Weight-loss regimen a preferred choice for countering diabetes

After all those well-intentioned New Year's resolutions have yielded to the force of habit, many of the nation's 79 million obese adults will have a day of reckoning with their primary care physicians.

Lose weight and get active, the doctor will order, or risk developing diabetes. Then the MD will scribble a prescription.

For most patients, the prescribed treatment will not be a pill. It will be a 12-week program aimed at preventing Type 2 diabetes by getting obese adults to shed as little as 10 pounds and exercise for a little more than 20 minutes a day.

That regimen — the Diabetes Prevention Program — may soon become the blockbuster prescription medicine you've never heard of. In 2013, it is poised to become the envy of pharmaceutical companies, a new rival to programs such as Weight Watchers, and a target of opportunity for healthcare entrepreneurs.

Led by a trained coach, it is a testament to the power of a mentor and of setting modest goals in spurring healthful behavior. And it may be a crucial first test of the Affordable Care Act's focus on preventive health.

In nearly 30 clinical trials, scientists have established that the program is far more effective at helping people lose weight and prevent or delay the onset of diabetes than "usual care" — essentially, a doctor telling a patient to slim down and get active, and then sending him on his way. But the program hasn't been packaged in a form that healthcare providers can simply and cheaply offer to patients, said Dr. Jun Ma of the Palo Alto Medical Foundation Research Institute, who studies diabetes prevention.

The Diabetes Prevention Program is not rocket science. In 12 weekly sessions, a coach teaches obese subjects at high risk of developing diabetes to set goals for losing 5% to 7% of their body weight, limit the fat and calories they consume, track their food intake, get at least 150 minutes of exercise each week, and devise strategies to avoid gaining back lost pounds.

In trials, subjects who attended the tightly scripted sessions and followed the regimen were far more likely than those who were on their own to reach their weight-loss goals in three months — and to keep that weight off for more than a year. By doing so, they drove down their risk of developing Type 2 diabetes by 58%, according to a landmark report published in the New England Journal of Medicine in 2002.

The program, in short, is powerful medicine.

"If you could take it as a pill, it would definitely be commercialized," said Sean Duffy, a software designer and former Google employee who launched an online version of the program about a month ago.

In June, a panel of physicians and public health experts that advises the Department of Health and Human Services gave the program a mighty push into everyday medical practice. The U.S. Preventive Services Task Force recommended that doctors refer their obese patients to "intensive, multicomponent behavioral interventions" designed to promote weight loss and physical activity. It cited only one that met its strict standards: the Diabetes Prevention Program.

Under the Affordable Care Act, that carries significant weight. Starting in June, most health insurers will be required to make proven weight-loss and behavior-modification programs available without a copayment to obese customers with a doctor's referral.

No one knows whether expanded coverage of such programs can save money and head off a public health disaster. But without it, experts believe a tidal wave of Type 2 diabetes and heart disease — with a 20-year price tag estimated at $550 billion in the U.S. alone — is a virtual certainty.

For all its promise, the program has remained little more than a good idea — and a pretty expensive one at that — for years. The researchers who developed it at the University of Indiana pegged the cost of the trial's intensive 12-week phase and nine months of maintenance at about $1,300 per patient. To make it cheaper and more accessible, they trained a few YMCA chapters to deliver the program.

Today, about 75 chapters in 28 states and the District of Columbia offer it. The Centers for Disease Control and Prevention, which has been charged with broadening access to "lifestyle change" programs, disbursed $6.75 million in 2012 to encourage health insurers, public health advocates and employer groups to offer versions of the program.

But with more than 78 million people potentially in line to get it, demand far outstrips supply.

Researchers like Ma have been working on ways to use technology to make the program more widely available. In a study published last month in the Archives of Internal Medicine, she and her colleagues found that putting the 12-week curriculum on an inexpensive DVD and assigning a coach to answer questions and offer support helped 37% of obese participants lose 7% of their body weight — a rate more than twice as high as for those who got no help at all.

In a related study published in the same journal, researchers gave obese volunteers a personal digital device to monitor their weight, diet and physical activity and had them check in with a coach every other week. The volunteers lost more weight than trial subjects who were on their own.

The UnitedHealth Group's Diabetes Prevention and Control Alliance in Minnetonka, Minn., has worked to make the Diabetes Prevention Program available on demand to Comcast cable subscribers nationwide. UnitedHealth Group physicians and public health specialists worked with a TV production crew to create a reality-show version of the program. After the pilot aired last year in Philadelphia and Knoxville, Tenn., it took just three weeks to get 700 people to volunteer for a clinical trial of the TV-based program. The results of that will be published soon, said Dr. Deneen Vojta, chief clinical officer for the UnitedHealth program.

"These people lost a ton of weight," she said.

The growing scientific consensus around the diabetes program has not been lost on one of the nation's most ubiquitous and respected weight-loss programs, Weight Watchers. With 20,000 meetings a week across the United States, Weight Watchers International has the infrastructure that the Diabetes Prevention Program lacks. Like the diabetes program, its groups are run by coaches who give advice and encouragement and teach members to track their intake. The company has steadily added features — most recently a spate of food-tracking apps — as clinical trials showed their value.

Weight Watchers has been lobbying the government to recognize its programs as an effective tool for diabetes prevention. The stakes are huge: If insurers were required to cover the costs of patients' Weight Watchers memberships, the customer base could expand by leaps and bounds.

In Britain, the National Health Service will pay for the company's initial 12-week course, said David Kirchhoff, chief executive of Weight Watchers International in New York City. Given the program's widespread presence in the U.S. and evidence of its effectiveness in clinical trials, it makes sense for insurers here to pay too, he said.

Entrepreneurs are also getting in on the act. Duffy's San Francisco-based startup, Omada Health, launched an online version of the Diabetes Prevention Program called Prevent that may be the first of many digital spinoffs.

Designed to win the CDC's seal of approval, Prevent resembles a Facebook version of the Diabetes Prevention Program while preserving the privacy of customers who prefer it. Incoming members are matched to a group, and everyone works toward a goal of losing 5% to 7% of their body weight in 12 weeks under the supervision of a coach. Members' weights are transmitted to the coach by a digital scale upon enrollment and weekly thereafter.

Early testing has shown that as groups jell, members learn from — and lean on — one another, Duffy said. He plans to sell the program at about $120 per month for four months, primarily to insurers and companies for use by their customers and employees.

Payment will be due only after users show results, he said.

melissa.healy@latimes.com

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Google Maps of <em>Django Unchained'</em>s Plantation and Other Infamous Tarantino Locations

Naturally, Quentin Tarantino's new saddles-and-spurs flick Django Unchained has probably attracted at least a few fans of Westerns. But fans of one more recent Western may recognize some of its environs a little too well.

It was partially shot on the same set at HBO's series Deadwood. The Melody Ranch in Santa Clarita served as the frontier for Django (Jamie Foxx) and Dr. King Schultz (Christoph Waltz) and as the home of the foul-mouthed denizens of Deadwood, South Dakota.

But that's just a set. Many of the locations used by Tarantino in the past are actual places that you — yes, you! — can visit anytime. (Well, most of them. The infamous diner from Pulp Fiction got torn down some time after the film's release. There's an auto parts store there now.)

Click through the gallery above for names and locations to guide your Tarantino pilgrimage.

(Also, check out Badass Digest's video pilgrimage through Tarantino's LA here.)

Above:

Location: Melody Ranch in Santa Clarita, California

Set the scene: The first half of Django follows the eponymous lead character as he's shown the ropes of bounty hunting by Dr. Schultz in small frontier towns in the American South and West — most of which were filmed at Melody Ranch.

Location fun fact: Singing cowboy Gene Autry once owned the place. Gunsmoke was filmed there.

Map:

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Photo courtesy The Weinstein Company

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“Lincoln” leads BAFTA film nominations with 10

LONDON (Reuters) – “Lincoln”, the story of U.S. President Abraham Lincoln’s battle to end slavery starring Daniel Day-Lewis in the title role, won 10 BAFTA nominations on Wednesday, putting it ahead of the pack at Britain’s top film honors.

The biopic was shortlisted in categories including best film, actor, supporting actor (Tommy Lee Jones) and supporting actress (Sally Field), but director Steven Spielberg was not nominated.

Added to its domination of the Golden Globe contenders going into Sunday night’s awards ceremony, British critics said the film appeared to be in pole position to sweep Oscar nominations which are announced on Thursday.

“Les Miserables”, the movie version of the global hit stage musical, and shipwreck saga “Life of Pi” followed with nine BAFTA nominations each, while the latest installment of James Bond, “Skyfall”, garnered eight.

Iranian hostage thriller “Argo” won seven nominations and “Anna Karenina”, an adaptation of the Russian novel, earned six.

Quentin Tarantino’s quirky slavery-era Western “Django Unchained” and “Zero Dark Thirty”, about the hunt for Osama bin Laden, were just behind with five nominations apiece.

“Amour”, Austrian director Michael Haneke’s moving portrayal of death, bagged four nominations, an unusually high number for a film in a foreign language.

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Eric Fellner of Working Title Films, the company behind Les Miserables and Anna Karenina, said he was pleased that two potentially risky projects had been recognized.

Les Miserables, by Oscar-winning director of “The King’s Speech” Tom Hooper, was sung live on set, while Joe Wright’s Anna Karenina, starring Keira Knightley and Jude Law, was set against the backdrop of elaborate stage sets.

“We knew that it was a much-loved musical and there was a large part of the world’s population who were also aware of the book,” Fellner said of Les Miserables after the BAFTA nominations were announced.

“But it didn’t stack up as a mainstream movie because over the past decades very few (musicals) have worked. It was a big risk,” he told Reuters, adding that awards recognition could provide a big lift for a picture just hitting theatres now.

Of Anna Karenina, he added: “The minute you do anything different it becomes harder to get it made. But we really believe in our film makers.”

Skyfall’s Judi Dench was nominated for best supporting actress as Bond’s spymaster M and Spanish actor Javier Bardem was nominated for best supporting actor as the villain Silva.

There is likely to be disappointment, however, that the movie which has become the most successful in British box office history, with critical acclaim to match, was not included on the most coveted shortlist – best film.

That award will be contested by Argo, Lincoln, Life of Pi, Les Miserables and Zero Dark Thirty.

Up for best actor alongside Day-Lewis is Ben Affleck (Argo), Bradley Cooper (Silver Linings Playbook), Hugh Jackman (Les Miserables) and Joaquin Phoenix in Scientology tale The Master.

The best actress award is between 85-year-old Emmanuelle Riva (Amour), Helen Mirren (Hitchcock), Jennifer Lawrence (Silver Linings Playbook), Jessica Chastain (Zero Dark Thirty) and Marion Cotillard (Rust and Bone).

As well as Haneke and Affleck, Ang Lee is in the running for best director (Life of Pi) as is Tarantino and Kathryn Bigelow (Zero Dark Thirty).

The BAFTAs have a patchy record in predicting which films go on to scoop the biggest movie honors, the Oscars, although last year the main winner in London, “The Artist”, also swept to success at the Academy Awards.

The awards ceremony for the BAFTAs, formally called the EE British Academy Film Awards, takes place in London on February 10.

(Reporting by Mike Collett-White, editing by Paul Casciato)

Movies News Headlines – Yahoo! News

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Gaps Seen in Therapy for Suicidal Teenagers

Most adolescents who plan or attempt suicide have already received at least some mental health treatment, raising questions about the effectiveness of current approaches to helping troubled youths, according to the largest in-depth analysis to date of suicidal behaviors in American teenagers.

The study, in the journal JAMA Psychiatry, found that 55 percent of suicidal teenagers had received some therapy before they thought about suicide, planned it or tried to kill themselves, contradicting the widely held belief that suicide is due in part to a lack of access to treatment.

The findings, based on interviews with a nationwide sample of more than 6,000 teenagers and at least one parent of each, linked suicidal behavior to complex combinations of mood disorders like depression and behavior problems like attention-deficit and eating disorders, as well as alcohol and drug abuse.

The study found that about one in eight teenagers had persistent suicidal thoughts at some point, and that about a third of those who had suicidal thoughts had made an attempt, usually within a year of having the idea.

Previous studies have had similar findings, based on smaller, regional samples. But the new study is the first to suggest, in a large nationwide sample, that access to treatment does not make a big difference.

The study suggests that effective treatment for severely suicidal teenagers must address not just mood disorders, but also behavior problems that can lead to impulsive acts, experts said. According to the Centers for Disease Control and Prevention, 1,386 people between the ages of 13 and 18 committed suicide in 2010, the latest year for which numbers are available.

“I think one of the take-aways here is that treatment for depression may be necessary but not sufficient to prevent kids from attempting suicide,” said Dr. David Brent, a professor of psychiatry at the University of Pittsburgh, who was not involved in the study. “We simply do not have empirically validated treatments for recurrent suicidal behavior.”

The report said nothing about whether the therapies given were state of the art or carefully done, said Matt Nock, a professor of psychology at Harvard and the lead author, and it is possible that some of the treatments prevented suicide attempts. “But it’s telling us we’ve got a long way to go to do this right,” Dr. Nock said. His co-authors included Ronald C. Kessler of Harvard and researchers from Boston University and Children’s Hospital Boston.

Margaret McConnell, a consultant in Alexandria, Va., said her daughter Alice, who killed herself in 2006 at the age of 17, was getting treatment at the time. “I think there might have been some carelessness in the way the treatment was done,” Ms. McConnell said, “and I was trusting a 17-year-old to manage her own medication. We found out after we lost her that she wasn’t taking it regularly.”

In the study, researchers surveyed 6,483 adolescents from the ages of 13 to 18 and found that 9 percent of male teenagers and 15 percent of female teenagers experienced some stretch of having persistent suicidal thoughts. Among girls, 5 percent made suicide plans and 6 percent made at least one attempt (some were unplanned).

Among boys, 3 percent made plans and 2 percent carried out attempts, which tended to be more lethal than girls’ attempts.

(Suicidal thinking or behavior was virtually unheard-of before age 10.)

Over all, about one-third of teenagers with persistent suicidal thoughts went on to make an attempt to take their own lives.

Almost all of the suicidal adolescents in the study qualified for some psychiatric diagnosis, whether depression, phobias or generalized anxiety disorder. Those with an added behavior problem — attention-deficit disorder, substance abuse, explosive anger — were more likely to act on thoughts of self-harm, the study found.

Doctors have tested a range of therapies to prevent or reduce recurrent suicidal behaviors, with mixed success. Medications can ease depression, but in some cases they can increase suicidal thinking. Talk therapy can contain some behavior problems, but not all.

One approach, called dialectical behavior therapy, has proved effective in reducing hospitalizations and suicide attempts in, among others, people with borderline personality disorder, who are highly prone to self-harm.

But suicidal teenagers who have a mixture of mood and behavior issues are difficult to reach. In one 2011 study, researchers at George Mason University reduced suicide attempts, hospitalizations, drinking and drug use among suicidal adolescent substance abusers. The study found that a combination of intensive treatments — talk therapy for mood problems, family-based therapy for behavior issues and patient-led reduction in drug use — was more effective than regular therapies.

“But that’s just one study, and it’s small,” said Dr. Brent of the University of Pittsburgh. “We can treat components of the overall problem, but that’s about all.”

Ms. McConnell said that her daughter’s depression had seemed mild and that there was no warning that she would take her life. “I think therapy does help a lot of people, if it’s handled right,” she said.

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DealBook: Former Analyst Cooperates in Insider Trading Case

A former analyst at SAC Capital Advisors, the hedge fund owned by the billionaire investor Steven A. Cohen, has given federal agents the names of about 20 people he said had engaged in insider trading, according to a court filing.

The disclosure of the extraordinary cooperation by the former SAC analyst, Wesley Wang, emerged in a pleading filed by federal prosecutors. In a letter to a judge, the government credited Mr. Wang with substantial assistance in its broad insider trading crackdown.

In addition to the 20 names, the government said information provided by Mr. Wang had contributed to the criminal convictions of more than 10 people.

Hedge Fund Inquiry

The letter, which was filed in connection with Mr. Wang’s sentencing, named 12 individuals who have already been charged or identified in public as part of the investigation. But the section that gave specifics about Mr. Wang’s help — and named other people, according to a person with knowledge of the letter — was heavily redacted.

Prosecutors emphasized that Mr. Wang’s help was still yielding fruit.

“The full extent of Wang’s information and cooperation remains to be fully realized,” the government said in the filing. “Even taking into account what has been developed to date, it is exceptional.”

Prosecutors praised Mr. Wang’s assistance in advance of the sentencing, which is scheduled for Wednesday afternoon in Federal District Court in Manhattan. They urged Judge Jed. S. Rakoff to hand down a lenient sentence. Government cooperators have been vital to prosecutors in the insider trading investigation, which has resulted in the guilty pleas or convictions of more than 70 individuals since mid-2009.

A lawyer for Mr. Wang, Michael Celio, declined to comment.

Mr. Wang is one of a number of former traders and analysts previously associated with SAC Capital, which manages $14 billion and has one of the best investment track records on Wall Street. At least six former SAC employees have been tied to insider trading while at the fund, which is based in Stamford, Conn. The most recent case — an indictment of a former SAC portfolio manager, Mathew Martoma — connects Mr. Cohen to questionable trades.

Mr. Cohen and SAC have not been charged with any wrongdoing, and Mr. Cohen has told his employees and clients that he believes he and the firm acted appropriately at all times. The Securities and Exchange Commission has warned SAC that it may file a civil action against the firm in connection with the Martoma case.

The case against Mr. Wang, a journeyman hedge fund analyst who spent just a couple of years at SAC nearly a decade ago, has largely gone unnoticed.

A native of Taiwan, Mr. Wang, 39, of Berkeley, Calif., worked as a technology stock analyst at the SAC unit Sigma Capital from 2002 to 2005. The F.B.I. first learned about Mr. Wang’s insider trading in 2008 from another cooperator. Agents approached him in early 2009 and he almost immediately began cooperating, agreeing to wear a wire in meetings and also recording telephone conversations with his Wall Street and corporate contacts.

“While these meetings caused Mr. Wang considerable stress, he nonetheless maintained his composure throughout them,” the prosecutors wrote in the sentencing letter.

Last summer, Mr. Wang appeared in a federal court and entered a guilty plea, admitting to leaking confidential information about technology stocks to a former Sigma portfolio manager, Dipak Patel, and to the former head of Whitman Capital, Douglas F. Whitman.

A jury convicted Mr. Whitman in August. He has yet to be sentenced. The government has not charged Mr. Patel.

Mr. Wang testified at Mr. Whitman’s trial. He said that he obtained inside information about Cisco Systems and passed it on to Mr. Whitman, who in turn shared secret data about other companies.

In the sentencing letter, prosecutors said the information provided by Mr. Wang led to their being able to approach certain other people who then also agreed to cooperate. They included Karl Motey, a crucial figure in the government’s extensive investigation into expert network firms — middlemen connecting traders to public company employees — that led to dozens of convictions.

Prosecutors emphasized that they still had plenty of work to do with all of the information supplied to them by Mr. Wang, and requested that his continued cooperation be made a condition of his sentencing.

“Wang has also identified a number of individuals involved in insider trading whom the F.B.I. has not yet approached and/or whom the government has not yet charged,” the letter said.

A version of this article appeared in print on 01/09/2013, on page B1 of the NewYork edition with the headline: Ex-Analyst Cooperates In Insider Trade Case.

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LAPD force exceeds 10,000 for the first time, officials say

For the first time in the city's history, Los Angeles' police force now exceeds 10,000 officers, city officials said Monday.

Appearing with LAPD Chief Charlie Beck to discuss the continued drop in crime last year, Mayor Antonio Villaraigosa said the department is budgeted for 10,023 officers, up from the 9,963 authorized over the last three years, during a deep budget crisis.

The staffing increase took effect Jan. 1, when 60 sworn officers moved into the LAPD from the General Services Department, which patrols parks, libraries and other municipal buildings, said Villaraigosa spokesman Peter Sanders. Those officers will continue to patrol city facilities, budget officials said.

Some questioned the significance of the staffing milestone, since the overall number of sworn officers employed by the city hasn't grown.

"It's an increase for show," said Kevin James, a candidate for mayor in the March 5 election who has questioned Villaraigosa's LAPD hiring goals. "The mayor really wanted to get to 10,000 one way or the other before he left office, and this was the way he could do it under the current budget constraints."

Los Angeles experienced a 10.5% decrease in gang crime and an 8.2% drop in violent crime last year, compared with 2011. The city had the lowest number of violent crimes per capita of any major city, including New York and Chicago, Villaraigosa said.

The mayor attributed those numbers — and a decade-long decline in crime — in large part to the expansion of the police force.

Villaraigosa originally promised to add 1,000 new officers to the department during the 2005 election campaign, criticizing then-Mayor James K. Hahn for failing to do so. Since then, he has succeeded in adding 800 officers, Sanders said. On Monday, Villaraigosa suggested that the addition of the final 200 will not be achieved until after June 30, when he leaves office.

"I would hope that the next mayor would, as we get out of this economic crisis, increase our Police Department to that 1,000," he said.

While Villaraigosa has been pushing for continued hiring at the LAPD, Beck has warned in recent weeks that the LAPD would lose 500 officers if voters fail to approve Proposition A, a half-cent sales tax measure on the March 5 ballot. That would represent more than half of the LAPD buildup accomplished by Villaraigosa.

Despite Beck's warnings, Villaraigosa said he is not ready to endorse Proposition A until the council makes a series of cost-cutting moves, such as turning over operation of the city zoo to a private entity.

Since Villaraigosa took office, homicides have decreased 38% and gang crime has dropped by a similar amount. The number of slayings has stayed largely the same over the last three years, with 297 homicides in 2010, 297 in 2011 and 298 last year. Overall crime dropped 1.4% last year. Property crimes, which are more numerous than violent crimes, increased for the first time in several years — driven in part by a 30% increase in cell phone thefts, officials said.

With little money to pay officers for overtime, the department has been compensating them with time off. The resulting staffing loss has been the equivalent of about 450 officers at any given time, according to department figures — a hit that has complicated crime-fighting strategies.

Preserving LAPD funding has become increasingly challenging for council members. For nine months they have debated whether to lay off dozens of civilian LAPD employees while continuing to hire enough police officers to maintain current staffing levels.

Councilman Paul Koretz, who opposed the layoffs, said the movement of the 60 building patrol officers to the LAPD was "a little smoke and mirrors." He questioned whether the LAPD buildup in the Villaraigosa era was financially sustainable.

"It just seems like we really never did the analysis to see if we could afford it," he said.

A defeat of the sales tax increase, which is projected to generate roughly $215 million in new revenue, would leave council members no choice but to roll back the size of the LAPD, Koretz said.

But Villaraigosa warned that would be dangerous, saying other California cities have seen upticks in crime after cutting back on officers.

"I know some people think that 10,000 cops is a magical illusion, a meaningless number, that more officers don't necessarily lead to a reduction in crime," said the mayor, adding: "Those critics talk a lot, but they're just plain wrong."

david.zahniser@latimes.com

richard.winton@latimes.com

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Tower-Climbing, Frisbee-Tossing Robots Kick Off 2013 START Competition

Representatives from more than 50 high schools gathered at San Jose State University Saturday for the kickoff to the 2013 season of the FIRST Robotics Competition, inventor Dean Kamen’s attempt to turn robotics and engineering education into a high school sports-like event. This year’s competition: build a robot that can throw Frisbees and climb a 90-inch-tall metal pyramid tower.

The 22nd annual kickoff brought the Silicon Valley Region together for a video broadcast announcing the particulars of the season, which will incorporate six weeks of building, followed by regional competitions and eventually an international championship. Each year, teams of high school students receive a kit of parts and detailed descriptions of a game their robots must play. Typically, the goals involve some sort of projectile and alliances of three robots, each backed by their builders/operators. But each year the game is different; in the past, robots have fired basketballs at hoops, placed inflatables on racks and knocked soccer balls through goals.

Though the game changes, the goal is the same — to grow the status of STEM (Science Technology Engineering Mathematics) education. Even the name FIRST, while sometimes confusing, is a reference to that object: For Inspiration and Recognition of Science and Technology.

“People tend to really enjoy engineering and math and science if they get to build robots,” says Anand Atreya, a FIRST alum from 10 years ago, who has since received degrees from Princeton and MIT, and is currently a Ph.D. student in electrical engineering at Stanford. Volunteering on FIRST’s Silicon Valley Regional Planning Committee, he says the competition has changed in two primary ways: the number of teams has grown, as has the quality of equipment in the kits that each team receives as part of the kickoff. While still not as popular as high school football, funding has grown too — sponsors donate parts for the kits, and universities and professional associations offer more than $16 million in scholarships to FIRST graduates.

Teams in the 2013 competition, titled “Ultimate Ascent,” will compete to throw Frisbees through goals on either end of the playing court. Points are awarded for successful tosses, based on the difficulty of each goal. Then, as the competition ends, the robots can ascend a pyramid made of metal pipes on their side of the field — if they remain suspended, they get extra points.

But it gets more complicated. Because robots are allied in groups of three, not every robot does the same thing. Each gets points for climbing, but some will play defense, and some will scoop up Frisbees to deliver to robots that specialize in throwing. It’s a collaborative, competitive effort.

For Presentation High School in San Jose, 2013 will be the team’s 7th year competing. The school is all-girls, so the team is too.

“The girls are every bit as smart as the guys, but they don’t have confidence,” says David Simpson, the team’s coach, adding that part of why he’s involved is to help more girls to participate in engineering. “What we’ve found is that having FIRST on the application is a big help getting into school,” he says.

Led by senior co-captains Gabi Pastera, Jen Earley, and Emily Mullins, the team is already brainstorming as they go to pick up their kits.

“We gotta make it really light,” says Earley.

“We can use 16th-inch wall, if we’re not worried about people pushing us around,” Mullins suggests. They haven’t decided whether to build a defensive or offensive robot.

The team of about 30 students will spend nights and weekends for the next six weeks at Presentation’s machine shop, a dedicated space for the robotics club in a house across the street from the school. The shop has been outfitted with three computers running SolidWorks, and a Syil CNC milling machine. Scattered about the workshop are other tools, motors, wires, and parts of robots from previous years. Mullins will design parts on SolidWorks, Pastera and Earley will mill them on the machine.

But first, they convene with the rest of the team. It’s still early on a Saturday morning — the kickoff started early, and teams had grabbed their kits, taken a look at a sample pyramid, and split by 8:30am — but the girls buzz with energy (and donuts) as they go over the rules. Then Earley, Pastera, and junior Kiki Sham open the kit, comparing the cables, motors, sensors, and hundreds of other parts to the kit checklist. Most teams will have additional parts — Presentation has been stockpiling aluminum — from sponsors or from previous years. They have six weeks to work on the robot, after which they must seal it in a bag, to be opened only at competitions.

In April, Presentation High will compete at the Silicon Valley Regional Competition, one of 57 around the country that will send a total of about 400 teams to the 2013 championships, held April 24-27 in St. Louis. (FIRST encourages spectators to attend the competitions; a full list of dates and locations can be found on their website.)

Next year, Gabi will be moving on to engineering school. Though she hasn’t decided which one, her passion for the subject arose from her involvement in FIRST, which she joined as a freshman.

“I actually didn’t know anything about robotics before I joined,” she says. “It kind of becomes an addiction after a while.”

Photos: Nathan Hurst

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Mariah Carey increased security in feud with fellow “Idol” judge

NEW YORK (Reuters) – Pop diva Mariah Carey said she hired increased security following what she described as threats reportedly made against her by fellow ‘American Idol‘ judge Nicki Minaj, according to an interview on ABC News.

Carey, 42, one of three new judges to join the “American Idol” panel for the hit talent show’s new season on January 16, told Barbara Walters in an interview airing on Monday, “it felt like an unsafe work environment.”

“Anytime anybody’s reeling threats at somebody, you know, it’s not appropriate,” Carey said.

“I’m a professional. I’m not used to that type of environment,” she said, adding that she hired extra security.

The diva was alluding to widely reported tension between her and Minaj, who were seen arguing with one another in a video from the show’s audition phase.

Walters has reported that, according to Carey, others on the “Idol” set heard Minaj go further and say, off-camera, “If I had a gun, I would shoot that bitch.”

Minaj, a Trinidadian-born singer and songwriter, previously denied making any remarks about firearms, but Carey told Walters that beefing up her security “was the appropriate thing to do.”

“Sitting there on the road with two babies, I’m not going to take any chances,” she said, referring to her 20-month old twins with husband Nick Cannon.

But in a sign of media savvy, she noted that “for all the drama, I hope it helps the show.”

Walters also asked Carey about reports she is being paid $ 18 million for each “Idol” season.

“I think we’re in the ballpark, (but) I can’t even talk about those things,” the singer replied.

(Reporting by Chris Michaud; Editing by Piya Sinha-Roy and Paul Simao)

Music News Headlines – Yahoo! News

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The New Old Age Blog: Who Should Receive Organ Transplants?

Joe Gammalo had been contending with pulmonary fibrosis, a scarring of the lungs, for more than a decade when he came to the Cleveland Clinic in 2008 seeking a lung transplant.

“It had gotten to the point where I was on oxygen all the time and in a wheelchair,” he told me in an interview. “I didn’t expect to live.”

Lung transplants are a dicey proposition, involving a huge surgical procedure, arduous follow-up, the lifelong use of potent immunosuppressive drugs and high rates of serious side effects. “It’s not like taking out an appendix,” said Dr. Marie Budev, the medical director of the clinic’s lung transplant program.

Only 50 to 57 percent of all recipients live for five years, she noted, and they will still die of their disease. But there’s no other treatment for pulmonary fibrosis.

Some medical centers would have turned Mr. Gammalo away. Because survival rates are even lower for older patients, guidelines from the International Society for Heart and Lung Transplantation caution against lung transplants for those over 65, though they set no age limit.

But “we are known as an aggressive, high-risk center,” said Dr. Budev. So Mr. Gammalo was 66 when he received a lung; his newly found buddy, Clyde Conn, who received the other lung from the same donor, was 69.

You can’t mistake the trend: A graying population and revised policies determining who gets priority for donated organs, have led to a rising proportion of older adults receiving transplants.

My colleague Judith Graham has reported on the increase in heart transplants, but the pattern extends to other organs, too.

The number of kidney transplants performed annually on adults over 65 tripled between 1998 and last year, according to data from the Scientific Registry of Transplant Recipients. In 2001, 7.4 percent of liver transplant recipients were over 65; last year, that rose to 13 percent.

The rise in elderly lung transplant candidates is particularly dramatic because, since 2005, a “lung allocation score” puts those at the highest mortality risk, rather than those who’ve waited longest, at the top of the list.

In 2001, about 3 percent of those on the wait list and of those transplanted were over 65; last year, older patients represented almost 18 percent of wait-listed candidates and more than a quarter of transplant recipients. (Medicare pays for the surgery, though patients face co-pays and considerable out-of-pocket costs, including for drugs and travel.)

The debate has grown, too: When the number of adults awaiting transplants keeps growing, but organ donations stay flat, is it desirable or even ethical that an increasing proportion of recipients are elderly?

Dr. Budev, who estimated that a third of her program’s patients are over 65, votes yes. As long as a program selects candidates carefully, “how can you deny them a therapy?” she asked. So the Cleveland Clinic has no age limit. “We feel that everyone should have a chance.”

At the University of Michigan, by contrast, the age limit remains 65, though Dr. Kevin Chan, the transplant program’s medical director, acknowledged that some fit older patients get transplanted.

“You can talk about this all day — it’s a tough one,” Dr. Chan said. Younger recipients have greater physiologic reserve to aid in the arduous recovery; older ones face higher risk of subsequent kidney failure, stroke, diabetes and other diseases, and, of course, their lifespans are shorter to begin with.

Donated lungs, fragile and prone to injury, are a particularly scarce commodity. Last year, surgeons performed 16,055 kidney transplants, 5,805 liver transplants and 1,949 heart transplants. Only1,830 patients received lung transplants.

“What if there’s a 35-year-old on a ventilator who needs the lung just as much?” Dr. Chan said. “Why should a 72-year-old possibly take away a lung from a 35-year-old?” Yet, he acknowledged, “it’s easy to look at the statistics and say, ‘Give the lungs to younger patients.’ At the bedside, when you meet this patient and family, it’s a lot different.”

These questions about who deserves scarce resources — those most likely to die without them? or those most likely to live longer with them? — will persist as the population ages. They’re also likely to arise when the International Society for Heart and Lung Transplantation begins working towards revised guidelines this spring. (I’d also like to hear your take, below.)

Lots of 65- and 75-year-olds are very healthy. Yet transplants themselves can cause harm and there’s no backup, like dialysis. Without the transplant, they die. But when the transplant goes wrong, they also die.

More than four years post-transplant, the Cleveland Clinic’s “lung brothers” are success stories. Mr. Conn, who lives near Dayton, Ohio, can’t walk very far or lift more than 10 pounds, but he works part time as a real-estate appraiser and enjoys cruises with his wife.

Mr. Gammalo, a onetime musician, has developed diabetes, like nearly half of all lung recipients. But he went onstage a few weeks back to sing “Don’t Be Cruel” with his son’s rock band, “a highlight of both our lives,” he said.

Yet when I asked Mr. Conn, now 73, how he felt about having priority over a younger but healthier person, he paused. “It’s a good question,” he said, to which he had no answer.

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

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Wall Street Trades Lower as Earnings Reports Begin

Stocks trading on Wall Street ticked lower at the opening on Tuesday as an earnings season that is expected to show sluggish corporate growth got under way.

The Standard & Poor’s 500-stock index fell 0.2 percent in morning trading, the Dow Jones industrial average also lost 0.2 percent and the Nasdaq composite index was flat.

Over the next couple of weeks, quarterly reports on fourth-quarter profits are expected to come in above the previous quarter’s lackluster results, but analysts’ current estimates are down sharply from where they were in October. Quarterly earnings are expected to grow by 2.8 percent, according to Thomson Reuters data.

German data showed industrial orders fell more than forecast in November because of a sharp drop in demand from abroad, reinforcing concerns that Europe’s largest economy may have contracted in the fourth quarter of 2012.

“I’m surprised futures are holding up, given the relative disappointment that German data showed, but I think all eyes are on the beginning of earnings season,” said Kim Forrest, senior equity research analyst at Fort Pitt Capital Group in Pittsburgh.

European shares were mixed after the German report, with the DAX index in Frankfurt down 0.1 percent and the CAC 40 in Paris up 0.5 percent in afternoon trading.

Monsanto shares rose 3.5 percent after the world’s largest seed company raised its earnings outlook for fiscal 2013 and posted strong first-quarter results.

Shares of the restaurant-chain operator Yum Brands fell 4.6 percent. On Monday the company, which owns KFC, warned that sales in China, its largest market, shrank more than expected in the fourth quarter.

Vodafone shares rose almost 3 percent in London after its American partner in the joint venture Verizon Wireless said it would be “feasible” to buy out the British group.

Sears Holdings shares were 1.9 percent lower a day after the company said its chief executive would step down for family health reasons.

GameStop shares fell 6.8 percent after it reported sales for the holiday season and cut its guidance.

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