Fiscal Deal’s Passage Ends Standoff





WASHINGTON — Ending a climactic fiscal showdown in the final hours of the 112th Congress, the House late Tuesday passed and sent to President Obama legislation to avert big income tax increases on most Americans and prevent large cuts in spending for the Pentagon and other government programs.




The measure, brought to the House floor less than 24 hours after its passage in the Senate, was approved 257 to 167, with 85 Republicans joining 172 Democrats in voting to allow income taxes to rise for the first time in two decades, in this case for the highest-earning Americans. Voting no were 151 Republicans and 16 Democrats.


The bill was expected to be signed quickly by Mr. Obama, who won re-election on a promise to increase taxes on the wealthy.


Mr. Obama strode into the White House briefing room shortly after the vote, less to hail the end of the fiscal crisis than to lay out a marker for the next one. “The one thing that I think, hopefully, the new year will focus on,” he said, “is seeing if we can put a package like this together with a little bit less drama, a little less brinkmanship, and not scare the heck out of folks quite as much.”


In approving the measure after days of legislative intrigue, Congress concluded its final and most pitched fight over fiscal policy, the culmination of two years of battles over taxes, the federal debt, spending and what to do to slow the growth in popular social programs like Medicare.


The decision by Republican leaders to allow the vote came despite widespread scorn among House Republicans for the bill, passed overwhelmingly by the Senate in the early hours of New Year’s Day. They were unhappy that it did not include significant spending cuts in health and other social programs, which they say are essential to any long-term solution to the nation’s debt.


Democrats, while hardly placated by the compromise, celebrated Mr. Obama’s nominal victory in his final showdown with House Republicans in the 112th Congress, who began their term emboldened by scores of new, conservative members whose reach to the right ultimately tipped them over.


“The American people are the real winners tonight,” Representative Bill Pascrell Jr., Democrat of New Jersey, said on the House floor, “not anyone who navigates these halls.”


Not a single leader among House Republicans came to the floor to speak in favor of the bill, though Speaker John A. Boehner, who rarely takes part in roll calls, voted in favor. Representative Eric Cantor of Virginia, the majority leader, and Representative Kevin McCarthy of California, the No. 3 Republican, voted no. Representative Paul D. Ryan, the budget chairman who was the Republican vice-presidential candidate, supported the bill.


Despite the party divisions, many Republicans in their remarks characterized the measure, which allows taxes to go up on household income over $400,000 for individuals and $450,000 for couples but makes permanent tax cuts for income below that level, as a victory of sorts, even as so many of them declined to vote for it.


“After more than a decade of criticizing these tax cuts,” said Representative Dave Camp of Michigan, “Democrats are finally joining Republicans in making them permanent. Republicans and the American people are getting something really important, permanent tax relief.”


The dynamic with the House was a near replay of a fight at the end of 2011 over a payroll tax break extension. In that showdown, Senate Democrats and Republicans passed legislation, and while House Republicans fulminated, they were eventually forced to swallow it.


On Tuesday, as they got a detailed look at the Senate’s fiscal legislation, House Republicans ranging from Midwest pragmatists to Tea Party-blessed conservatives voiced serious reservations about the measure, emerging from a lunchtime New Year’s Day meeting with their leaders, eyes flashing and faces grim, insisting they would not accept a bill without substantial savings from cuts.


The unrest reached to the highest levels as Mr. Cantor told members in a closed-door meeting in the basement of the Capitol that he could not support the legislation in its current form.


Mr. Boehner, who faces a re-election vote on his post on Thursday when the 113th Congress convenes, had grave concerns as well, but he had pledged to allow the House to consider any legislation that cleared the Senate. And he was not eager to have such a major piece of legislation pass with mainly opposition votes, and the outcome could be seen as undermining his authority.


Robert Pear and Peter Baker contributed reporting.



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Scant Proof Is Found to Back Up Claims by Energy Drinks





Energy drinks are the fastest-growing part of the beverage industry, with sales in the United States reaching more than $10 billion in 2012 — more than Americans spent on iced tea or sports beverages like Gatorade.




Their rising popularity represents a generational shift in what people drink, and reflects a successful campaign to convince consumers, particularly teenagers, that the drinks provide a mental and physical edge.


The drinks are now under scrutiny by the Food and Drug Administration after reports of deaths and serious injuries that may be linked to their high caffeine levels. But however that review ends, one thing is clear, interviews with researchers and a review of scientific studies show: the energy drink industry is based on a brew of ingredients that, apart from caffeine, have little, if any benefit for consumers.


“If you had a cup of coffee you are going to affect metabolism in the same way,” said Dr. Robert W. Pettitt, an associate professor at Minnesota State University in Mankato, who has studied the drinks.


Energy drink companies have promoted their products not as caffeine-fueled concoctions but as specially engineered blends that provide something more. For example, producers claim that “Red Bull gives you wings,” that Rockstar Energy is “scientifically formulated” and Monster Energy is a “killer energy brew.” Representative Edward J. Markey of Massachusetts, a Democrat, has asked the government to investigate the industry’s marketing claims.


Promoting a message beyond caffeine has enabled the beverage makers to charge premium prices. A 16-ounce energy drink that sells for $2.99 a can contains about the same amount of caffeine as a tablet of NoDoz that costs 30 cents. Even Starbucks coffee is cheap by comparison; a 12-ounce cup that costs $1.85 has even more caffeine.


As with earlier elixirs, a dearth of evidence underlies such claims. Only a few human studies of energy drinks or the ingredients in them have been performed and they point to a similar conclusion, researchers say — that the beverages are mainly about caffeine.


Caffeine is called the world’s most widely used drug. A stimulant, it increases alertness, awareness and, if taken at the right time, improves athletic performance, studies show. Energy drink users feel its kick faster because the beverages are typically swallowed quickly or are sold as concentrates.


“These are caffeine delivery systems,” said Dr. Roland Griffiths, a researcher at Johns Hopkins University who has studied energy drinks. “They don’t want to say this is equivalent to a NoDoz because that is not a very sexy sales message.”


A scientist at the University of Wisconsin became puzzled as he researched an ingredient used in energy drinks like Red Bull, 5-Hour Energy and Monster Energy. The researcher, Dr. Craig A. Goodman, could not find any trials in humans of the additive, a substance with the tongue-twisting name of glucuronolactone that is related to glucose, a sugar. But Dr. Goodman, who had studied other energy drink ingredients, eventually found two 40-year-old studies from Japan that had examined it.


In the experiments, scientists injected large doses of the substance into laboratory rats. Afterward, the rats swam better. “I have no idea what it does in energy drinks,” Dr. Goodman said.


Energy drink manufacturers say it is their proprietary formulas, rather than specific ingredients, that provide users with physical and mental benefits. But that has not prevented them from implying otherwise.


Consider the case of taurine, an additive used in most energy products.


On its Web site, the producer of Red Bull, for example, states that “more than 2,500 reports have been published about taurine and its physiological effects,” including acting as a “detoxifying agent.” In addition, that company, Red Bull of Austria, points to a 2009 safety study by a European regulatory group that gave it a clean bill of health.


But Red Bull’s Web site does not mention reports by that same group, the European Food Safety Authority, which concluded that claims about the benefits in energy drinks lacked scientific support. Based on those findings, the European Commission has refused to approve claims that taurine helps maintain mental function and heart health and reduces muscle fatigue.


Taurine, an amino acidlike substance that got its name because it was first found in the bile of bulls, does play a role in bodily functions, and recent research suggests it might help prevent heart attacks in women with high cholesterol. However, most people get more than adequate amounts from foods like meat, experts said. And researchers added that those with heart problems who may need supplements would find far better sources than energy drinks.


Hiroko Tabuchi contributed reporting from Tokyo and Poypiti Amatatham from Bangkok.



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Scant Proof Is Found to Back Up Claims by Energy Drinks





Energy drinks are the fastest-growing part of the beverage industry, with sales in the United States reaching more than $10 billion in 2012 — more than Americans spent on iced tea or sports beverages like Gatorade.




Their rising popularity represents a generational shift in what people drink, and reflects a successful campaign to convince consumers, particularly teenagers, that the drinks provide a mental and physical edge.


The drinks are now under scrutiny by the Food and Drug Administration after reports of deaths and serious injuries that may be linked to their high caffeine levels. But however that review ends, one thing is clear, interviews with researchers and a review of scientific studies show: the energy drink industry is based on a brew of ingredients that, apart from caffeine, have little, if any benefit for consumers.


“If you had a cup of coffee you are going to affect metabolism in the same way,” said Dr. Robert W. Pettitt, an associate professor at Minnesota State University in Mankato, who has studied the drinks.


Energy drink companies have promoted their products not as caffeine-fueled concoctions but as specially engineered blends that provide something more. For example, producers claim that “Red Bull gives you wings,” that Rockstar Energy is “scientifically formulated” and Monster Energy is a “killer energy brew.” Representative Edward J. Markey of Massachusetts, a Democrat, has asked the government to investigate the industry’s marketing claims.


Promoting a message beyond caffeine has enabled the beverage makers to charge premium prices. A 16-ounce energy drink that sells for $2.99 a can contains about the same amount of caffeine as a tablet of NoDoz that costs 30 cents. Even Starbucks coffee is cheap by comparison; a 12-ounce cup that costs $1.85 has even more caffeine.


As with earlier elixirs, a dearth of evidence underlies such claims. Only a few human studies of energy drinks or the ingredients in them have been performed and they point to a similar conclusion, researchers say — that the beverages are mainly about caffeine.


Caffeine is called the world’s most widely used drug. A stimulant, it increases alertness, awareness and, if taken at the right time, improves athletic performance, studies show. Energy drink users feel its kick faster because the beverages are typically swallowed quickly or are sold as concentrates.


“These are caffeine delivery systems,” said Dr. Roland Griffiths, a researcher at Johns Hopkins University who has studied energy drinks. “They don’t want to say this is equivalent to a NoDoz because that is not a very sexy sales message.”


A scientist at the University of Wisconsin became puzzled as he researched an ingredient used in energy drinks like Red Bull, 5-Hour Energy and Monster Energy. The researcher, Dr. Craig A. Goodman, could not find any trials in humans of the additive, a substance with the tongue-twisting name of glucuronolactone that is related to glucose, a sugar. But Dr. Goodman, who had studied other energy drink ingredients, eventually found two 40-year-old studies from Japan that had examined it.


In the experiments, scientists injected large doses of the substance into laboratory rats. Afterward, the rats swam better. “I have no idea what it does in energy drinks,” Dr. Goodman said.


Energy drink manufacturers say it is their proprietary formulas, rather than specific ingredients, that provide users with physical and mental benefits. But that has not prevented them from implying otherwise.


Consider the case of taurine, an additive used in most energy products.


On its Web site, the producer of Red Bull, for example, states that “more than 2,500 reports have been published about taurine and its physiological effects,” including acting as a “detoxifying agent.” In addition, that company, Red Bull of Austria, points to a 2009 safety study by a European regulatory group that gave it a clean bill of health.


But Red Bull’s Web site does not mention reports by that same group, the European Food Safety Authority, which concluded that claims about the benefits in energy drinks lacked scientific support. Based on those findings, the European Commission has refused to approve claims that taurine helps maintain mental function and heart health and reduces muscle fatigue.


Taurine, an amino acidlike substance that got its name because it was first found in the bile of bulls, does play a role in bodily functions, and recent research suggests it might help prevent heart attacks in women with high cholesterol. However, most people get more than adequate amounts from foods like meat, experts said. And researchers added that those with heart problems who may need supplements would find far better sources than energy drinks.


Hiroko Tabuchi contributed reporting from Tokyo and Poypiti Amatatham from Bangkok.



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Tech Giants, Learning the Ways of Washington, Brace for More Scrutiny


Mario Tama/Getty Images


Nadine Wolf demonstrated against online piracy legislation a year ago in New York. The measures were defeated.







SAN FRANCISCO — Silicon Valley lobbied hard in Washington in 2012, and despite some friction with regulators, fared fairly well. In 2013, though, government scrutiny is likely to grow. And with this scrutiny will come even greater efforts by the tech industry to press its case in the nation’s capital and overseas.




In 2012, among other victories, the industry staved off calls for federal consumer privacy legislation and successfully pushed for a revamp of an obscure law that had placed strict privacy protections on Americans’ video rental records. It also helped achieve a stalemate on a proposed global effort to let Web users limit behavioral tracking online, using Do Not Track browser settings.


But this year is likely to put that issue in the spotlight again, and bring intense negotiations between industry and consumer rights groups over whether and how to allow consumers to limit tracking.


Congress is likely to revisit online security legislation — meant to safeguard critical infrastructure from attack — that failed last year. And a looming question for Web giants will be who takes the reins of the Federal Trade Commission, the industry’s main regulator, this year. David C. Vladeck, the director of the commission’s Bureau of Consumer Protection, has resigned, and there have been suggestions that its chairman, Jon Leibowitz, would step down.


The agency is investigating Google over possible antitrust violations and will subject Facebook to audits of its privacy policy for the next 20 years. Its next steps could serve as a bellwether of how aggressively the commission will take on Web companies in the second Obama administration.


“Now that the election is over, Silicon Valley companies each are thinking through their strategy for the second Obama administration,” said Peter Swire, a law professor at Ohio State University and a former White House privacy official. “The F.T.C. will have a new Democratic chairman. A priority for tech companies will be to discern the new chair’s own priorities.”


In early 2012, an unusual burst of lobbying by tech companies helped defeat antipiracy bills, which had been backed by the entertainment industry. Silicon Valley giants like Facebook and Google feared that the bills would force them to police the Internet.


At the end of the year, Silicon Valley also got its way when the Obama administration stood up against a proposed global treaty that would have given government authorities greater control over the Web.


The key to the industry’s successes in 2012 was simple: it expanded its footprint in Washington just as Washington began to pay closer attention to how technology companies affect consumers. “Privacy and security became top-tier important policy issues in Washington in 2012,” said David A. Hoffman, director of security policy and global privacy officer at Intel.


“Industry has realized it is important to be engaged,” he continued, “to make sure government stakeholders are fully informed and educated about the role that new technology plays and to make sure any action taken doesn’t unnecessarily burden the innovation economy while still protecting individual trust in new technology.”


At the end of 2012, tech companies were on track to have spent record amounts on lobbying for the year. In the first three quarters, they spent close to $100 million, which meant that they were likely to surpass the $127 million they spent on lobbying in 2011, according to an analysis by the Center for Responsive Politics, a Washington-based nonpartisan group that tracks corporate spending. Even the venture capital firm Andreessen Horowitz hired a lobbyist in Washington: Adrian Fenty, a former mayor of the city.


Technology executives and investors also made generous contributions in the 2012 presidential race, luring both President Obama and Mitt Romney to Northern California for fund-raisers and nudging them to speak out on issues like immigration overhaul and lower tax rates.


In a blog post in November, the center said Silicon Valley’s lobbying expenditures have ballooned in recent years, even as spending by other industries has fallen.


Facebook more than doubled its lobbying outlay in the year, reporting close to $2.6 million through the third quarter of 2012. Google spent more than any other company in the industry, doling out more than $13 million in the same period and more than double its nearest competitor, Microsoft, which spent just over $5.6 million in the same period.


Among Google’s advocates on Capitol Hill is a former Republican congresswoman, Susan Molinari, who heads Google’s office in Washington.


Google has particular reason to be engaged. It faces a wide-reaching antitrust investigation by the Federal Trade Commission, just as Microsoft did a decade ago. At issue is whether Google’s search engine results favor Google products over its rivals’.


Although the agency was ready to settle that case before the holidays, without harsh remedies, late last month it shelved the inquiry and put stronger penalties back in play. A resolution is expected in January.


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Letter from India: City Setting, but Village Mentalities







NEW DELHI — India is essentially a village, and because it is a village it is a woman’s ancient foe. Even the country’s apparent cities are overwhelmed by deep and enduring infestations of rural tradition and the fellowships of the conservatives who hold women in low esteem. The Parliament and legislative assemblies are largely confederations of village headmen.




The most ardent fan of the Indian village was Mohandas K. Gandhi, who said, probably with joy, “The soul of India lives in its villages.”


That is true even now, but the village is also at the heart of most of India’s social problems. The most factual analysis of the Indian village was from a man who could not stand Gandhi — the primary author of the Indian Constitution and arguably the nation’s most underrated writer, B.R. Ambedkar, who wrote more than 60 years ago, “The love of the intellectual Indian for the village community is of course infinite, if not pathetic. … What is a village but a sink of localism, a den of ignorance, narrow mindedness and communalism?”


His view holds even today.


The Indian village is the most formidable preserve of caste hierarchies, and at the very bottom of its many social rungs is the woman. The city, for its part, attempts to dissolve everything that the village holds dear, especially its hierarchies, its “narrow mindedness” and its close scrutiny of women. All of India’s struggles for modernity have been about this — the battle of the idea of the city against the idea of the village. The latest uprising in India is a part of this tired war, even though at first glance it appears to be a society’s outrage at the rape and murder of a young woman in Delhi.


On the night of Dec. 16, a 23-year-old student was raped and brutalized for nearly an hour in a moving bus in Delhi by six drunken men, and thrown out of the vehicle. She battled for her life for nearly two weeks before succumbing to complications arising from severe injuries. India reacted to the rape and eventually to her death in a profound way. How it reacted became an accidental survey of the many psychological states of urban India, which included, inexorably, the city’s contempt for the village.


What happened to this young woman could have happened anywhere in the world, and such crimes have indeed occurred even in some of the most affluent nations. But nowhere else in the world did such an event set off an urban middle-class movement across several cities against the government. The protesters slammed the government for its failure to make Delhi and other Indian cities safe for women.


But, largely, the demonstrations were a lament of the city against a nation that has, going by the statements of politicians and policemen in the past, blamed attacks on women on the women’s own modernity.


The placards, which were mostly in English, of the women who marched in Delhi in protest, carried statements like these: “Just because I show my legs, it does not mean I will spread them for you,” “Don’t tell me how to dress, tell them not to rape,” and “My body, my right. My city, my right.”


In numerous television chat shows and articles, women accused the very core of India for their daily humiliations. The phrase “feudal structure” was used several times to describe a rural Indian society where men perceive rape as a way of showing a woman her place and how such men carry that perception with them when they migrate to the cities.


If the idea of a city, as evident in the world’s greatest cities, is the very opposite of the reality of an Indian village, if a city is supposed to be a liberal, broad-minded place that is a young woman’s best friend, then does India truly have even a single city?


Mumbai alone appears to come close, but it is today a decaying city run by rustics. Politicians and policemen whose morality seems chiefly to concern the sexual and drinking habits of unmarried women express their alarm now and then. In Mumbai’s bars, under an old law that until the past year was largely unenforced, you actually need a permit to consume alcohol. And a portion of the city’s beautiful southern tip by the Arabian Sea has become an almost exclusive peninsula for fundamentalist vegetarians who have somehow ensured that it is hard for anyone to find meat or even eggs in their neighborhood.


Eight years ago, the hotelier Sanjay Narang told me that when he defied them and opened a nonvegetarian restaurant in the area, in the ground floor of a residential building, angry residents of the building stood in their balconies and spat on the patrons. He soon had to shut down.


As for the city’s reputation as being safe for women, according to several of its women, this is an exaggeration, or at best a relative virtue.


Why does India not have real cities? Because cities require a critical mass of liberal people, or at least its elite, to be somewhat independent — free of their cultural, familial and communal roots, whereas it is the nature of the average Indian to be dependent on a network of his own kind, to deepen his roots and marinate in too many value judgments about other people.


Manu Joseph is editor of the Indian newsweekly Open and author of the novel “The Illicit Happiness of Other People.”


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Senate Passes Tax Increases on Wealthy Americans


Jonathan Ernst/Reuters


Senator Mitch McConnell, the Republican leader, departed early Tuesday after the vote.







WASHINGTON – The Senate, in a pre-dawn vote two hours after the deadline passed to avert automatic tax increases, overwhelmingly approved legislation Tuesday that would allow tax rates to rise only on affluent Americans while temporarily suspending sweeping, across-the-board spending cuts.




The deal, worked out in furious negotiations between Vice President Joseph R. Biden Jr. and the Republican Senate leader, Mitch McConnell, passed 89-8, with just three Democrats and five Republicans voting no. Although it lost the support of some of the Senate’s most conservative members, the broad coalition that pushed the accord across the finish line could portend swift House passage as early as New Year’s Day.


Quick passage before the markets reopen Wednesday would likely negate any economic damage from Tuesday’s breach of the so-called “fiscal cliff” and largely spare the nation’s economy from the one-two punch of large tax increases and across-the-board military and domestic spending cuts in the New Year.


“This shouldn’t be the model for how to do things around here,” Senator McConnell said just after 1:30 a.m. “But I think we can say we’ve done some good for the country.”


“You surely shouldn’t predict how the House is going to vote,” Mr. Biden said late New Year’s Eve after meeting with leery Senate Democrats to sell the accord. “But I feel very, very good.”


The eight senators who voted no included Marco Rubio, Republican of Florida and a potential presidential candidate in 2016, two of the Senate’s most ardent small-government Republicans, Rand Paul of Kentucky and Mike Lee of Utah, and Senator Charles E. Grassley, who as a former Finance Committee chairman helped secure passage of the Bush-era tax cuts, then opposed making almost all of them permanent on Tuesday. Two moderate Democrats, Tom Carper of Delaware and Michael Bennet of Colorado, also voted no, as did the liberal Democrat Tom Harkin, who said the White House had given away too much in the compromise. Senator Richard Shelby, Republican of Alabama, also voted no.


The House Speaker, John A. Boehner, and the Republican House leadership said the House would “honor its commitment to consider the Senate agreement.” But, they added, “decisions about whether the House will seek to accept or promptly amend the measure will not be made until House members – and the American people – have been able to review the legislation.”


Even with that cautious assessment, Republican House aides said a vote Tuesday is possible.


Under the agreement, tax rates would jump to 39.6 percent from 35 percent for individual incomes over $400,000 and couples over $450,000, while tax deductions and credits would start phasing out on incomes as low as $250,000, a clear victory for President Obama, who ran for re-election vowing to impose taxes on the wealthy.


Just after the vote, Mr. Obama called for quick House passage of the legislation.


“While neither Democrats nor Republicans got everything they wanted, this agreement is the right thing to do for our country and the House should pass it without delay,” he said.


 Democrats also secured a full year’s extension of unemployment insurance without strings attached and without offsetting spending cuts, a $30 billion cost. But the two-percentage point cut to the payroll tax that the president secured in late 2010 lapsed at midnight and will not be renewed.


In one final piece of the puzzle, negotiators agreed to put off $110 billion in across-the-board cuts to military and domestic programs for two months while broader deficit reduction talks continue. Those cuts begin to go into force on Wednesday, and that deadline, too, might be missed before Congress approves the legislation.


To secure votes, Senator Harry Reid, the Senate Democratic leader, also told Democrats the legislation would cancel a pending congressional pay raise — putting opponents in the politically difficult position of supporting a raise — - and extend an expiring dairy policy that would have seen the price of milk double in some parts of the country.


The nature of the deal ensured that the running war between the White House and Congressional Republicans on spending and taxes would continue at least until the spring. Treasury Secretary Timothy F. Geithner formally notified Congress that the government reached its statutory borrowing limit on New Year’s Eve. Through some creative accounting tricks, the Treasury Department can put off action for perhaps two months, but Congress must act to keep the government from defaulting just when the “pause” on pending cuts is up. Then in late March, a law financing the government expires.


Jennifer Steinhauer and Robert Pear contributed reporting.



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In Theory: Pill Could Join Arsenal Against Bedbugs

THE HYPOTHESIS

A common deworming drug can be used to kill bedbugs.

THE INVESTIGATOR

Dr. Johnathan M. Sheele, Eastern Virginia Medical School

It was a visit to a cousin in New York City two years ago that inspired Thang D. Tran, a medical student at Eastern Virginia Medical School, to volunteer to become a human booby trap in the war on bedbugs.

“She told me everyone in New York was scared of bedbugs,” he said of his cousin. So when Dr. Johnathan M. Sheele, an emergency medicine specialist at his school, asked for volunteers to test a new way of killing the pests, Mr. Tran raised his arm. Soon, it was covered with itchy welts.

Dr. Sheele’s study, released at a tropical medicine convention in November, unveiled a possible new superweapon against Cimex lectularius: a deworming pill.

You take the pill and go to bed — perchance even to sleep, if you can sleep knowing how patiently bedbugs wait in your walls or mattress, sniffing for the sweet stream of your exhaled carbon dioxide and for your warm skin to grow still. You let them bite you. And then — in a few days — they die.

The technique is known as xenointoxication, which sounds like intergalactic beer pong but in medical pathology is Greek for “poisoning the guest.” In Dr. Sheele’s study, over 60 percent of the bedbugs died after volunteers like Mr. Tran took a single pill. Bigger or more regular doses might improve the lethality.

And it’s not as if the drug is rare and dangerous. It’s already in thousands of American households: ivermectin, the active ingredient in the beef-flavored Heartgard Chewables that kill heartworm in dogs.

(For humans, the brand name is Stromectol, and it is available by prescription only, usually for travelers who pick up worms overseas, or toddlers who get them from playing in sandboxes used by dogs.)

Ivermectin is also very safe. Millions of doses have been given to African children to kill the worms that cause river blindness. Many Papua New Guineans get double doses to kill scabies. One early study of the drug found that up to 10 times the normal dose was safe.

Ivermectin attacks a type of “gated chloride channel” in the nerves of insects that does not exist in mammals.

Dr. Sheele is not advising bedbug-tormented Americans to start eating Fido’s worm tablets. With only four volunteers, his study was tiny and preliminary, he emphasized. Neither the Food and Drug Administration nor any medical society has approved using ivermectin this way, and no one yet knows what the ideal antibedbug dose is.

But ivermectin experts say his idea isn’t crazy.

“Maybe partially crazy,” said Dr. Peter J. Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine. “But not entirely crazy.”

Dr. Hotez’s hesitation is mostly that bedbugs, unlike body lice and worms, do not cause disease, so xenointoxication seems heavy-handed.

But many Americans, including many New Yorkers, are so terrified of the bugs that they have spent thousands of dollars fighting them, so ivermectin could be cost-effective.

Brian D. Foy, a virologist at Colorado State University’s veterinary school, has shown that it also kills mosquitoes, and so could be used against malaria. His initial reaction to using it against bedbugs was that he thought it would be easier to clean one’s house and throw out one’s mattress.

“But maybe that’s just my ignorance about bedbugs,” he admitted. “We don’t have them out here in Colorado.”

(Local news reports do not back him up on that.)

“Needless to say,” he correctly pointed out, “this isn’t going to solve the problem of bedbugs in hotel rooms.”

Dr. Sheele speculated that ivermectin might be best used in combination with current measures like pesticides, desiccant powders, mattress covers, heat treatment, steaming and vacuuming. While it might not work alone, it could give exterminators a head start.

Dr. Frank O. Richards Jr., a parasitologist at the Carter Center in Atlanta who has spent years running programs in Africa and Asia that give out ivermectin donated by Merck to fight river blindness, said he was “excited to see how this plays out.” Americans might be initially squeamish about deworming pills, he said, but the country does have “a lot of worried rich people who don’t like bug bites.”

He has tracked women in his river-blindness programs who took ivermectin before realizing they were pregnant, he said, “and all their babies were cool.”Nonetheless, he said, even though one 2002 study found a huge dose to be safe, which theoretically means that multiple small ones also would be, “as a physician, I’d be very concerned about an off-label use like that.”

“If I gave that out, and something happened,” he continued, “I would not have a leg to stand on in court.”

Because each bug feeds only occasionally, he said, “I don’t buy that a week would do the trick. I think you’re going to need two, three, four weeks. And that’s concerning. We don’t have any toxicity data like that.”

Like Dr. Sheele, he favors more testing of multiple doses.

Ivermectin is not cheap. In the United States, a typical adult dose of Stromectol is about $40, and no generic version is sold legally. A year’s supply of Heartgard for a big dog can cost more than $100.

But, Dr. Sheele said, that pales beside the price of multiple visits by a team of exterminators.

He got interested in bedbugs, he said, because they plagued so many of his Norfolk, Va., emergency room patients.

“I even had one patient come in with a baggie full of them,” he said. “As a physician, there’s nothing you can do for them except give them Benadryl and steroids for the itching.”

He knew about ivermectin’s power to kill skin parasites because he had done a fellowship in international emergency medicine, he said.

His school provided financing but was nervous about letting him officially import bedbugs to campus, so he had to borrow the lab of a tick researcher at Old Dominion University. (Mr. Tran remembers it as humid and redolent of lab rats.)

Eastern Virginia Medical School also wanted animal studies before he recruited medical students, so he dosed mice first; in that case, 86 percent of the bedbugs died.

Now he hopes to find support for a full-fledged clinical trial.

And he is working on a new project: If xenointoxication kills bedbugs, he surmised, how about ticks?

The parasite-host relationship isn’t as predictable as it is between bedbugs and their dinner. But the stakes are higher, since ticks carry serious diseases like Lyme and babesiosis.

“It could be interesting for people who have to spend a lot of time in the woods — like soldiers,” he said.

Meanwhile, Mr. Tran and An Teng, another medical student and study participant, are enjoying their new notoriety.

“My friends were completely grossed out that I let myself be bitten,” said Mr. Tran, whose rash from the bites lasted for a month. “But working on something so relevant to society caught my attention.”


In this video from Eastern Virginia Medical School, one of the bedbug study participants demonstrates how he became human bait for bedbugs.

Read More..

In Theory: Pill Could Join Arsenal Against Bedbugs

THE HYPOTHESIS

A common deworming drug can be used to kill bedbugs.

THE INVESTIGATOR

Dr. Johnathan M. Sheele, Eastern Virginia Medical School

It was a visit to a cousin in New York City two years ago that inspired Thang D. Tran, a medical student at Eastern Virginia Medical School, to volunteer to become a human booby trap in the war on bedbugs.

“She told me everyone in New York was scared of bedbugs,” he said of his cousin. So when Dr. Johnathan M. Sheele, an emergency medicine specialist at his school, asked for volunteers to test a new way of killing the pests, Mr. Tran raised his arm. Soon, it was covered with itchy welts.

Dr. Sheele’s study, released at a tropical medicine convention in November, unveiled a possible new superweapon against Cimex lectularius: a deworming pill.

You take the pill and go to bed — perchance even to sleep, if you can sleep knowing how patiently bedbugs wait in your walls or mattress, sniffing for the sweet stream of your exhaled carbon dioxide and for your warm skin to grow still. You let them bite you. And then — in a few days — they die.

The technique is known as xenointoxication, which sounds like intergalactic beer pong but in medical pathology is Greek for “poisoning the guest.” In Dr. Sheele’s study, over 60 percent of the bedbugs died after volunteers like Mr. Tran took a single pill. Bigger or more regular doses might improve the lethality.

And it’s not as if the drug is rare and dangerous. It’s already in thousands of American households: ivermectin, the active ingredient in the beef-flavored Heartgard Chewables that kill heartworm in dogs.

(For humans, the brand name is Stromectol, and it is available by prescription only, usually for travelers who pick up worms overseas, or toddlers who get them from playing in sandboxes used by dogs.)

Ivermectin is also very safe. Millions of doses have been given to African children to kill the worms that cause river blindness. Many Papua New Guineans get double doses to kill scabies. One early study of the drug found that up to 10 times the normal dose was safe.

Ivermectin attacks a type of “gated chloride channel” in the nerves of insects that does not exist in mammals.

Dr. Sheele is not advising bedbug-tormented Americans to start eating Fido’s worm tablets. With only four volunteers, his study was tiny and preliminary, he emphasized. Neither the Food and Drug Administration nor any medical society has approved using ivermectin this way, and no one yet knows what the ideal antibedbug dose is.

But ivermectin experts say his idea isn’t crazy.

“Maybe partially crazy,” said Dr. Peter J. Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine. “But not entirely crazy.”

Dr. Hotez’s hesitation is mostly that bedbugs, unlike body lice and worms, do not cause disease, so xenointoxication seems heavy-handed.

But many Americans, including many New Yorkers, are so terrified of the bugs that they have spent thousands of dollars fighting them, so ivermectin could be cost-effective.

Brian D. Foy, a virologist at Colorado State University’s veterinary school, has shown that it also kills mosquitoes, and so could be used against malaria. His initial reaction to using it against bedbugs was that he thought it would be easier to clean one’s house and throw out one’s mattress.

“But maybe that’s just my ignorance about bedbugs,” he admitted. “We don’t have them out here in Colorado.”

(Local news reports do not back him up on that.)

“Needless to say,” he correctly pointed out, “this isn’t going to solve the problem of bedbugs in hotel rooms.”

Dr. Sheele speculated that ivermectin might be best used in combination with current measures like pesticides, desiccant powders, mattress covers, heat treatment, steaming and vacuuming. While it might not work alone, it could give exterminators a head start.

Dr. Frank O. Richards Jr., a parasitologist at the Carter Center in Atlanta who has spent years running programs in Africa and Asia that give out ivermectin donated by Merck to fight river blindness, said he was “excited to see how this plays out.” Americans might be initially squeamish about deworming pills, he said, but the country does have “a lot of worried rich people who don’t like bug bites.”

He has tracked women in his river-blindness programs who took ivermectin before realizing they were pregnant, he said, “and all their babies were cool.”Nonetheless, he said, even though one 2002 study found a huge dose to be safe, which theoretically means that multiple small ones also would be, “as a physician, I’d be very concerned about an off-label use like that.”

“If I gave that out, and something happened,” he continued, “I would not have a leg to stand on in court.”

Because each bug feeds only occasionally, he said, “I don’t buy that a week would do the trick. I think you’re going to need two, three, four weeks. And that’s concerning. We don’t have any toxicity data like that.”

Like Dr. Sheele, he favors more testing of multiple doses.

Ivermectin is not cheap. In the United States, a typical adult dose of Stromectol is about $40, and no generic version is sold legally. A year’s supply of Heartgard for a big dog can cost more than $100.

But, Dr. Sheele said, that pales beside the price of multiple visits by a team of exterminators.

He got interested in bedbugs, he said, because they plagued so many of his Norfolk, Va., emergency room patients.

“I even had one patient come in with a baggie full of them,” he said. “As a physician, there’s nothing you can do for them except give them Benadryl and steroids for the itching.”

He knew about ivermectin’s power to kill skin parasites because he had done a fellowship in international emergency medicine, he said.

His school provided financing but was nervous about letting him officially import bedbugs to campus, so he had to borrow the lab of a tick researcher at Old Dominion University. (Mr. Tran remembers it as humid and redolent of lab rats.)

Eastern Virginia Medical School also wanted animal studies before he recruited medical students, so he dosed mice first; in that case, 86 percent of the bedbugs died.

Now he hopes to find support for a full-fledged clinical trial.

And he is working on a new project: If xenointoxication kills bedbugs, he surmised, how about ticks?

The parasite-host relationship isn’t as predictable as it is between bedbugs and their dinner. But the stakes are higher, since ticks carry serious diseases like Lyme and babesiosis.

“It could be interesting for people who have to spend a lot of time in the woods — like soldiers,” he said.

Meanwhile, Mr. Tran and An Teng, another medical student and study participant, are enjoying their new notoriety.

“My friends were completely grossed out that I let myself be bitten,” said Mr. Tran, whose rash from the bites lasted for a month. “But working on something so relevant to society caught my attention.”


In this video from Eastern Virginia Medical School, one of the bedbug study participants demonstrates how he became human bait for bedbugs.

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Gadgetwise Blog: Q&A: How to Cut a LinkedIn Connection

I accepted a LinkedIn invitation from someone who looked like a good professional contact, but has just been spamming me with messages. How do I get rid of this person?

Although the LinkedIn social-networking site skews more toward people looking to make business connections, it can still suffer from the same annoyances that plague Facebook, Twitter, and other services. If you need to dump someone you have connected with on the site, start by logging into your LinkedIn account on the Web.

At the top of your profile page, click the Contacts link. On the right side of the Contacts page, click Remove Connections. When your list of LinkedIn contacts appears, turn on the checkbox next to the name or names of the people you wish to remove. Click the Remove Connection button. Your newly severed connection is not notified that you have parted ways.

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Syrian Military Mounts Offensive in Damascus Suburb





BEIRUT, Lebanon — Syria’s military was mounting what opposition activists said was the largest incursion in months on a rebellious suburb of Damascus on Monday, in an effort to drive back rebel forces that have taken up positions within miles of the center of the capital.




At least three people were killed in the fighting in the suburb, Daraya, southwest of Damascus, which was a focal point for the protest movement early in the uprising against President Bashar al-Assad, and later became a stronghold for fighters trying to topple his government. In one of the deadliest episodes of the war, hundreds of people, including many civilians, were killed in August when the military stormed Daraya in what it called a “cleansing” operation using troops and attack helicopters.


Attempts by rebel fighters to control territory around the capital has turned a ring of suburbs into a deadly cat and mouse game, as the army pounds residential neighborhoods with artillery and rockets to vanquish fighters who often retreat to the countryside and then return.


On Monday, the Syrian state news agency, SANA, said that the military was “continuing to clear the city of Daraya in the Damascus countryside” and that it had “destroyed a terrorist base and killed huge numbers of terrorists,” without providing more detail. Opposition groups reported that between three and nine people were killed by government shelling.


An opposition activist in Daraya who gave his name as Ismail said fighting in the town — all but emptied after previous government attacks — had been going on for weeks. On Sunday, government forces cut off a highway into the town, stopping civilian cars that tried to enter. Heavy shelling started around 9 a.m. on Monday, Ismail said, as a large military convoy that included tanks appeared on the town’s outskirts.


The shelling could be heard in the background as he spoke over Skype. “The regime forces are fighting fiercely to control Daraya,” he said. “It’s just a few kilometers to the presidential palace.”


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