IHT Rendezvous: A Crystal Award for Charlize Theron

DAVOS, Switzerland — The actress Charlize Theron and two documentary filmmakers received awards for their humanitarian work as the World Economic Forum opened in Davos Tuesday.

Ms. Theron, who won the best actress Oscar in 2004 for the film “Monster,” was honored Tuesday for her work fighting H.I.V. among impoverished young people in South Africa, where she was born.

Ms. Theron’s appearance was a bit of a departure for the World Economic Forum, which had dialed back the celebrity glamour after the appearance in 2006 by Brad Pitt and Angelina Jolie threatened to overshadow the rest of the annual meeting.

Ms. Theron was decidedly lowkey and humble as she accepted the Forum’s Crystal award from a stage in the Davos Congress Center.

“There is an incredible brain trust in this room,” she said, referring to the Davos participants. “I feel like I’m getting smarter just by osmosis.”

Wearing a simple blue dress and heels, Ms. Theron noted, with some understatement, that she was often in the spotlight. “I decided the best thing you can do with that spotlight is to stand in the shadow of something and shed some light,” she said.

The Charlize Theron Africa Outreach Project finances programs designed to prevent the spread of H.I.V. among young Africans, particularly in South Africa, which has 5.9 million infected people, Ms. Theron said. According to the organization’s Web site, charlizeafricaoutreach.org, the programs include mobile health services in an exceptionally impoverished region of South Africa.

The World Economic Forum also honored two other artists: Sharmeen Obaid-Chinoy, a Pakistani filmmaker; and Vik Muniz, a Brazilian artist.

Ms. Obaid-Chinoy’s film “Saving Face” chronicles the efforts of a plastic surgeon to help women disfigured by acid thrown by abusive husbands or other family members. In her acceptance remarks, Ms. Obaid-Chinoy said the film, which won an Oscar in 2012 for best short documentary, had prompted Pakistan to increase criminal penalties for such acts.

Mr. Muniz and his work was featured in “Waste Land,” a documentary about the lives of scavengers at the world’s largest garbage dump, outside Rio de Janeiro. In 2011 the film was nominated for an Academy Award.

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DealBook: Atari's U.S. Division Files for Bankruptcy, Hoping for a Sale

Nearly three decades after Atari closed the doors on its first iteration, the video game pioneer is trying another reinvention. It just had to file for bankruptcy first.

The company’s United States subsidiary, Atari Interactive, filed for Chapter 11 protection on Monday as part of an effort to cleave itself from its French parent, Atari S.A.

The move, made in the Bankruptcy Court for the Southern District of New York, is meant to pave the way for a sale of the division, including its distinctive logo and rights to the staples from the childhoods of many members of Generation X: Pong, Asteroids and Centipede, among other games. The company will continue to operate normally during the bankruptcy case.

If successful, the move will be the latest chapter for a company that introduced video games to millions by letting them thwack a crude virtual ball back and forth across a television screen.

Atari first faltered during the bursting of the video game bubble in 1983 and has made periodic efforts to remake itself since. Its latest phase is more in keeping with the times: the company now focuses on producing mobile and online games, including remakes of its top titles for iOS and Android devices.

Beginning in 2000, the company began its absorption into Infogrames, a French video game producer that in 2008 adopted the name of its prominent subsidiary. But Atari S.A., as the newly rechristened company is now known, has struggled financially. Several weeks ago, the company lost access to new money from its primary lender, BlueBay Asset Management.

Atari S.A.’s shares have tumbled nearly 49 percent over the last 12 months, closing on Monday at just 86 euro cents.

Now, Atari is seeking to sell its American operations through what is known as a 363 sale, allowing a buyer to gain control of the company’s core assets free of any liabilities.

“In light of the current situation with BlueBay, we have decided to take what we think is the best decision to protect the company and its shareholders,” Jim Wilson, Atari S.A.’s chief executive, said in a statement. “Through these ongoing procedures, and especially the auction process in the U.S., we will seek to maximize the proceeds in the best interest of the company and all of its shareholders.”

In a court filing, Atari listed having less than $50 million in assets and less than $500,000 in liabilities. It has obtained about $5.25 million in bankruptcy financing from Tenor Capital Management.

Atari Interactive's bankruptcy filing by

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The New Old Age Blog: The Brutal Truth of 'Amour'

It has been a few days since I left the movie theater in a bit of a daze, and I’m still thinking about “Amour.”

So much of this already much-honored film rings utterly true: the way a long-married Parisian couple’s daily routines, their elegant life of books and music and art, can be upended in a moment. The tender care that Georges (Jean-Louis Trintignant) provides for Anne (Emmanuelle Riva) as multiple strokes claim her body and her mind, and the inexorable way that care wears them both down. Their withdrawal into a proud dyad that seeks and accepts little help from outsiders, even family. “We’ve always coped, your mother and I,” Georges tells their daughter.

The writer and director Michael Haneke’s previous movies, which I haven’t seen, tend to be described as shocking, violent, even punitive. “Amour,” which Times critic Manohla Dargis called a masterpiece, includes one brief spasm of violence, but the movie remains restrained, not graphic. It’s brutal only because life, and death, can be brutal.

Is popular culture paying more attention to aging and caregiving? In the last couple of years, I have written about these subjects surfacing in a YouTube series (“Ruth & Erica”), in movies like “The Iron Lady,” in novels like Walter Mosley’s “The Last Days of Ptolemy Grey.”

A couple of weeks back, watching a play called “The Other Place,” starring the remarkable Laurie Metcalfe, I suddenly realized that the dynamic physician and businesswoman onstage had some sort of early-onset dementia. Dementia seems a particularly popular subject, in fact. Intrinsically dramatic, it suffuses the Mosley novel and Alice LaPlante’s “Turn of Mind,” and some of my favorite movies about aging, “Away From Her,” “Iris” and “The Savages.”

“Kings Point,” Sari Gilman’s compelling documentary about a retirement community in Florida where nobody seemed to expect to grow old, just won an Oscar nomination for best short-subject documentary and will be shown on HBO in March. And “Amour,” which won the Palme d’Or at Cannes, is up for five Academy Awards, including best picture, best director and a best actress nomination for the 85-year-old Ms. Riva. (Academy voters: Just give it to her.)

A number of these artists, Mr. Haneke included, have spoken about their own experiences with aged relatives. Perhaps, as the population ages and more people confront the consequences, the stories our culture tells itself have evolved to include more old people, more caregivers. Or maybe I just want that to be true.

“Do not go see this,” my movie-going buddy had been warned, probably because her mother has dementia and friends who had seen the film wanted to spare her. I know some people found “Amour” too slow-paced or claustrophobic — like many elderly couples’ lives, it basically takes place in four rooms — or too grim. (If you’ve seen it, tell us what you thought.)

If you’re a full-time caregiver or you’re coping with a relative with dementia, perhaps you would prefer to spend your 2 hours 7 minutes of precious time off watching something funny. Escapism has its virtues.

But I found “Amour” unflinching and provocative and beautiful.

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

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The New Old Age Blog: The Brutal Truth of 'Amour'

It has been a few days since I left the movie theater in a bit of a daze, and I’m still thinking about “Amour.”

So much of this already much-honored film rings utterly true: the way a long-married Parisian couple’s daily routines, their elegant life of books and music and art, can be upended in a moment. The tender care that Georges (Jean-Louis Trintignant) provides for Anne (Emmanuelle Riva) as multiple strokes claim her body and her mind, and the inexorable way that care wears them both down. Their withdrawal into a proud dyad that seeks and accepts little help from outsiders, even family. “We’ve always coped, your mother and I,” Georges tells their daughter.

The writer and director Michael Haneke’s previous movies, which I haven’t seen, tend to be described as shocking, violent, even punitive. “Amour,” which Times critic Manohla Dargis called a masterpiece, includes one brief spasm of violence, but the movie remains restrained, not graphic. It’s brutal only because life, and death, can be brutal.

Is popular culture paying more attention to aging and caregiving? In the last couple of years, I have written about these subjects surfacing in a YouTube series (“Ruth & Erica”), in movies like “The Iron Lady,” in novels like Walter Mosley’s “The Last Days of Ptolemy Grey.”

A couple of weeks back, watching a play called “The Other Place,” starring the remarkable Laurie Metcalfe, I suddenly realized that the dynamic physician and businesswoman onstage had some sort of early-onset dementia. Dementia seems a particularly popular subject, in fact. Intrinsically dramatic, it suffuses the Mosley novel and Alice LaPlante’s “Turn of Mind,” and some of my favorite movies about aging, “Away From Her,” “Iris” and “The Savages.”

“Kings Point,” Sari Gilman’s compelling documentary about a retirement community in Florida where nobody seemed to expect to grow old, just won an Oscar nomination for best short-subject documentary and will be shown on HBO in March. And “Amour,” which won the Palme d’Or at Cannes, is up for five Academy Awards, including best picture, best director and a best actress nomination for the 85-year-old Ms. Riva. (Academy voters: Just give it to her.)

A number of these artists, Mr. Haneke included, have spoken about their own experiences with aged relatives. Perhaps, as the population ages and more people confront the consequences, the stories our culture tells itself have evolved to include more old people, more caregivers. Or maybe I just want that to be true.

“Do not go see this,” my movie-going buddy had been warned, probably because her mother has dementia and friends who had seen the film wanted to spare her. I know some people found “Amour” too slow-paced or claustrophobic — like many elderly couples’ lives, it basically takes place in four rooms — or too grim. (If you’ve seen it, tell us what you thought.)

If you’re a full-time caregiver or you’re coping with a relative with dementia, perhaps you would prefer to spend your 2 hours 7 minutes of precious time off watching something funny. Escapism has its virtues.

But I found “Amour” unflinching and provocative and beautiful.

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

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

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

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

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

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

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

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

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

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

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

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France’s National Library Hopes to Buy Sade’s ‘120 Days’





PARIS — “The 120 Days of Sodom,” by the Marquis de Sade, is one of the most perverse works of 18th-century literature.




It tells the story of four rich “libertines” who lock themselves in a remote medieval castle with 46 victims (including eight boys and eight girls, ages 12 to 15). The men are assisted by four female brothel keepers who arouse their hosts by recounting their outlandish (and embellished) experiences.


The work describes orgies and acts of abuse — sexual and otherwise — including pedophilia, necrophilia, incest, torture, rape, murder, infanticide, bestiality, violent anal and oral sex acts and the use of urination and defecation to humiliate and punish.


Sade called it “the most impure tale that has ever been told since our world began.”


There is nothing erotic about it.


Even Bruno Racine, director of the Bibliothèque Nationale de France, the National Library, calls it “depraved.”


But that hasn’t stopped him from negotiating long and hard to buy Sade’s manuscript. He has convinced the Foreign and Culture Ministries of its importance. He has argued in front of the Commission of National Treasures to declare it provisionally a “national treasure” that needs to be preserved in the library. And he is ready to pay more than $5 million to get it.


“The document is Sade’s most atrocious, extreme, radical work,” Mr. Racine said. “But we make no moral judgment about it.” A rambling, unfinished draft, “120 Days” has been praised and vilified. Simone de Beauvoir defended it as an important contribution to the dark side of humanity in her essay “Must We Burn Sade?”


The American feminist writer Andrea Dworkin branded it a “vile” story written by a woman-hating pornographer. In a 1975 film Pier Paolo Pasolini set the story in an imaginary Italian republic as a condemnation of Mussolini’s Fascist regime.


Sade wrote the draft in 37 days in 1785 in the Bastille, where he had been imprisoned under a royal order initiated against him by his mother-in-law. He wrote in tiny script on both sides of a sheaf of narrow paper, whose sheets he attached into a single 39-foot-long roll. Fearing that his work would be confiscated, he hid the roll in a crevice in a stone wall of his cell.


Days before the storming of the Bastille on July 14, 1789, Sade was transferred at night to a prison for the insane. He wrote that he “wept tears of blood” over the manuscript’s loss, and he went to his grave in 1814 without knowing its fate.


But it was recovered, sold, resold and then published for the first time by a German doctor in an error-filled version in 1904.


In 1929 Viscount Charles de Noailles, whose wife, Marie-Laure, was a direct descendant of Sade’s, bought the manuscript. The couple, wealthy and passionate patrons of the arts, handed it down to their daughter, Natalie, who kept it in a drawer at the family’s estate in Fontainebleau. She would sometimes unroll it and show it to guests; the Italian writer Italo Calvino was one of them.


“My mother showed me the manuscript when I was a boy,” Carlo Perrone, an Italian newspaper publisher who is Natalie de Noailles’s son, said in a telephone interview from Rome. “I remember the handwriting was so small, and that there were no corrections. It gave you the impression that paper was very scarce and precious for him, and that he had to fill up every space.”


Ms. de Noailles eventually entrusted both that manuscript and the manuscript of Stravinsky’s ballet “Les Noces” to a friend, the publisher Jean Grouet.


Mr. Grouet turned out to be a swindler. In 1982 he smuggled the Sade manuscript into Switzerland and sold it to Gérard Nordmann, a Swiss collector of erotica, for about $60,000.


Ms. de Noailles sued. After a long legal case, France’s highest court ruled in 1990 that the work had been stolen and must be returned. (The family was able to retrieve the Stravinsky manuscript, which had remained in France.)


Since Switzerland had not yet signed the Unesco convention requiring the restitution of stolen cultural objects, Ms. de Noailles was forced to sue again in that country. In 1998 the Swiss federal court ruled in Mr. Nordmann’s favor, saying that he had bought the manuscript in good faith.


Afterward, the manuscript was kept at a cultural foundation in Switzerland.


Then, last January, Mr. Nordmann’s heirs offered to sell the manuscript to a French collector. Mr. Perrone intervened.


“Anyone who wants to buy the manuscript in France needs my consent,” he said in the interview. “My mother had a very strong wish that one day the manuscript would be given to the Bibliothèque Nationale, which is my wish as well. It’s an important historical document, a piece of French history.”


Enter Mr. Racine. Since taking over as director of the Bibliothèque Nationale in 2007, he has sought to have important manuscripts classified as “national treasures” in order to acquire them for the library.


Among other purchases, he has bought Casanova’s memoirs with $9.6 million from an anonymous donor; the archives of the French philosopher Michel Foucault; and the archives of the French Marxist theorist, writer and filmmaker Guy Debord (preventing them from leaving the country and going to Yale).


“I don’t know of any director of a world-class library today who is making the kind of brilliant strategic acquisitions that Bruno Racine is making at the Bibliothèque Nationale,” said Paul Le Clerc, the former head of the New York Public Library and the director of Columbia University’s programs in Europe.


Now Mr. Racine is negotiating with Mr. Perrone and the heirs of Mr. Nordmann to buy the Sade manuscript and give each party a cut. The estimated sale price — more than $5 million — would be raised from private donors.


Mr. Racine’s goal is to put the manuscript on display, along with other Sade works in the library’s collection, for the 200th anniversary of Sade’s death next year.


“It is a unique, exceptional work, and a miracle that it survived,” he said. “It is part of our cultural heritage. Whether we like it or not, it belongs in the Bibliothèque Nationale.”


Emerik Derian contributed reporting.



This article has been revised to reflect the following correction:

Correction: January 22, 2013

An earlier version of this story misstated the offenses for which Marquis de Sade was imprisoned in 1785. He had been imprisoned under a royal order initiated against him by his mother-in-law, not for assaulting women and girls.



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DealBook: In Davos, Atmosphere for Bankers Improves

Two years ago, Jamie Dimon, chief executive of JPMorgan Chase, told an audience in Davos, Switzerland, that people should stop picking on bankers. Mr. Dimon is still waiting for his wish to come true.

Bankers, always a big presence at the World Economic Forum in Davos, will arrive this year under less regulatory pressure and with better profits than in past years. But they are still on the defensive.

Mr. Dimon, scheduled to appear on one of the first panels when the Davos forum opens on Wednesday, is again embroiled in controversy. Last week, JPMorgan’s board cut his pay for 2012 in half, to $11.5 million, holding him accountable for a multibillion-dollar loss on derivatives trading.

International bankers are under pressure from the law enforcement authorities as well, and examples can be found near Davos.

UBS, based in Zurich, agreed to pay a $1.5 billion fine to the global authorities after admitting this month that it had helped manipulate a benchmark rate used to set mortgage and other interest rates.

And Wegelin & Company, a private bank based in St. Gallen, Switzerland, shut down this month after admitting it had helped wealthy Americans evade taxes. The bank, founded in 1741, was the oldest in Switzerland.

At a news conference last week in Washington, the managing director of the International Monetary Fund, Christine Lagarde, lamented a “waning commitment” to tougher financial regulation and called upon the banking authorities to finish the job of fixing the world’s banks.

For all that, though, bankers may find the atmosphere in Davos a bit more congenial than in some recent years. Among the government overseers who will also be in attendance, there appears to be a growing sentiment that the banks have taken enough abuse.

This month in Basel, Switzerland, for instance, an international gathering of central bankers and bank supervisors relaxed new rules that were intended to ensure that banks would be able to survive an event like the collapse of Lehman Brothers in 2008.

The rules, which are not binding but serve as a benchmark for national regulators, would require banks to maintain a 30-day supply of cash or liquid assets that are easy to convert into cash. But after the decision in Basel this month, banks would have until 2019 to accumulate the additional cash and assets, instead of 2015.

The regulators also broadened the types of assets that could be used to include even some mortgage-backed securities — the same general class of security that was at the heart of the crisis.

Many analysts see the decision as a gift to the banking industry, which had insisted that planned new regulations would lead banks to curtail lending. Bank stocks in Europe rose after the decision.

“Most bankers I talked to breathed a huge sigh of relief,” said Cornelius K. Hurley, a professor at the Boston University School of Law and former assistant general counsel to the board of governors of the Federal Reserve.

Gavan Nolan, a credit analyst at Markit, a data provider in London, agreed that changes in the rules “went further than many had presumed, and in a direction that seems to favor the banks.” Still, he wrote in a note to clients, “the effects shouldn’t be overstated,” adding that the rules “will still make it more difficult to make money, in comparison to the previous era.”

The discussions at Davos may offer clues about whether the Basel decisions foreshadow other concessions.

There is a risk that efforts to rein in financial risk could lose momentum as the trauma of Lehman’s collapse fades, Mr. Hurley said.

“We said to ourselves back in 2008, a crisis is a terrible thing to waste,” he said. “It seems the farther away we get, the evidence is that we are wasting it.”

The World Economic Forum tends to be a place for talk rather than action, but it is one of the few events that reliably brings central bankers, regulators, economists, legislators and bankers under one snow-laden roof.

The discussions have sometimes been contentious, as in 2010 when American policy makers like Representative Barney Frank met behind closed doors with top bankers including Brian T. Moynihan, then the chief executive of Bank of America.

Mr. Frank left the meeting fuming about bankers’ unwillingness to accept more safeguards and vowed to impose them anyway. Six months later, Congress passed the sweeping financial regulation bill known as Dodd-Frank.

But Mr. Frank has retired, and there are signs that the officials who set the tone for global regulation of banks have become more worried about a credit squeeze in Europe than about the risk of another banking crisis.

Some of the most influential people in the regulation debate are sounding more conciliatory.

“We welcome these rules, we think they are important,” Mario Draghi, president of the European Central Bank and a member of the group that met in Basel, said this month. “We also welcome their gradual phasing in.”

At least some banks have had a profit rebound recently, including JPMorgan, Morgan Stanley and Goldman Sachs, whose chief executive, Lloyd C. Blankfein, is scheduled to take part in a panel on competitiveness at Davos on Friday.

European banks are still ailing, though, which threatens the fragile calm that has prevailed in financial markets. Whereas the euro zone debt crisis has fallen most heavily on southern European countries like Spain, weakness in the banking system is a problem even in healthier countries like Germany.

Deutsche Bank, the largest lender in Germany, is profitable but faces official investigations in Germany and the United States, mostly related to its activities before the financial crisis.

In December, police officers surrounded the bank’s headquarters in Frankfurt and seized documents as part of a tax-evasion inquiry that involves one of the bank’s co-chief executives, Jürgen Fitschen.

Other large German banks like Commerzbank and several of the state-owned landesbanks are still hobbled by bad investments they made before Lehman collapsed.

Belgium, France and Austria also have troubled banks, even though they are not considered to be countries in crisis.

“The bottom line is that I don’t think the banking system is in good condition, and I don’t expect it to come back to good condition soon,” said Nicolas Véron, a senior fellow at Bruegel, a research institute in Brussels.

Mr. Véron said he did not have reservations about the decision in Basel to ease new regulations on liquid assets, noting that previously there were no rules at all on liquidity.

“I think the big headline remains that liquidity regulations have been introduced,” he said. “When you look at what has happened in the crisis, that is a good thing.”

But he sounded less optimistic that policy makers meeting in Davos or elsewhere were making progress on other important banking issues, like how to close down terminally ill banks at no cost to taxpayers.

“We have not had the systemwide restructuring process I believe is necessary to get back to sound conditions,” he said.

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Well: A Check on Physicals

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Well: A Check on Physicals

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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



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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


John Schwartz contributed reporting.



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