile and digital for Walmart Global eCommerce.

Target is also testing a way-finding feature on its app at stores that include some in Seattle, Chicago and Los Angeles. If a shopper types in an item, the app will give its location.

Other app makers are betting that shoppers want apps that pull in information from many stores.

RedLaser, an eBay app, lets shoppers use their phones to compare prices and recently started using location data to give shoppers personalized promotions when they walk into stores, including items not on store shelves at Best Buy, for instance. RetailMeNot, which offers e-commerce coupons, now has offline coupons that will pop up on users’ cellphones when they step near 500 malls on Black Friday.

“Consumers are not going to download 40 different apps for 40 different stores,” said Cyriac Roeding, co-founder of Shopkick, a location-based app that gives shoppers points, redeemable for perks, when they walk into stores or scan certain items.

For Black Friday, Shopkick is publishing what it calls a little black book with the top doorbusters. Shoppers will earn extra points and rewards for shopping on Black Friday.

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Military Analysis: For Israel, Gaza Conflict Is Test for an Iran Confrontation

Menahem Kahana/Agence France-Presse — Getty Images

An Israeli missile is launched from a battery. Officials said their antimissile system shot down 88 percent of all assigned targets.

WASHINGTON — The conflict that ended, for now, in a cease-fire between Hamas and Israel seemed like the latest episode in a periodic showdown. But there was a second, strategic agenda unfolding, according to American and Israeli officials: The exchange was something of a practice run for any future armed confrontation with Iran, featuring improved rockets that can reach Jerusalem and new antimissile systems to counter them.

It is Iran, of course, that most preoccupies Prime Minister Benjamin Netanyahu and President Obama. While disagreeing on tactics, both have made it clear that time is short, probably measured in months, to resolve the standoff over Iran’s nuclear program.

And one key to their war-gaming has been cutting off Iran’s ability to slip next-generation missiles into the Gaza Strip or Lebanon, where they could be launched by Iran’s surrogates, Hamas, Hezbollah and Islamic Jihad, during any crisis over sanctions or an Israeli strike on Iran’s nuclear facilities.

Michael B. Oren, the Israeli ambassador to the United States and a military historian, likened the insertion of Iranian missiles into Gaza to the Cuban missile crisis.

“In the Cuban missile crisis, the U.S. was not confronting Cuba, but rather the Soviet Union,” Mr. Oren said Wednesday, as the cease-fire was declared. “In Operation Pillar of Defense,” the name the Israel Defense Force gave the Gaza operation, “Israel was not confronting Gaza, but Iran.”

It is an imprecise analogy. What the Soviet Union was slipping into Cuba 50 years ago was a nuclear arsenal. In Gaza, the rockets and parts that came from Iran were conventional, and, as the Israelis learned, still have significant accuracy problems. But from one point of view, Israel was using the Gaza battle to learn the capabilities of Hamas and Islamic Jihad — the group that has the closest ties to Iran — as well as to disrupt those links.

Indeed, the first strike in the eight-day conflict between Hamas and Israel arguably took place nearly a month before the fighting began — in Khartoum, the capital of Sudan, as another mysterious explosion in the shadow war with Iran.

A factory said to be producing light arms blew up in spectacular fashion on Oct. 22, and within two days the Sudanese charged that it had been hit by four Israeli warplanes that easily penetrated the country’s airspace. Israelis will not talk about it. But Israeli and American officials maintain that Sudan has long been a prime transit point for smuggling Iranian Fajr rockets, the kind that Hamas launched against Tel Aviv and Jerusalem over recent days.

The missile defense campaign that ensued over Israeli territory is being described as the most intense yet in real combat anywhere — and as having the potential to change warfare in the same way that novel applications of air power in the Spanish Civil War shaped combat in the skies ever since.

Of course, a conflict with Iran, if a last-ditch effort to restart negotiations fails, would look different than what has just occurred. Just weeks before the outbreak in Gaza, the United States and European and Persian Gulf Arab allies were practicing at sea, working on clearing mines that might be dropped in shipping lanes in the Strait of Hormuz.

But in the Israeli and American contingency planning, Israel would face three tiers of threat in a conflict with Iran: the short-range missiles that have been lobbed in this campaign, medium-range rockets fielded by Hezbollah in Lebanon and long-range missiles from Iran.

The last of those three could include the Shahab-3, the missile Israeli and American intelligence believe could someday be fitted with a nuclear weapon if Iran ever succeeded in developing one and — the harder task — shrinking it to fit a warhead.

A United States Army air defense officer said that the American and Israeli militaries were “absolutely learning a lot” from this campaign that may contribute to a more effective “integration of all those tiered systems into a layered approach.”

The goal, and the challenge, is to link short-, medium- and long-range missile defense radar systems and interceptors against the different types of threats that may emerge in the next conflict.

Even so, a historic battle of missile versus missile defense has played out in the skies over Israel, with Israeli officials saying their Iron Dome system shot down 350 incoming rockets — 88 percent of all targets assigned to the missile defense interceptors. Israeli officials declined to specify the number of interceptors on hand to reload their missile-defense batteries.

Before the conflict began, Hamas was estimated to have amassed an arsenal of 10,000 to 12,000 rockets. Israeli officials say their pre-emptive strikes on Hamas rocket depots severely reduced the arsenal of missiles, both those provided by Iran and some built in Gaza on a Syrian design.

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