Egypt Sends Prime Minister to Gaza in Show of Solidarity

Ilia Yefimovich/Getty Images

Smoke rose over Gaza on Friday. Israel denied launching airstrikes. More Photos »

GAZA CITY — After a night of ferocious airstrikes in Gaza and rocket fire toward Israel, Egypt on Friday launched a remarkable diplomatic initiative, sending its prime minister to show support for Palestinians in the beleaguered enclave, a move that prompted his Israeli counterpart to agree to a temporary, though flawed, cease-fire even as Israeli commanders sent armored vehicles toward the overcrowded coastal strip and called up reservists for a possible invasion.

The frail truce barely took root. Even as Prime Minister Hesham Kandil of Egypt arrived in Gaza, Israel Radio said Palestinian militants fired 25 rockets into southern Israel, with one rocket striking a house. There were no immediate reports of casualties.

The thump of airstrikes by Israeli F-16s was also audible in Gaza City. The Israeli military said no such strikes had taken place, but the Hamas health ministry reported that two people, including a child, were killed in the north of Gaza City while the Egyptian delegation was on the ground, pushing the Palestinian death toll in three days of aerial bombardment to 21.

Three Israelis were killed in a rocket attack on Thursday in Kiryat Malachi, a small town in southern Israel, when a rocket fired from Gaza struck their apartment house.

Prime Minister Benjamin Netanyahu had made the temporary cease-fire by Israel’s airplanes conditional on a corresponding halt to rocket fire from Gaza.

Mr. Kandil’s visit produced dramatic imagery to underpin Cairo’s support for Hamas, which Israel, the United States and much of the West consider to be a terrorist organization.

Mr. Kandil and Ismail Haniya, his Hamas equivalent, visited the Al Shifa hospital amid a huge scrum of bodyguards and journalists, saying they had carried the body of Mohammed Yasser, one of eight children who Palestinian health officials say have been killed in the surge of violence since a top Hamas commander was killed in an Israeli airstrike on Wednesday.

“This is the blood of our children on our clothes,” Mr. Haniyeh said as he showed spatters on his clothing, “These are the Egyptian and the Palestinian blood united together.”

Like President Mohamed Morsi of Egypt on Thursday, Mr. Kandil walked a delicate line between support for Hamas, condemnation of Israel and a quest for calm in a region increasingly threatened by the spillovers from Syria’s civil war into neighboring countries as well as by the long-festering impasse between Israelis and Palestinians.

“The aim of this visit is not only to show political support but to support the Palestinian people on the ground,” Mr. Kandil said, noting that he had brought with him a delegation from the Egyptian Health Ministry. He said a cease-fire between Gaza and Israel was “the only way to achieve stability in the region” and also called on the Palestinians to repair the rift between Hamas in Gaza and the Fatah group that dominates the Palestinian Authority in the West Bank. “We call on the Palestinian people to unite because their power and strength is in their unity,” Mr. Kandil said. “That’s the only way to liberate Palestine.”

The visit was the first of such a high-ranking Egyptian official to this coastal enclave since the militant Hamas faction gained control in 2007 and offered a potent sign of how Egypt’s revolution and new Islamist leadership since the overthrow of President Hosni Mubakrak last year has shifted the geopolitics of the Israeli-Palestinian conflict.

Egypt, Mr. Kandil said, would “save nothing to stop the aggression and achieve a continuous cease-fire on the way to having a Palestinian state with Jerusalem as its capital.”

The display of support — improbable throughout the Mubarak era — emboldened the Hamas leadership.

“The time in which the Israeli occupation does whatever it wants in Gaza is gone,” Mr. Haniyeh said. “Egypt cannot accept the aggression as before,” Mr. Haniyeh said. “I welcome Egypt for this historical visit that comes in harmony with the will of the free Egypt.” Before the visit, residents in Gaza said the night was filled with the boom and crash of airstrikes, with loud explosions at dawn on Friday, a day after Israel and the Hamas rulers of Gaza brushed aside international calls for restraint and escalated their lethal conflict. In Gaza, Palestinian militants launched hundreds of rockets into Israeli territory, targeting Tel Aviv for the first time, and Israel intensified its aerial assaults.

Defense Minister Ehud Barak of Israel, expressing outrage over a pair of long-range Palestinian rockets that whizzed toward Tel Aviv and set off the first air-raid warning in the Israeli metropolis since it was threatened by Iraqi Scud missiles in the Persian Gulf war of 1991, said, “There will be a price for that escalation that the other side will have to pay.”

Jodi Rudoren reported from Gaza City, Isabel Kershner from Jerusalem, and Alan Cowell from Paris. Reporting was contributed by Fares Akram from Gaza, Rick Gladstone from New York, Rina Castelnuovo from Kiryat Malachi, Israel, Mayy El Sheikh and David D. Kirkpatrick from Cairo, Gabby Sobelman from Jerusalem, and Elisabeth Bumiller from Bangkok.

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Miguel Cabrera, Buster Posey win MVP awards

NEW YORK (AP) — Miguel Cabrera has a Most Valuable Player award to go with his Triple Crown. And Buster Posey has an MVP prize to put alongside his second World Series ring.

The pair of batting champions won baseball's top individual honors Thursday by large margins.

Cabrera, the first Triple Crown winner in 45 years, won the AL MVP by receiving 22 of 28 first-place votes and 362 points from a panel of Baseball Writers' Association of America.

The Detroit third baseman easily beat Los Angeles Angels rookie center fielder Mike Trout, who had six firsts and 281 points.

Cabrera hit .330 with 44 homers and 139 RBIs to become the first Triple Crown winner since Boston's Carl Yastrzemski in 1967. Cabrera also led the league with a .606 slugging percentage for the AL champion Tigers.

Some of the more sabermetric-focused fans supported Trout, who hit .326 with 30 homers and 83 RBIs, and he led the majors with 129 runs and 49 steals and topped all players in WAR — Wins Above Replacement. Trout won AL Rookie of the Year earlier in the week.

"I was a little concerned. I thought the new thing about computer stuff, I thought Trout's going to win because they put his numbers over me," Cabrera said. "I was like relax. ... if he wins, it's going to be fair because he had a great season."

His victory is a win for the traditional statistics.

"At the end of the game, it's going to be the same baseball played back in the day," Cabrera said.

Posey, at a charity event at his mother's school in Leesburg, Va., followed the AL debate and Googled to find out the winner.

"I think it intrigued everybody," he said. "As a fan of the game, it was a fun race to watch."

With three fewer hits or two less homers, Cabrera would have fallen short of the Triple Crown. The last four Triple Crown winners have been voted MVP, including Mickey Mantle in 1956 and Frank Robinson in 1966.

"I think winning the Triple Crown had a lot to do with me winning this honor," he said.

Cabrera became the second straight Detroit player voted MVP, following pitcher Justin Verlander in 2011, and was the first Venezuelan to earn the honor. Countryman Pablo Sandoval took home World Series MVP honors last month.

Before the season, Cabrera switched from first base to third to make way for Prince Fielder, who signed with Detroit as a free agent.

"I focused too much in spring training about defense, defense, defense," Cabrera said. "I forgot a little bit about hitting, about getting in the cage like I normally do."

In spring training, Posey's focus was just to get back on the field. His 2011 season was cut short by a collision with the Marlins' Scott Cousins on May 25 that resulted in a fractured bone in Posey's lower left leg and three torn ankle ligaments.

Posey not only returned, he became the first catcher in 70 years to win the NL batting title and helped San Francisco win its second World Series championship in three seasons.

"I definitely have a deeper appreciation for being able to play baseball," he said. "I've seen that it can be taken away quick."

The first catcher in four decades to win the NL award, Posey got 27 of 32 firsts and 422 points to outdistance 2011 winner Ryan Braun of Milwaukee, who was second with 285 points.

Pittsburgh outfielder Andrew McCutchen (245) was third, followed by St. Louis catcher Yadier Molina (241).

Posey, a boyish-looking 25, was the 2010 NL Rookie of the Year as the Giants won their first World Series since 1954. This year he set career highs with a .336 average, 24 homers and 103 RBIs as San Francisco won again.

Posey took the NL batting title after teammate Melky Cabrera requested a rules change that disqualified him. Cabrera, who hit .346, missed the final 45 games of the regular-season while serving a suspension for a positive testosterone test and would have won the batting crown if the rule hadn't been changed.

Ernie Lombardi had been the previous catcher to capture the NL batting championship, in 1942.

"I think anybody that has caught before understands the grind of catching, not only the physical, the nicks, the wear and tear of squatting for nine innings night in, day out, but just the mental grind of working a pitching staff," Posey said. "It's demanding."

NOTES: In his first season with the Angels, Albert Pujols didn't finish among the top 10 for the first time in his career. While with St. Louis, he won three times, was second four times and also finished third, fourth, fifth and ninth. ... Catchers have won the NL MVP just eight times, with Posey joining Gabby Hartnett (1935), Lombardi (1938), Roy Campanella (1951, 1953, 1955) and Johnny Bench (1970, 1972). Posey became the first Giants player to win since Barry Bonds was voted his record seventh MVP award in 2004. ... Cabrera earned a $500,000 bonus, Adrian Beltre $150,000 for finishing third in the AL and Josh Hamilton $50,000 for fifth place. Braun gets a $75,000 bonus, and McCutchen and Molina $50,000 each. The Yankees' Derek Jeter finished seventh in the AL, one place below the level where his 2014 player option would have increased by $2 million to $10 million.

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For Alzheimer’s, Detection Advances Outpace Treatment Options

Joshua Lott for The New York Times

Awilda Jimenez got a scan for Alzheimer’s after she started forgetting things. It was positive.

When Awilda Jimenez started forgetting things last year, her husband, Edwin, felt a shiver of dread. Her mother had developed Alzheimer’s in her 50s. Could his wife, 61, have it, too?

He learned there was a new brain scan to diagnose the disease and nervously agreed to get her one, secretly hoping it would lay his fears to rest. In June, his wife became what her doctor says is the first private patient in Arizona to have the test.

“The scan was floridly positive,” said her doctor, Adam S. Fleisher, director of brain imaging at the Banner Alzheimer’s Institute in Phoenix.

The Jimenezes have struggled ever since to deal with this devastating news. They are confronting a problem of the new era of Alzheimer’s research: The ability to detect the disease has leapt far ahead of treatments. There are none that can stop or even significantly slow the inexorable progression to dementia and death.

Families like the Jimenezes, with no good options, can only ask: Should they live their lives differently, get their affairs in order, join a clinical trial of an experimental drug?

“I was hoping the scan would be negative,” Mr. Jimenez said. “When I found out it was positive, my heart sank.”

The new brain scan technology, which went on the market in June, is spreading fast. There are already more than 300 hospitals and imaging centers, located in most major metropolitan areas, that are ready to perform the scans, according to Eli Lilly, which sells the tracer used to mark plaque for the scan.

The scans show plaques in the brain — barnaclelike clumps of protein, beta amyloid — that, together with dementia, are the defining feature of Alzheimer’s disease. Those who have dementia but do not have excessive plaques do not have Alzheimer’s. It is no longer necessary to wait until the person dies and has an autopsy to learn if the brain was studded with plaques.

Many insurers, including Medicare, will not yet pay for the new scans, which cost several thousand dollars. And getting one comes with serious risks. While federal law prevents insurers and employers from discriminating based on genetic tests, it does not apply to scans. People with brain plaques can be denied long-term care insurance.

The Food and Drug Administration, worried about interpretations of the scans, has required something new: Doctors must take a test showing they can read them accurately before they begin doing them. So far, 700 doctors have qualified, according to Eli Lilly. Other kinds of diagnostic scans have no such requirement.

In another unusual feature, the F.D.A. requires that radiologists not be told anything about the patient. They are generally trained to incorporate clinical information into their interpretation of other types of scans, said Dr. R. Dwaine Rieves, director of the drug agency’s Division of Medical Imaging Products.

But in this case, clinical information may lead radiologists to inadvertently shade their reports to coincide with what doctors suspect is the underlying disease. With Alzheimer’s, Dr. Rieves said, “clinical impressions have been misleading.”

“This is a big change in the world of image interpretation,” he said.

Like some other Alzheimer’s experts, Dr. Fleisher used the amyloid scan for several years as part of a research study that led to its F.D.A. approval. Subjects were not told what the scans showed. Now, with the scan on the market, the rules have changed.

Dr. Fleisher’s first patient was Mrs. Jimenez. Her husband, the family breadwinner, had lost his job as a computer consultant when the couple moved from New York to Arizona to take care of Mrs. Jimenez’s mother. Paying several thousand dollars for a scan was out of the question. But Dr. Fleisher found a radiologist, Dr. Mantej Singh Sra of Sun Radiology, who was so eager to get into the business that he agreed to do Mrs. Jimenez’s scan free. His plan was to be the first in Arizona to do a scan, and advertise it.

After Dr. Sra did the scan, the Jimenezes returned to Dr. Fleisher to learn the result.

Dr. Fleisher, sad to see so much plaque in Mrs. Jimenez’s brain, referred her to a psychiatrist to help with anxiety and suggested she enter clinical trials of experimental drugs.

But Mr. Jimenez did not like that idea. He worried about unexpected side effects.

“Tempting as it is, where do you draw the line?” he asks. “At what point do you take a risk with a loved one?”

At Mount Sinai Medical Center in New York, Dr. Samuel E. Gandy found that his patients — mostly affluent — were unfazed by the medical center’s $3,750 price for the scan. He has been ordering at least one a week for people with symptoms ambiguous enough to suggest the possibility of brain plaques.

Most of his patients want their names kept confidential, fearing an inability to get long-term care insurance, or just wanting privacy.

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BBC Failures Show Limits of Guidelines

LONDON — It was 2004, and the British Broadcasting Corporation was gripped by a crisis over journalistic standards that had led to Parliamentary hearings, public recrimination and the resignations of its two top officials. Vowing change, the corporation established elaborate bureaucratic procedures that placed more formal responsibility for delicate decisions in the hands not of individual managers, but of rigid hierarchies.

The corporation also appointed a deputy director general in charge of news operations; established a “journalism board” to monitor editorial policy; issued numerous new guidelines on journalistic procedures; and put an increasing emphasis on “compliance” — a system in which managers are required to file cumbersome forms flagging dozens of potential trouble spots, from bad language to “disturbing content” like exorcism or beheadings, in every program taped for broadcast.

More crises would follow — the history of the BBC can be measured out in crises — and with each new one, the management team under Mark Thompson, director general from 2004 through mid-September 2012, added more guidelines and put more emphasis on form-filling and safety checks in news and entertainment programs. An organization already known for its bureaucracy became even more unwieldy (the editorial guidelines are now 215 pages long).

But it is these very structures that seem to have failed the BBC in the most recent scandal, in which its news division first canceled a child abuse segment it should have broadcast, and later broadcast one it should have canceled. In the first instance, it appears that people overseeing the program were too cautious, so that top managers were left unaware of its existence; in the second, managers may have relied too much on rigid procedures at the expense of basic journalistic principles.

“They burned their fingers,” said Tim Luckhurst, a journalism professor at the University of Kent who worked at the BBC for 10 years. “They wanted systems that could take responsibility instead of people.”

The recent scandal has had a number of immediate results. Mr. Thompson’s successor as director general, George Entwistle, resigned after just 54 days on the job. (Mr. Thompson is now president and chief executive of The New York Times Company.) Outside investigators were appointed to interrogate BBC employees in at least three different inquiries. A number of lower- and midlevel managers had to withdraw temporarily from their jobs and, facing possible disciplinary action, hired lawyers. And, once again, the BBC is talking about reorganizing structures.

Through a spokesman, Mr. Entwistle declined to comment on the scandal or the BBC’s management practices, saying he was “not doing any media interviews at present.” Mr. Thompson also declined to comment.

But Mr. Entwistle’s temporary successor, Tim Davie, who had previously been director of BBC Audio & Music, acknowledged that changes had to be made. “If the public are going to get journalism they trust from the BBC I have to be, as director general, very clear on who’s running the news operation and ensuring that journalism that we put out passes muster,” Mr. Davie said in his first week on the job. The first thing to do, he said, was to “take action and build trust by putting a clear line of command in.”

This is a complicated scandal in two parts. The first part was over the BBC’s decision last December not to broadcast a report saying that Jimmy Savile, a longtime BBC television host, had been a serial child molester, and instead to broadcast several glowing tributes to his career. The second part was its decision on Nov. 2 to accuse a member of Margaret Thatcher’s government of being a pedophile, an accusation that turned out to be patently false.

But both exposed the problems in a system that seems to insulate the BBC’s director general — who is also the editor in chief — from knowledge of basic issues like what potentially contentious programs are scheduled for broadcast. And both decisions were the result, it seems, of a system that failed in practice, even as it was correctly followed in theory.

Ben Bradshaw, a former BBC correspondent and now a Labour member of Parliament, said the 2004 scandal, touched off by reporting about British intelligence on Iraqi weapons of mass destruction, had created a system based on “fear and anxiety.” The BBC, he added, became “even more bureaucratic and had even more layers, which exacerbated the problem of buck passing and no one being able to take a decision.”

Speaking of the Nov. 2 broadcast, the chairman of the BBC Trust, Chris Patten, said in a television interview that the piece went through “every damned layer of BBC management bureaucracy, legal checks” without anyone raising any serious objections.

Matthew Purdy contributed reporting from New York, and Lark Turner from London.

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R.A. Dickey, David Price win Cy Young awards

NEW YORK (AP) — R.A. Dickey languished in the minors for 14 years, bouncing from one team to another before finally perfecting that perplexing knuckleball that made him a major league star.

David Price was the top pick in the draft and an ace by age 25, throwing 98 mph heat with a left arm live enough to make the most hardened scout sing.

Raised only 34 miles apart in central Tennessee, Dickey and Price won baseball's Cy Young awards on Wednesday — one by a wide margin, the other in a tight vote.

Two paths to the pantheon of pitching have rarely been more different.

"Isn't that awesome?" said Dickey, the first knuckleballer to win a Cy Young. "It just shows you there's not just one way to do it, and it gives hope to a lot of people."

Dickey said he jumped up and yelled in excitement, scaring one of his kids, when he saw on television that Price edged Justin Verlander for the American League prize. Both winners are represented by Bo McKinnis, who watched the announcements with Dickey at his home in Nashville, Tenn.

"I guess we can call him Cy agent now," Price quipped on a conference call.

The hard-throwing lefty barely beat out Verlander in balloting by the Baseball Writers' Association of America, preventing the Detroit Tigers' ace from winning consecutive Cy Youngs.

Runner-up two years ago, Price was the pick this time. He received 14 of 28 first-place votes and finished with 153 points to 149 for Verlander, chosen first on 13 ballots.

"It means a lot," Price said. "It's something that I'll always have. It's something that they can't take away from me."

Other than a 1969 tie between Mike Cuellar and Denny McLain, it was the closest race in the history of the AL award.

Rays closer Fernando Rodney got the other first-place vote and came in fifth.

The 38-year-old Dickey was listed first on 27 of 32 National League ballots and totaled 209 points, 113 more than 2011 winner Clayton Kershaw of the Los Angeles Dodgers. Washington lefty Gio Gonzalez finished third.

Cincinnati right-hander Johnny Cueto and Atlanta closer Craig Kimbrel each received a first-place vote, as did Gonzalez. Kershaw had two.

Dickey joined Dwight Gooden (1985) and three-time winner Tom Seaver as the only Mets to win the award. The right-hander went 20-6 with a 2.73 ERA, making him the club's first 20-game winner since Frank Viola in 1990, and became the first major leaguer in 24 years to throw consecutive one-hitters.

Perhaps most impressive, Dickey did it all during a season when the fourth-place Mets finished 74-88.

"It just feels good all over," he said on MLB Network.

Dickey switched from conventional pitcher to full-time knuckleballer in a last-ditch effort to save his career. It took him years to finally master the floating, darting pitch, which he often throws harder (around 80 mph) and with more precision than almost anyone who used it before him.

"I knew what I was going to be up against in some regard when I embraced this pitch," Dickey said.

He was the first cut at Mets spring training in 2010 but earned a spot in the big league rotation later that season and blossomed into a dominant All-Star this year. He led the NL in strikeouts (230), innings (233 2-3), complete games (five) and shutouts (three) — pitching through an abdominal injury most of the way.

"I am not a self-made man by any stretch of the imagination," Dickey said. "The height of this story, it's mind-blowing to me, it really is."

A member of the 1996 U.S. Olympic team and a first-round draft pick out of Tennessee, Dickey was devastated when the Texas Rangers reduced their signing-bonus offer from more than $800,000 to $75,000 after they discovered during a physical that he was missing a major ligament in his pitching elbow.

Undeterred, perseverance got him to the big leagues anyway. When he failed, the knuckleball brought him back.

Among those he thanked ceaselessly for helping him on that long and winding road to success were all his proud knuckleball mentors, including Charlie Hough, Tim Wakefield and Hall of Famer Phil Niekro.

"It brings a real degree of legitimacy I think to the knuckleball fraternity and I'm glad to represent them and I'm certainly grateful to all those guys," Dickey said. "This was a victory for all of us."

Dickey said he received 127 text messages and 35-40 phone calls in the moments immediately following the Cy Young announcement.

The only call he took was from Niekro, a 318-game winner from 1964-87. The first texts Dickey responded to were from Wakefield and Hough.

"Most well-deserved," Niekro said in a comment provided by the Hall of Fame. "I'm super proud of him, as a pitcher and as an individual."

Dickey has one year left on his contract at $5.25 million and New York general manager Sandy Alderson has said signing the pitcher to a multiyear deal is one of his top offseason priorities. Alderson, however, would not rule out trading his unlikely ace.

"I believe the Mets are going to be a lot better and I want to be part of the solution," Dickey said, adding that he hopes the sides can strike a deal and he'd be happy to end his career in New York.

"I want to be loyal to an organization that's given me an opportunity," he said. "At the same time, you don't want to be taken advantage of. I've been on that side of it, too, as a player."

Price went 20-5 to tie Jered Weaver for the American League lead in victories and winning percentage. The 27-year-old lefty had the lowest ERA at 2.56 and finished sixth in strikeouts with 205.

Verlander, also the league MVP a year ago, followed that up by going 17-8 with a 2.64 ERA and pitching the Detroit Tigers to the World Series. He led the majors in strikeouts (239), innings (238 1-3) and complete games (six).

Price tossed 211 innings in 31 starts, while Verlander made 33. One factor that could have swung some votes, however, was this: Price faced stiffer competition in the rugged AL East than Verlander did in the AL Central.

"I guess it's a blessing and a curse at the same time," Price said. "There's not an easy out in the lineups every game. It feels like a postseason game."

The No. 1 pick in the 2007 amateur draft out of Vanderbilt, Price reached the majors the following year and has made three straight All-Star teams.

Despite going 19-6 with a 2.72 ERA in 2010, he finished a distant second in Cy Young voting to Felix Hernandez, who won only 13 games for last-place Seattle but dominated most other statistical categories that year.

The two MVP awards will be announced Thursday. Verlander's teammate, Triple Crown winner Miguel Cabrera, is a leading contender in the American League.

NOTES: The last AL pitcher to win back-to-back Cy Youngs was Boston's Pedro Martinez in 1999 and 2000. San Francisco RHP Tim Lincecum did it in the National League in 2008-09. ... Price and Dickey became the fourth pair of Cy Young winners born in the same state, according to STATS. The others were Jim Lonborg and Mike McCormick in 1967 (California), Viola and Orel Hershiser in 1988 (New York) and Pat Hentgen and John Smoltz in 1996 (Michigan). ... Niekro and his brother, Joe, both finished second in Cy Young voting, as did fellow knuckleballer Wilbur Wood.

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Alzheimer’s Tied to Mutation Harming Immune Response

Alzheimer’s researchers and drug companies have for years concentrated on one hallmark of Alzheimer’s disease: the production of toxic shards of a protein that accumulate in plaques on the brain.

But now, in a surprising coincidence, two groups of researchers working from entirely different starting points have converged on a mutated gene involved in another aspect of Alzheimer’s disease: the immune system’s role in protecting against the disease. The mutation is suspected of interfering with the brain’s ability to prevent the buildup of plaque.

The discovery, researchers say, provides clues to how and why the disease progresses. The gene, known as TREM2, is only the second found to increase Alzheimer’s risk substantially in older people.

“It points very specifically to a potential metabolic pathway that you could intervene in to change the course of Alzheimer’s disease,” said William Thies, chief medical and scientific officer of the Alzheimer’s Association.

Much work remains to be done before scientists understand precisely how the newly discovered gene mutation leads to Alzheimer’s, but already there are some indications from studies in mice. When the gene is not mutated, white blood cells in the brain spring into action, gobbling up and eliminating the plaque-forming toxic protein, beta amyloid. As a result, Alzheimer’s can be staved off or averted.

But when the gene is mutated, the brain’s white blood cells are hobbled, making them less effective in their attack on beta amyloid.

People with the mutated gene have a threefold to fivefold increase in the likelihood of developing Alzheimer’s disease in old age.

The intact gene, says John Hardy of University College London, “is a safety net.” And those with the mutation, he adds, “are living life without a safety net.” Dr. Hardy is lead author of one of the papers.

The discovery also suggests that a new type of drug could be developed to enhance the gene’s activity, perhaps allowing the brain’s white blood cells to do their work.

“The field is in desperate need of new therapeutic agents,” said Alison Goate, an Alzheimer’s researcher at Washington University in St. Louis who contributed data to Dr. Hardy’s study. “This will give us an alternative approach.”

The fact that two research groups converged on the same gene gives experts confidence in the findings. Both studies were published online Wednesday in The New England Journal of Medicine. “Together they make a good case that this really is an Alzheimer’s gene,” said Gerard Schellenberg, an Alzheimer’s researcher at the University of Pennsylvania who was not involved with the work.

The other gene found to raise the odds that a person will get Alzheimer’s, ApoE4, is much more common and confers about the same risk as the mutated version of TREM2. But it is still not clear why ApoE4, discovered in 1993, makes Alzheimer’s more likely.

Because the mutations in the newly discovered gene are rare, occurring in no more than 2 percent of Alzheimer’s patients, it makes no sense to start screening people for them, Dr. Thies said. Instead, the discovery provides new clues to the workings of Alzheimer’s disease.

To find the gene, a research group led by Dr. Kari Stefansson of deCODE Genetics of Iceland started with a simple question.

“We asked, ‘Can we find anything in the genome that separates those who are admitted to nursing homes before the age of 75 and those who are still living at home at 85?’ ” he said.

Scientists searched the genomes of 2,261 Icelanders and zeroed in on TREM2. Mutations in that gene were more common among people with Alzheimer’s, as well as those who did not have an Alzheimer’s diagnosis but who had memory problems and might be on their way to developing Alzheimer’s.

The researchers confirmed their results by looking for the gene in people with and without Alzheimer’s in populations studied at Emory University, as well as in Norway, the Netherlands and Germany.

The TREM2 connection surprised Dr. Stefansson. Although researchers have long noticed that the brain is inflamed in Alzheimer’s patients, he had dismissed inflammation as a major factor in the disease.

“I was of the opinion that the immune system would play a fairly small role, if any, in Alzheimer’s disease,” Dr. Stefansson said. “This discovery cured me of that bias.”

Meanwhile, Dr. Hardy and Rita Guerreiro at University College London, along with Andrew Singleton at the National Institute on Aging, were intrigued by a strange, rare disease. Only a few patients had been identified, but their symptoms were striking. They had crumbling bones and an unusual dementia, sclerosing leukoencephalopathy.

“It’s a weird disease,” Dr. Hardy said.

He saw one patient in her 30s whose brain disease manifested in sexually inappropriate behavior. Also, her bones kept breaking. The disease was caused by mutations that disabled both the copy of TREM2 that she had inherited from her mother and the one from her father.

Eventually the researchers searched for people who had a mutation in just one copy of TREM2. To their surprise, it turned out that these people were likely to have Alzheimer’s disease.

They then asked researchers around the world who had genetic data from people with and without Alzheimer’s to look for TREM2 mutations.

“Sure enough, they had good evidence,” Dr. Hardy said. The mutations occurred in one-half of 1 percent of the general population but in 1 to 2 percent of patients with Alzheimer’s disease.

“That is a big effect,” Dr. Hardy said.

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France Grants Full Recognition to Syria Rebels While U.S. Waits

Javier Manzano/Agence France-Presse — Getty Images

Smoke billowed from burning tires as a Syria rebel fired towards regime forces during clashes in the Al-Amariya district of Aleppo in Syria on Tuesday.

PARIS — France announced Tuesday that it was recognizing the newly formed Syrian rebel coalition and would consider arming the group, seeking to inject momentum into a broad Western and Arab effort to build a viable and effective opposition to hasten the end of a stalemated civil war that has destabilized the Middle East.

But, for its part on Wednesday, the United States signaled a reluctance to go beyond its characterization of the rebel alliance as what officials have termed a legitimate representative of the Syrian people, rather than as their sole representative. Speaking in Perth, Australia, Secretary of State Hillary Rodham Clinton said Washington first wanted to see the coalition influencing events on the ground.

“As the Syrian opposition takes these steps and demonstrates its effectiveness in advancing the cause of a unified, democratic, pluralistic Syria, we will be prepared to work with them to deliver assistance to the Syrian people,” news reports quoted her saying.

At the same time, she announced $30 million in American humanitarian aid to feed people affected by the civil war, bringing the total American assistance to almost $200 million. A day earlier, the announcement by President François Hollande made France the first Western country to fully embrace the new coalition, which came together this past weekend under Western pressure after days of difficult negotiations in Doha, Qatar.

The goal was to make an opposition leadership — both inside and outside the country — representative of the array of Syrian groups pressing for the downfall of President Bashar al-Assad. Although Mr. Assad is increasingly isolated as his country descends further into mayhem and despair after 20 months of conflict, he has survived partly because of the disagreements and lack of unity among his opponents.

Throughout the conflict, the West has taken half measures and been reluctant to back an aggressive effort to oust Mr. Assad. This appears to be the first time that Western nations, with Arab allies, are determined to build a viable opposition leadership that can ultimately function as a government. Whether it can succeed remains unclear.

Mr. Hollande went beyond other Western pledges of support for the new Syrian umbrella rebel group, which calls itself the National Coalition of Syrian Revolutionary and Opposition Forces. But Mr. Hollande’s announcement clearly signaled expectations that if the group can establish political legitimacy and an operational structure inside Syria, creating an alternative to the Assad family’s four decades in power, it will be rewarded with further recognition, money and possibly weapons.

“I announce that France recognizes the Syrian National Coalition as the sole representative of the Syrian people and thus as the future provisional government of a democratic Syria and to bring an end to Bashar al-Assad’s regime,” said Mr. Hollande, who has been one of the Syrian president’s harshest critics.

As for weapons, Mr. Hollande said, France had not supported arming the rebels up to now, but “with the coalition, as soon as it is a legitimate government of Syria, this question will be looked at by France, but also by all countries that recognize this government.”

The six Arab countries of the Gulf Cooperation Council, including key opposition supporters Qatar and Saudi Arabia, recognized the rebel coalition on Monday as the legitimate Syrian government. Political analysts called Mr. Hollande’s announcement an important moment in the Syrian conflict, which began as a peaceful Arab Spring uprising in March 2011. It was harshly suppressed by Mr. Assad, turned into a civil war and has left nearly 40,000 Syrians dead, displaced about 2.5 million and forced more than 400,000 to flee to neighboring countries, according to international relief agencies.

“It’s certainly another page of the story,” Augustus Richard Norton, a professor of international relations at Boston University and an expert on Middle East political history, said of the French announcement. “I think it’s important. But it will be much more important if other countries follow suit. I don’t think we’re quite there yet.”

Some drew an analogy to France’s leading role in the early days of the Libyan uprising when it helped funnel aid, and later military support, to the rebels who had firmly established themselves in eastern Libya and would later topple Col. Muammar el-Qaddafi. But in Syria, rebels have not been as organized and have no hold on significant amounts of territory — at least not enough to create a provisional government that could resist Mr. Assad’s military assaults. The West has also refused, so far, to impose a no-fly zone over Syria, which was critical to the success of the Libyan uprising.

Andrew J. Tabler, a Syria expert at the Washington Institute for Near East Policy, said that the new coalition would have to create a secure zone in Syria to be successful, and that that step would require support from the United States, which was instrumental in the negotiations that led to the group’s creation but has not yet committed to giving it full recognition.

Steven Erlanger reported from Paris, and Rick Gladstone from New York. Reporting was contributed by Neil MacFarquhar and Hwaida Saad from Beirut, Lebanon; Nick Cumming-Bruce from Geneva; and Alan Cowell from Paris.

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AP source: Marlins trade 3 stars to Blue Jays

MIAMI (AP) — Reacting to the Miami Marlins' latest payroll purge on Twitter, slugger Giancarlo Stanton gave it three exclamation marks.

He wasn't exaggerating. The Marlins' spending spree a year ago didn't work, so they went the salary-dumping route again Tuesday, shedding some of their biggest stars and multimillion-dollar salaries in one blockbuster deal.

The Marlins swapped high-priced talent for top prospects, trading All-Star shortstop Jose Reyes, left-hander Mark Buehrle and ace right-hander Josh Johnson to the Toronto Blue Jays, a person familiar with the agreement said.

The person confirmed the trade to The Associated Press on condition of anonymity because the teams weren't officially commenting. The person said the trade sent several of the Blue Jays' best young players to Miami.

The stunning agreement came less than a year after the Marlins added Reyes, Buehrle and closer Heath Bell in an uncharacteristic $191 million spending binge as they rebranded and moved into a new ballpark. The acquisitions raised high hopes, but the Marlins instead finished last in the NL East.

Salary-paring actually began in July, when the Marlins parted with former NL batting champion Hanley Ramirez, second baseman Omar Infante and right-hander Anibal Sanchez, among others. Bell, the team's high-profile bust, was traded to Arizona last month.

Under owner Jeffrey Loria, long the target of fan acrimony, the Marlins have usually been among baseball's thriftiest teams. Management pledged that would change with the new ballpark, but team officials were disappointed with attendance in 2012, and revenue fell far short of their projections.

Even so, the blockbuster deal came as a shock. The players involved must undergo physicals before the trade becomes final.

Stanton, the Marlins' precocious slugger, wasn't involved in the deal but wasn't happy about it.

"Alright, I'm (mad)!!! Plain & Simple," he tweeted shortly after the news broke.

The housecleaning was also the subject of much mirth on Twitter.

"Good trade, I think we won it," tweeted FakeSamson, a site that mocks team president David Samson.

Toronto star Jose Bautista had a different interpretation.

"Its a good day to be a bluejay!" he tweeted.

The swap was easier for the Marlins to swing because of their longstanding policy of refusing to include no-trade clauses in contracts.

The deal gave an immediate boost to the Blue Jays, who have not reached the playoffs since winning their second consecutive World Series in 1993. Toronto went 73-89 this season and finished fourth in the AL East for the fourth straight year, again falling short in a division that includes big spenders.

The Marlins changed their name a year ago but failed to change their losing ways, and instead of contending for a playoff berth, they finished 69-93, their worst record since 1999.

The Marlins drew more than 2.2 million fans but had projected attendance of nearly 3 million. Team officials blamed the difference in part on manager Ozzie Guillen's laudatory comments early in the year about former Cuban leader Fidel Castro, which antagonized a large segment of an already-small fan base.

Guillen was fired after only one season with the team and replaced this month by the Marlins' former backup catcher, Mike Redmond.

President of baseball operations Larry Beinfest hinted at a big change in direction less than two weeks ago.

"We've kind of lost our Marlins way," he said. "The real Marlins way was we always outperformed our challenges. Whatever our challenges were, whether it was playing in a football stadium or weather or a lack of fans, or lack of revenue for that matter, we always found a way to outperform our challenges."

It now appears management will field a team with the expectation players will outperform their contracts, which was the franchise model for most of the past decade. The roster shake-up during the season reduced the payroll to $90.3 million from $112 million on opening day, and now could be dramatically lower next season.

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Recipes for Health: Roasted Eggplant and Chickpeas — Recipes for Health

Andrew Scrivani for The New York Times

Eggplant is always a good, substantial vegetable to use for a vegetarian main dish. The chickpeas and the feta provide plenty of protein. Vegans can leave out the feta and substitute sugar or agave nectar for the honey.

 

1/4 cup extra virgin olive oil

2 garlic cloves, minced

1 28-ounce can chopped tomatoes, with juice, pulsed to a coarse purée

1 teaspoon mild honey (more to taste)

1/4 to 1/2 teaspoon cinnamon, to taste

Salt to taste

1 large or 2 medium eggplants (about 1 1/4 pounds), cut into 1/3-inch-thick slices

3 cups cooked chickpeas (2 cans, drained and rinsed, or, 1 1/2 cups dried – about 3/4 pound

4 ounces feta, crumbled (3/4 cup)

1 teaspoon dried oregano, preferably Greek or Turkish

 

1. Make the tomato sauce. Heat 1 tablespoon of the olive oil in a heavy skillet or wide saucepan over medium heat, and add the garlic. Cook, stirring, until it smells fragrant, about 30 seconds, and add the tomatoes, honey, salt to taste and cinnamon. Cook over medium heat until the tomatoes have cooked down and the sauce is fragrant, about 20 minutes. Taste and adjust seasonings.

2. Meanwhile, heat the oven to 425 degrees. Line a baking sheet with aluminum foil and brush the boil with olive oil. Place the eggplant slices on the baking sheet, salt lightly and brush with olive oil. Place in the oven and bake 20 minutes, or until eggplant is lightly browned and soft all the way through. Remove from the heat. Fold the aluminum foil over and crimp the edges together so that the eggplant steams as it cools. Do this in batches if you need more than one baking sheet. Turn the oven down to 350 degrees.

3. Oil a 2-quart baking dish or gratin. Place the chickpeas in the baking dish and stir in 1 cup of the tomato sauce. Layer the eggplant over the chickpeas and top with the remaining tomato sauce. Sprinkle the feta over the top and drizzle on any remaining olive oil. Sprinkle with the oregano and cover tightly with foil. Bake 30 minutes. Uncover and bake another 10 minutes, until the dish is bubbling.

Yield: 6 servings

Advance preparation: The eggplant slices can be cooked up to a day ahead. Hold in the refrigerator, covered. The tomato sauce will keep for 3 days in the refrigerator and freezes well.

Nutritional information per serving: 366 calories; 16 grams fat; 4 grams saturated fat; 2 grams polyunsaturated fat; 8 grams monounsaturated fat; 17 milligrams cholesterol; 44 grams carbohydrates; 14 grams dietary fiber; 431 milligrams sodium (does not include salt to taste); 15 grams protein

Martha Rose Shulman is the author of “The Very Best of Recipes for Health

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At Microsoft, Sinofsky Seen as Smart but Abrasive

On a warm night in late October, Steven Sinofsky stood on a platform in New York’s Times Square, smiling as a huge crowd roared at the unveiling of a Microsoft retail store, where Windows 8 and the company’s new Surface tablet were about to go on sale.

Less than three weeks later, Mr. Sinofsky — who, as the head of Windows, was arguably the second-most important leader at Microsoft — suddenly left the company. His abrasive style was a source of discord within Microsoft, and he and Steven A. Ballmer, Microsoft’s chief executive, agreed that it was time for him to leave, according to a person briefed on the situation who was not authorized to speak publicly about it.

Mr. Sinofsky was widely admired for his effectiveness in running one of the biggest and most important software development organizations on the planet. But his departure, which Microsoft announced late on Monday, parallels in many respects that of Scott Forstall, the headstrong former head of Apple’s mobile software development, who was fired by Apple’s chief executive, Timothy D. Cook, in late October.

Both cases underscore a quandary that chief executives sometimes face: when do the costs of keeping brilliant leaders who cannot seem to get along with others outweigh the benefits?

The tipping point that led to Mr. Sinofsky’s departure came after an accumulation of run-ins with Mr. Ballmer and other company leaders, rather than a single incident, according to interviews with several current and former Microsoft executives who declined to be named discussing internal matters.

One example of the kind of behavior that hurt Mr. Sinofsky’s standing at the company occurred this year at a two-day retreat for Microsoft’s senior executives at the Semiahmoo resort on the coast just below the Canadian border in Washington State. At the meeting, Microsoft’s various division heads were expected to make presentations on their businesses, answer questions and remain to hear their peers repeat the exercise.

When Mr. Sinofsky stood on the first day to speak about the Windows division, he told the group he had not prepared a presentation, and if they wanted to catch up on the progress of Windows 8, they could read his company blog, where he publicly chronicled the software’s development. He answered questions from the audience and then left the resort, while his colleagues remained until the next day, according to multiple people who were present.

Mr. Sinofsky’s early exit and halfhearted presentation were widely noted by his colleagues, irking even his admirers in the company. “He lost a lot of support,” one attendee said.

It wasn’t until this Monday, though, that Mr. Sinofsky and Mr. Ballmer both decided it would be best if Mr. Sinofsky left. Bill Gates, Microsoft’s chairman, supported the move, a person briefed on the matter said. Mr. Sinofsky served as a technical assistant to Mr. Gates in the 1990s.

In an e-mail to Microsoft employees, Mr. Sinofsky said the decision to leave “was a personal and private choice.” Many surprised Microsoft insiders noted that Mr. Sinofsky’s departure was immediate, an unusual arrangement for someone with a 23-year track record at the company. A Microsoft spokesman, Frank Shaw, said Mr. Sinofsky was not available to comment.

Although Mr. Ballmer grew increasingly impatient with Mr. Sinofsky throughout the year, he held back from taking any action earlier to avoid disrupting the release of Windows 8, the most important product Microsoft has unveiled in years, a person with knowledge of his thinking said.

The final decision could not have come lightly. Although many people at Microsoft viewed him as a ruthless corporate schemer, Mr. Sinofsky ran the highly complex organization responsible for Windows as a disciplined army that met deadlines, and he was respected by people on his team.

He achieved hero status within Microsoft several years ago by taking over the leadership of Windows after the debacle that was Windows Vista, a much-delayed operating system whose sluggish performance and technical problems worsened Microsoft’s reputation for mediocre software. Mr. Sinfosky led the development of a new version of the operating system, Windows 7, which was positively reviewed and sold well.

“He did great things with Windows,” said Michael Cusumano, a professor at the Sloan School of Management at the Massachusetts Institute of Technology. “That’s still the core of the company.”

But while Mr. Sinofsky was effective, Mr. Cusumano said, he could be secretive and difficult to get along with, as he learned while dealing with Mr. Sinofsky while Mr. Cusumano was writing a book on Microsoft in the early 1990s. “I could imagine that he burned a lot of bridges and created a bunch of enemies,” he said.

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Afghan Warlord Ismail Khan’s Call to Arms Rattles Kabul

Bryan Denton for The New York Times

Mujahedeen commanders at a gathering in Herat, Afghanistan, to address the threat to security posed by the Taliban.

HERAT, Afghanistan — One of the most powerful mujahedeen commanders in Afghanistan, Ismail Khan, is calling on his followers to reorganize and defend the country against the Taliban as Western militaries withdraw, in a public demonstration of faltering confidence in the national government and the Western-built Afghan National Army.

Mr. Khan is one of the strongest of a group of warlords who defined the country’s recent history in battling the Soviets, the Taliban and one another, and who then were brought into President Hamid Karzai’s cabinet as a symbol of unity. Now, in announcing that he is remobilizing his forces, Mr. Khan has rankled Afghan officials and stoked fears that other regional and factional leaders will follow suit and rearm, weakening support for the government and increasing the likelihood of civil war.

This month, Mr. Khan rallied thousands of his supporters in the desert outside Herat, the cultured western provincial capital and the center of his power base, urging them to coordinate and reactivate their networks. And he has begun enlisting new recruits and organizing district command structures.

“We are responsible for maintaining security in our country and not letting Afghanistan be destroyed again,” Mr. Khan, the minister of energy and water, said at a news conference over the weekend at his office in Kabul. But after facing criticism, he took care not to frame his action as defying the government: “There are parts of the country where the government forces cannot operate, and in such areas the locals should step forward, take arms and defend the country.”

President Karzai and his aides, however, were not greeting it as an altruistic gesture. The governor of Herat Province called Mr. Khan’s reorganization an illegal challenge to the national security forces. And Mr. Karzai’s spokesman, Aimal Faizi, tersely criticized Mr. Khan.

“The remarks by Ismail Khan do not reflect the policies of the Afghan government,” Mr. Faizi said. “The government of Afghanistan and the Afghan people do not want any irresponsible armed grouping outside the legitimate security forces structures.”

In Kabul, Mr. Khan’s provocative actions have played out in the news media and brought a fierce reaction from some members of Parliament, who said the warlords were preparing to take advantage of the American troop withdrawal set for 2014.

“People like Ismail Khan smell blood,” Belqis Roshan, a senator from Farah Province, said in an interview. “They think that as soon as foreign forces leave Afghanistan, once again they will get the chance to start a civil war, and achieve their ominous goals of getting rich and terminating their local rivals.”

Indeed, Mr. Khan’s is not the only voice calling for a renewed alliance of the mujahedeen against the Taliban, and some of the others are just as familiar.

Marshal Muhammad Qasim Fahim, an ethnic Tajik commander who is President Karzai’s first vice president, said in a speech in September, “If the Afghan security forces are not able to wage this war, then call upon the mujahedeen.”

Another prominent mujahedeen fighter, Ahmad Zia Massoud, said in an interview at his home in Kabul that people were worried about what was going to happen after 2014, and he was telling his own followers to make preliminary preparations.

“They don’t want to be disgraced again,” Mr. Massoud said. “Everyone tries to have some sort of Plan B. Some people are on the verge of rearming.”

He pointed out that it was significant that the going market price of Kalashnikov assault rifles had risen to about $1,000, driven up by demand from a price of $300 a decade ago. “Every household wants to have an AK-47 at home,” he said.

“The mujahedeen come here to meet me,” Mr. Massoud added. “They tell me they are preparing. They are trying to find weapons. They come from villages, from the north of Afghanistan, even some people from the suburbs of Kabul, and say they are taking responsibility for providing private security in their neighborhood.”

Habib Zahori and Jawad Sukhanyar contributed reporting from Herat, Afghanistan, and an employee of The New York Times from Kabul.

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Roethlisberger hurt, Steelers survive Chiefs 16-13

PITTSBURGH (AP) — The Pittsburgh Steelers are right where they expected to be heading into a vital three-week stretch that includes two games against the AFC North-leading Baltimore Ravens.

They're just not sure quarterback Ben Roethlisberger will be along for the ride.

The Steelers survived a scare from lowly Kansas City on Monday night, winning 16-13 in overtime when Lawrence Timmons intercepted Matt Cassel on the second snap of the extra session and Shaun Suisham hit a 23-yard field goal one play later.

It took some of the sting out of watching Roethlisberger head to the locker room — and ultimately the hospital — with a busted right shoulder after getting slammed to the turf by a pair of Kansas City linebackers in the third quarter.

Coach Mike Tomlin declined to speculate on Roethlisberger's status, though backup Byron Leftwich sounds like he's planning to be pretty busy over the next few days.

"I don't know the situation with Ben, but I got to make sure I'm ready if he can't go," Leftwich said.

The Steelers (6-3) have won four straight and can move into first place next week if they can beat the Ravens (7-2). The showdown takes on a different hue with Roethlisberger's health in question.

"You obviously worry about it because that's your starting quarterback, you want to see him out there," Pittsburgh linebacker James Harrison said. "But at the same point in time you've got a guy, two guys that are behind him can do the job just as well if not better."

Roethlisberger completed 9 of 18 passes for 84 yards and a touchdown before leaving. Leftwich, playing for the first time in the regular season in nearly two years, completed 7 of 14 passes for 73 yards and led the Steelers to a go-ahead field goal in the fourth quarter.

"After four or five plays, it was like riding a bike," Leftwich said. "I took a few hits. I hadn't hit the ground in a while. It was a whole lot of things I hadn't done in a while. It was good."

Even if Roethlisberger was not. Tackle Max Starks didn't think the notoriously gritty Roethlisberger was in any real danger when he stood up after getting sandwiched between Tamba Hali and Justin Houston.

"It didn't seem like a tough hit ... but he came to the sideline and next thing you know he was gone," Starks said. "I'm hoping it was nothing serious. Honestly it didn't seem like it."

While the Steelers ponder their postseason prospects with Roethlisberger uncertain, the Chiefs (1-8) are simply wondering when they're going to win another game.

Jamaal Charles ran for 100 yards and a score but couldn't stop Kansas City from dropping its sixth straight.

The Chiefs had their chances, taking their first lead in regulation all season in the first half then overcoming a series of embarrassing miscues to tie the game at 13 at the end of regulation.

Taking over at the Kansas City 20 with 1:51 remaining, Cassel led the Chiefs 52 yards — converting a fourth-and-15 in the process — to set up a 46-yard field goal by Ryan Succop as time expired.

"I thought our guys played and competed all night long," Cassel said. "We went up against a good football team and unfortunately we weren't able to pull it out in the end, but I thought the way the guys handled the environment of Monday Night Football was great."

Kansas City's only other victory this season came in overtime, a stunning upset in New Orleans in September. Any chance at a repeat faded when Cassel's pass on the second play of extra period landed in the hands of Timmons, who returned it 23 yards to set up Suisham's second game-winning field goal of the season.

It was sweet vindication for a Pittsburgh defense that allowed AFC lesser lights Tennessee and Oakland mount fourth-quarter comebacks earlier this season. Though the Steelers only managed to get the Chiefs — last in the NFL in turnover differential — to cough it up once, timing is everything.

"We got the one that count baby," linebacker Larry Foote said. "We got the one that count. They did a good job tonight, but we got the one that was big time."

NOTES: The Steelers have won 15 consecutive home games on Monday night ... Roethlisberger topped 1,000 career rushing yards with a 13-yard scramble in the first half ... Pittsburgh S Ryan Clark left the game in the fourth quarter with a concussion.

___

Online: http://pro32.ap.org/poll and http://twitter.com/AP_NFL

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Lance Armstrong Cuts Officials Ties With His Livestrong Charity

In the wake of being stripped of his seven Tour de France titles for doping, Lance Armstrong last week cut all official ties with Livestrong, the charity he founded 15 years ago while he was treated for testicular cancer.

On Nov. 4, he resigned from the organization’s board of directors; he had previously stepped down as the chairman of the board Oct. 17. He has distanced himself from the charity to try to protect it from any damage caused by his doping controversy, the new board chairman, Jeff Garvey, said in a statement.

“Lance Armstrong was instrumental in changing the way the world views people affected by cancer,” Garvey said. “His devotion to serving survivors is unparalleled, and for 15 years, he committed himself to that cause with all his heart.”

Garvey said that the Armstrong family had donated nearly $7 million to the foundation and that the organization under Armstrong had raised close to $300 million to serve cancer survivors.

Last month, the United States Anti-Doping Agency made public its evidence in its doping case against Armstrong, saying he had doped and encouraged his teammates to dope so they could help him win races. He was subsequently barred from Olympic sports for life and was stripped of all the cycling titles he won from August 1998 on.

Since then, Armstrong has spent several weeks in Hawaii, out of the public eye. On Saturday, though, he posted a photograph on Twitter showing him at home in Austin, Tex. He is lounging on a couch with his seven yellow Tour jerseys framed on the wall in the background.

In the post, he said, “Back in Austin and just layin’ around.” The photograph had more than 400,000 page views as of Monday evening, with many people posting negative comments on the page.

“Lance, you have no moral conscious and it’s obvious many of your followers don’t either,” said one person who went by the Twitter handle “irobot,” who also posted that Armstrong needed “professional help.”

A person posting under the name “Aumann” said: “An art thief enjoying all his da Vincis.”

Other people posted words of support, including many who said they still thought Armstrong was the top cyclist in history.

“TomShelton” said of Armstrong’s seven Tour titles, “You earned all 7 of them no matter what is being said about you!”

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False Posts on Facebook Undermine Its Credibility

SAN FRANCISCO — The Facebook page for Gaston Memorial Hospital, in Gastonia, N.C., offers a chicken salad recipe to encourage healthy eating, tips on avoiding injuries at Zumba class, and pictures of staff members dressed up at Halloween. Typical stuff for a hospital in a small town.

But in October, another Facebook page for the hospital popped up. This one posted denunciations of President Obama and what it derided as “Obamacare.” It swiftly gathered hundreds of followers, and the anti-Obama screeds picked up “likes.” Officials at the hospital, scrambling to get it taken down, turned to their real Facebook page for damage control. “We apologize for any confusion,” they posted on Oct. 8, “and appreciate the support of our followers.”

The fake page came down 11 days later, as mysteriously as it had come up. The hospital says it has no clue who was behind it.

Fakery is all over the Internet. Twitter, which allows pseudonyms, is rife with fake followers, and has been used to spread false rumors, as it was during Hurricane Sandy. False reviews are a constant problem on consumer Web sites.

Gaston Memorial’s experience is an object lesson in the problem of fakery on Facebook. For the world’s largest social network, it is an especially acute problem, because it calls into question its basic premise. Facebook has sought to distinguish itself as a place for real identity on the Web. As the company tells its users: “Facebook is a community where people use their real identities.” It goes on to advise: “The name you use should be your real name as it would be listed on your credit card, student ID, etc.”

Fraudulent “likes” damage the trust of advertisers, who want clicks from real people they can sell to and whom Facebook now relies on to make money. Fakery also can ruin the credibility of search results for the social search engine that Facebook says it is building.

Facebook says it has always taken the problem seriously, and recently stepped up efforts to cull fakes from the site. “It’s pretty much one of the top priorities for the company all the time,” said Joe Sullivan, who is in charge of security at Facebook.

The fakery problem on Facebook comes in many shapes. False profiles are fairly easy to create; hundreds can pop up simultaneously, sometimes with the help of robots, and often they persuade real users into friending them in a bid to spread malware. Fake Facebook friends and likes are sold on the Web like trinkets at a bazaar, directed at those who want to enhance their image. Fake coupons for meals and gadgets can appear on Facebook newsfeeds, aimed at tricking the unwitting into revealing their personal information.

Somewhat more benignly, some college students use fake names in an effort to protect their Facebook content from the eyes of future employers.

Mr. Sullivan declined to say what portion of the company’s now one billion plus users were fake. The company quantified the problem last June, in responding to an inquiry by the Securities and Exchange Commission. At that time, the company said that of its 855 million active users, 8.7 percent, or 83 million, were duplicates, false or “undesirable,” for instance, because they spread spam.

Mr. Sullivan said that since August, the company had put in place a new automated system to purge fake “likes.” The company said it has 150 to 300 staff members to weed out fraud.

Flags are raised if a user sends out hundreds of friend requests at a time, Mr. Sullivan explained, or likes hundreds of pages simultaneously, or most obvious of all, posts a link to a site that is known to contain a virus. Those suspected of being fakes are warned. Depending on what they do on the site, accounts can be suspended.

In October, Facebook announced new partnerships with antivirus companies. Facebook users can now download free or paid antivirus coverage to guard against malware.

“It’s something we have been pretty effective at all along,” Mr. Sullivan said.

Facebook’s new aggressiveness toward fake “likes” became noticeable in September, when brand pages started seeing their fan numbers dip noticeably. An average brand page, Facebook said at the time, would lose less than 1 percent of its fans.

But the thriving market for fakery makes it hard to keep up with the problem. Gaston Memorial, for instance, first detected a fake page in its name in August; three days later, it vanished. The fake page popped up again on Oct. 4, and this time filled up quickly with the loud denunciations of the Obama administration. Dallas P. Wilborn, the hospital’s public relations manager, said her office tried to leave a voice-mail message for Facebook but was disconnected; an e-mail response from the social network ruled that the fake page did not violate its terms of service. The hospital submitted more evidence, saying that the impostor was using its company logo.

Eleven days later, the hospital said, Facebook found in its favor. But by then, the local newspaper, The Gaston Gazette, had written about the matter, and the fake page had disappeared.

Facebook declined to comment on the incident, and pointed only to its general Statement of Rights and Responsibilities.

The election season seems to have increased the fakery.

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The New Islamists: Tunisia Battles Over Pulpits and a Revolution’s Legacy

Moises Saman for The New York Times

Female students at the Grand Mosque in Kairouan, Tunisia, a site of anti-Western sermons.

KAIROUAN, Tunisia — On the Friday after Tunisia’s president fell, Mohamed al-Khelif mounted the pulpit of this city’s historic Grand Mosque to deliver a full-throttle attack on the country’s corrupt culture, to condemn its close ties with the West and to demand that a new constitution implement Shariah, or Islamic law.

“They’ve slaughtered Islam!” thundered Dr. Khelif, whom the ousted government had barred from preaching for 20 years. “Whoever fights Islam and implements Western plans becomes in the eyes of Western politicians a blessed leader and a reformer, even if he was the most criminal leader with the dirtiest hands.”

Mosques across Tunisia blazed with similar sermons that day and, indeed, every Friday since, in what has become the battle of the pulpit, a heated competition to define Tunisia’s religious and political identity.

Revolution freed the country’s estimated 5,000 officially sanctioned mosques from the rigid controls of the previous government, which appointed every prayer leader and issued lists of acceptable topics for their Friday sermons.

That system pushed a moderate, apolitical model of Islam that avoided confronting a dictator. When the system collapsed last year, ultraconservative Salafis seized control of up to 500 mosques by government estimates. The government, a proponent of a more temperate political Islam, says it has since wrested back control of all but 70 of the mosques, but acknowledges it has not yet routed the extremists nor thwarted their agenda.

“Before, the state suffocated religion — they controlled the imams, the sermons, the mosques,” said Sheik Tai’eb al-Ghozzi, the Friday Prayer leader at the Grand Mosque here. “Now everything is out of control — the situation is better but needs control.”

To this day, Salafi clerics like Dr. Khelif, who espouse the most puritanical, most orthodox interpretation of Islam, hammer on favorite themes that include putting Islamic law into effect immediately, veiling women, outlawing alcohol, shunning the West and joining the jihad in Syria. Democracy, they insist, is not compatible with Islam.

“If the majority is ignorant of religious instruction, then they are against God,” said Sheik Khatib al-Idrissi, 60, considered the spiritual guide of all Tunisian Salafis. “If the majority is corrupt, how can we accept them? Truth is in the governance of God.”

The battle for Tunisia’s mosques is one front in a broader struggle, as pockets of extremism take hold across the region. Freshly minted Islamic governments largely triumphed over their often fractious, secular rivals in postrevolutionary elections. But those new governments are locked in fierce, sometimes violent, competition with the more hard-line wing of the Islamic political movements over how much of the faith can mix with democracy, over the very building blocks of religious identity. That competition is especially significant in Tunisia, once the most secular of the Arab nations, with a large educated middle class and close ties to Europe.

The Arab Spring began in Tunisia, and its ability to reconcile faith and governance may well serve as a barometer for the region.

Some analysts link the assertive Tunisian Salafi movement to what they consider a worrying spread of violent extremism across North Africa — including an affiliate of Al Qaeda seizing control of northern Mali; a murderous attack on the American diplomatic mission in Benghazi, Libya; a growing jihadi force facing Israel in the Sinai; and a mob looting an American school and parts of the United States Embassy in Tunis.

Senior government officials said the various groups share an ideology and are in contact with one another, suggesting that while they are scattered and do not coordinate their operations, they reinforce one another’s agendas. There have been several episodes of jihadists caught smuggling small arms from Libya to Mali or Algeria across Tunisia, for example, including two small trucks packed with Kalashnikovs and some manner of shoulder-fired missiles or grenades in June, said Ali Laarayedh, the interior minister.

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Lakers hire Mike D'Antoni as new coach

LOS ANGELES (AP) — The Los Angeles Lakers hired Mike D'Antoni late Sunday night, signing the former coach of the Suns and Knicks to replace Mike Brown.

The Lakers and D'Antoni's agent, Warren LeGarie, confirmed the deal two days after the Lakers fired Brown five games into the season.

D'Antoni agreed to a three-year deal with a team option for a fourth season.

D'Antoni got the high-profile job running the 16-time NBA champions only after the club's negotiations broke down with former Lakers coach Phil Jackson. The 11-time NBA champion coach met with Lakers owners Jerry and Jim Buss and general manager Mitch Kupchak on Saturday to discuss a return for a third stint on Los Angeles' bench.

The Lakers' top brass instead went with D'Antoni, who coached Lakers point guard Steve Nash during five seasons in Phoenix. Nash won two MVP awards while running D'Antoni's signature up-tempo offense for the coach's final four seasons, when they won at least 54 games each season and reached two Western Conference finals.

D'Antoni then coached New York for the past four seasons, resigning last March after a largely unsuccessful tenure featuring just one playoff appearance and no postseason victories. D'Antoni also coached the Denver Nuggets during the lockout-shortened 1998-99 season.

Nash and Kobe Bryant both have expressed enthusiasm about the prospect of playing for D'Antoni, although Bryant also campaigned eagerly for Jackson. Bryant idolized D'Antoni while growing up in Italy, where D'Antoni was a star player for Olimpia Milano in the Italian pro league.

D'Antoni underwent knee replacement surgery earlier this month and could be limited in his mobility and travel for the first few weeks of his tenure in Los Angeles, although the Lakers likely won't announce specifics until later in the week.

Jackson won five titles and reached seven NBA finals during two stints totaling 11 seasons with Los Angeles. He walked away from the club 18 months ago after a second-round playoff sweep by Dallas, and Brown led Los Angeles to a 41-25 mark and another second-round playoff defeat last summer.

The Lakers traded for Nash and Dwight Howard, setting up a season of enormous expectations for Brown — but the Lakers struggled to learn his new, Princeton-influenced offense while playing mediocre defense.

After the Lakers stumbled out of the gate while Howard and Bryant missed preseason games to preserve their health, Nash incurred a small fracture in his leg during the Lakers' second regular-season game, keeping him out of the lineup for their past five games and for at least another week.

The Lakers reached a deal with D'Antoni several hours after they beat Sacramento 103-90 for their second straight win under interim coach Bernie Bickerstaff.

The Lakers have improved to 3-4 after following up their winless preseason with four losses in their first five regular-season games, the club's worst start since 1993.

D'Antoni's reputation as an innovative coach wasn't helped by his tenure in New York, although he took over a moribund franchise and eventually returned it to respectability.

Despite his reputation for offensive acumen, D'Antoni's NBA teams typically have played fairly solid defense, statistically speaking — and they never had the imposing Howard or defensive stopper Metta World Peace in their lineups.

Nash had his best NBA seasons as the versatile quarterback of the Suns' offense under D'Antoni, and point guard Jeremy Lin became a star on the Knicks last season while filling much the same role. D'Antoni resigned late last season following a six-game losing streak, surprising many observers.

The Lakers' next game is Tuesday night against San Antonio. Phoenix visits Staples Center on Friday.

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Well: Quitting Smoking for Good

Few smokers would claim that it’s easy to quit. The addiction to nicotine is strong and repeatedly reinforced by circumstances that prompt smokers to light up.

Yet the millions who have successfully quit are proof that a smoke-free life is achievable, even by those who have been regular, even heavy, smokers for decades.

Today, 19 percent of American adults smoke, down from more than 42 percent half a century ago, when Luther Terry, the United States surgeon general, formed a committee to produce the first official report on the health effects of smoking. Ever-increasing restrictions on where people can smoke have helped to swell the ranks of former smokers.

Now, however, as we approach the American Cancer Society’s 37th Great American Smokeout on Thursday, the decline in adult smoking has stalled despite the economic downturn and the soaring price of cigarettes.

Currently, 45 million Americans are regular smokers who, if they remain smokers, can on average expect to live 10 fewer years. Half will die of a tobacco-related disease, and many others will suffer for years with smoking-caused illness. Smoking adds $96 billion to the annual cost of medical care in this country, Dr. Nancy A. Rigotti wrote in The Journal of the American Medical Association last month. Even as some adult smokers quit, their ranks are being swelled by the 800,000 teenagers who become regular smokers each year and by young adults who, through advertising and giveaways, are now the prime targets of the tobacco industry.

People ages 18 to 25 now have the nation’s highest smoking rate: 40 percent. I had to hold my breath the other day as dozens of 20-somethings streamed out of art gallery openings and lighted up. Do they not know how easy it is to get hooked on nicotine and how challenging it can be to escape this addiction?

Challenging, yes, but by no means impossible. on the Web you can download a “Guide to Quitting Smoking,” with detailed descriptions of all the tools and tips to help you become an ex-smoker once and for all.

Or consult the new book by Dr. Richard Brunswick, a retired family physician in Northampton, Mass., who says he’s helped hundreds of people escape the clutches of nicotine and smoking. (The printable parts of the book’s provocative title are “Can’t Quit? You Can Stop Smoking.”)

“There is no magic pill or formula for beating back nicotine addiction,” Dr. Brunswick said. “However, with a better understanding of why you smoke and the different tools you can use to control the urge to light up, you can stop being a slave to your cigarettes.”

Addiction and Withdrawal

Nicotine beats a direct path to the brain, where it provides both relaxation and a small energy boost. But few smokers realize that the stress and lethargy they are trying to relieve are a result of nicotine withdrawal, not some underlying distress. Break the addiction, and the ill feelings are likely to dissipate.

Physical withdrawal from nicotine is short-lived. Four days without it and the worst is over, with remaining symptoms gone within a month, Dr. Brunswick said. But emotional and circumstantial tugs to smoke can last much longer.

Depending on when and why you smoke, cues can include needing a break from work, having to focus on a challenging task, drinking coffee or alcohol, being with other people who smoke or in places you associate with smoking, finishing a meal or sexual activity, and feeling depressed or upset.

To break such links, you must first identify them and then replace them with other activities, like taking a walk, chewing sugar-free gum or taking deep breaths. These can help you control cravings until the urge passes.

If you’ve failed at quitting before, try to identify what went wrong and do things differently this time, Dr. Brunswick suggests. Most smokers need several attempts before they can become permanent ex-smokers.

Perhaps most important is to be sure you are serious about quitting; if not, wait until you are. Motivation is half the battle. Also, should you slip and have a cigarette after days or weeks of not smoking, don’t assume you’ve failed and give up. Just go right back to not smoking.

Aids for Quitting

Many if not most smokers need two kinds of assistance to become lasting ex-smokers: psychological support and medicinal aids. Only about 4 percent to 7 percent of people are able to quit smoking on any given attempt without help, the cancer society says.

All 50 states and the District of Columbia have free telephone-based support programs that connect would-be quitters to trained counselors. Together, you can plan a stop-smoking method that suits your smoking pattern and helps you avoid common pitfalls.

Online support groups and Nicotine Anonymous can help as well. To find a group, ask a local hospital or call the cancer society at (800) 227-2345. Consider telling relatives and friends about your intention to quit, and plan to spend time in smoke-free settings.

More than a dozen treatments can help you break the physical addiction to tobacco. Most popular is nicotine replacement therapy, sold both with and without a prescription. The Food and Drug Administration has approved five types: nicotine patches of varying strengths, gums, sprays, inhalers and lozenges that can curb withdrawal symptoms and help you gradually reduce your dependence on nicotine.

Two prescription drugs are also effective: an extended-release form of the antidepressant bupropion (Zyban or Wellbutrin), which reduces nicotine cravings, and varenicline (Chantix), which blocks nicotine receptors in the brain, reducing both the pleasurable effects of smoking and the symptoms of nicotine withdrawal. Combining a nicotine replacement with one of these drugs is often more effective than either approach alone.

Other suggested techniques, like hypnosis and acupuncture, have helped some people quit but lack strong proof of their effectiveness. Tobacco lozenges and pouches and nicotine lollipops and lip balms lack evidence as quitting aids, and no clinical trials have been published showing that electronic cigarettes can help people quit.

The cancer society suggests picking a “quit day”; ridding your home, car and workplace of smoking paraphernalia; choosing a stop-smoking plan, and stocking up on whatever aids you may need.

On the chosen day, keep active; drink lots of water and juices; use a nicotine replacement; change your routine if possible; and avoid alcohol, situations you associate with smoking and people who are smoking.

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