A delicate new balancing act in senior healthcare

When Claire Gordon arrived at Cedars-Sinai Medical Center, nurses knew she needed extra attention.

She was 96, had heart disease and a history of falls. Now she had pneumonia and the flu. A team of Cedars specialists converged on her case to ensure that a bad situation did not turn worse and that she didn't end up with a lengthy, costly hospital stay.

Frail seniors like Gordon account for a disproportionate share of healthcare expenditures because they are frequently hospitalized and often land in intensive care units or are readmitted soon after being released. Now the federal health reform law is driving sweeping changes in how hospitals treat a rapidly growing number of elderly patients.

The U.S. population is aging quickly: People older than 65 are expected to make up nearly 20% of it by 2030. Linda P. Fried, dean of the Columbia University Mailman School of Public Health, said now is the time to train professionals and test efforts to improve care and lower healthcare costs for elderly patients.

"It's incredibly important that we prepare for being in a society where there are a lot of older people," she said. "We have to do this type of experiment right now."

At Cedars-Sinai, where more than half the patients in the medical and surgical wards are 65 or older, one such effort is dubbed the "frailty project." Within 24 hours, nurses assess elderly patients for their risk of complications such as falls, bed sores and delirium. Then a nurse, social worker, pharmacist and physician assess the most vulnerable patients and make an action plan to help them.

The Cedars project stands out nationally because medical professionals are working together to identify high-risk patients at the front end of their hospitalizations to prevent problems at the back end, said Herb Schultz, regional director of the U.S. Department of Health and Human Services.

"For seniors, it is better care, it is high-quality care and it is peace of mind," he said.

The effort and others like it also have the potential to reduce healthcare costs by cutting preventable medical errors and readmissions, Schultz said. The federal law penalizes hospitals for both.

Gordon, an articulate woman with brightly painted fingernails and a sense of humor, arrived at Cedars-Sinai by ambulance on a Monday.

Soon, nurse Jacquelyn Maxton was at her bedside asking a series of questions to check for problems with sleep, diet and confusion. The answers led to Gordon's designation as a frail patient. The next day, the project team huddled down the hall and addressed her risks one by one. Medical staff would treat the flu and pneumonia while at the same time addressing underlying health issues that could extend Gordon's stay and slow her recovery, both in the hospital and after going home.

To reduce the chance of falls, nurses placed a yellow band on her wrist that read "fall risk" and ensured that she didn't get up on her own. To prevent bed sores, they got her up and moving as often as possible. To cut down on confusion, they reminded Gordon frequently where she was and made sure she got uninterrupted sleep. Medical staff also stopped a few unnecessary medications that Gordon had been prescribed before her admission, including a heavy narcotic and a sleeping pill.

"It is really a holistic approach to the patient, not just to the disease that they are in here for," said Glenn D. Braunstein, the hospital's vice president for clinical innovation.

Previously, nurse Ivy Dimalanta said, she and her colleagues provided similar care but on a much more random basis. Under the project, the care has become standardized.

The healthcare system has not been well designed to address the needs of seniors who may have had a lifetime of health problems, said Mary Naylor, gerontology professor at the University of Pennsylvania School of Nursing. As a result, patients sometimes fall through the cracks and return to hospitals again and again.

"That is not good for them and that is not good for society to be using resources in that way," Naylor said.

Using data from related projects, Cedars began a pilot program in 2011 and expanded it last summer. The research is continuing but early results suggest that the interventions are leading to fewer seniors being admitted to the intensive care unit and to shorter hospital stays, said Jeff Borenstein, researcher and lead clinician on the frailty project. "It definitely seems to be going in the right direction," he said.

The hospital is now working with Naylor and the University of Pennsylvania to design a program to help the patients once they go home.

"People who are frail are very vulnerable when they leave the hospital," said Harriet Udin Aronow, a researcher at Cedars. "We want to promote them being safe at home and continuing to recover."

In Gordon's case, she lives alone with the help of her children and a caregiver. The hospital didn't want her experiencing complications that would lengthen the stay, but they also didn't want to discharge her before she was ready. Under the health reform law, hospitals face penalties if patients come back too soon after being released.

Patients and their families often are unaware of the additional attention. Sitting in a chair in front of a vase of pink flowers, Gordon said she knew she would have to do her part to get out of the hospital quickly. "You have to move," she said. "I know you get bed sores if you stay in bed."

Gordon said she was comfortable at the hospital but she wanted to go back to her house as quickly as she could. "There's no place like home," she said.

Two days later, that's where she was.

anna.gorman@latimes.com

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DC Comics Turns the Occupy Movement Into a Superhero Title

Eighteen months after the phrase first entered the collective public consciousness, the plight of the 99 percent is coming to mainstream superhero comics — via a new series from the second biggest publisher in the American comic industry, which just happens to be a subsidiary of a multi-national corporation that makes around $12 billion a year. Irony, anybody?

In May, DC Comics will launch two new series taking place in their mainstream superhero universe that offer different insights into the class struggle in a world filled with superheroes, alien races and inexplicable events. The Green Team, written by Tiny Titans and Superman Family Adventures creators Art Baltazar and Franco, with art by Ig Guara, revives an obscure 1975 concept about teenage rich kids who try to make the world a better place with their outrageous wealth. In an interview promoting the series, Franco promised that it would address questions like “Can money make you happy?” and “If you had unlimited wealth, could you use that to make the lives of people better?”

Obviously, this is one of the more fanciful series DC will be publishing.

But while DC is promoting The Green Team series as the adventures of the “1%,” its companion title, The Movement, is teased as a chance for us to “Meet the 99%… They were the super-powered disenfranchised — now they’re the voice of the people!”

“It’s a book about power,” explained The Movement writer Gail Simone. “Who owns it, who uses it, who suffers from its abuse. As we increasingly move to an age where information is currency, you get these situations where a single viral video can cost a previously unassailable corporation billions, or can upset the power balance of entire governments. And because the sources of that information are so dispersed and nameless, it’s nearly impossible to shut it all down.”

“The thing I find fascinating and a little bit worrisome is, what happens when a hacktivist group whose politics you find completely repulsive has this same kind of power and influence,” she elaborated in an interview at Big Shiny Robot. “What if a racist or homophobic group rises up and organizes in the same manner?”

While the concept is ambitious, the idea that a comic capable of living up to the book’s populist inspiration could come from DC Entertainment still strikes some as unlikely. Matt Pizzolo, the editor of the Occupy Comics anthology, told Wired that “though DC Comics did help launch Alan Moore and David Lloyd’s seminal anarchist epic V For Vendetta over two decades ago, it’s unlikely they would do so today. Between dismantling Vertigo and frankensteining Watchmen, the past year has demonstrated DC isn’t a safe place for bold creators who want to tell the kinds of stories that would inspire things like Occupy, rather than just cash in on them.”

Still, Simone says that the use of the iconography and language of a real-world populist movement is deliberate, promising that the book will reflect today’s decentralized political world and offer ”a slice of rarity that we’re unlikely to see in most superhero books.”

This wouldn’t the first time that DC has attempted to offer pre-packaged populist rebellion, of course; in addition to the aforementioned publication of the anti-establishment V For Vendetta, the company’s Vertigo imprint also published Grant Morrison’s The Invisibles, a series centering around an international organization struggling against forces of authority and repression that included anti-corporate themes.

Only time will tell whether The Movement will live up to the subversive examples of these earlier books, or just end up a well-intentioned piece of topical super heroics that trades on, and commodifies, a real political movement.

The Movement #1 will be available in both print and digital formats on May 1, while The Green Team #1 will be released on May 22.

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Charlie Sheen revisits alter-ego in movie “Mind of Charles Swan”

LOS ANGELES (Reuters) – It’s a downward spiral for Charlie, a successful professional whose life slides into despair when his girlfriend breaks up with him.

This Charlie could be Charlie Sheen, but it’s actually the fictional Charles Swan, a charming, immature character played by Hollywood’s favorite bad boy actor and filmed only a few months after Sheen‘s off-screen antics got him fired in 2011 from TV comedy “Two and a Half Men.”

Sheen stars in “A Glimpse Inside the Mind of Charles Swan III,” opening in U.S. movie theaters on Friday. The film is directed and written by Roman Coppola, son of “The Godfather” director Francis Ford Coppola.

Coppola, 47, who is Oscar-nominated for his work on the screenplay of “Moonrise Kingdom,” talked with Reuters about working with Sheen on the “playful romp” about lost love and revenge fantasies set in a stylized Los Angeles.

Q: Did you write the film specifically for Charlie Sheen to star in?

A: “I didn’t write it for him in mind. I was excited to write a piece about a very outlandish lead character, someone charming, immature, struggling and full of imagination. As I was finishing it, I kind of realized Charlie Sheen would be perfect. Both are larger than life. They use their wit and charm to smooth over problems in their life to not deal with things. But it’s a coincidence that it’s the same first name.”

Q: Both of you are part of Hollywood dynasties. Your father is Francis Ford Coppola and his dad is Martin Sheen. When did you and Charlie first meet?

A: “We met as boys when we were around 11 years old on the set of (the 1979 film) ‘Apocalypse Now’ (which Francis Ford Coppola directed and Martin Sheen starred in). Our families were in the Philippines (for the shoot) for many months so Charlie and I became pals. We have a lot of fond memories hanging out together in that exotic location.”

Q: What type of memories?

A: “I remember being with him when they built the (fictional) Kurtz Compound. Charlie and I would cruise around (the set) and there would be all sorts of skulls and weapons and things that are interesting to 11-year old boys. I was also interested in theatrical makeup, so I introduced Charlie to the hobby of making scars.”

Q: Did you get any pushback from family, friends or financiers when you decided to cast Sheen in “Charles Swan“?

A: “Basically there was no film company willing to finance the movie with Charlie. Insurance companies didn’t want my business, nor did any bond company. There was very little support in the film community to finance that picture. So I had to be very crafty about getting the financing.”

Q: Were you surprised at that?

A: “I was surprised to some degree because I had other talent attached to it like Jason Schwartzman and Bill Murray. You’d think that would tip people’s curiosity. When people say ‘No’ or ‘Why would you want to cast Charlie Sheen?’ it makes me feel like everyone else is crazy.”

Q: But it’s Charlie who conjures up the images of crazy – public battles with “Two and Half Men” creator Chuck Lorre and his ex-wives, Denise Richards and Brook Mueller. He is the one who was in rehab for drugs, who damaged hotel rooms, lived with porn stars, and called himself a warlock with “tiger blood” and “Adonis DNA.”

A: “But that’s very comic book, that’s not a real person. That’s a portrayal that comes from wanting to make stories. He’s an individual. He’s obviously a talented guy and talent doesn’t go away. Ten years ago we’d be having this exact same conversation about Robert Downey Jr. and how crazy and irresponsible he is. Now we know he’s at the top of his game. So to me it’s kind of immature to cotton to that kind of stuff. It’s gossipy and phony.”

Q: So none of that was prevalent during the shooting of your film?

A: “Charlie was totally committed throughout the entire shooting. He showed up every day, he knew his lines, he learned Spanish and he learned to dance. I had a professional, fantastic experience with a highly skilled and dedicated performer.”

Q: How would you describe Charlie’s acting?

A: “He’s very intuitive. On a technical level, he’s very experienced and capable. He knows where to stand, where the light is. Then there is the magical aspect of acting where you’re able to create a see-through veil in which your feelings come out and they’re captured by the camera.

“No one knows how it works. Some people can do it and Charlie certainly has it. So despite all the chitter chatter of Charlie this and breakdown that, he’s a fine actor and he shines in this performance.”

(Reporting By Zorianna Kit, editing by Jill Serjeant and Doina Chiacu)

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In Nigeria, Polio Vaccine Workers Are Killed by Gunmen

At least nine polio immunization workers were shot to death in northern Nigeria on Friday by gunmen who attacked two clinics, officials said.

The killings, with eerie echoes of attacks that killed nine female polio workers in Pakistan in December, represented another serious setback for the global effort to eradicate polio.

Most of the victims were women and were shot in the back of the head, local reports said.

A four-day vaccination drive had just ended in Kano State, where the killings took place, and the vaccinators were in a “mop-up” phase, looking for children who had been missed, said Sarah Crowe, a spokeswoman for the United Nations Children’s Fund, one of the agencies running the eradication campaign.

Dr. Mohammad Ali Pate, Nigeria’s minister of state for health, said in a telephone interview that it was not entirely clear whether the gunmen were specifically targeting polio workers or just attacking the health centers where vaccinators happened to be gathering early in the morning. “Health workers are soft targets,” he said.

No one immediately took responsibility, but suspicion fell on Boko Haram, a militant Islamist group that has attacked police stations, government offices and even a religious leader’s convoy.

Polio, which once paralyzed millions of children, is now down to fewer than 1,000 known cases around the world, and is endemic in only three countries: Nigeria, Pakistan and Afghanistan.

Since September — when a new polio operations center was opened in the capital and Nigeria’s president, Goodluck Jonathan, appointed a special adviser for polio — the country had been improving, said Dr. Bruce Aylward, chief of polio eradication for the World Health Organization. There have been no new cases since Dec. 3.

While vaccinators have not previously been killed in the country, there is a long history of Nigerian Muslims shunning the vaccine.

Ten years ago, immunization was suspended for 11 months as local governors waited for local scientists to investigate rumors that it caused AIDS or was a Western plot to sterilize Muslim girls. That hiatus let cases spread across Africa. The Nigerian strain of the virus even reached Saudi Arabia when a Nigerian child living in hills outside Mecca was paralyzed.

Heidi Larson, an anthropologist at the London School of Hygiene and Tropical Medicine who tracks vaccine issues, said the newest killings “are kind of mimicking what’s going on in Pakistan, and I feel it’s very much prompted by that.”

In a roundabout way, the C.I.A. has been blamed for the Pakistan killings. In its effort to track Osama bin Laden, the agency paid a Pakistani doctor to seek entry to Bin Laden’s compound on the pretext of vaccinating the children — presumably to get DNA samples as evidence that it was the right family. That enraged some Taliban factions in Pakistan, which outlawed vaccination in their areas and threatened vaccinators.

Nigerian police officials said the first shootings were of eight workers early in the morning at a clinic in the Tarauni neighborhood of Kano, the state capital; two or three died. A survivor said the two gunmen then set fire to a curtain, locked the doors and left.

“We summoned our courage and broke the door because we realized they wanted to burn us alive,” the survivor said from her bed at Aminu Kano Teaching Hospital.

About an hour later, six men on three-wheeled motorcycles stormed a clinic in the Haye neighborhood, a few miles away. They killed seven women waiting to collect vaccine.

Ten years ago, Dr. Larson said, she joined a door-to-door vaccination drive in northern Nigeria as a Unicef communications officer, “and even then we were trying to calm rumors that the C.I.A. was involved,” she said. The Iraq and Afghanistan wars had convinced poor Muslims in many countries that Americans hated them, and some believed the American-made vaccine was a plot by Western drug companies and intelligence agencies.

Since the vaccine ruse in Pakistan, she said, “Frankly, now, I can’t go to them and say, ‘The C.I.A. isn’t involved.’ ”

Dr. Pate said the attack would not stop the newly reinvigorated eradication drive, adding, “This isn’t going to deter us from getting everyone vaccinated to save the lives of our children.”

Aminu Abubakar contributed reported from Kano, Nigeria.

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U.S. Use of Mexican Battery Recyclers Is Faulted

United States companies are sending spent lead batteries to recycling plants in Mexico that do not meet American environmental standards, according to an environmental agency created under the North American Free Trade Agreement, putting Mexican communities at risk.

In a blistering report submitted this week, the agency, the Commission for Environmental Cooperation, notes that the United States does not fully follow procedures common among developed nations that treat international battery shipments as hazardous waste. It faults environmental agencies on both sides of the border for lapses in regulation and enforcement. Cross-border trade in lead batteries increased by up to 525 percent from 2004 to 2011, the report said.

The report, which has been circulating in draft form, has been forwarded to the governments of the United States, Canada and Mexico, which have 60 days to object to its publication. An estimated 20 percent of lead acid batteries from the United States now go to Mexico for recycling, according to trade statistics.

“There needs to be better coordination between government agencies and better cross-border tracking,” said Evan Lloyd, who was the agency’s executive director until late last year and oversaw the yearlong study.

The report highlighted a number of shortcomings: Customs data on the number of batteries crossing the border did not mesh with counts by the United States Environmental Protection Agency. Though the E.P.A. requires notice of batteries leaving the United States, there was no effort to make sure that they had arrived at qualified recyclers in Mexico. The data that battery companies sent to the E.P.A. about exports consisted of “piles of paper,” Mr. Lloyd said, and it was never amassed into an electronic database that would be “useful to regulators.”

Almost all lead acid batteries used in the United States are recycled to extract the lead for reuse because lead is a dangerous pollutant and because it is a valuable commodity. Lead batteries are used in vehicles, cellphone towers and wind turbines.

Since 2008, new United States limits on lead pollution have made domestic recycling complicated and costly. That has helped propel the recycling trade to Mexico, both legally and illegally, environmental groups say, because that country has less stringent limits for lead pollution, and far less vigorous enforcement.

“There’s a pretty consistent pattern suggesting that exports are the direct result of U.S. emissions standards,” said Perry Gottesfeld, executive director of Occupational Knowledge International, which has led the campaign against lead poisoning internationally. Mr. Gottesfeld noted that a Mexican plant owned by a major American recycler, Johnson Controls Inc., puts out more than 30 times as much lead emissions as its newest plant in the United States.

“What Mexico needs to do is to get its recycling up to U.S. standards, and the U.S. needs to do a much better job of tracking batteries overseas,” he said. In an e-mail, Johnson Controls, based in Milwaukee, said it was “modernizing and reinvesting” in the Mexican facility, acquired in 2005, “to reduce its environmental footprint.”

The report was initiated in response to a report by Occupational Knowledge International and Fronteras Comunes, a Mexican environmental group, as well as to an investigative article in The New York Times, Mr. Lloyd said. Soil collected by The Times in a school playground near a recycling plant outside Mexico City was found to have lead levels five times those allowed in the United States.

Lead poisoning causes high blood pressure, kidney damage and abdominal pain in adults, and serious developmental delays and behavioral problems in young children. When batteries are broken for recycling, the lead is released as dust and, during melting, as lead-laced emissions.

In the United States, recyclers operate in highly mechanized, tightly sealed plants, with smokestack scrubbers and extensive monitors to detect lead release. Plants in Mexico vary greatly in safety standards, and in some, the recycling process is little more than men with hammers smashing batteries and melting down their contents in furnaces.

In recent months, there have been new efforts to curb the flow of batteries south of the border, though many battery makers have fought that. In response to a draft of the report released late last year, Battery Council International, an industry group, said it opposed “the creation of additional burdensome certification programs.”

Last year, the United States General Services Administration, which is responsible for federal vehicles, asked ASTM International, an independent standards agency, to explore a voluntary standard for battery recycling.

But that effort came to naught after the proposal was voted down at an open meeting attended by representatives from industry, government and environmental groups in December. Of the 103 people at the meeting, 49 worked for Johnson Controls.

This article has been revised to reflect the following correction:

Correction: February 9, 2013

An earlier version of this article misstated part of the name of an American recycler cited by Perry Gottesfeld, executive director of Occupational Knowledge International, as the owner of a Mexican plant that puts out more than 30 times as much lead emissions as the company’s newest plant in the United States. The American recycling company is Johnson Controls Inc., not Johnson Controls International.

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Big Bear locked down amid manhunt

The bustling winter resort of Big Bear took on the appearance of a ghost town Thursday as surveillance aircraft buzzed overhead and police in tactical gear and carrying rifles patrolled mountain roads in convoys of SUVs, while others stood guard along major intersections.

Even before authorities had confirmed that the torched pickup truck discovered on a quiet forest road belonged to suspected gunman Christopher Dorner, 33, officials had ordered an emergency lockdown of local businesses, homes and the town's popular ski resorts. Parents were told to pick up their children from school, as rolling yellow buses might pose a target to an unpredictable fugitive on the run.

By nightfall, many residents had barricaded their doors as they prepared for a long, anxious evening.

PHOTOS: A tense manhunt amid tragic deaths

"We're all just stressed," said Andrea Burtons as she stocked up on provisions at a convenience store. "I have to go pick up my brother and get him home where we're safe."

Police ordered the lockdown about 9:30 a.m. as authorities throughout Southern California launched an immense manhunt for the former lawman, who is accused of killing three people as part of a long-standing grudge against the LAPD. Dorner is believed to have penned a long, angry manifesto on Facebook saying that he was unfairly fired from the force and was now seeking vengeance.

Forest lands surrounding Big Bear Lake are cross-hatched with fire roads and trails leading in all directions, and the snow-capped mountains can provide both cover and extreme challenges to a fugitive on foot. It was unclear whether Dorner was prepared for such rugged terrain.

Footprints were found leading from Dorner's burned pickup truck into the snow off Forest Road 2N10 and Club View Drive in Big Bear Lake.

San Bernardino County Sheriff John McMahon said that although authorities had deployed 125 officers for tracking and door-to-door searches, officers had to be mindful that the suspect may have set a trap.

"Certainly. There's always that concern and we're extremely careful and we're worried about this individual," McMahon said. "We're taking every precaution we can."

PHOTOS: A fugitive's life on Facebook

Big Bear has roughly 400 homes, but authorities guessed that only 40% are occupied year-round.

The search will probably play out with the backdrop of a winter storm that is expected to hit the area after midnight.

Up to 6 inches of snow could blanket local mountains, the National Weather Service said.

FULL COVERAGE: Sweeping manhunt for rampaging ex-cop

Gusts up to 50 mph could hit the region, said National Weather Service meteorologist Mark Moede, creating a wind-chill factor of 15 to 20 degrees.

Extra patrols were brought in to check vehicles coming and going from Big Bear, McMahon said, but no vehicles had been reported stolen.

"He could be anywhere at this point," McMahon said. When asked if the burned truck was a possible diversion, McMahon replied: "Anything's possible."

Dorner had no known connection to the area, authorities said.

Craig and Christine Winnegar, of Murrieta, found themselves caught up in the lockdown by accident. Craig brought his wife to Big Bear as a surprise to celebrate their 28th wedding anniversary. Their prearranged dinner was canceled when restaurant owners closed their doors out of fear.

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Sandboxr's Animation Interface Offers Completely Customizable 3-D Printed Figurines

Walt Disney invented feature animation by painting on plastic cels, Pixar reinvented the artform with computer graphics, and now Sandboxr is bringing animation to life with 3-D printers.

Animation fans, using Sandboxr’s web-based software via laptop or tablet, can digitally pose character models, change their scale, give them accessories, create scenes, and then 3-D print their custom-built result for less than the cost of a movie ticket.

3-D printed figurines already exist — MyRobotNation and FigurePrints offer similar services, allowing gamers to print models from World of Warcraft and Minecraft. But the interfaces for those sites have limited character flexibility, usually just a set of predefined poses and options. “Services like that are the tip of the iceberg,” says founder Berk Frei. “We’re trying to be the rest of the iceberg.”

What makes Sandboxr unique is how users experience some of the creative flexibility a professional animator does. All of the Sandboxr models are “rigged” — each model has a skeleton that a customer can pose like a doll, then print a souvenir of the experience. And, unlike the animators at movie studios, Sandboxr customers don’t have to learn complicated modeling software. The company has built an engine that lets people experiment with character poses using sliders to create sophisticated, animated poses, simply.

Frei is also passionate about taking the grunt work out of the process. “When I’m getting something ready for 3-D printing it’s not an easy process,” he says. “The printers choke on models with holes, multiple meshes, all these things that look visually impressive. Shelling models to reduce waste materials and adding drain holes takes a lot of time, but we’ve automated all of that. You’re going to save a lot of time using Sandboxr to post-process models.”

These automated features will do a lot to keep costs competitive with services like Shapeways. According to Frei, a 3.5-inch figure will cost approximately $20 to $25 and a 2.5-inch model will cost around $12, but final pricing is still to be determined.

To ensure that there are plenty of options for customers, the platform will be open to 3-D artists. Independent animators and toy designers will be able to post their characters and let fans interact with them in new and exciting ways. Frei says they’re also getting an “overwhelming” response from established videogame companies. “Game companies are excited for us to exist. They’ve made a game and the content already exists. We use the same model files and textures as they do to build the game so it’s an easy transition. Ultimately, we provide a store front that doesn’t cost anything to create and an infinite amount of inventory.”

The response has been so potent, Frei is looking into purchasing 40 ZCorp 3-D printers to keep up with initial demand. “We’ve decided we’re going to get capital equipment and build out our infrastructure, which is a bigger risk, but also gives us the ability to provide lower cost prints.”

For now, the site is in private beta, a Kickstarter campaign is imminent, but for those in the Salt Lake City area, the first Sandboxer project is on view at The Leonardo, a contemporary science museum.

Beyond the lively product, Sandboxr marks an important change in the industry. Most first-generation companies focused on 3-D printing were founded by engineers and focused on developing new, better hardware.

Frei and Sandboxr represent a new wave where designers are driving the technology in new directions increasingly through software. “Working with 3-D printing companies wasn’t that cool of an experience,” he says. “You’re just dropping your file off.”

Frei was introduced to 3-D printing while working as a CG animator in an arts-focused coworking space. He immediately understood the implications of the technology and had a vast library of digital content that could be printed. He also saw a huge problem. “You need to be a sophisticated designer to do anything cool with a 3-D printer,” says Frei. “My idea was to bridge the gap between an everyday person and 3-D printers.”

After evaluating systems from all the major manufacturers Frei found them lacking. He immediately got to work pitching investors on his software concept and recruited a team of engineers and 3-D artists to build the service. ”First and foremost I was thinking what a designer toy artist could do with Sandboxr,” says Frei. “Artists can collaborate with their fans.”

Frei also sees a big future for the product beyond games.

“We’re 3-D artists and game designers, but we built the system with customization in mind so that it can be interacted with in interesting ways,” he says. “I’ll be surprised what they’ll use it for — maybe cool jewelry, wedding cake toppers, who knows. I just want people to feel like they can be Tony Stark from Iron Man. They can design something in their computer and build it.”

All images: Courtesy of Sandboxr

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Katie Holmes takes fashion line crosstown

NEW YORK (AP) — Katie Holmes and her business partner and stylist Jeanne Yang joined the New York Fashion Week frenzy last season with a show at Lincoln Center, only to leave it behind this time around.

It wasn’t all the people, or even the paparazzi, that drove them away. It was their own clothes. Their look, which they describe as one of careful artistry and potential heritage pieces that women will keep a lifetime, is a little too quiet for all the splash, they said.

“We wanted to tell the full story behind the frivolity,” said Yang, adding: “It’s a quiet approach.”

Holmes and Yang sat down at a hotel on the opposite side of Manhattan with a handful of fashion journalists on Thursday, the opening day of fashion week, to walk them personally through 15 looks Holmes called their favorites.

Katharine Hepburn‘s practical-yet-chic look of the 1940s, Donna Karan‘s use of the shoulders and back as erogenous zones, Halston’s glamorous sportswear and Chanel’s mastery of seaming and studs were all in their minds as they built the pieces and outfits.

“We’re not trying to be trendy … but we’re trying to make high-quality pieces you’ll wear over and over again,” Holmes said.

Holmes was wearing an A-line shirtdress in the blue-and-black plaid that was dominant in the collection, while Yang wore one of the slouchy blazers that has become a key piece for the label, founded in 2009.

For fall, they’ll offer a peplum top with a suede waist band and maxi skirt in the same plaid. Holmes suggested that outfit for a dinner out. Swap the shirt for a tank top for brunch and a blouse to go to the theater. Yang said she hoped a customer would “feel smart” in a white cashmere-silk boucle sweaterdress with a strip of white silk at the hem.

Holmes, meanwhile, was partial to the baggy suede caramel-colored pants that hit just above the ankle, worn with a bow-neck blouse in a deep shade of lipstick pink.

The duo made a point of noting that 70 percent of production of Holmes & Yang happens in New York and the other 30 percent in Los Angeles.

___

Follow Samantha Critchell on Twitter at http://twitter.com/AP_Fashion

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The New Old Age: The Executor's Assistant

I’m serving as executor for my father’s estate, a role few of us are prepared for until we’re playing it, so I was grateful when the mail brought “The American Bar Association Guide to Wills and Estates” — the fourth edition of a handbook the A.B.A. began publishing in 1995.

This is a legal universe, I’m learning, in which every step — even with a small, simple estate that owes no taxes and includes no real estate or trusts — turns out to be at least 30 percent more complicated than expected.

If my dad had been wealthy or owned a business, or if we faced a challenge to his will, I would have turned the whole matter over to an estate lawyer by now. But even then, it would be helpful to know what the lawyer was talking about. The A.B.A. guide would help.

Written with surprising clarity (hey, they’re lawyers), it maps out all kinds of questions and decisions to consider and explains the many ways to leave property to one’s heirs. Updated from the third edition in 2009, the guide not only talks taxes and trusts, but also offers counsel for same-sex couples and unconventional families.

If you want to permit your second husband to live in the family home until he dies, but then guarantee that the house reverts to the children of your first marriage, the guide tells you how a “life estate” works. It explains what is taxable and what isn’t, and discusses how to choose executors and trustees. It lists lots of resources and concludes with an estate-planning checklist.

In general, the A.B.A. intends its guide for the person trying to put his or her affairs in order, more than for family members trying to figure out how to proceed after someone has died. But many of us will play both these parts at some point (and if you are already an executor, or have been, please tell us how that has gone, and mention your state). We’ll need this information.

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

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Postal Service Posts Loss of $1.3 Billion in First Quarter

WASHINGTON — Holiday shipping and the 2012 election helped the Postal Service stems its losses, but the agency’s financial woes continued in the first quarter, which ended Dec 31.

The Postal Service posted a $1.3 billion loss in the first quarter, compared with a $3.1 billion loss over the same period last year. The agency said the first quarter has traditionally been one of its strongest periods.

Total mail volume continued to decline, however. Mail volume was 43.5 billion pieces for the quarter, down from 43.6 billion in earlier year, according to agency officials.

Revenue from first-class mail, which provides the bulk of the revenue for the Postal Service, declined $237 million, or 3.1 percent, from the same period last year, with a decrease in volume of 834 million pieces, or 4.5 percent. Revenue from advertising mail increased $141 million, or 3.1 percent, in the first quarter compared with the same period last year on a volume increase of 783 million pieces, or 3.6 percent. The increase is largely attributable to official election mail and political campaign advertising related to the presidential and Congressional elections mailed during the quarter, which began Oct. 31.

The agency’s shipping and packaging business increased by $154 million, or 4.7 percent, over 2012 first-quarter results, fueled by the growth of online shopping and the continuing success of Postal Service marketing campaigns to promote shipping services.

The agency also said that it cut its operating costs to $18.9 billion from $20.9 billion over the same period last year, a decrease of 9.8 percent. The agency attributed the savings to a number of cost-cutting measures it has undertaken, including staff reductions and the consolidation of some of its mail processing centers.

But postal officials said the agency’s actions alone are not enough.

“The encouraging results from our holiday mailing season cannot sustain us as we move deeper into the current fiscal year and face continuing financial challenges,” said Patrick R. Donahoe, the postmaster general. “We urgently need Congress to do its part and pass legislation that allows us to better manage our costs and gives us the commercial flexibility needed to operate more like a business does. This will help ensure the future success of the Postal Service and the mailing industry it supports.”

The agency announced earlier this week that it would seek to move to a new delivery schedule beginning the week of Aug. 5. The post office would stop delivering or picking up mail on Saturdays, ending a practice that goes back to the 1890s. Packages would continue to be delivered Monday through Saturday. The Postal Service said the change would result in an annual cost savings of approximately $2 billion if the new delivery plan is fully implemented.

Members of Congress, postal unions and some businesses strongly oppose the move. But Mr. Donahoe said the Postal Service's dire financial situation calls for drastic measures.

Current projections show the Postal Service will have less than five days of operating cash reserves by the end of the 2013 fiscal year, which the post office said would leave it unable to react to possible economic downturns or other issues.

The Postal Service wants Congress to remove a 2006 requirement that it pay nearly $5.5 billion a year for health benefits to future retirees, a mandate imposed on no other government agency, that officials have said has crippled the post office. The agency defaulted on two payments last year for the first time and said it would not be able to pay them this year. The agency also wants to be able to enter into new areas, like shipping beer and wine through the mail, which is currently prohibited.

Last April, the Senate passed a bill that would have allowed the Postal Service to ship beer and wine, reduced its work force, and allowed the agency to recoup more than $11 billion it overpaid into an employee pension fund. The Senate refused to stop Saturday deliveries. The House has taken no action on its own postal overhaul.

“Our liquidity concerns can only be fully resolved if Congress takes action to address our unsustainable business model, including resolving the overly aggressive payment schedule to prefund retiree health benefits,” said Joseph Corbett, the agency’s chief financial officer. “The Postal Service will continue to prioritize payments to our employees and suppliers ahead of those to the federal government to ensure that we maintain high-quality customer service.”

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Police on high alert after ex-LAPD cop's alleged shooting rampage

Authorities across Southern California were on high alert Thursday morning as a massive manhunt was underway for an ex-Los Angeles police officer sought in connection with a double homicide and the shootings of three police officers, one of whom was killed.

Local, state and federal authorities are involved in the search for Christoper Jordan Dorner, 33, who threatened "unconventional and asymmetrical warfare" against police in an manifesto posted on his Facebook page.

Dorner also threatened more than two dozen people -- including police officials -- in his manifesto. Officers from around Southern California have been deployed to protect those people. In some cases, police said, those at risk have relocated for their safety.

 LAPD Charlie Beck is expected to hold a press conference at 10 a.m.

When asked if police felt they were under attack, Riverside Police Lt. Guy Toussaint said: “Based on the circumstances of the shooting, yes I do.”

Hours after authorities announced they were looking for Dorner in connection with a double homicide in Orange County, the search intensified after three police officers were shot in Riverside County and Dorner was identified as a possible suspect.

Freeway signs urged motorists to call 911 if they saw the suspect's vehicle as officers patrolled the streets near one of the Riverside County crime scenes with rifles at the ready. Los Angeles was put on a citywide tactical alert and California Highway Patrol issued a "blue alert" for nine Southern California counties warning Dorner was considered "armed and extremely dangerous."

The first shooting occurred about 1:30 a.m. Thursday in Corona, where two Los Angeles Police Department officers providing protection for someone mentioned in Dorner's manifesto, officials said. One officer suffered a graze wound to the head during a shootout and Dorner fled the scene, police said.

A short time later, two Riverside officers were shot at the corner of Magnolia Avenue and Arlington Avenue in Riverside. Toussaint said the officers were sitting at a red light when they were ambushed. One was killed, the other was still in surgery Thursday morning.

There was no indication the officers were "actively seeking Dorner," Toussaint said.

“Our officers were stopped at an intersection at a red light when they were ambushed," he said. "Because of the close proximity to the timeline, we believe there is a strong likelihood that former LAPD Officer Christopher Dorner was involved in our incident.”

In the online manifesto, Dorner specifically named the father of Monica Quan, the Cal State Fullerton assistant basketball coach who was found dead Sunday in Irvine along with her fiance, Keith Lawrence.

Randy Quan, a retired LAPD captain, was involved in the review process that ultimately led to Dorner’s dismissal. A former U.S. Navy reservist, Dorner was fired in 2009 for allegedly making false statements about his training officer. In the manifesto, he complained that Randy Quan and others did not fairly represent him at the review hearing.

“The violence of action will be high .... I will bring unconventional and asymmetrical warfare to those in LAPD uniform whether on or off duty," Dorner wrote.

As authorities swarmed the area, two officer-involved shootings occurred in Torrance after police came across vehicles they thought might be Dorner's.

The first Torrance incident occurred about 5:20 a.m. in the 19500 block of Redbeam Avenue in Torrance, Lt. Devin Chase said. That incident involved Los Angeles police detectives from the Hollywood division, sources said.

Two people were struck by gunfire and transported to an area hospital with unknown injuries, Chase said. No officers were injured.

The second incident, which involved Torrance police officers, occurred at Flagler Lane and Beryl Street about 5:45 a.m. No injuries were reported in that incident.

Chase said both incidents involved vehicles matching the description of the one sought in connection with Dorner.

"Now it appears neither of them are directly related," Chase said. "In both of them, officers believed they were at the time."

Authorities said they believe Dorner attempted to steal a boat from an elderly man about 10:30 p.m. Wednesday at the Point Loma Yacht Club in San Diego, hours before the shootings in Riverside County.

The boat owner reported being accosted by a burly man who tied him up, threatened him with a gun and said he wanted the boat to flee to Mexico.

But while they were trying to get underway, a rope became entangled in the propeller and the boat was inoperable, authorities said.

The suspect fled the scene and the boat owner was unharmed.

About 2 a.m., a citizen reported finding property belonging to Dorner on a street near Lindbergh Field, not far from the scen

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The UFO Is Fake in Animator's YouTube Prank — But So Is Everything Else

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Well: Think Like a Doctor: A Confused and Terrified Patient

The Challenge: Can you solve the mystery of a middle-aged man recovering from a serious illness who suddenly becomes frightened and confused?

Every month the Diagnosis column of The New York Times Magazine asks Well readers to sift through a difficult case and solve a diagnostic riddle. Below you will find a summary of a case involving a 55-year-old man well on his way to recovering from a series of illnesses when he suddenly becomes confused and paranoid. I will provide you with the main medical notes, labs and imaging results available to the doctor who made the diagnosis.

The first reader to figure out this case will get a signed copy of my book, “Every Patient Tells a Story,” along with the satisfaction of knowing you solved a case of Sherlockian complexity. Good luck.

The Presenting Problem:

A 55-year-old man who is recovering from a devastating injury in a rehabilitation facility suddenly becomes confused, frightened and paranoid.

The Patient’s Story:

The patient, who was recovering from a terrible injury and was too weak to walk, had been found on the floor of his room at the extended care facility, raving that there were people out to get him. He was taken to the emergency room at the Waterbury Hospital in Connecticut, where he was diagnosed with a urinary tract infection and admitted to the hospital for treatment. Doctors thought his delirium was caused by the infection, but after 24 hours, despite receiving the appropriate antibiotics, the patient remained disoriented and frightened.

A Sister’s Visit:

The man’s sister came to visit him on his second day in the hospital. As she walked into the room she was immediately struck by her brother’s distress.

“Get me out of here!” the man shouted from his hospital bed. “They are coming to get me. I gotta get out of here!”

His brown eyes darted from side to side as if searching for his would-be attackers. His arms and legs shook with fear. He looked terrified.

For the past few months, the man had been in and out of the hospital, but he had been getting better — at least he had been improving the last time his sister saw him, the week before. She hurried into the bustling hallway and found a nurse. “What the hell is going on with my brother?” she demanded.

A Long Series of Illnesses:

Three months earlier, the patient had been admitted to that same hospital with delirium tremens. After years of alcohol abuse, he had suddenly stopped drinking a couple of days before, and his body was wracked by the sudden loss of the chemical he had become addicted to. He’d spent an entire week in the hospital but finally recovered. He was sent home, but he didn’t stay there for long.

The following week, when his sister hadn’t heard from him for a couple of days, she forced her way into his home. There she found him, unconscious, in the basement, at the bottom of his staircase. He had fallen, and it looked as if he may have been there for two, possibly three, days. He was close to death. Indeed, in the ambulance on the way to the hospital, his heart had stopped. Rapid action by the E.M.T.’s brought his heart back to life, and he made it to the hospital.

There the extent of the damage became clear. The man’s kidneys had stopped working, and his body chemistry was completely out of whack. He had a severe concussion. And he’d had a heart attack.

He remained in the intensive care unit for nearly three weeks, and in the hospital another two weeks. Even after these weeks of care and recovery, the toll of his injury was terrible. His kidneys were not working, so he required dialysis three times a week. He had needed a machine to help him breathe for so long that he now had to get oxygen through a hole that had been cut into his throat. His arms and legs were so weak that he could not even lift them, and because he was unable even to swallow, he had to be fed through a tube that went directly into his stomach.

Finally, after five weeks in the hospital, he was well enough to be moved to a short-term rehabilitation hospital to complete the long road to recovery. But he was still far from healthy. The laughing, swaggering, Harley-riding man his sister had known until that terrible fall seemed a distant memory, though she saw that he was slowly getting better. He had even started to smile and make jokes. He was confident, he had told her, that with a lot of hard work he could get back to normal. So was she; she knew he was tough.

Back to the Hospital:

The patient had been at the rehab facility for just over two weeks when the staff noticed a sudden change in him. He had stopped smiling and was no longer making jokes. Instead, he talked about people that no one else could see. And he was worried that they wanted to harm him. When he remained confused for a second day, they sent him to the emergency room.

You can see the records from that E.R. visit here.

The man told the E.R. doctor that he knew he was having hallucinations. He thought they had started when he had begun taking a pill to help him sleep a couple of days earlier. It seemed a reasonable explanation, since the medication was known to cause delirium in some people. The hospital psychiatrist took him off that medication and sent him back to rehab that evening with a different sleeping pill.

Back to the Hospital, Again:

Two days later, the patient was back in the emergency room. He was still seeing things that weren’t there, but now he was quite confused as well. He knew his name but couldn’t remember what day or month it was, or even what year. And he had no idea where he was, or where he had just come from.

When the medical team saw the patient after he had been admitted, he was unable to provide any useful medical history. His medical records outlined his earlier hospitalizations, and records from the nursing home filled in additional details. The patient had a history of high blood pressure, depression and alcoholism. He was on a long list of medications. And he had been confused for the past several days.

On examination, he had no fever, although a couple of hours earlier his temperature had been 100.0 degrees. His heart was racing, and his blood pressure was sky high. His arms and legs were weak and swollen. His legs were shaking, and his reflexes were very brisk. Indeed, when his ankle was flexed suddenly, it continued to jerk back and forth on its own three or four times before stopping, a phenomenon known as clonus.

His labs were unchanged from the previous visit except for his urine, which showed signs of a serious infection. A CT scan of the brain was unremarkable, as was a chest X-ray. He was started on an intravenous antibiotic to treat the infection. The thinking was that perhaps the infection was causing the patient’s confusion.

You can see the notes from that second hospital visit here.

His sister had come to visit him the next day, when he was as confused as he had ever been. He was now trembling all over and looked scared to death, terrified. He was certain he was being pursued.

That is when she confronted the nurse, demanding to know what was going on with her brother. The nurse didn’t know. No one did. His urinary tract infection was being treated with antibiotics, but he continued to have a rapid heart rate and elevated blood pressure, along with terrifying hallucinations.

Solving the Mystery:

Can you figure out why this man was so confused and tremulous? I have provided you with all the data available to the doctor who made the diagnosis. The case is not easy — that is why it is here. I’ll post the answer on Friday.

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Rules and Regulations: Post your questions and diagnosis in the comments section below.. The correct answer will appear Friday on Well. The winner will be contacted. Reader comments may also appear in a coming issue of The New York Times Magazine.

Correction: The patient’s eyes were brown, not blue.

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TIMESCAST: PC Industry Shifts as Dell Goes Private

February 6, 2013By Fritzie Andrade, Zena Barakat, Emily B. Hager, Erica Berenstein, Krishnan Vasudevan, Kriston Lewis, Abe Sater and Robin Lindsay

TimesCast Media+Tech: The effects of Dell’s landmark deal. | Kit Eaton reviews video editing apps. | The entrepreneur and inventor James Dyson.

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Postal Service seeks to end Saturday mail delivery

Postal Service to Cut Saturday Mail

By Michael Muskal

February 6, 2013, 8:34 a.m.

The U.S. Postal Service, struggling under a financial load and facing tough competition, will stop delivering mail on Saturdays beginning this summer, officials announced.

The announcement, which had been expected, is seen as an attempt to force Congress to deal with the Postal Service's increasing financial woes. Congress has tried to reorganize the agency, but efforts have been derailed because of politics.

Material prepared for a Wednesday news conference by Postmaster General Patrick R. Donahoe says that Postal Service market research and other research has indicated that nearly 7 in 10 Americans support the switch to five-day delivery as a way for the agency to reduce costs.

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Obama urges short-term solution to prevent steep budget cuts

UPS earnings fall shy of analysts' expectations; weak '13 forecast

FedEx expects record shipping day with boost from online sales

UPS guy steals homeowner's FedEx package -- on video

QUIZ: Test your knowledge about the debt limit

"The Postal Service is advancing an important new approach to delivery that reflects the strong growth of our package business and responds to the financial realities resulting from America's changing mailing habits," Donahoe said. "We developed this approach by working with our customers to understand their delivery needs and by identifying creative ways to generate significant cost savings."

The Postal Service contends that it has the authority to cut back service, though some in Congress insist that lawmakers have the final word. In any case, the announcement is expected to move the issue to a front burner.

According to postal officials, the end of Saturday delivery would begin on Aug. 1. The service said it will continue to deliver packages on Saturdays.

Ending Saturday service is estimated to save the agency about $2 billion a year. Officials said it lost about $16 billion in fiscal 2012, which ended Sept. 30 -- about three times the loss it had a year ago.

The proposal comes as the agency has closed post offices and changed procedures to try to stem its hemorrhaging of billions of dollars in recent years. More people have been turning to alternatives to traditional mail service, including electronic tools such as email and outside competitors such as Fed Ex, both of which have seriously cut into the Postal Service's erstwhile monopoly.

Congress in recent years has prohibited the Postal Service from dropping Saturday mail delivery, but the initial response to Wednesday's announcement was more accepting of what might be inevitable.

"This common-sense reform would save the Postal Service more than $2 billion annually," two top Republicans, Rep. Darrell Issa of California and Sen. Tom Coburn of Oklahoma, said in a statement.

"In his recent inaugural address, President Obama spoke about the need to find real solutions to our nation’s problems. Supporting the U.S. Postal Service's plan to move forward with 5-day mail delivery is one such solution worthy of bipartisan support," they said.

Rep. Elijah E. Cummings of Maryland, the top Democrat on the House Oversight and Government Reform Committee chaired by Issa, agreed that action was needed, but questioned whether the Postal Service could act alone.

"The Postal Service's declining mail volume poses a significant challenge, and the enactment of comprehensive postal reform legislation must be an urgent priority for the current Congress," Cummings said in a statement. “However, the issue of service delivery frequency should be addressed in that legislation rather than through arbitrary action by the Postal Service.”

Recent national polls show that a majority of respondents support ending Saturday mail delivery, and Obama has proposed halting such service as part of his budget-cutting proposals. Though the Postal Service is a quasi-governmental, self-funding entity, its worker compensation and retirement plans are tied to the federal budget.

Lawmakers have tried unsuccessfully for years to overhaul the Postal Service, but efforts have fallen victim to different needs in different areas. Representatives of rural areas tend to argue that traditional mail delivery is needed, a position backed by magazine publishers and other heavy users of the Postal Service.

The president of the National Assn. of Letter Carriers, Fredric Rolando, said in a statement that the end of Saturday mail delivery is "a disastrous idea that would have a profoundly negative effect on the Postal Service and on millions of customers,” particularly businesses, rural communities, the elderly, the disabled and others who depend on Saturday delivery for commerce and communication.

ALSO:

Alabama kidnapper, who had bombs, reportedly died in shootout

Florida judge denies request to postpone George Zimmerman trial

Gov. Christie eats doughnut with Letterman; talks Sandy storm aid

Times staff writers Richard Simon and Jim Puzzanghera contributed to this report.

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Amazon Launches Its Own Currency to Make It Easier to Spend on the Kindle

Following in the footsteps of Microsoft and Nintendo, Amazon has announced its own virtual currency for game, app, and in-app purchases, called Amazon Coins, on the Kindle Fire HD. The e-commerce giant is billing it as a way for developers to make more money by making it easier for shoppers to buy apps and games.

Android and iOS app developer Zak Tanjeloff agrees that Amazon Coins could put more cash in developer’s bank accounts. ”Any time you reduce the friction in buying an app or an in-app purchase, developers see better sales,” he says. It could also open the door for more in-app promos, where consumers can win coins and use them for future in-app purchases, which would help developers earn even more money, Tanjeloff says.

One Amazon Coin equals one U.S. penny, meaning a 99 cent game will cost 99 coins, a $1.99 app costs 199 coins, and so on. By converting coins to pennies instead of dollars, Amazon is giving developers the flexibility to sell in-app purchases for less than a dollar if they choose. It also means that mentally converting your Amazon Coin balance to real dollars won’t be too hard, a problem that’s plagued Microsoft Points and Nintendo Points.

With Amazon already accepting two forms of payment for Kindle purchases (credit/debit cards and gift cards), it begs the question: why another Amazon specific currency? One answer is that virtual currency takes the sting out of a purchase, it’s not real money after all, thus encouraging us to buy more. Perhaps more to the point, and the audience, the virtual coins also make it easy for kids to buy games and apps on the Kindle Fire without badgering their parents for real money – at least not until the coins run out.

It’s well-documented that we spend more money with credit cards than we do with cash, because instead of forking over a $100 bill, you’re merely swiping a card and not watching the money fly from your wallet. Likewise, it’s easy to forget you’re spending real money when you pay with virtual currency, because you’re thinking in terms of coins or points, not cash. Since you’ve already pre-paid for your Amazon Coins, several small purchases hardly feel like a drain on your bank account, at least until it’s time to reload your balance. “Using virtual currency takes the user one level away from actual dollars, which can lure them to spend more,” says Tanjeloff. “It’s like when you get chips at a casino, it’s easy to forget that you’re playing with real money.” In the long run, that could help developers boost their app sales and rake in more cash (they get 70 percent of every Amazon Appstore purchase), if shoppers are more willing to dole out Amazon Coins instead of dollars.

Though Amazon didn’t offer any details on why it thinks consumers will adopt its virtual currency, it makes sense that the company would have kids and parents in mind. Amazon knows that more kids are getting their hands on tablets like the Kindle Fire, and parents don’t want to constantly field requests to buy a new app or pay a few dollars for in-app characters or special features. Right now, if you want to keep your kids away from your credit card on a Kindle, you can buy an Amazon gift card and load it into the Amazon App Store on the tablet.

That means the move into Amazon Coins is less about utility, and more about convenience. Instead of buying a gift card and loading it, a process that is frustratingly difficult on the Kindle Fire, but easier to do online, Amazon promises it will give shoppers a quick way to reload Amazon Coins, though didn’t elaborate on how that will work. That could make Amazon Coins enticing to parents, who could load an account with several dollars’ worth of Coins each month and let their kids spend them at will without any hassle.

The news is already spurring criticism from folks who have had unfavorable experiences with Microsoft Points and Nintendo Points, neither of which have a one to one currency conversion. Microsoft Points (MSP) – used to buy games, music, and video on the Xbox and other Microsoft devices – have a conversion rate of 80 MSP to one U.S. dollar, and 1000 Nintendo Points equals one dollar. That’s led countless gamers to complain that buying anything with MSPs or NPs makes the purchase process too complicated or confusing. Amazon penny-per-coin approach won’t suffer from that problem, but it may still be an uphill battle with people who have been burned by virtual currency.

Amazon Coins officially launch in May and Amazon will give “tens of millions of dollars’ worth of free Amazon Coins to spend on developers’ apps on Kindle Fire in the Amazon Appstore,” the company says. Developers have until April 25 to submit their app to run on the new Coins currency when it launches.

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Well: Getting Into Your Exercise Groove

Phys Ed

Gretchen Reynolds on the science of fitness.

This isn’t meant as an insult, but you are physiologically lazy. So am I. So are we all. Using treadmill testing, scientists have definitively established that, like other animals, humans naturally aim to use as little energy as possible during most movement. So when we walk or run, our bodies tend to choose a particular cadence, a combination of step length and step frequency, that allows us to move at any given speed with as little physiological effort as possible.

How we pick that cadence, though, and whether we can or would even want to change it has been unclear. But a series of recent studies involving runners, walkers, metronomes and virtual reality curtains suggests that while the tug of physiological laziness is strong, it can be controlled, or at least tweaked, with some conscious effort — and perhaps your iPhone playlist.

In the first and most revelatory of the studies, physiologists at Simon Fraser University in British Columbia asked adult volunteers to walk on a treadmill at an easy pace. Using motion capture technology, the scientists determined how many steps each person was taking per minute at this speed. A person’s pace depends, of course, on both step length and step frequency. But because the two are inextricably entwined — lengthen your stride and you’ll take fewer steps over a given distance — studying one provides sufficient information about the other, and frequency is easier to enumerate.

After establishing each volunteer’s preferred step frequency, the scientists then sped up or slowed the treadmill, and the researchers measured how quickly people’s legs responded.

The body, remember, wants things to be easy. When you increase or decrease the speed of your walking or running, various physiological changes occur; the amount of oxygen in your blood rises or falls, for instance, because your muscles start requiring more or less of the stuff. Other biochemical changes also occur within muscle cells. Sensing those changes, the body realizes that, at this new speed, your cadence isn’t ideal; you’re taking too few or too many steps to use the least possible amount of energy. Your body adjusts.

But that process takes a little while, at least five seconds or so for the oxygen levels to change and your body to recognize the alteration, says Max Donelan, a professor at Simon Fraser University who was a co-author of the study with his graduate student Mark Snaterse and others.

However, the walkers in the study were adjusting their step frequency within less than two seconds after the treadmill speed changed, Dr. Donelan points out. They then fine-tuned their pacing after that. But the first adjustment came almost instantly.

The same process occurred when the researchers repeated the experiment with runners. If the treadmill speed changed, the runners’ step frequency shifted almost immediately, too fast for internal physiology to have played much of a role.

These intsy adjustments suggest that our brains very likely contain huge libraries of preset paces, Dr. Donelan and his colleagues have concluded, of idealized, “physiologically efficient” step cadences for any given speed and condition. It seems probable, in fact, that over our lifetimes, Dr. Donelan says, our brains develop and store countless templates for most pacing situations. We learn and remember what cadence allows us to use the least energy at that speed, and when we reach that speed, we immediately default to our body’s most efficient pace.

Just how the brain recognizes that we are moving at any particular speed is not completely understood, Dr. Donelan says, but almost surely involves messages from the eyes, feet, ears, nervous system, skin and other bodily systems.

Interestingly, it seems to be quite difficult to fool your brain. When Dr. Donelan and his colleagues draped shower-curtain-like enclosures around the front of a treadmill, projected a virtual reality scene of a hallway onto it and then manipulated people’s sense of the speed with which they were moving through the hallway, they found that people’s step frequency would quickly change to match this supposed new speed. But then they would settle back into their former cadence, even as the virtual hallway continued to move past them at unnatural speed.

Visual cues simply were not strong enough to affect pacing for long.

But the scientists have found one signal that does seem effectively to override the body’s strong pull toward its preferred ways of moving: a strongly rhythmic beat. When Dr. Donelan and his colleagues fitted runners or walkers with headphones tuned to a metronome, they found that they could increase or decrease volunteers’ step frequency, even if that frequency was faster or slower than a person’s preferred step pattern. They would also maintain that pace for as long as the metronomic rhythm continued unaltered. The volunteers aligned their movement to the beat.

In practical terms, this finding suggests that music may be one of the best ways to affect the pace of your running or walking, especially if you are trying to maintain a pace with which you are not familiar or which feels awkward. Want to start jogging faster than you have in the past? Load your iPod with uptempo music, Dr. Donelan suggests (although obviously ease into any changes in training slowly, to lessen the risk of injuries).

Dr. Donelan and his colleagues even have recently launched an iPhone app called Cruise Control that allows people to coordinate their pacing with their playlists. Input your preferred running or walking speed and the app skims your music library (nonjudgmentally; if you like Nickelback, that’s your business) and strings together songs with the requisite beat, even subtly altering the tempo of songs, if needed.

But of course, if you’re comfortable with your pace as it is, stick with it. For me, the most stirring message of these recent experiments is that, left to its own devices, your body will almost always obligingly try to choose the least demanding pace for you, a goal with which I’m happy to fall into step.

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DealBook: As Unit Pleads Guilty, R.B.S. to Pay $612 Million Over Rate Rigging

LONDON – The Royal Bank of Scotland on Wednesday struck a combined $612 million settlement with American and British authorities over accusations that it manipulated interest rates, the latest case to emerge from a broad international investigation.

In an embarrassing blow to the bank, its Japanese subsidiary also pleaded guilty to criminal wrongdoing in its settlement with the Justice Department. The R.B.S. subsidiary, a hub of rate-rigging activity, agreed to a single count of felony wire fraud to resolve the case.

The settlement reflects the Justice Department’s renewed vigor for punishing banks ensnared in the rate manipulation case. In December, a Japanese subsidiary of UBS pleaded guilty to felony wire fraud as part of a larger settlement, representing the first unit of a big bank to agree to criminal charges in more than a decade.

As authorities built the R.B.S. case, they seized on a series of incriminating yet colorful e-mails that highlighted an effort to influence the rate-setting process, a plot that spanned multiple currencies and countries from 2006 to 2010. One senior trader expressed disbelief at reaping lucrative profits from the scheme, saying “it’s just amazing” how rate “fixing can make you that much money,” according to the government’s complaint. Another trader, after pressuring a colleague to submit a certain rate, offered a reward of sorts: “I would come over there and make love to you.”

In a statement on Wednesday, the American regulator leading the case slammed the bank for manipulating benchmarks like the London Interbank Offered Rate, or Libor. The regulator, the Commodity Futures Trading Commission, noted that R.B.S. employees “aided and abetted” UBS and other firms in the rate-rigging scheme and continued to run afoul of the law, though more covertly, even after learning of a federal investigation.

“The public is deprived of an honest benchmark interest rate when a group of traders sits around a desk for years falsely spinning their bank’s Libor submissions, trying to manufacture winning trades. That’s what happened at R.B.S.,” David Meister, the enforcement director of the commission, said in the statement.

Libor Explained

The settlement represents the latest setback for Royal Bank of Scotland, which has struggled to shake the legacy of the 2008 financial crisis. The British firm already has put aside $2.7 billion to compensate customers who were inappropriately sold loan insurance over recent years. On Jan. 31, British regulators also called on the bank and other local rivals to review the sale of interest-rate hedging products after more than 90 percent of a sample were found to have been sold improperly.

The broader rate-rigging case has centered on how much the Royal Bank of Scotland and a dozen other banks, including Citigroup and HSBC, charge each other for loans. Such benchmarks, including Libor, help determine the borrowing costs for trillions of dollars in financial products like corporate loans, mortgages and credit cards.

But the Royal Bank of Scotland, like many of its competitors, corrupted the process. Government complaints filed over the last year outlined a scheme in which banks reported false rates to lift trading profits and deflect concerns about their health during the crisis.

Authorities filed the first Libor case in June, extracting a $450 million settlement with the British bank Barclays. In December, UBS agreed to a record $1.5 billion settlement with European regulators, the Justice Department and the American regulator that opened the case, the Commodity Futures Trading Commission. The Justice Department’s criminal division, which secured the guilty plea from the bank’s Japanese unit, also filed criminal charges against two former UBS traders.

Some of the world’s largest financial institutions remain caught in the cross hairs of the case. Deutsche Bank has set aside an undisclosed amount to cover potential penalties.

While foreign banks have received the brunt of the scrutiny to date, an American institution could be among the next to settle. Citigroup and JPMorgan Chase are under investigation.

In the $612 million Royal Bank of Scotland case, authorities levied the second-largest fine in the multiyear investigation into rate manipulation.

The fine included a $325 million penalty from the trading commission and a £87.5 million ($137 million) sanction from the Financial Services Authority, the British regulator, marking one of the largest financial penalties ever from British authorities. The Justice Department, for its part, imposed a $150 million fine as part of a deferred-prosecution agreement with R.B.S. In addition to wire fraud, the Justice Department cited the bank for its role in a “price-fixing conspiracy” that violated anti-trust laws.

R.B.S., based in Edinburgh, had aimed to avert the guilty plea for its Japanese subsidiary. But the Justice Department’s criminal division declined to back down, and the bank had little leverage to push back. If it had balked at a plea deal, the Justice Department could have moved to indict the subsidiary.

“Like with Barclays and UBS, the settlement with R.B.S. is much more than a slap on the wrist,” said Bart Chilton, a member of the trading commission who is critical of soft fines on big banks.

In the wake of the settlement, Royal Bank of Scotland is shaking up its management team as it moves to repair its bruised image. John Hourican, the firm’s investment banking chief, resigned on Wednesday, and agreed to forgo some of his past and current compensation totaling around $14.1 million. While Mr. Hourican was not implicated in the scandal, senior executives said he was taking blame for wrongdoing in his division.

“John is the right senior person to take responsibility for this,” the bank’s chairman, Philip Hampton, told reporters on Wednesday.

Royal Bank of Scotland, in which the government holds an 82 percent stake after providing a $73 billion bailout in 2008, also plans to claw back bonuses and other long-term compensation totaling $471 million to help pay for the rate-rigging penalty. The bank will will primarily use the figure to pay the fines from U.S. authorities, while penalties from the British regulator will be recycled back to the British government.

At a press conference in central London on Wednesday, Stephen Hester, the bank’s chief executive, condemned the illegal behavior of some of the firm’s employees, but acknowledged that Royal Bank of Scotland did not monitor its Libor submissions closely enough to catch the wrongdoing.

Mr. Hester, who has led the bank through a series of scandals and has been dogged by politicians’ demands for reductions in bonuses, admitted that the rate-rigging episode had placed the bank under a lot of strain.

“It is one of the most difficult moments over the entire period,” he said.

Mr. Hester, a former chief executive of the property developer British Land, has focused on paring back the bank’s operations. The C.E.O. has cut more than 30,000 job cuts since 2008, attempted to spin-off of the mergers and acquisitions unit and cut the size of its balance sheet by £600 billion since 2009. Mr. Hester also waved his $1.5 million bonus for 2011 after coming under pressure from British politicians.

In the Libor case, the wrongdoing at R.B.S. occurred on smaller scale than at other banks. The breach, authorities say, was limited to Libor submitters and traders who sought to bolster their bottom line. By comparison, top executives at Barclays knew the bank was lowballing its Libor rates to assuage concerns about its high borrowing costs.

R.B.S., which admitted that 21 of its employees altered the firm’s Libor submissions for financial gain on hundreds of occasions, either disciplined or fired most of the employees. The rest left before they were implicated. In the UBS case, the trading commission cited more than 2,000 instances of illegal acts involving dozens of employees.

Still, the government complaints against R.B.S. portray a permissive culture that allowed rate-rigging to persist for some four years.

The bank’s own records captured the scheme in striking detail, revealing how traders pressured other employees to submit certain Libor figures. Submitters and traders sat in earshot of each other on a trading desk in London, forming what authorities termed a “cozy ring.”

The bank eventually separated the employees, forcing them to communicate over e-mail and phone. A flurry of instant messages ensued, some more vulgar than others.

A trader noted in September 2009 that his requests for rates moved up and down, “like a whores drawers.” Another employee acknowledged that the Libor rate-setting process is “a cartel now.”

To get their way with employees who submitted Libor rates, traders promised “love” and affection. Others merely offered steak and sushi. One trader resorted to begging, invoking a plea of “pretty please.”

When authorities started investigating, the traders adapted. One employee noted that federal authorities “are all over us.”

The concerns prompted a more covert approach. In September 2010, after the trading commission ordered an internal investigation at R.B.S., a derivatives trader urged a colleague who requested a higher Libor rate to send “no emails anymore.”

Two months later, a Libor submitter rebuffed an instant message request to manipulate rates. But then, the submitter spoke with the trader via telephone, explaining “we’re not allowed to have those conversations” over instant message.

Their call was recorded. The employees laughed, according to a transcript, and the submitter reassured the trader that he would fulfill the request: “Leave it with me, and uh, it won’t be a problem.”

The lobbying paid off. When employees submitted bogus rates, government authorities said, Libor was altered.

Lanny Breuer, the head of the Justice Department’s criminal division, called the actions a “stunning abuse of trust.”

He also warned of coming actions against other big banks. “Our message is clear: no financial institution is above the law.”

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