Personal Health: Keeping Blood Pressure in Check

Since the start of the 21st century, Americans have made great progress in controlling high blood pressure, though it remains a leading cause of heart attacks, strokes, congestive heart failure and kidney disease.

Now 48 percent of the more than 76 million adults with hypertension have it under control, up from 29 percent in 2000.

But that means more than half, including many receiving treatment, have blood pressure that remains too high to be healthy. (A normal blood pressure is lower than 120 over 80.) With a plethora of drugs available to normalize blood pressure, why are so many people still at increased risk of disease, disability and premature death? Hypertension experts offer a few common, and correctable, reasons:


Jane Brody speaks about hypertension.




¶ About 20 percent of affected adults don’t know they have high blood pressure, perhaps because they never or rarely see a doctor who checks their pressure.

¶ Of the 80 percent who are aware of their condition, some don’t appreciate how serious it can be and fail to get treated, even when their doctors say they should.

¶ Some who have been treated develop bothersome side effects, causing them to abandon therapy or to use it haphazardly.

¶ Many others do little to change lifestyle factors, like obesity, lack of exercise and a high-salt diet, that can make hypertension harder to control.

Dr. Samuel J. Mann, a hypertension specialist and professor of clinical medicine at Weill-Cornell Medical College, adds another factor that may be the most important. Of the 71 percent of people with hypertension who are currently being treated, too many are taking the wrong drugs or the wrong dosages of the right ones.

Dr. Mann, author of “Hypertension and You: Old Drugs, New Drugs, and the Right Drugs for Your High Blood Pressure,” says that doctors should take into account the underlying causes of each patient’s blood pressure problem and the side effects that may prompt patients to abandon therapy. He has found that when treatment is tailored to the individual, nearly all cases of high blood pressure can be brought and kept under control with available drugs.

Plus, he said in an interview, it can be done with minimal, if any, side effects and at a reasonable cost.

“For most people, no new drugs need to be developed,” Dr. Mann said. “What we need, in terms of medication, is already out there. We just need to use it better.”

But many doctors who are generalists do not understand the “intricacies and nuances” of the dozens of available medications to determine which is appropriate to a certain patient.

“Prescribing the same medication to patient after patient just does not cut it,” Dr. Mann wrote in his book.

The trick to prescribing the best treatment for each patient is to first determine which of three mechanisms, or combination of mechanisms, is responsible for a patient’s hypertension, he said.

¶ Salt-sensitive hypertension, more common in older people and African-Americans, responds well to diuretics and calcium channel blockers.

¶ Hypertension driven by the kidney hormone renin responds best to ACE inhibitors and angiotensin receptor blockers, as well as direct renin inhibitors and beta-blockers.

¶ Neurogenic hypertension is a product of the sympathetic nervous system and is best treated with beta-blockers, alpha-blockers and drugs like clonidine.

According to Dr. Mann, neurogenic hypertension results from repressed emotions. He has found that many patients with it suffered trauma early in life or abuse. They seem calm and content on the surface but continually suppress their distress, he said.

One of Dr. Mann’s patients had had high blood pressure since her late 20s that remained well-controlled by the three drugs her family doctor prescribed. Then in her 40s, periodic checks showed it was often too high. When taking more of the prescribed medication did not result in lasting control, she sought Dr. Mann’s help.

After a thorough work-up, he said she had a textbook case of neurogenic hypertension, was taking too much medication and needed different drugs. Her condition soon became far better managed, with side effects she could easily tolerate, and she no longer feared she would die young of a heart attack or stroke.

But most patients should not have to consult a specialist. They can be well-treated by an internist or family physician who approaches the condition systematically, Dr. Mann said. Patients should be started on low doses of one or more drugs, including a diuretic; the dosage or number of drugs can be slowly increased as needed to achieve a normal pressure.

Specialists, he said, are most useful for treating the 10 percent to 15 percent of patients with so-called resistant hypertension that remains uncontrolled despite treatment with three drugs, including a diuretic, and for those whose treatment is effective but causing distressing side effects.

Hypertension sometimes fails to respond to routine care, he noted, because it results from an underlying medical problem that needs to be addressed.

“Some patients are on a lot of blood pressure drugs — four or five — who probably don’t need so many, and if they do, the question is why,” Dr. Mann said.


How to Measure Your Blood Pressure

Mistaken readings, which can occur in doctors’ offices as well as at home, can result in misdiagnosis of hypertension and improper treatment. Dr. Samuel J. Mann, of Weill Cornell Medical College, suggests these guidelines to reduce the risk of errors:

¶ Use an automatic monitor rather than a manual one, and check the accuracy of your home monitor at the doctor’s office.

¶ Use a monitor with an arm cuff, not a wrist or finger cuff, and use a large cuff if you have a large arm.

¶ Sit quietly for a few minutes, without talking, after putting on the cuff and before checking your pressure.

¶ Check your pressure in one arm only, and take three readings (not more) one or two minutes apart.

¶ Measure your blood pressure no more than twice a week unless you have severe hypertension or are changing medications.

¶ Check your pressure at random, ordinary times of the day, not just when you think it is high.

Read More..

Personal Health: Keeping Blood Pressure in Check

Since the start of the 21st century, Americans have made great progress in controlling high blood pressure, though it remains a leading cause of heart attacks, strokes, congestive heart failure and kidney disease.

Now 48 percent of the more than 76 million adults with hypertension have it under control, up from 29 percent in 2000.

But that means more than half, including many receiving treatment, have blood pressure that remains too high to be healthy. (A normal blood pressure is lower than 120 over 80.) With a plethora of drugs available to normalize blood pressure, why are so many people still at increased risk of disease, disability and premature death? Hypertension experts offer a few common, and correctable, reasons:


Jane Brody speaks about hypertension.




¶ About 20 percent of affected adults don’t know they have high blood pressure, perhaps because they never or rarely see a doctor who checks their pressure.

¶ Of the 80 percent who are aware of their condition, some don’t appreciate how serious it can be and fail to get treated, even when their doctors say they should.

¶ Some who have been treated develop bothersome side effects, causing them to abandon therapy or to use it haphazardly.

¶ Many others do little to change lifestyle factors, like obesity, lack of exercise and a high-salt diet, that can make hypertension harder to control.

Dr. Samuel J. Mann, a hypertension specialist and professor of clinical medicine at Weill-Cornell Medical College, adds another factor that may be the most important. Of the 71 percent of people with hypertension who are currently being treated, too many are taking the wrong drugs or the wrong dosages of the right ones.

Dr. Mann, author of “Hypertension and You: Old Drugs, New Drugs, and the Right Drugs for Your High Blood Pressure,” says that doctors should take into account the underlying causes of each patient’s blood pressure problem and the side effects that may prompt patients to abandon therapy. He has found that when treatment is tailored to the individual, nearly all cases of high blood pressure can be brought and kept under control with available drugs.

Plus, he said in an interview, it can be done with minimal, if any, side effects and at a reasonable cost.

“For most people, no new drugs need to be developed,” Dr. Mann said. “What we need, in terms of medication, is already out there. We just need to use it better.”

But many doctors who are generalists do not understand the “intricacies and nuances” of the dozens of available medications to determine which is appropriate to a certain patient.

“Prescribing the same medication to patient after patient just does not cut it,” Dr. Mann wrote in his book.

The trick to prescribing the best treatment for each patient is to first determine which of three mechanisms, or combination of mechanisms, is responsible for a patient’s hypertension, he said.

¶ Salt-sensitive hypertension, more common in older people and African-Americans, responds well to diuretics and calcium channel blockers.

¶ Hypertension driven by the kidney hormone renin responds best to ACE inhibitors and angiotensin receptor blockers, as well as direct renin inhibitors and beta-blockers.

¶ Neurogenic hypertension is a product of the sympathetic nervous system and is best treated with beta-blockers, alpha-blockers and drugs like clonidine.

According to Dr. Mann, neurogenic hypertension results from repressed emotions. He has found that many patients with it suffered trauma early in life or abuse. They seem calm and content on the surface but continually suppress their distress, he said.

One of Dr. Mann’s patients had had high blood pressure since her late 20s that remained well-controlled by the three drugs her family doctor prescribed. Then in her 40s, periodic checks showed it was often too high. When taking more of the prescribed medication did not result in lasting control, she sought Dr. Mann’s help.

After a thorough work-up, he said she had a textbook case of neurogenic hypertension, was taking too much medication and needed different drugs. Her condition soon became far better managed, with side effects she could easily tolerate, and she no longer feared she would die young of a heart attack or stroke.

But most patients should not have to consult a specialist. They can be well-treated by an internist or family physician who approaches the condition systematically, Dr. Mann said. Patients should be started on low doses of one or more drugs, including a diuretic; the dosage or number of drugs can be slowly increased as needed to achieve a normal pressure.

Specialists, he said, are most useful for treating the 10 percent to 15 percent of patients with so-called resistant hypertension that remains uncontrolled despite treatment with three drugs, including a diuretic, and for those whose treatment is effective but causing distressing side effects.

Hypertension sometimes fails to respond to routine care, he noted, because it results from an underlying medical problem that needs to be addressed.

“Some patients are on a lot of blood pressure drugs — four or five — who probably don’t need so many, and if they do, the question is why,” Dr. Mann said.


How to Measure Your Blood Pressure

Mistaken readings, which can occur in doctors’ offices as well as at home, can result in misdiagnosis of hypertension and improper treatment. Dr. Samuel J. Mann, of Weill Cornell Medical College, suggests these guidelines to reduce the risk of errors:

¶ Use an automatic monitor rather than a manual one, and check the accuracy of your home monitor at the doctor’s office.

¶ Use a monitor with an arm cuff, not a wrist or finger cuff, and use a large cuff if you have a large arm.

¶ Sit quietly for a few minutes, without talking, after putting on the cuff and before checking your pressure.

¶ Check your pressure in one arm only, and take three readings (not more) one or two minutes apart.

¶ Measure your blood pressure no more than twice a week unless you have severe hypertension or are changing medications.

¶ Check your pressure at random, ordinary times of the day, not just when you think it is high.

Read More..

Yahoo Earnings Handily Beat Forecasts


SAN FRANCISCO — Marissa Mayer, just by being Marissa Mayer, has done more to move Yahoo forward in her first six months as chief executive than any of her five predecessors did over as many years.


An accomplished engineer and executive, Ms. Mayer joined Yahoo from Google as a Silicon Valley celebrity. Since then, just her presence at the company’s Sunnyvale, Calif., headquarters seems to have jolted Yahoo back to life. On Monday, Yahoo reported a good quarter, increasing revenue for the first time in four years and beating Wall Street expectations by 30 percent.


That pushed Yahoo’s stock to $20.91 in after-hours trading — a four-year high (but still well below the $31 Microsoft offered the company back in 2008).


Ms. Mayer attributed growth to a renewed focus on “people and products” in a call with analysts on Monday.


She has added new Yahoo fans by revamping Yahoo’s e-mail service and redesigning Flickr, the firm’s photo-sharing app, which sent the number of photo uploads rising 25 percent. Ms. Mayer said those improvements were a hint of more under way.


“We are off to a very good start,” Ms. Mayer told analysts. “We are making the world’s habits more inspiring and entertaining.”


She has also introduced several morale boosters since joining the company — including free cafeteria food and new iPhones and Android-powered phones — to staff members who were more accustomed to cost cutting and layoffs. In a further sign that the company was no longer considered a sinking ship, she lured another Silicon Valley tech star, Max Levchin, a PayPal co-founder, to Yahoo’s board last month.


But those were just the office things. Analysts were more impressed with improvements to the company’s search business. Yahoo outsourced it to Microsoft in 2009 and it has languished ever since, propped up only because of a revenue-guarantee clause in its contract with Microsoft that is set to expire in March. Yahoo’s search revenue rose 4 percent in the fourth quarter, to $482 million, compared with $465 million for the period a year earlier.


Over all, Yahoo reported net income in the fourth quarter of $272.3 million, or 23 cents a share, compared with $295.6 million, or 24 cents a share, in the period a year earlier.


The company said revenue was up 1.6 percent, to $1.35 billion.


The improvement to its search business was offset by continued declines in Yahoo’s display ad revenue. The company said it made $591 million in display ad sales last quarter, a 3 percent decline from the $612 million in the quarter a year ago.


Yahoo, once the biggest seller of display ads in the United States, went from a leading 15.5 percent share of all digital ad revenues in the United States in 2009, to an 8.4 percent share last year, even as total digital ad spending grew, according to eMarketer. Meanwhile, its competitor, Google, increased its share to 41 percent.


“More personalized content and increased product innovation will be key to getting us back to the path for display revenue growth,” Ms. Mayer said on the call.


The fourth-quarter results impressed analysts, but many remained skeptical.


“Marissa will have to protect Yahoo’s legacy business while positioning the company for future growth,” Colin Gillis, an Internet analyst at BGC Partners, said in an interview Monday. “That is not easy.”


With Ms. Mayer’s honeymoon with Wall Street expected to end soon, investors are eager to see whether she can deliver sustained growth. Yahoo, with 700 million monthly users, commands one of the largest audiences on the Web. But the company, an Internet pioneer, has been unable to attract advertisers and increase revenue.


As Ms. Mayer has acknowledged, Yahoo’s future growth may well depend on its mobile strategy. And without mobile hardware like a tablet computer, a browser or a social networking platform of its own, Yahoo has a long way to go.


The company continues to be outspent in research and development by Google, Apple, Facebook and Amazon. It also continues to have a hard time convincing Silicon Valley’s engineering talent to join Yahoo instead of its competitors.


Ms. Mayer has said Yahoo’s mobile growth may come from acquisitions of mobile app companies. In six months, Ms. Mayer has acquired three start-ups — Stamped, OnTheAir and Snip.it — for undisclosed sums, more for the engineering talent than the products.


“The road will only get harder,” said Mr. Gillis. But compared to Ms. Mayer’s disgraced immediate predecessor, Scott Thompson, who left the company after four months over embellishments on his résumé, Mr. Gillis added, “at least she got a honeymoon.”


This article has been revised to reflect the following correction:

Correction: January 28, 2013

Because of an editing error, an earlier version of this article misstated the percentage increase in Yahoo’s quarterly revenue. It was 1.6 percent, not 1.5 percent.



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Protests Grow on Fifth Day of Unrest in Egypt


Tara Todras-Whitehill for The New York Times


Egyptians in Port Said mourned on Monday for people killed in clashes with the police a day earlier.







PORT SAID, Egypt — The police fired indiscriminately into the streets outside their besieged station, a group of protesters arrived with a crate of gasoline bombs, and others cheered a masked man on a motorcycle who arrived with a Kalashnikov.




The growing chaos along the vital canal zone showed little sign of abating on Monday as President Mohamed Morsi called out the army to try to regain control of three cities along the Suez Canal whose growing lawlessness is testing the integrity of the Egyptian state.


In Port Said, street battles reached a bloody new peak with a death toll over three days of at least 45, with at least five more protesters killed by bullet wounds, hospital officials said.


Such violence has flared across Egypt with increasing frequency since President Hosni Mubarak was forced out by the revolution two years ago.


President Morsi had already declared a monthlong state of emergency here and in the other canal towns of Suez and Ismailia, applying a Mubarak-era law that virtually eliminates due process protections against abuse by the police. Angry crowds burned tires and hurled rocks at the police. And the police, with little training and less credibility, hunkered down behind barrages of tear gas, birdshot and occasional bullets.


The sense that the state was unraveling may have been strongest here in Port Said, where demonstrators have proclaimed their city an independent nation. But in recent days the unrest has risen in towns across the country and in Cairo as well. In the capital on Monday, a mob of protesters managed to steal an armored police vehicle, drive it to Tahrir Square and make it a bonfire.


After two years of torturous transition, Egyptians have watched with growing anxiety as the erosion of the public trust in the government and a persistent security vacuum have fostered a new temptation to resort to violence to resolve disputes, said Michael Hanna, a researcher at the New York-based Century Foundation who is now in Cairo. “There is a clear political crisis that has eroded the moral authority of the state,” he said.


And the spectacular evaporation of the government’s authority here in Port Said has put that crisis on vivid display, most conspicuously in the rejection of Mr. Morsi’s declarations of the curfew and state of emergency.


As in Suez and Ismailia, tens of thousands residents of Port Said poured into the streets in defiance just as a 9 p.m. curfew was set to begin. Bursts of gunfire echoed through the city for the next hours, and between 9 and 11 p.m. hospital officials raised the death count to seven from two.


When two armored personnel carriers approached a funeral Monday morning for some of the seven protesters killed the day before, a stone-throwing mob of thousands quickly chased them away. And within a few hours the demonstrators had resumed their siege of a nearby police station, burning tires to create a smoke screen to hide behind amid tear gas and gunfire.


Many in the city said they saw no alternative but to continue to stay in the streets. They complained that the hated security police remained unchanged and unaccountable even after Mr. Mubarak had been ousted. They saw no recourse in the justice system, which is also unchanged; they dismissed the courts as politicized, especially after the acquittals of all those accused of killing protesters during the revolution. Then came the death sentences handed down Saturday to 21 Port Said soccer fans for their role in a deadly brawl. The death sentences set off the current unrest here.


Nor, they said, did they trust the political process that brought to power Mr. Morsi and his Islamist allies in the Muslim Brotherhood. He had vowed to usher in the rule of law as “a president for all Egyptians.” But in November he used a presidential decree to temporarily stifle potential legal objections so that his Islamist allies could rushed out a new Constitution. His authoritarian move kicked off a sharp uptick in street violence leading to this weekend’s Port Said clashes.


“Injustice beyond imagination,” one man outside the morning funeral said of Mr. Morsi’s emergency decree, before he was drowned out a crowd of others echoing the sentiment.


“He declared a curfew, and we declare civil disobedience,” another man said.


“This doesn’t apply to Port Said because we don’t recognize him as our president,” said a third. “He is the president of the Muslim Brotherhood only.”


Kareem Fahim contributed reporting from Cairo.



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Japan to Ease Restrictions on U.S. Beef


Reflecting diminishing fears over mad cow disease, Japan eased its decade-old restriction on imports of American beef on Monday. But industry experts say beef producers have many more challenges to overcome if they are going to reverse a prolonged slump that has pared the nation’s herd to its lowest level in 60 years and sent prices soaring.


A Japanese government council that oversees food and drug safety cleared a change in import regulations on Monday that would permit imports of meat from American cattle aged 30 months or younger, rather than the current 20 months, according to materials distributed at the council’s meeting in Tokyo.


The change is set to take effect on Feb. 1 for American beef processed after that date, and shipments could start arriving in Japan in mid-February, according to the Japanese Ministry of Agriculture. Bans remain on parts of cattle considered to carry a higher risk of transmitting the disease.


Japan, the world’s largest net importer of food, slapped a ban on American beef in 2003 after bovine spongiform encephalopathy, an illness more commonly known as mad cow disease, was found in a single cow in Washington State. Humans are thought to catch the disease’s fatal human variant, Creutzfeldt-Jakob disease, by eating meat, including the brain and spinal cord, from contaminated carcasses.


Japan eased the ban in 2006 but only for meat from cattle 20 months or younger, an age limit American exporters said had no scientific basis. Japanese officials argued that the incidence of the disease was higher in older animals.


Aside from the reduction in exports, ranchers have also been grappling over the last half-dozen years or so with rising feed prices —as ethanol producers drove up the price of corn — and with drought that has parched grazing land and deprived their animals of water. The recession and changing consumer tastes contributed to the woes. While the industry has had boom and bust cycles lasting on average four to five years, the current decline is firmly entrenched.


“Previous cycles of production and prices going back 100 years related to the particular workings of the beef industry and were usually self-correcting,” said Derrell Peel, professor of agricultural economics at Oklahoma State. “But the current cycle is largely due to external factors and that is really why we are at this historic low.”


Cameron Bruett, the spokesman for one of the largest beef processors, JBS, welcomed Japan’s decision, saying it would help increase business certainty and reduce complexity for the company’s beef production, which operates in Brazil, Argentina, Canada and the United States. “While the declining herd remains a challenge for the industry, any time you increase access to additional consumers that benefits the whole supply chain,” Mr. Bruett said.


JBS has eight processing facilities in the United States and Canada. While another major producer, Cargill, announced plans two weeks ago to close a plant in Texas — one of 10 it has in the United States — Mr. Bruett said JBS has no closure plans.


Japan’s decision will mark a bright spot at the annual gathering next week in Tampa of what Chandler Keys, a beef industry consultant, calls “the hat and boots crowd,” or the members of the National Cattlemen’s Beef Association. 


“It should be a shot in the arm to the market, which will be helpful,” said Bob McCan, a rancher who will be named the association’s president-elect at that meeting. Mr. McCann and his family operate a ranch in Victoria, Tex., with more than 3,600 head of Braford cattle, down from 5,000 six years ago. “Everyone looks at the high price of beef and says we must be making money, “ he said. “But profitability is more difficult due to the drought that started in Texas, the biggest cattle producing state, almost five years ago and has since widened into the Midwest.”


That has raised the cost of production, as corn used in feed has become more scarce and animals have to rely on pumped water rather than water holes.


“The bottom line is that the beef production system we have used for the last 40 or 50 years depends heavily on the incentive of very cheap grain,” Professor Peel said. “Now we don’t have cheap grain, and we are seeing fundamentally higher production costs that I don’t think are going to go away.”


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Ariel Sharon Brain Scan Shows Response to Stimuli





JERUSALEM — A brain scan performed on Ariel Sharon, the former Israeli prime minister who had a devastating stroke seven years ago and is presumed to be in a vegetative state, revealed significant brain activity in response to external stimuli, raising the chances that he is able to hear and understand, a scientist involved in the test said Sunday.




Scientists showed Mr. Sharon, 84, pictures of his family, had him listen to a recording of the voice of one of his sons and used tactile stimulation to assess the extent of his brain’s response.


“We were surprised that there was activity in the proper parts of the brain,” said Prof. Alon Friedman, a neuroscientist at Ben-Gurion University of the Negev and a member of the team that carried out the test. “It raises the chances that he hears and understands, but we cannot be sure. The test did not prove that.”


The activity in specific regions of the brain indicated appropriate processing of the stimulations, according to a statement from Ben-Gurion University, but additional tests to assess Mr. Sharon’s level of consciousness were less conclusive.


“While there were some encouraging signs, these were subtle and not as strong,” the statement added.


The test was carried out last week at the Soroka University Medical Center in the southern Israeli city of Beersheba using a state-of-the-art M.R.I. machine and methods recently developed by Prof. Martin M. Monti of the University of California, Los Angeles. Professor Monti took part in the test, which lasted approximately two hours.


Mr. Sharon’s son Gilad said in October 2011 that he believed that his father responded to some requests. “When he is awake, he looks at me and moves fingers when I ask him to,” he said at the time, adding, “I am sure he hears me.”


Professor Friedman said in a telephone interview that the test results “say nothing about the future” but may be of some help to the family and the regular medical staff caring for Mr. Sharon at a hospital outside Tel Aviv.


“There is a small chance that he is conscious but has no way of expressing it,” Professor Friedman said, but he added, “We do not know to what extent he is conscious.”


Read More..

Ariel Sharon Brain Scan Shows Response to Stimuli





JERUSALEM — A brain scan performed on Ariel Sharon, the former Israeli prime minister who had a devastating stroke seven years ago and is presumed to be in a vegetative state, revealed significant brain activity in response to external stimuli, raising the chances that he is able to hear and understand, a scientist involved in the test said Sunday.




Scientists showed Mr. Sharon, 84, pictures of his family, had him listen to a recording of the voice of one of his sons and used tactile stimulation to assess the extent of his brain’s response.


“We were surprised that there was activity in the proper parts of the brain,” said Prof. Alon Friedman, a neuroscientist at Ben-Gurion University of the Negev and a member of the team that carried out the test. “It raises the chances that he hears and understands, but we cannot be sure. The test did not prove that.”


The activity in specific regions of the brain indicated appropriate processing of the stimulations, according to a statement from Ben-Gurion University, but additional tests to assess Mr. Sharon’s level of consciousness were less conclusive.


“While there were some encouraging signs, these were subtle and not as strong,” the statement added.


The test was carried out last week at the Soroka University Medical Center in the southern Israeli city of Beersheba using a state-of-the-art M.R.I. machine and methods recently developed by Prof. Martin M. Monti of the University of California, Los Angeles. Professor Monti took part in the test, which lasted approximately two hours.


Mr. Sharon’s son Gilad said in October 2011 that he believed that his father responded to some requests. “When he is awake, he looks at me and moves fingers when I ask him to,” he said at the time, adding, “I am sure he hears me.”


Professor Friedman said in a telephone interview that the test results “say nothing about the future” but may be of some help to the family and the regular medical staff caring for Mr. Sharon at a hospital outside Tel Aviv.


“There is a small chance that he is conscious but has no way of expressing it,” Professor Friedman said, but he added, “We do not know to what extent he is conscious.”


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Unboxed: Literary History, Seen Through Big Data’s Lens





ANY list of the leading novelists of the 19th century, writing in English, would almost surely include Charles Dickens, Thomas Hardy, Herman Melville, Nathaniel Hawthorne and Mark Twain.




But they do not appear at the top of a list of the most influential writers of their time. Instead, a recent study has found, Jane Austen, author of “Pride and Prejudice, “ and Sir Walter Scott, the creator of “Ivanhoe,” had the greatest effect on other authors, in terms of writing style and themes.


These two were “the literary equivalent of Homo erectus, or, if you prefer, Adam and Eve,” Matthew L. Jockers wrote in research published last year. He based his conclusion on an analysis of 3,592 works published from 1780 to 1900. It was a lot of digging, and a computer did it.


The study, which involved statistical parsing and aggregation of thousands of novels, made other striking observations. For example, Austen’s works cluster tightly together in style and theme, while those of George Eliot (a k a Mary Ann Evans) range more broadly, and more closely resemble the patterns of male writers. Using similar criteria, Harriet Beecher Stowe was 20 years ahead of her time, said Mr. Jockers, whose research will soon be published in a book, “Macroanalysis: Digital Methods and Literary History” (University of Illinois Press).


These findings are hardly the last word. At this stage, this kind of digital analysis is mostly an intriguing sign that Big Data technology is steadily pushing beyond the Internet industry and scientific research into seemingly foreign fields like the social sciences and the humanities. The new tools of discovery provide a fresh look at culture, much as the microscope gave us a closer look at the subtleties of life and the telescope opened the way to faraway galaxies.


“Traditionally, literary history was done by studying a relative handful of texts,” says Mr. Jockers, an assistant professor of English and a researcher at the Center for Digital Research in the Humanities at the University of Nebraska. “What this technology does is let you see the big picture — the context in which a writer worked — on a scale we’ve never seen before.”


Mr. Jockers, 46, personifies the digital advance in the humanities. He received a Ph.D. in English literature from Southern Illinois University, but was also fascinated by computing and became a self-taught programmer. Before he moved to the University of Nebraska last year, he spent more than a decade at Stanford, where he was a founder of the Stanford Literary Lab, which is dedicated to the digital exploration of books.


Today, Mr. Jockers describes the tools of his trade in terms familiar to an Internet software engineer — algorithms that use machine learning and network analysis techniques. His mathematical models are tailored to identify word patterns and thematic elements in written text. The number and strength of links among novels determine influence, much the way Google ranks Web sites.


It is this ability to collect, measure and analyze data for meaningful insights that is the promise of Big Data technology. In the humanities and social sciences, the flood of new data comes from many sources including books scanned into digital form, Web sites, blog posts and social network communications.


Data-centric specialties are growing fast, giving rise to a new vocabulary. In political science, this quantitative analysis is called political methodology. In history, there is cliometrics, which applies econometrics to history. In literature, stylometry is the study of an author’s writing style, and these days it leans heavily on computing and statistical analysis. Culturomics is the umbrella term used to describe rigorous quantitative inquiries in the social sciences and humanities.


“Some call it computer science and some call it statistics, but the essence is that these algorithmic methods are increasingly part of every discipline now,” says Gary King, director of the Institute for Quantitative Social Science at Harvard.


Cultural data analysts often adapt biological analogies to describe their work. Mr. Jockers, for example, called his research presentation “Computing and Visualizing the 19th-Century Literary Genome.”


Such biological metaphors seem apt, because much of the research is a quantitative examination of words. Just as genes are the fundamental building blocks of biology, words are the raw material of ideas.


“What is critical and distinctive to human evolution is ideas, and how they evolve,” says Jean-Baptiste Michel, a postdoctoral fellow at Harvard.


Mr. Michel and another researcher, Erez Lieberman Aiden, led a project to mine the virtual book depository known as Google Books and to track the use of words over time, compare related words and even graph them.


Google cooperated and built the software for making graphs open to the public. The initial version of Google’s cultural exploration site began at the end of 2010, based on more than five million books, dating from 1500. By now, Google has scanned 20 million books, and the site is used 50 times a minute. For example, type in “women” in comparison to “men,” and you see that for centuries the number of references to men dwarfed those for women. The crossover came in 1985, with women ahead ever since.


In work published in Science magazine in 2011, Mr. Michel and the research team tapped the Google Books data to find how quickly the past fades from books. For instance, references to “1880,” which peaked in that year, fell to half by 1912, a lag of 32 years. By contrast, “1973” declined to half its peak by 1983, only 10 years later. “We are forgetting our past faster with each passing year,” the authors wrote.


JON KLEINBERG, a computer scientist at Cornell, and a group of researchers approached collective memory from a very different perspective.


This article has been revised to reflect the following correction:

Correction: January 27, 2013

An earlier version of this article misstated Matthew L. Jockers’s age. He is 46, not 48. 



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Italy’s New Tool for Tax Cheats: the ‘Redditometro’


Andrew Medichini/Associated Press


Financial police officers tracking tax evasion operations around Italy. Tax authorities now have the “redditometro,” which has drawn criticism though the nation is desperate for revenue.







ROME — Despite the government’s best efforts, tax evasion remains something of a pastime in Italy, where, famously, more than a few of the Ferrari-driving set claim impoverishment when it comes to declaring their incomes.




So this month, not without controversy, the National Revenue Agency decided to try a new tack. Rather than attempting to ferret out how much suspected tax cheats earn, the agency began trying to infer it from how much they spend.


The new tool, known as the “redditometro,” or income measurer, aims to minimize the wiggle room for evasion by examining a taxpayer’s expenditures in dozens of categories, like household costs, car ownership, vacations, gym subscriptions, cellphone usage and clothing. If the taxpayer’s spending appears to be more than 20 percent greater than the income he or she has declared, the agency will ask for an explanation.


In a country that is desperate for revenue to straighten out its ailing public finances — and where newspapers routinely publish articles about Lamborghini-loving proletarians — one might expect the redditometro to attract some support, at least among Italians who file truthful tax returns. Yet the redditometro has run into strong opposition, not least from the nation’s suffering retailers, who are worried that it will discourage consumer spending and sink their businesses further. Others have criticized it on civil rights grounds, saying it is overly intrusive.


However it is received, the measure reflects the government’s widening effort to persuade more Italians — some say, to bully them — to comply with the tax code.


“This tool is part of a broader strategy of tension, which is the real objective,” said Andrea Carinci, a professor of tax law at the University of Bologna. “Not to create panic, but to make taxpayers understand that they have to be virtuous, because there is no escaping. The revenue agency wants to give a message to frighten people.”


The message is being received.


Serena Sileoni, a legal expert with the Bruno Leoni Institute, an Italian research organization, said in an interview on Radio 24 that forcing taxpayers to keep receipts to document their spending amounted to “an act of psychological terrorism.”


Even before the redditometro was introduced, the Italian tax authorities had been steadily adopting tougher measures that have begun to bite. The financial police said last week that in 2012, they uncovered more than 8,600 full-blown tax evaders — individuals who were not in their files at all — with more than $30 billion in undeclared income. Another $23 billion in income that should have been declared on Italian tax returns was unearthed abroad, they said.


Even so, those figures represent a relatively small part of Italy’s tax collection shortfall. The national statistics agency estimates that as much as 18 percent of Italy’s gross domestic product comes from the underground economy; if taxes were paid on all of that money, the state would take in as much as $162 billion more each year.


When the redditometro was first presented in November, the tax authorities said that by their analyses, about one-fifth of all Italian households exhibited “contradictory results” in their returns. Such contradictions do not necessarily imply tax evasion, officials hastened to add, but they would be enough to warrant closer scrutiny in some cases.


The redditometro cross-checks spending against the type of household — say, young single adults, families with children, or retirees — as well as where the taxpayer lives. It also considers national averages for various kinds of spending, calculated by the national statistical agency, Istat.


Critics decry what they say is a presumption of guilt, and say the hunt for tax evaders is having a chilling effect on parts of the economy.


Sales of domestic sports cars and luxury autos plummeted last year, in part because of higher taxes and tighter tax scrutiny, industry experts say. Other big-ticket luxury goods are also suffering. “People feel under such scrutiny, they’re afraid — and that stops them from purchasing items that are seen as luxury goods,” said Raffaella Cortese, the owner of a gallery in Milan that specializes in contemporary art. “It’s paralyzing for our field.”


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The Media Equation: ‘South Park’ Creators Fortify Their Content Empire





When it comes to success stories in the entertainment world, it doesn’t get much better than the one about a pair of regular guys from Colorado, Matt Stone and Trey Parker, who took cutout paper dolls, animated them and triumphed on cable television, on the Web, at the multiplex and on Broadway.







Frederic J. Brown/Agence France-Presse — Getty Images

Matt Stone, left, and Trey Parker are forming a production company called Important Studios.







Last week, Mr. Stone arrived at a coffee shop in the Chelsea neighborhood of New York so bundled up that he resembled Kenny, who always shows up on “South Park” encased in a big orange parka. He was leaving the next day for London, where the fourth production of “The Book of Mormon” will soon begin a run.


Over the course of 16 seasons and 237 episodes, “South Park,” an assault on good taste built on the misadventures of four crudely animated and crudely spoken boys, has entered every pore of the culture. In the meantime, the two creators have helped put Comedy Central on the map, made four feature films, produced a sitcom and landed a Broadway hit with “Book of Mormon,” produced by Scott Rudin and Anne Garefino and created along with Robert Lopez.


Now Mr. Stone and Mr. Parker are about to finish a video game version of “South Park,” and they recently announced that they were forming a production company called Important Studios, valued at $300 million.


The success of “South Park” is a stark lesson in the fundamentals of entertainment: if you tell stories that people want to hear, the audience will find you.


This is true no matter how fundamentally the paradigms shift, or how many platforms evolve.


“We’ve been doing it long enough to figure out that content will ride on top of whatever wave comes along,” Mr. Stone said.


You might think that after all they’ve accomplished, they would be ready to step back a bit, and this is essentially true. Don’t worry, they aren’t going to actually kill Kenny, who is ritually sacrificed in every episode. But “South Park,” which generally has been produced in two batches of seven episodes for a total of 14 every year, will be cut back to a single run of 10 episodes, beginning on Sept. 25.


“Why did we do seven and seven to begin with?” Mr. Stone said. “We just sort of made that up. And we are switching to 10 for the same reason. It just sounded like a good number, and we won’t break up the year so we can more easily do other stuff.”


The change sounds casually tossed off, but there is nothing unformed about the thinking that drives their choices.


“There is no appointment viewing anymore,” Mr. Stone said.


“In our first season, you had to show up on Wednesday nights at 10 p.m. on the comedy channel to catch the show. Now, I don’t even know where or how people watch our show. We sort of don’t really care about ratings. It’s more important to come up with work that will add to the library in a way that we’re proud of and will make people want to catch the show wherever they want to.”


That could happen on Netflix, on iTunes, on an ad-supported streaming format on Hulu, or hosted by the servers in the Los Angeles offices of Mr. Stone’s and Mr. Parker’s company.


The two men had the prescience to negotiate a 50-50 split on all digital revenue with Comedy Central, and part of the reason they remain so engaged is that they have real participation in the “South Park” enterprise.


“We have always owned our stuff or acted like we do,” Mr. Stone said as he worked his way through a late lunch. He pointed to Louis C. K., the comedian who took his last comedy special directly to fans on the Web, as an example of an artist moving to the sweet spot of the business that she or he creates.


“Owning your own stuff means that you control not only the content, but the life you are living while you are producing it,” he said.


“And then, if things go well, you can be part of the upside.”


Mr. Stone thinks it’s silly for creators to rely only on outside financing. Why drop years of sweat equity into creating something but not invest any cold hard cash?


“It took us four years to work out ‘Book of Mormon,’ and when you think of the opportunity cost of that — other projects that we walked by — it would be sort of silly not to put money in,” he said.


E-mail: carr@nytimes.com;


twitter.com/carr2n



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