Patient factors play key role in emergency department imaging

Public release date: 25-Jun-2013
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Contact: Linda Brooks
lbrooks@rsna.org
630-590-7762
Radiological Society of North America

OAK BROOK, Ill. Despite concerns to the contrary, very little of the variation in Emergency Department (ED) imaging utilization is attributable to physician experience, training or gender, according to a new study published online in the journal Radiology.

Imaging exams like X-rays and CT scans are common in the ED. In 2010, slightly more than 47 percent of all ED visits in the United States had an imaging exam associated with them.

"Analyzing and understanding drivers of use of imaging in the ED is important for several reasons," said Christopher L. Sistrom, M.D., M.P.H., Ph.D., from the departments of radiology at Massachusetts General Hospital in Boston and the University of Florida in Gainesville, Fla. "There's a balance of cost and benefits to the patient, institution and payer, as well as the overarching issue of radiation exposure."

Previous studies have found substantial variation in imaging rates across and within EDs, suggesting different tendencies among physicians when ordering imaging. However, much of the existing research is limited, according to Dr. Sistrom.

"A lot of literature on imaging variability can lead to a false assumption that doctors are primarily responsible," he said. "The problem is that it is difficult to fully describe and quantify variability at the different levels it can occur."

In the new study, Dr. Sistrom and colleagues analyzed 88,851 ED visits during 2011 at Massachusetts General Hospital. They used an analytical tool known as hierarchical logistic regression to identify multiple predictors of the probability that imaging was ordered during a given visit.

"That's what makes our paper unique," Dr. Sistrom said. "Hierarchal modeling allows us to ask very specific questions about the relative contributions of various factors to imaging use."

The overall rate of imaging utilization in the Massachusetts General ED was 45.4 percent in 2011, similar to the 2010 national average of 47.2 percent. Analysis of the data revealed that physician-related factors like gender, experience and training did not correlate with imaging use.

"The key finding in our study is that doctors don't make much difference in imaging utilization," Dr. Sistrom said. "Our data showed that doctors are responsible for about one percent of the variability in probability of having an imaging exam during an ED visit."

Instead, patient and visit factors were the predominant predictors of the likelihood of imaging for a given ED visit. These factors include prior visit, referral source, arrival mode and clinical reason for the visit.

The workload of the ED was another significant factor in imaging use. When the ED was the least busy, the odds of low-cost imaging were 11 percent higher than the reference standard. A busier ED resulted in a tendency towards more high-cost imaging.

The new study shows that medical management efforts looking to reduce imaging utilization may be misguided in focusing on remediating ED physicians.

"To reduce imaging utilization, a lot of people in quality improvement and medical management might try to identify high outliers and punish them," Dr. Sistrom said. "In settings like the one we studied, that strategy won't get you anything but angry doctors."

###

"Use of Imaging in the Emergency Department: Physicians Have Limited Effect on Variation." Collaborating with Dr. Sistrom were Hannah J. Wong, Ph.D., Theodore I. Benzer, M.D., Ph.D., Elkan F. Halpern, Ph.D., Dante J. Morra, M.D., M.B.A., G. Scott Gazelle, M.D., M.P.H., Ph.D., Timothy G. Ferris, M.P.H., M.D., and Jeffrey B. Weilburg, M.D.

Radiology is edited by Herbert Y. Kressel, M.D., Harvard Medical School, Boston, Mass., and owned and published by the Radiological Society of North America, Inc.

RSNA is an association of more than 51,000 radiologists, radiation oncologists, medical physicists and related scientists promoting excellence in patient care and health care delivery through education, research and technologic innovation. The Society is based in Oak Brook, Ill. (RSNA.org)

For patient-friendly information on imaging exams, visit RadiologyInfo.org.

---

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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.

Public release date: 25-Jun-2013
[ | E-mail | Share ]

Contact: Linda Brooks
lbrooks@rsna.org
630-590-7762
Radiological Society of North America

OAK BROOK, Ill. Despite concerns to the contrary, very little of the variation in Emergency Department (ED) imaging utilization is attributable to physician experience, training or gender, according to a new study published online in the journal Radiology.

Imaging exams like X-rays and CT scans are common in the ED. In 2010, slightly more than 47 percent of all ED visits in the United States had an imaging exam associated with them.

"Analyzing and understanding drivers of use of imaging in the ED is important for several reasons," said Christopher L. Sistrom, M.D., M.P.H., Ph.D., from the departments of radiology at Massachusetts General Hospital in Boston and the University of Florida in Gainesville, Fla. "There's a balance of cost and benefits to the patient, institution and payer, as well as the overarching issue of radiation exposure."

Previous studies have found substantial variation in imaging rates across and within EDs, suggesting different tendencies among physicians when ordering imaging. However, much of the existing research is limited, according to Dr. Sistrom.

"A lot of literature on imaging variability can lead to a false assumption that doctors are primarily responsible," he said. "The problem is that it is difficult to fully describe and quantify variability at the different levels it can occur."

In the new study, Dr. Sistrom and colleagues analyzed 88,851 ED visits during 2011 at Massachusetts General Hospital. They used an analytical tool known as hierarchical logistic regression to identify multiple predictors of the probability that imaging was ordered during a given visit.

"That's what makes our paper unique," Dr. Sistrom said. "Hierarchal modeling allows us to ask very specific questions about the relative contributions of various factors to imaging use."

The overall rate of imaging utilization in the Massachusetts General ED was 45.4 percent in 2011, similar to the 2010 national average of 47.2 percent. Analysis of the data revealed that physician-related factors like gender, experience and training did not correlate with imaging use.

"The key finding in our study is that doctors don't make much difference in imaging utilization," Dr. Sistrom said. "Our data showed that doctors are responsible for about one percent of the variability in probability of having an imaging exam during an ED visit."

Instead, patient and visit factors were the predominant predictors of the likelihood of imaging for a given ED visit. These factors include prior visit, referral source, arrival mode and clinical reason for the visit.

The workload of the ED was another significant factor in imaging use. When the ED was the least busy, the odds of low-cost imaging were 11 percent higher than the reference standard. A busier ED resulted in a tendency towards more high-cost imaging.

The new study shows that medical management efforts looking to reduce imaging utilization may be misguided in focusing on remediating ED physicians.

"To reduce imaging utilization, a lot of people in quality improvement and medical management might try to identify high outliers and punish them," Dr. Sistrom said. "In settings like the one we studied, that strategy won't get you anything but angry doctors."

###

"Use of Imaging in the Emergency Department: Physicians Have Limited Effect on Variation." Collaborating with Dr. Sistrom were Hannah J. Wong, Ph.D., Theodore I. Benzer, M.D., Ph.D., Elkan F. Halpern, Ph.D., Dante J. Morra, M.D., M.B.A., G. Scott Gazelle, M.D., M.P.H., Ph.D., Timothy G. Ferris, M.P.H., M.D., and Jeffrey B. Weilburg, M.D.

Radiology is edited by Herbert Y. Kressel, M.D., Harvard Medical School, Boston, Mass., and owned and published by the Radiological Society of North America, Inc.

RSNA is an association of more than 51,000 radiologists, radiation oncologists, medical physicists and related scientists promoting excellence in patient care and health care delivery through education, research and technologic innovation. The Society is based in Oak Brook, Ill. (RSNA.org)

For patient-friendly information on imaging exams, visit RadiologyInfo.org.

---

[ | E-mail | Share ]

?

AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.

Source: http://www.eurekalert.org/pub_releases/2013-06/rson-pfp061813.php

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'Bing for Schools' tailors Microsoft's search engine to K-12, cuts ads and filters adult content

Bing is headed to the classroom in a more targeted form, with Redmond announcing this morning a new version of the engine dubbed "Bing for Schools." The initiative takes the standard Bing search engine and cuts all adverts in search, filters "adult content" (the specifications of that are murky) adds more privacy protection, and adds "specialized learning features to enhance digital literacy." Schools can opt in on a per-case basis, and if they do, that will enable the specialized version of Bing on an entire school's network. The program's kicking off "later this year," and interested parties can put their name in the hat right here. Should you like to see the full note introducing Bing for Schools from Microsoft's Bing Behavioral Scientist Matt Wallaert, we've dropped it just beyond the break.

Filed under: Internet, Software, Microsoft

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Source: Microsoft, Bing for Schools

Source: http://feeds.engadget.com/~r/weblogsinc/engadget/~3/PBq3SOb0DTs/

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Families skeptical of Pratt cancer study findings

HARTFORD, Conn. (AP) -- For jet engine maker Pratt & Whitney, a long-simmering dispute over worker illnesses was settled by a massive 11-year study that found no elevated risk of brain cancer at its plants. But for dead workers' relatives who first raised concerns years ago, the matter is far from closed.

Their next step hasn't been decided, and the choices are limited. Matt Shafner, a New London lawyer who represents families, said more than 90 workers' compensation claims have been filed. But he won't move forward until an independent review of the study is completed, he said.

"It's not over," said Carol Shea, whose husband, John Shea, worked at Pratt & Whitney's North Haven plant for 35 years and died of brain cancer in 2000 at age 56.

Some relatives of workers who died of brain cancer a decade or more ago are dissatisfied with the study, saying it failed to prove that the deaths of their loved ones were part of a broader problem.

Todd Atcherson, whose father, Charles Atcherson, died in 1998 after working at Pratt & Whitney for about 25 years, said the enormous scope of the study ? health and work records of more than 200,000 employees were reviewed ? fail to explain the deaths of his father and a small group of other workers at the North Haven plant.

"They skewed out the numbers so far, they lost focus of five people who worked in the same site and all died," he said.

Shea said she believes the researchers are "way off."

"I couldn't believe they couldn't come up with anything," she said.

The study, released last month, was launched "in response to the perception of an unusual occurrence" of glioblastoma, a common and aggressive malignant brain tumor, at the North Haven plant. It found the incidence rates of glioblastoma at the site weren't related to workplace exposures.

The environment at the plant featured a blue haze, a product of aerosol generated from metalworking fluids during fast, hot grinding.

The study, which examined seven other Pratt & Whitney plants in Connecticut, found no statistically significant elevations in the rate of cancer among workers. Researchers at the University of Pittsburgh and University of Illinois at Chicago said they identified 723 workers diagnosed with tumors between 1976 and 2004 at the subsidiary of United Technologies Corp.

The tumors were malignant, benign or unspecified and included 277 cases of brain cancer. Of those, 167 were at Pratt & Whitney's East Hartford site and 57 at North Haven, though North Haven workers were at greater risk of having brain cancer, the study said.

But following a study of the North Haven plant, researchers said they couldn't conclude that the environment or exposures were related to the overall elevations in brain cancer.

Gary Marsh, the University of Pittsburgh researcher who led the study, said that he understands family members' frustrations but that the study is conclusive and definitive.

"Let's face it: Brain cancer is a terrible disease and anyone who suffers from it or had a loved one suffer from it wants to know why they got that disease," he said. "We looked at everything conceivable as a possible cause of brain cancer."

Ray Hernandez, a spokesman for Pratt & Whitney, said the company is satisfied with the study's conclusions and considers the matter closed.

"Since we are confident in the scientific rigor of this comprehensive study, we think it provides the best possible information about this issue," he said in an emailed statement.

The study found no connection between brain cancer and the workplace and researchers found no patterns or trends of other causes of death "suggestive of a workplace relationship," Hernandez said.

In Connecticut, Pratt & Whitney over the years has shut down all but its Middletown and East Hartford plants. Manufacturing processes from decades ago have been transformed and haven't recently raised safety issues.

A few family members said they are wary of the study because it was commissioned by Pratt & Whitney at a cost of $12 million. The university researchers worked independently of Pratt & Whitney and the state Department of Public Health established an advisory group to review the progress, methods and other aspects of the study and address concerns about the study's independence.

John DeLeone, a grinding machine operator at the North Haven plant from 1984 until it closed in 2002, said workers suspected that chemicals specific to that plant were lethal. He criticized the study, which was launched in 2002 in response to concerns about employee deaths at North Haven, for being overly broad rather than focusing on that plant.

"It seemed that only people who got sick were those who transferred from North Haven," he said.

Marsh said the study adds to the body of knowledge of occupational health, used by researchers and relevant to other jet engine manufacturers, such as General Electric Co. and Rolls Royce, he said.

"We concluded there is no evidence of elevated health risks of this population. That's a good thing to know," he said.

But Debra Belancik, the Machinists' union's safety and health representative, said the study "doesn't bring any closure at all."

"All this work we did, all the high rates, all the funerals and wakes I went to, it kind of bothered me a little bit," she said.

Source: http://news.yahoo.com/families-skeptical-pratt-cancer-study-180254208.html

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'Mad Men's' Don Draper: Sexy, but so sad

TV

Anna Chan TODAY

10 hours ago

Michael Yarish / AMC

Don Draper found himself surrounded by people, yet all alone and sad, in the ninth episode of the season, titled "Better Half."

It's been a long, sad season for Don Draper on "Mad Men." It seemed almost every episode featured at least one shot of the handsome ad man brooding -- and in some cases, even shedding a tear or two.

What's he got to cry about, you say? We hear you: He's a rich, very successful, good-looking guy with a gorgeous wife. As far as viewers can see, he's still got his health too. (At least, we think so. His liver hasn't started failing from all that drinking yet, right?) So why the long face, Don?

Turns out maybe we should cut the guy a little slack. Money and good looks can't buy happiness, after all. (Just a lot of other stuff that makes life a bit easier.)

Dumped
Nobody tells Don Draper what's what! Unless you're his neighbor/mistress, apparently. In the episode titled "Man With a Plan," the ad man does his own version of "50 Shades of Grey" and orders lover Sylvia to stay in her hotel room all day (although it felt more like days), even taking away her book at one point. By the end of that ordeal, she'd had an epiphany and dumped him. His response? Disbelief. Sad face. Begging. And later, more begging on the phone.

Who are you?
Daughter Sally delivered a knife to Don's -- and viewers' -- hearts this year. After the Draper residence is burgled while the adults are away and Sally was left behind to watch her little brothers, she explained to Don why she was duped into believing the thief -- a black woman -- was her grandma. "She said she knew you," Sally told her dad on the phone later. "I asked her everything I know and she had an answer for everything. Then I realized I don't know anything about you." Sad, ponderous face.

All by himself
Don's often surrounded by people, whether he's at the office, having a meal with clients or enjoying a little tryst with someone. When he hooked up with ex-wife Betty while visiting son Bobby at camp, he admitted that he'd missed her, hinting at how unhappy he is in his current marriage. "Why is sex the definition of being close to someone?" he asked. Her reply? "I don't know. But it is for me, it is for most people." Cue the sad face. And by the next morning, they were miles apart again. As Don headed into the diner for breakfast, he saw Betty sitting with her husband, Henry ... and Don shuffled off to sit alone.

Drowning
After smoking some hashish at a Hollywood party, Don started to hallucinate first the happy, then the sad. The vision of a pregnant Megan came to him first, then Dinkins, the soldier he met in the season premiere. Except now, the young man is missing an arm -- and is dead. "Dying doesn't make you whole," Dinkins told Don when asked why the deceased vet was still missing his appendage in the afterlife. "You should see what you look like." And what does the ad man look like? Depressed. And dead. Floating in a pool face-down dead. But fortunately for him, the dead part was a hallucination, but he really was drowning in the pool until Roger dove in and saved him.

Busted
When Don finally got caught cheating with Sylvia, it wasn't by who viewers -- or Don himself -- were probably expecting. It was Sally who walked in on the two lovebirds. This sent Don first into panic mode, which eventually morphed into depression. It became obvious two episodes later, when Don started out the penultimate episode of the season curled up in a fetal position on Sally's bed, and ended the hour the same way, realizing that his actions have cost him a relationship with his little girl.

What Sunday's finale holds for Don's happiness, you'll have to tune in and see at 10 p.m. on AMC.

Source: http://www.today.com/entertainment/mad-mens-don-draper-sexy-successful-so-sad-6C10367555

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Zimmerman judge: No testimony on 911 call screams

SANFORD, Fla. (AP) ? The judge in the murder trial of George Zimmerman said Saturday that prosecution audio experts who point to Trayvon Martin as screaming on a 911 call moments before he was killed won't be allowed to testify at trial.

The screams are crucial pieces of evidence because they could determine who the aggressor was in the confrontation before Zimmerman fatally shot the unarmed teenager. Martin's family contends it was the teen screaming, while Zimmerman's father has said it was his son.

Judge Debra Nelson ruled that the methods used by the experts aren't reliable. But her ruling doesn't prevent the 911 calls from being played at trial.

She reached the decision after hearing arguments that stretched over several days this month on whether to allow testimony from two prosecution experts. One expert ruled out Zimmerman as the screamer and another said it was Martin. Defense experts argued there was not enough audio to determine who the screams are coming from. Zimmerman's attorneys also argued that the state experts' analysis is flawed.

Opening statements are set for Monday in the second-degree murder trial for the former neighborhood watch volunteer who says he fired on the black teenager in self-defense last year. Zimmerman is pleading not guilty.

The elimination of the audio experts will likely shorten the trial by a week. Before the ruling, attorneys had predicted the trial could last two to four weeks after opening statements.

A spokeswoman for prosecutors didn't immediately return an email Saturday.

Audio experts from both sides testified at different times during the hearing, which stretched over three weeks. Voice experts were hired by lawyers and news organizations to analyze the calls, which were made during the confrontation between the two. The experts arrived at mixed conclusions.

In deciding whether to admit the voice-recognition technology used by prosecution audio experts Tom Owen and Alan Reich, Nelson had to determine whether it is too novel or whether it has been accepted by the scientific community at-large.

"There is no evidence to establish that their scientific techniques have been tested and found reliable," the judge said in her ruling.

Owen was hired by the Orlando Sentinel last year to compare a voice sample of Zimmerman with screams for help captured on 911 calls made by neighbors. He said Zimmerman's voice doesn't match the screams. He only compared Zimmerman's voice to the 911 calls because he didn't have a voice sample for Martin at the time.

"The screams don't match at all," Owen testified during the hearing. "That's what tells me the screams aren't George Zimmerman."

Owen also testified that remarks Zimmerman made in a conversation with a police dispatcher aren't a racial slur. He testified Zimmerman said, "These f------ punks."

Reich testified in a report for prosecutors that the screams on the 911 tapes were from Martin, and the defense does not want him to testify at trial.

Reich's analysis also picked up words that other experts couldn't find. They include the words, "This shall be" from Zimmerman and "I'm begging you" from Martin.

Reich's testimony would "confuse issues, mislead the jury," the judge said.

In contrast, a British audio expert testified for the defense that it would be extremely difficult to analyze voices by comparing screaming to a normal voice.

"I've never come across a case in my 13 years where anybody's tried to compare screaming to a normal voice," said audio expert Peter French.

A second audio expert for the defense, George Doddington, also criticized prosecution experts who said Friday that screams and pleas on a 911 recording likely belonged to Martin.

"It's all ridiculous," Doddington said.

___

Follow Kyle Hightower on Twitter at http://www.twitter.com/khightower .

Follow Mike Schneider on Twitter at http://twitter.com/MikeSchneiderAP .

Source: http://news.yahoo.com/zimmerman-judge-no-testimony-911-call-screams-173730410.html

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Government on offensive outside Syria's capital

BEIRUT (AP) ? Syrian government forces stepped up their attack against rebel strongholds north of the capital Damascus on Saturday, while opposition fighters declared their own offensive in the country's largest city Aleppo.

Both sides intensified operations as an 11-nation group that includes the U.S., dubbed the Friends of Syria, began meeting in Qatar to discuss how to coordinate military and other aid to the rebels seeking to oust Syrian President Bashar Assad.

Friends of Syria agreed on Saturday to do more to help the embattled rebels trying to overthrow Assad, U.S. Secretary of State John Kerry said. While he offered no specifics about stepped-up military and humanitarian aid, Kerry said the assistance would help change the balance on the battlefield.

Kerry also denounced Assad for inviting Iranian and Hezbollah fighters to fight alongside his troops, saying the Syrian president risked turning the civil war into a regional sectarian conflict.

The fighting in Damascus came as the Syrian government announced salary increases to state employees and members of the military, days after the Syrian currency dipped to a record low of 210 pounds to the dollar compared with 47 when the crisis began more than two years ago. The raise also covered pensions.

The Britain-based Syrian Observatory for Human Rights, which relies on an extensive network of activists in Syria, said the shelling of the district of Qaboun has killed three children, including two from the same family, since Friday.

Activists reported heavy shelling on many fronts on districts north of Damascus, apparently an attempt to cut links between rebel-held districts that have served as launching pads for operations against the capital.

The Lebanese TV station Al-Mayadeen, which had a reporter embedded with Syrian government forces in the offensive, quoted a military official as saying that the operation aims to cut rebel supply lines, separate one group from another, and secure the northern entrances to the capital. The regime's forces have struggled for months to regain control of these suburbs.

The Observatory said the neighborhood was being attacked from several different sides, while the shelling has caused structural damage and started fires. Activists from Qaboun posted on Facebook that government forces had brought up new tanks to reinforce its positions outside the neighborhood, and the bombardment had brought buildings down.

The Observatory said rebels targeted a police academy in the nearby Barzeh area Saturday, pushing back against a government attempt to storm the neighborhood. One rebel was killed in overnight fighting, it said.

State news agency SANA said troops "inflicted heavy losses" among rebels in several suburbs of Damascus.

A recent declaration by the U.S. that it had conclusive evidence that President Bashar Assad's regime used chemical weapons on a small scale against opposition forces prompted Washington to authorize the arming of rebels, a major shift in policy. The decision also followed advances by the government forces aided by fighters from Lebanon's Hezbollah.

Rebels say they have already received new weapons from allied countries? but not the U.S. ? that they claim will help them to shift the balance of power on the ground. Experts and activists said the new weapons include anti-tank missiles and small quantities of anti-aircraft missiles.

It was not clear if any of the new weapons have made it to the Damascus area. A spokesman for one of the main groups fighting outside of Damascus, the al-Islam brigade, said his group had none of the new weapons. The spokesman, who declined to be named for fear of government reprisals, spoke to The Associated Press through Skype.

He said government forces were shelling Barzeh from Qasioun mountain overlooking Damascus. Syria's main Western-backed opposition group said Thursday that 40,000 civilians in the two northern districts of Damascus are suffering from shortages of food and medical supplies.

Rebels and government also clashed in and around the northern city of Aleppo, where government forces announced an offensive earlier this month. Activists said troops clashed in the southern neighborhoods of Rashideen and Hamdaniya and in the western suburbs.

The Observatory said rebels pounded a military academy in the area, causing a fire in the compound. There were no immediate reports of casualties. In Rashideen, rebel forces have pushed government forces out from parts of the neighborhood, according to the local Aleppo Media Center network and posts on Facebook.

A statement by a coalition of rebel groups, posted on the Center's page, declared that the fighters are launching a new operation to seize control of the western neighborhoods of Aleppo. Amateur showed what appeared to be intense government shelling of villages in the area.

On Saturday, a dozen shells from Syrian forces landed in a northern Lebanese border town, some landing near homes, causing a panic among residents, the Lebanese news agency reported.

Syria's official news agency said government troops were targeting a group of infiltrators across the border. It gave no further details.

Rockets from Syria fall regularly into towns and villages near the border. On Friday, a rocket slammed into a suburb of Beirut, bringing the war closer to Lebanon's bustling capital, the second in less than a month. No one claimed responsibility for that attack, but rebels in Syria have vowed to retaliate against Hezbollah's Beirut strongholds for its increasingly active role assisting Assad.

In Damascus, a presidential decree said that the raise for the public sector could reach up to 40 percent depending on the salary of the civil servant. Pensions could rise by up to 25 percent, according to the decree.

It said those who make 10,000 pounds ($54) a month will get a 40 percent raise, while who make double that amount will get a 20 percent boost. People making 40,000 pounds a month will get a 5 percent raise, it said.

Syria's 2-year civil war has killed nearly 93,000 people. It increasingly pits Sunni against Shiite Muslims and threatening the stability of Syria's neighbors.

Source: http://news.yahoo.com/government-offensive-outside-syrias-capital-113710792.html

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Obama to meet with privacy, civil liberties board

FILE - This Sept. 19, 2007 file photo shows the National Security Agency building at Fort Meade, Md. As many as one of every five worldwide terror threats picked up by U.S. government surveillance has been targeted on the United States, the Obama administration says. But officials are reluctant to say much more about the 50 plots they claim have been thwarted. (AP Photo/Charles Dharapak, File)

FILE - This Sept. 19, 2007 file photo shows the National Security Agency building at Fort Meade, Md. As many as one of every five worldwide terror threats picked up by U.S. government surveillance has been targeted on the United States, the Obama administration says. But officials are reluctant to say much more about the 50 plots they claim have been thwarted. (AP Photo/Charles Dharapak, File)

WASHINGTON (AP) ? President Barack Obama is holding his first meeting with a privacy and civil liberties board Friday as he seeks to make good on his pledge to have a public discussion about secretive government surveillance programs.

Obama has said the little-known Privacy and Civil Liberties Oversight Board will play a key role in that effort. The federal oversight board reviews anti-terror programs to ensure that privacy concerns are taken into account.

The president is also tasking the director of national intelligence, James Clapper, to consider declassifying more details about the government's collection of U.S. phone and Internet records. Obama is specifically asking Clapper to review possible declassification of opinions from the Foreign Intelligence Surveillance Court, which approves the surveillance efforts.

Obama's meeting with the board was taking place Friday afternoon, but the White House wasn't planning to allow press coverage. White House spokesman Jay Carney said the meeting would take place in the White House Situation Room "to allow for the discussion of classified matters."

"It's certainly more than a get-to-know-you session," Carney said.

The government has already lifted some of the secrecy surrounding the programs following disclosures earlier this month about their existence by former National Security Agency contractor Edward Snowden. But the legal opinions from the highly secretive court remain private.

The privacy board was created in 2004 but has operated fitfully ever since, given congressional infighting and at times, censorship by government lawyers. The board was dormant during Obama's first term and only became fully functional in May, before the NSA programs became public.

The board's chairman, David Medine, said the five-member group has a "broad range of questions" to ask about the NSA's widespread collection programs. The board was given a classified briefing on the programs last week and plans to release a report eventually with recommendations for the government.

___

Follow Julie Pace at on Twitter at http://twitter.com/jpaceDC

Associated Press

Source: http://hosted2.ap.org/APDEFAULT/3d281c11a96b4ad082fe88aa0db04305/Article_2013-06-21-US-Obama-NSA-Surveillance/id-58d9b156ed3940178eed3a3235c0527a

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Obama: Time for excuses on immigration is over

WASHINGTON (AP) ? Declaring "the time for excuses is over," President Barack Obama is trumpeting the economic benefits of an immigration overhaul, arguing that a bipartisan bill picking up steam in the Senate would put the nation's loathed deficits and fragile entitlements on better footing.

A recent analysis from the Congressional Budget Office, lawmakers' nonpartisan scorekeeper, was Exhibit A in Obama's weekly radio and Internet address Saturday. The report shows deficits would fall nearly $1 trillion over two decades after the bill becomes law.

What's more, Obama said, the influx of immigrant-driven investment, technology and businesses would give the economy a 5 percent shot in the arm.

"This bipartisan, common-sense bill will help the middle class grow our economy and shrink our deficits, by making sure that every worker in America plays by the same set of rules and pays taxes like everyone else," he said.

Confidence that the overhaul could pass the Senate by impressive margins is growing, and leaders scheduled a test vote on the bill for Monday, with a final vote expected by the end of next week. Although the heart of the bill is a 13-year pathway to citizenship for millions living in the United States illegally, it was a military-style surge to U.S.-Mexican border security, added this week to placate wary Republicans, that was credited for giving the bill a much-needed boost.

Obama didn't specifically address the border amendment Saturday, but he did note that the bill "would continue to strengthen security at our borders." Despite concerns from some Democrats that the security provisions ? 20,000 new agents, 350 miles of new fencing, 18 new unmanned drones ? are overkill, Obama spokesman Jay Carney said Friday it would constitute a "breakthrough" that the White House applauded.

"The bill isn't perfect. It's a compromise," Obama said, reprising a line he's used throughout the process when Democrats have complained the bill has become too conservative. "But it's consistent with the principles that I and others have laid out."

In the Republican address, Rep. John Kline of Minnesota says Obama must show leadership to avoid an impending hike on student loan interest rates. He said it's fortunate that Obama and House Republicans agree on the issue and have both proposed plans that would tie interest rates to the market. He accused Senate Democrats of blocking each plan.

"If I didn't know any better, I would say they are content to let rates double," Kline said. "This eleventh-hour scrambling is a perfect demonstration of why we need to take the politics out of student loans once and for all."

___

Online:

Obama address: www.whitehouse.gov

GOP address: www.youtube.com/HouseConference

Source: http://news.yahoo.com/obama-time-excuses-immigration-over-100152943.html

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AdoptUSKids.org Celebrates 20,000 Foster Children Adopted Through Website (INFOGRAPHIC)

WASHINGTON -- Federal officials say 20,000 foster children have been adopted after being listed on a national website that links adoptive families with kids.

The number is especially significant because the majority of those adopted were not infants, but many were teens, minorities and those with disabilities.

Health and Human Services Secretary Kathleen Sebelius praised the efforts, but said Thursday that many more children still need permanent homes. More than 100,000 of the country's roughly 400,000 foster kids are looking for adoptive families.

The website, AdoptUSKids.org, gives prospective parents background information and a photo of each child. Once a parent indicates an interest, the website connects them with the child's caseworker.

Actor Bruce Willis was the face of the campaign when President George W. Bush launched it in 2002.

___

Online: http://www.adoptuskids.org/

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Source: http://www.huffingtonpost.com/2013/06/22/adoptusekids-200000-kids-adopted_n_3481754.html

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What a new jumbo particle reveals about extreme matter

We're used to scientists making ever bigger atoms. Now it seems subatomic particles can be pushed to similar extremes to create new forms of matter. Researchers at two particle detectors reported on Monday the strongest evidence yet for a particle made of more than three quarks, the subatomic building blocks of matter. What does that mean for understanding of matter ? and why does that matter? New Scientist investigates

What is matter made of?
Quarks are the fundamental building blocks and come in six "flavours" ? up, down, strange, charm, bottom and top. Ordinarily, they combine in threes to form particles like neutrons and protons: two ups and one down make a proton, while two downs and one up make a neutron. Neutrons and protons make up atomic nuclei, which combine with electrons to form atoms, which link up to make molecules.

What's the maximum number of quarks that can clump together?
The theory that describes how quarks stick together, quantum chromodynamics is disappointingly mum on this, leaving physicists reliant on observations. While quarks can also pair up to form particles such as kaons and pions, no particle had ever been found to contain more than three quarks.

Eric Swanson of the University of Pittsburgh in Pennsylvania, who was not involved in the new research, describes the hunt to find particles made of ever more quarks as looking for a horse with more than four legs. "There's nothing in nature that says you can't have an eight-legged horse, but we've never seen one," he says. "If someone found an eight-legged horse, you'd say 'Oh, that's interesting!' Then you'd want to fit it into your evolutionary theory."

What had people come up with in the past?
Various experiments have been vying to find the particle equivalent of an eight-legged horse. In 2003, results from the Belle Collaboration at the High Energy Accelerator Research Organization in Tsukuba, Japan, hinted at the existence of a pentaquark, but that was ruled out two years later. After that, focus shifted to the possibility of a tetraquark, with multiple potential candidates for such a structure, most recently in 2010.

What's special about the latest discovery?
On 17 June, Belle and the BESIII Collaboration at the Beijing Electron Positron Collider in China each independently reported evidence for the same particle, unromantically called Z_c(3900), made of four quarks. The fact that two teams saw what looks like the same combination ? as well as the number of instances of the particle seen by each team ? makes this the strongest evidence yet for a structure made of more than three quarks. "This discovery clearly indicates that there is a new particle, which may combine quarks in a way not seen before," says Hisaki Hayashii of the Belle collaboration.

Does any other structure fit the observations?
Rather than being a single particle, Z_c(3900) could also be the subatomic equivalent of a molecule, made of two particles orbiting each other. The new particle could actually be two D-mesons that form a loosely bound state called a hadron molecule.

"That would also be a new form of matter," Swanson says, although it's less exotic than a new kind of proton ? more like discovering a platypus than an eight-legged horse.

In either case, Z_c(3900) should help us to better understand how the strong force binds quarks into larger objects, says Ryan Mitchell of Indiana University.

So when will we know whether it's a platypus or an octo-horse?
So far, the two experiments have seen a combined total of 466 instances of the Z_c(3900) particle. They'll need between 10 and 100 times more sightings to be able to tell enough about it to distinguish between the two options, says Belle team member Leo Piilonen of Virginia Tech in Blacksburg.

Will that lead to new understanding of matter?
It could lead to a better understanding of quantum chromodynamics. That could, in turn, help us understand the exotic states of matter inside neutron stars or in the very early universe, Swanson says. Neutron stars have cores so dense that atomic nuclei dissolve into a neutron-rich soup, but no one knows exactly how matter behaves under these extreme conditions. Finding out could help us understand how stars evolve and how matter gets distributed throughout the universe.

Journal references: Physical Review Letters, DOI: 10.1103/PhysRevLett.110.252001 and 10.1103/PhysRevLett.110.252002

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Uncovering quantum secret in photosynthesis

June 20, 2013 ? The efficient conversion of sunlight into useful energy is one of the challenges which stand in the way of meeting the world's increasing energy demand in a clean, sustainable way without relying on fossil fuels. Photosynthetic organisms, such as plants and some bacteria, have mastered this process: In less than a couple of trillionths of a second, 95 percent of the sunlight they absorb is whisked away to drive the metabolic reactions that provide them with energy. The efficiency of photovoltaic cells currently on the market is around 20 percent. What hidden mechanism does nature use to transfer energy so efficiently?

Various research groups around the world have shown that this highly efficient energy transport is connected to a quantum-mechanical phenomenon. However, until now, no one had directly observed the possible impacts of such a quantum transport mechanism at work at room temperature.

In an article published in the journal Science, researchers from ICFO- Institute of Photonic Sciences, in collaboration with biochemists from the University of Glasgow, have been able to show for the first time at ambient conditions that the quantum mechanisms of energy transfer make phyotosynthesis more robust in the face of environmental influences. The quantum phenomenon responsible, known as coherence, is manifested in so-called photosynthetic antenna proteins that are responsible for absorption of sunlight and energy transport to the photochemical reaction centers of photosynthesis.

In order to observe quantum effects in photosynthesis, the research group led by Niek van Hulst developed a pioneering experimental technique. Energy transport during photosynthesis is extremely fast and takes place at a molecular scale. To observe these processes they pushed the ultrafast spectroscopy techniques to the single-molecule limit. This involves sending ultrafast femtosecond light flashes to capture a high-speed series of 'pictures' of the states of individual antenna proteins after light absorption (during one femtosecond light travels only one hundredth of the diameter of a human hair, while in one second it travels from earth to moon). With these "snapshots" the researchers are able to understand how solar energy is transported through single proteins. "We have been able to observe how energy flows through sunlight absorbing photosynthetic systems with unprecedented spatial and temporal resolution. This allowed us to observe the fundamental role of quantum effects in photosynthesis at ambient conditions" explains Richard Hildner, first author of the publication.

Van Hulst and his group have evaluated the energy transport pathways of separate individual but chemically identical, antenna proteins, and have shown that each protein uses a distinct pathway. The most surprising discovery was that the transport paths within single proteins can vary over time due to changes in the environmental conditions, apparently adapting for optimal efficiency. "These results show that coherence, a genuine quantum effect of superposition of states, is responsible for maintaining high levels of transport efficiency in biological systems, even while they adapt their energy transport pathways due to environmental influences" says van Hulst.

The results presented raise fascinating questions. Was the exploitation of quantum effects in photosynthesis driven by evolution to achieve the extraordinary efficiencies, or in other words did quantum transport outcompete other mechanisms during evolution? Are there other biological processes in which quantum effects play an important role? In the case of light-harvesting proteins quantum transportation allows extreme transport energy efficiency and robustness. This discovery could lead to new research lines aiming at the developments of a new generation of solar cells that mimic these quantum coherences for efficient energy transfer.

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Story Source:

The above story is reprinted from materials provided by ICFO-The Institute of Photonic Sciences, via EurekAlert!, a service of AAAS.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

---

Journal Reference:

1. R. Hildner, D. Brinks, J. B. Nieder, R. J. Cogdell, N. F. van Hulst. Quantum Coherent Energy Transfer over Varying Pathways in Single Light-Harvesting Complexes. Science, 2013; 340 (6139): 1448 DOI: 10.1126/science.1235820

Note: If no author is given, the source is cited instead.

Source: http://feeds.sciencedaily.com/~r/sciencedaily/strange_science/~3/b4exqHgZMzg/130620142932.htm

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Watch for an Apple Sneak Attack on Living Room Gaming

How could Apple possible take on Microsoft's Xbox One and Sony's PS4? Sneakily. The Apple TV doesn't have to be the hardware processing brains of the gaming system -- your iPhone or iPad or Mac could be the processor, which is, when you think about it, the ultimate console gaming sneak attack. Boom. New rules for gaming in the living room.

Despite all the cool updates Apple promised to bring the world at its Worldwide Developers Conference -- iOS 7, OS X Mavericks, a new Mac Pro -- the most tantalizing new possibility wasn't described at all: games. Gaming. An Apple-made gaming console. A new vision for living room gaming delivered via home WiFi and an Apple TV. Since Apple wasn't out there on the stage talking about this specifically, why bother diving into the vaporous chance of a new class of Apple living room product now?

Two reasons: One, the lackluster and downright silly Anki Drive demonstration; and two, Apple released to its developer partners a new game controller framework with instructions and stipulations for building a physical game controller. If you're an Apple developer, you can access the document here.

These two essentially isolated events could mean everything or nothing, but this I know: If I were Microsoft or Sony trying to launch a snazzy and expensive new game console late this year before the holiday season, the thing I'd fear most is any Apple product that puts a physical gamepad in the hands of kids -- and worse yet, lets them gather around an HDTV in the living room.

What's Going On in Front of the Couch

There is so much going on right now in the space between your couch and your HDTV that it's hard to find a place to start. First, let's describe the landscape. Microsoft and Sony produce the popular Xbox 360 and PS3 dedicated gaming consoles.

Microsoft has been transforming its 360 console from a game-playing device into a television, movie, and music playing set-top box. If it weren't so clunky and hampered by Microsoft interface design and desperate attempts to squeeze revenue through its disingenuous Xbox Live system , it would be used by everyone in the household instead of Minecraft-playing tweeners.

Sony does better in international markets than in the U.S., where the Xbox 360 reigns, but the Sony ecosystem lacks vision and vitality. Its core reputation starts and ends with smart, dedicated console gamers.

Both companies will launch their next-generation powerhouse gaming consoles late this year in time for holiday sales .

Microsoft's Xbox One starts at US$499 and includes a mandatory Kinect so your gaming console can watch you move and speak, see your skin flush with excitement or fear, and generally give you a futuristic way to interact with your TV viewing and game playing. Sounds cool until you realize you have to trust Microsoft, which is hard to do.

Have you ever tried to disengage a credit card from your Xbox Live account without entering in a new credit card? There's a reason Microsoft doesn't make this easy, and it isn't a technical challenge a multibillion dollar corporation can't figure out. Oh, and by the way, your Xbox One requires an always- on Internet connection. If you lose your Internet connection for more than 24 hours, no more game playing for you. And used game sales? Ha ha. The hoops a player will have to jump through are many, small in diameter, and on fire.

Microsoft does have Xbox Live, which it is constantly enhancing with new apps and services, including SmartGlass that extends the Xbox Live world to and from smartphone and tablet screens. If you're cool with constantly sending money to Microsoft, the Xbox world will let you play all day and night.

Sony, on the other hand, isn't trying to control your entire world, won't impose wild DRM restrictions on pre-owned games, doesn't force the PS4 to call home or threaten to deactivate, costs $100 less ($399), and has a good library of titles to play. The problem with Sony is that it's next-generation console is a predictable, safe, old-school solution with a better haircut and faster running shoes.

Back to Apple

Most of the Apple TV hoopla has been centered on movies and TV shows, on figuring out how to replace cable and satellite television with something better, in addition to the notion that Apple could build a prettier big-screen HDTV worthy of a placing upon a pedestal of worship.

I've got problems with that.

First, I doubt Apple can shake loose the TV and movie industry from their traditional delivery models -- at least, not any time soon. There's just too much money tied up in broadcast television, hundreds of cable channels and commercials. Second, I doubt Apple can produce an HDTV that's price competitive. So, instead of a hobby, Apple would be heading toward an expensive hobby.

Unless it figures out living room gaming.

The Sneaky Backside Beatdown

Apple's iOS has already proven itself to be a freakishly popular gaming system, both due to its touch controls and despite them. The iOS gaming library is fantastically huge and has titles for every age group -- from toddlers learning ABCs to grandmothers playing Words with Friends. There are action titles, dark and scary thinker games, and even a version of Minecraft, which is both a travesty as well as a triumph of creative purity.

Apple has hundreds of thousands of developers and Apple has millions of screens.

The only thing Apple really needs is the connective glue -- the method for taking iPad, iPod touch, and iPhone games and screens and applying them to the land of dark carpeted basements.

There are multiple ways this could happen, and all of them would take a bite out the Xbox One and PS4.

First, Apple could beef up its Apple TV with a bigger processor and storage capabilities, letting customers buy and store games directly on the Apple TV. Personally, I'd like to see this, even at a price point approaching $499. The Apple TV is amazingly simple but woefully underpowered when it's time to explore the living room.

Plus, it needs a controller. Of course, you don't have to use the cute little aluminum remote control -- you can use an app on your iPad or iPhone. Nice. Even today, you can AirPlay games from your little iPhone to your HDTV via an Apple TV. The problem? Tactile feedback. You don't have it with a touchscreen. What else? The point. Why look at a big screen TV if you need to touch and tap your way along while navigating a screen to play many iOS games? Why not just look at the bright little screen?

A smarter Apple TV could connect multiple players, locally or remotely, to an Apple TV screen for new forms of collaborative game play.

Even simpler than this would be creating a set of controllers -- game pads -- that would let a gamer slip either an iPad or iPod into the controller and dive into a fast-paced action adventure using tactile controls. For an iPad, having a wireless traditional-style controller gamepad would permit you to easily play a game from your Mac's screen. . . or while watching an iPad on a stand. . . or while AirPlaying the iPad screen to your HDTV.

If you're following all this, it means the Apple TV doesn't have to be the hardware processing brains of the gaming system -- your iPhone or iPad or Mac could be the processor, which is, when you think about it, the ultimate console gaming sneak attack. Boom. New rules for gaming in the living room.

The cost of entry would be slow and incremental, and it's something inherently portable. Something that parents intuitively understand because they're already packing iPhones.

Once Apple has the mindshare, the magic of the Apple ecosystem will do the rest. The consoles will collect dust.

Why do I think this is moving from possible to likely?

For starters, Apple CEO Tim Cook shared the stage with Anki, which showed off a next-generation artificial intelligence game system where little cars drove themselves. . . and the brains were locked up in iOS devices. The prototype game was stupid, expensive, and more of an exercise in AI and robotics than anything any large number of people would ever buy. Still, Cook let them have the stage for a reason.

Then there are the APIs and specifications for third-party controllers. If Apple provides a consistent format for high-quality, simple-to-use controllers that will let you run iOS apps and games and enjoy them on your HDTV, the living room landscape will never look the same.

---

MacNewsWorld columnist Chris Maxcer has been writing about the tech industry since the birth of the email newsletter, and he still remembers the clacking Mac keyboards from high school -- Apple's seed-planting strategy at work. While he enjoys elegant gear and sublime tech, there's something to be said for turning it all off -- or most of it -- to go outside. To catch him, take a "firstnamelastname" guess at WickedCoolBite.com.

Source: http://www.technewsworld.com/rsstory/78319.html

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Michael Douglas: Oral Sex Caused My Throat Cancer | Gossip Cop

Michael Douglas The Guardian

12:02 pm, June 2nd, 2013

(GettyImages.com)

Michael Douglas makes a startling admission about his throat cancer in a new interview, saying his battle with the disease was caused by oral sex.

Asked if he regretted drinking and smoking for years prior to his 2010 diagnosis, Douglas tells The Guardian, ?No. Because without wanting to get too specific, this particular cancer is caused by HPV [human papillomavirus], which actually comes about from cunnilingus.?

?I did worry if the stress caused by my son?s incarceration didn?t help trigger it,? says the Behind the Candelabra star,??but yeah, it?s a sexually transmitted disease that causes cancer.?

Douglas went on to joke,??And if you have it, cunnilingus is also the best cure for it.?

Studies in recent years have, in fact, shown an increased link between oral sex and cancer, particularly among men, who aren?t usually vaccinated against HPV.

Douglas is now cancer-free.

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Source: http://www.gossipcop.com/michael-douglas-oral-sex-caused-throat-cancer-cause-hpv-human-papillomavirus-cunnilingus/

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