In burglary-plagued Oakland, it's easy to pick on this workshop









OAKLAND — Burglaries have plagued just about every corner of this beleaguered city of late: Last year, Oakland averaged one break-in every 42 minutes — a 44% increase over 2011.


So when Mayor Jean Quan recently included a workshop on lock-picking in the "Something for Everyone" section of her newsletter, it didn't go over well.


"Of all the incredibly unbelievable things I've witnessed in my life, this tops the list," one resident wrote in a letter that asked Quan to cancel the class. "What next?" another wrote on a neighborhood chat forum. "The fundamentals of armed robbery?"





In a hasty apology, Quan said she regretted the "inappropriate listing," which was part of a 20-page cut-and-pasted newsletter of local events assembled by volunteers. "It strikes the wrong note when we're doing everything we can to bring down crime," she said.


The Introduction to Lock-Picking class, to be held Saturday evening, is part of a downtown Workshop Weekend that includes more than 40 offerings, including Build a Robot, Electroluminescent Wire Projects, DNA Sequencing and Telescope Making.


The event was launched two years ago by a pair of brothers eager to help residents of all ages find their passion and learn how things work. But now Gil and J.D. Zamfirescu have found themselves doing damage control while giving this city a primer in the subculture of "sport-picking."


"We recognize there is a lot of community concern," Gil Zamfirescu said in an interview. "But the best way to combat crime is to educate yourself, to understand locks so you know how to protect yourself better."


Or, in the words of the 19th century locksmith and lock-picker Alfred Charles Hobbs: "Rogues knew a good deal about lock-picking long before locksmiths discussed it … the spread of the knowledge is necessary to give fair play to those who might suffer by ignorance."


Hobbs is a legend to the hobbyist lock-picker community. His quote graces the website of the Open Organisation of Lockpickers — or TOOOL — a group that started in the Netherlands and expanded to the U.S. in 2004.


In light of the Oakland brouhaha, the organization — which is hosting the Saturday class — has agreed not to offer the lock-pick kits normally sold at workshops and competitions. And just to ensure that all goes well, U.S. TOOOL co-founder Babak Javadi (a Philadelphia security consultant) and fellow board member Brian Rea (a security expert known in lock-picking circles as Deviant) are making a special trip to Oakland.


TOOOL has a strict code of ethics that association members and workshop participants must follow, including, of course, no lawbreaking.


And instructors abide by guidelines on what they will and won't teach. Rea said they dispense lock-pick kits but don't sell bump keys — which are used to quickly and forcefully open a lock. (They do explain bumping and discuss ways to make locks bump-proof.)


Though Javadi and Rea do provide know-how on covert entry, or the secret sexy stuff of James Bond movies, to their private clients, largely law enforcement and security officials, "we temper how we disseminate information, depending on who the audience is," Javadi said.


As for the risk of educating burglars, he said most can find guidance online without having to "pay $40 and come to an event where you have to use your real name." Besides, he said, the vast majority of burglars enter through open doors, kick them in or are lucky enough to find a key hidden under a rock.


Saturday's workshop description beckons: "In many cases, opening a lock without a key is easier than you think!" Open to participants ages 10-101, it has sold out.


"Sometimes a 12-year-old will come to a meeting and they're great. They just get it," said Michael Fitzhugh, a member of San Francisco's TOOOL chapter, who will be teaching the workshop. "For most people, it takes a lot of time and practice."


As for Quan, she called the class "part of a do-it-yourself, garage-science sort of event, and those are popular in our creative community." Still, she promised to "do a better job reviewing these listings in the future."


lee.romney@latimes.com





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Comings and goings at 'Downton Abbey' next season


NEW YORK (AP) — Shirley MacLaine will be returning to "Downton Abbey" next season, and opera star Kiri Te Kanawa is joining the cast.


MacLaine will reprise her role as Martha Levinson, Lord Robert Crawley's freewheeling American mother-in-law, Carnival Films and "Masterpiece" on PBS said Saturday. MacLaine appeared in episodes early last season.


New Zealand-born soprano Te Kanawa will play a house guest. She will sing during her visit.


Other new cast members and characters include:


— Tom Cullen as Lord Gillingham, described as an old family friend of the Crawleys who visits the family as a guest for a house party (and who might be the one to mend Lady Mary Crawley's broken heart).


— Nigel Harman will play a valet named Green.


— Harriet Walter plays Lady Shackleton, an old friend of the Dowager Countess.


— Joanna David will play a guest role as the Duchess of Yeovil.


— Julian Ovenden is cast as aristocrat Charles Blake.


"The addition of these characters can only mean more delicious drama, which is what 'Downton Abbey' is all about," said "Masterpiece" executive producer Rebecca Eaton.


Meanwhile, the producers have confirmed that villainous housemaid Sarah O'Brien won't be back. Siobhan Finneran, who played her, is leaving the show.


These announcements come shortly after the third season's airing in the United States. It concluded with the heartbreaking death of popular Matthew Crawley in a car crash, leaving behind his newborn child and loving wife, Lady Mary Crawley.


Matthew's untimely demise was the result of the departure from the series by actor Dan Stevens, who had starred in that role.


The third season also saw the shocking death of Lady Sybil Branson, who died during childbirth. She was played by the departing Jessica Brown Findlay.


Last season the wildly popular melodrama, set in early 20th century Britain, was the most-watched series on PBS since Ken Burns' epic "The Civil War," which first aired in 1990. The Nielsen Co. said 8.2 million viewers saw the "Downton" season conclusion.


"Downton Abbey," which airs on the "Masterpiece" anthology, won three Emmy awards last fall, including a best supporting actress trophy for Maggie Smith (the Dowager Countess), who also won a Golden Globe in January.


In all, the series has won nine Emmys, two Golden Globes and a Screen Actors Guild Award for the ensemble cast, which is the first time the cast of a British television show has won this award.


Hugh Bonneville, Michelle Dockery, Elizabeth McGovern, Jim Carter and Brendan Coyle are among its other returning stars.


___


Online:


http://www.pbs.org/downton


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U.S. Judges Offer Addicts a Way to Avoid Prison


Todd Heisler/The New York Times


Emily Leitch of Brooklyn, with her son, Nazir, 4, was arrested for importing cocaine but went to “drug court” to avoid prison.







Federal judges around the country are teaming up with prosecutors to create special treatment programs for drug-addicted defendants who would otherwise face significant prison time, an effort intended to sidestep drug laws widely seen as inflexible and overly punitive.




The Justice Department has tentatively embraced the new approach, allowing United States attorneys to reduce or even dismiss charges in some drug cases.


The effort follows decades of success for “drug courts” at the state level, which legal experts have long cited as a less expensive and more effective alternative to prison for dealing with many low-level repeat offenders.


But it is striking that the model is spreading at the federal level, where judges have increasingly pushed back against rules that restrict their ability to make their own determination of appropriate sentences.


So far, federal judges have instituted programs in California, Connecticut, Illinois, New Hampshire, New York, South Carolina, Virginia and Washington. About 400 defendants have been involved nationwide.


In Federal District Court in Brooklyn on Thursday, Judge John Gleeson issued an opinion praising the new approach as a way to address swelling prison costs and disproportionate sentences for drug trafficking.


“Presentence programs like ours and those in other districts mean that a growing number of courts are no longer reflexively sentencing federal defendants who do not belong in prison to the costly prison terms recommended by the sentencing guidelines,” Judge Gleeson wrote.


The opinion came a year after Judge Gleeson, with the federal agency known as Pretrial Services, started a program that made achieving sobriety an incentive for drug-addicted defendants to avoid prison. The program had its first graduate this year: Emily Leitch, a Brooklyn woman with a long history of substance abuse who was arrested entering the country at Kennedy International Airport with over 13 kilograms of cocaine, about 30 pounds, in her luggage.


“I want to thank the federal government for giving me a chance,” Ms. Leitch said. “I always wanted to stand up as a sober person.”


The new approach is being prompted in part by the Obama administration, which previously supported legislation that scaled back sentences for crimes involving crack cocaine. The Justice Department has supported additional changes to the federal sentencing guidelines to permit the use of drug or mental health treatment as an alternative to incarceration for certain low-level offenders and changed its own policies to make those options more available.


“We recognize that imprisonment alone is not a complete strategy for reducing crime,” James M. Cole, the deputy attorney general, said in a statement. “Drug courts, re-entry courts and other related programs along with enforcement are all part of the solution.”


For nearly 30 years, the United States Sentencing Commission has established guidelines for sentencing, a role it was given in 1984 after studies found that federal judges were giving defendants widely varying sentences for similar crimes. The commission’s recommendations are approved by Congress, causing judges to bristle at what they consider interference with their judicial independence.


“When you impose a sentence that you believe is unjust, it is a very difficult thing to do,” Stefan R. Underhill, a federal judge in Connecticut, said in an interview. “It feels wrong.”


The development of drug courts may meet resistance from some Republicans in Congress.


“It is important that courts give deference to Congressional authority over sentencing,” Representative F. James Sensenbrenner Jr., Republican of Wisconsin, a member and former chairman of the Judiciary Committee, said in a statement. He said sentencing should not depend “on what judge happens to decide the case or what judicial circuit the defendant happens to be in.”


At the state level, pretrial drug courts have benefited from bipartisan support, with liberals supporting the programs as more focused on rehabilitation, and conservatives supporting them as a way to cut spending.


Under the model being used in state and federal courts, defendants must accept responsibility for their crimes and agree to receive drug treatment and other social services and attend regular meetings with judges who monitor their progress. In return for successful participation, they receive a reduced sentence or no jail time at all. If they fail, they are sent to prison.


The drug court option is not available to those facing more serious charges, like people accused of being high-level dealers or traffickers, or accused of a violent crime. (These programs differ from re-entry drug courts, which federal judges have long used to help offenders integrate into society after prison.)


In interviews, the federal judges who run the other programs pointed to a mix of reasons for their involvement.


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Bell jurors ordered to begin anew after panelist is dismissed









After nearly five days of deliberations, jurors in the Bell corruption trial were ordered Thursday to begin anew after a member of the panel was dismissed for misconduct and replaced by an alternate.


The original juror, a white-haired woman identified only as Juror No. 3, told Los Angeles County Superior Court Judge Kathleen Kennedy she had gone onto a legal website to look up jury instructions and then asked her daughter to help find a definition for the word "coercion."


Although all but one defense attorney requested that the woman stay, Kennedy said the juror needed to be removed. "She has spoken about the deliberations with her daughter, she has conducted research on the Internet, and I've repeatedly, repeatedly throughout this trial — probably hundreds of times — cautioned the jury not to do that," the judge said.





The removal came after jurors notified the judge that they were deadlocked and that continued deliberations seemed fruitless.


It was unclear how to interpret the day's events, whether the dismissed juror had been a lone holdout or an indication of a fractured jury.


The juror started to tell the judge which way she was leaning in the case, saying she had gone online "looking to see at what point can I get the harassment to stop.... How long do I have to stay in there and deliberate with them when I have made my decision that I didn't think there was —"


Kennedy cut her off before she could finish.


The woman clasped her hands over her mouth and said, "I'm sorry."


Two defense attorneys thought she was leaning toward acquittal and wanted her to stay. "I would have preferred the deadlock to a guilty verdict," said Alex Kessel, the attorney for George Mirabal, one of six former council members charged with misappropriation of public funds.


The council members are charged with inflating their salaries in what prosecutors contend was a far-reaching web of corruption in which fat paychecks were placed ahead of the needs of the city's largely immigrant, working-poor constituents.


When attorneys and defendants were summoned to the courtroom Thursday morning, they were initially told that the jury appeared to be deadlocked.


"Your honor, we have reached a point where as a jury we have fundamental disagreements and cannot reach a unanimous verdict in this case," read a note signed by two jurors, including the foreman, that was given to Kennedy.


A note from another juror alerted the judge that Juror No. 3 had consulted an outside attorney. That did not appear to be the case, but her other actions were revealed under questioning from the judge.


The same juror made a tearful request Monday to be removed from the panel because she felt others were picking on her. Kennedy told the woman that although discussions can get heated, it was important to continue deliberating.


On Thursday, however, the juror again broke into tears and said she had spoken with her daughter about "the abuse I have suffered." She said her daughter told her, "Mom, they're trying to find the weak link."


The woman said she had turned to the Internet to better understand the rules about jury deliberations and came across the word "coercion." After her daughter helped her look up the word's definition, she wrote it down on a piece of paper and brought it with her to court. When the judge asked to see the paper she went into the jury room to retrieve it.


The woman later left the courtroom in tears.


With an alternate in place, Kennedy told the panel to act as if the earlier deliberations had not taken place. The alternate had sat in the jury box during the four-week trial but did not take part in deliberations.


Former council members Luis Artiga, Victor Bello, George Cole, Oscar Hernandez, Teresa Jacobo and Mirabal are accused of drawing annual salaries of as much as $100,000 a year by serving on boards that did little work and seldom met, part of a scandal that drew national attention to the small city in 2010.


Prosecutors said that Bell's charter follows state law regarding council members' compensation. In a city the size of Bell, council members should be paid no more than $8,076 a year.


The trial began in late January, and the case went to the jury last Friday.


As the jury resumed deliberations in downtown Los Angeles, the verdict was clearly in on the streets of Bell.


One resident unfurled old protest banners and signs from the days when the pay scandal was first exposed and then called former members of an activist group that had led the charge for reform in the city.


"We're holding our breaths and waiting," Denise Rodarte, a member of the grassroots group Bell Assn. to Stop the Abuse, said in regard to a verdict.


"It's cut and dry: Local elected officials were supposed to make a certain amount of money, and they made a lot more."


corina.knoll@latimes.com


jeff.gottlieb@latimes.com


Times staff writer Ruben Vives contributed to this report.





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Airports big and small may feel effects of federal budget feud









Get ready for longer lines at Los Angeles International Airport, slower delivery of packages and the possible shutdown of small Southern California airport control towers if a resolution isn't reached on federal budget cuts.


The good news is that the biggest effects probably will not take hold until April, giving President Obama and congressional leaders time to hammer out a deal to resolve the budget feud.


But if no agreement is reached, the Federal Aviation Administration will be forced to cut its budget about $600 million. That could force the FAA to close more than 100 air traffic control towers across the country, primarily at smaller regional airports, including in Santa Monica, Victorville and Oxnard.





The night shift for air traffic controllers could also be eliminated at about 70 larger airports, including LA/Ontario International.


The federal agency has also put out the option of furloughing FAA employees for one or two days per two-week pay period, beginning in mid-April.


At Los Angeles International Airport, officials say it is too early to gauge how much of an effect the budget cuts would have on the average air traveler.


But Transportation Security Administration head John Pistole said lines at security gates at major airports across the country could grow longer during the peak spring and summer travel seasons if he is forced to cut overtime pay, which would reduce the number of screening officers.


"The longer it goes, the greater the potential impact," he said of the budget battle.


The National Air Traffic Controllers Assn. expects the cuts to lead to fewer flights and increased delays of as long as 90 minutes during peak hours.


"Safety will remain the top priority, but in order to maintain the appropriate level of safety with fewer controllers, fewer planes will be allowed in the sky, as well as in and out of airports," the group said in a statement.


The FAA has announced plans to shut down towers at airports with fewer than 150,000 landings and takeoffs a year. Santa Monica Airport, which is on the FAA closure list, operates about 105,000 landings and takeoffs a year. Van Nuys Airport, which is not on the list, has more than 250,000 landings and takeoffs.


Still, the effect on smaller airports on the FAA cut list may not be severe because pilots can land and depart without the help of an air traffic controller by keeping track of each other through radio communications.


Joe Justice, who operates Justice Aviation, a company that offers flying lessons at Santa Monica Airport, said he doesn't expect his business to face major changes if the tower is closed.


"We would continue to give flying lessons," he said. "There would be no reason not to. We would depart here and practice at a place where there is an open tower."


Private jet charter companies said they may even get more business if sequestration increases delays on commercial airlines, forcing passengers to charter a jet.


"People who are sitting on the fence about wanting to hire a private jet may spend the extra money so they won't be caught in a situation where they have no idea how long their delays will be," said Ben Schusterman, founder of Los Angeles-based ElJet.


The closure of overnight shifts at the control tower in Ontario could eliminate 12 passenger flights, or 9% of operations, but a bigger effect would be the loss of 73 cargo flights, or 36% of all cargo operations.


Cargo operators at Ontario said they were still unsure of the effect of budget cuts on their businesses.


"UPS is closely monitoring the sequestration proceedings," United Parcel Service Inc. spokesman Mike Mangeot said. "And while we are in communications with the FAA regarding the effects of the possible cuts, it is premature to speculate at this time."


hugo.martin@latimes.com





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DNA science points to better treatment for acne









Ancient Egyptians were vexed by it, using sulfur to dry it out. Shakespeare wrote of its "bubukles, and whelks, and knobs, and flames o' fire."


Today, acne plagues us still. Doctors can cure some cancers and transplant vital organs like hearts, but they still have trouble getting rid of the pimples and splotches that plague 85% of us at some time in our lives — usually, when we're teenagers and particularly sensitive about they way we look.


But new research hints that there's hope for zapping zits in the future, thanks to advances in genetic research.








Using state-of-the-art DNA sequencing techniques to evaluate the bacteria lurking in the pores of 101 study volunteers' noses, scientists discovered a particular strain of Propionibacterium acnes bacteria that may be able to defend against other versions of P. acnes that pack a bigger breakout-causing punch.


As best as dermatologists can tell, zits occur when bacteria that reside in human skin, including P. acnes, feed on oils in the pores and prompt an immune response that results in red, sometimes pus-filled bumps. But the study subjects who had the newly discovered bacterial strain weren't suffering from whiteheads or blackheads, according to a report published Thursday in the Journal of Investigative Dermatology.


Someday, the realization that "not all P. acnes are created equal" might help dermatologists devise treatments that more precisely target bad strains while allowing beneficial ones to thrive, said Dr. Noah Craft, a dermatologist at the Los Angeles Biomedical Research Institute who conducted the study with colleagues from UCLA and Washington University in St. Louis.


Doctors might prescribe probiotic creams that deliver "good" P. acnes to the face the same way a daily serving of yogurt helps restore healthy bacteria in the digestive tract.


"There are healthy strains that we need on our skin," Craft said. "The idea that you'd use a nuclear bomb to kill everything — what we're currently doing with antibiotics and other treatments — just doesn't make sense."


The research is part of a broad effort backed by the National Institutes of Health to characterize the so-called human microbiome: the trillions of microbes that live in and on our bodies and evolve along with us, sometimes causing illness and often promoting good health.


Most of the microbiome attention so far has gone to studying species in the gut, said study leader Huiying Li, an assistant professor of molecular and medical pharmacology at UCLA's Geffen School of Medicine. But the NIH's Human Microbiome Project, which funds her research, also looks at microbial communities in the nasal passages, the mouth, the urogenital tract and the skin.


Li said she became interested in studying acne because the skin microbiome seemed particularly understudied.


The research team recruited 101 patients in their teens and 20s from dermatology clinics in Southern California. Among them, 49 had acne and 52 had "normal skin" and were not experiencing breakouts but had come to the clinics for other problems.


Doctors used adhesive pore strips to remove skin bacteria from patients' noses. The researchers then collected the waxy plugs — a combination of bacteria, oils, dead skin cells and other stuff — and used DNA to figure out which bacteria were present.


They found that the P. acnes species accounted for about 90% of the bacteria in pores, in both healthy patients and acne sufferers. Digging a little deeper into the DNA, they found that two particular strains appeared in about 20% of acne sufferers, while a third strain was found only in acne-free patients.


"Dogs are dogs, but a Chihuahua isn't a Great Dane," Craft said. "People with acne had pit bulls on their skin. Healthy people had poodles."


The team then sequenced the complete genomes — about 2.6 million base pairs apiece — of 66 of the P. acnes specimens to explore in more depth how the good and bad strains differed.


The two notable bad strains had genes, probably picked up from other bacteria or viruses, that are thought to change the shape of a microbe to make it more virulent. The researchers hypothesized that the foreign DNA, perhaps by sticking more effectively to human host tissues, may help trigger an inflammatory response in the skin: acne.


The good strain, on the other hand, contained an element known to work like an immune system in bacteria, Li said. Perhaps it allows this P. acne to fight off intruders and prevent pimples from forming.


Li said the researchers did not know why some people had the bad P. acnes strains and others did not, and whether genetics or environment played a bigger role.


Dr. Vincent Young, who conducts microbiome research at the University of Michigan Medical School but wasn't involved in the acne project, said advances in sequencing technology and analysis made the new study possible. In the past, he said, scientists wouldn't have tried to sequence dozens of genomes in a single species.


"They'd say, why waste the money?" he said. "Now you can do this in a couple of days."


Li and Craft — neither of whom suffered bad acne as teens — plan to keep up the work.


More research is needed to come up with super-targeted anti-microbial therapies, or to develop a probiotic cream for acne sufferers.


Craft continues collecting samples from patients' pores. He hopes to study whether twins share the same microbial profiles, how acne severity is reflected in bacteria populations, and how things change in a single patient over the course of a treatment regimen.


One of the study volunteers, 19-year-old UC Santa Cruz student Brandon Pritzker, said he would have loved to have treated his acne without affecting the rest of his body. When he took Accutane, he suffered back pain and mood shifts.


Now off the drug, Pritzker said he is at peace with his pimples. "I still have breakouts, but I figure I'm 19, that's the way it's going to be," he said.


But, he added, "it hindered my confidence at the time. Kids with clear skin are probably a little happier."


eryn.brown@latimes.com





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Steven Spielberg to head Cannes jury this year


PARIS (AP) — France's Cannes Film Festival says it has finally snagged Steven Spielberg to serve as president of the award jury.


Gilles Jacob, the festival's president, recounted how he had been trying to get the award-winning director to head the jury for years — but the American was always working. Finally, this year, Spielberg got in touch.


"When this year I was told 'E.T., phone home,' I understood and immediately replied: 'At last!'" Jacob said in a statement posted on the festival's website Thursday.


Spielberg, who was nominated but didn't win the directing Oscar for his biopic "Lincoln" this week, takes the reins from Italian Nanni Moretti. The 66th Cannes festival takes place in the glamorous French Mediterranean resort from May 15 to 26.


Spielberg's presence will likely give more of an American flavor this year to the Cannes festival, a mélange of intellectual international cinema and Hollywood glamour. Jury presidents in the festival's seven-decade history have included such figures as Tennessee Williams, Ingrid Bergman, Roman Polanski and Francis Ford Coppola.


Spielberg has had several films show at Cannes, and "E.T." had its world premiere there in 1982. His first film, "Sugarland Express," won best screenplay at Cannes in 1974.


"It is an honor and a privilege to preside over the jury of a festival that proves, again and again, that cinema is the language of the world," Spielberg was quoted as saying in a statement by the Cannes festival organizers. "The most prestigious of its kind, the festival has always established the motion picture as a cross cultural and generational medium."


At last year's Cannes festival, Michael Haneke won the top prize with his stark film about love and death, "Amour."


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Well: Think Like a Doctor: The Man Who Wobbled

The Challenge: Can you solve the medical mystery of a man who suddenly becomes too dizzy to walk?

Every month, the Diagnosis column of The New York Times Magazine asks Well readers to try their hand at solving a medical mystery. Below you will find the story of a 56-year-old factory worker with dizziness and panic attacks. I have provided records from his two hospital visits that will give you all the information available to the doctor who finally made the diagnosis.

The first reader to offer the correct diagnosis gets a signed copy of my book, “Every Patient Tells a Story,” and the satisfaction of solving a case that stumped a roomful of specialists.

The Patient’s Story:

The middle-aged man clicked his way through the multiple reruns of late-late-night television. He should have been in bed hours ago, but lately he hadn’t been able to get to sleep. Suddenly his legs took on a life of their own. Stretched out halfway to the center of the room, they began to shake and twitch and jump around. The man watched helplessly as his legs disobeyed his mental orders to stop moving. He had no control over them. He felt nauseous, sweaty and out of breath, as if he had been running some kind of race. He called out to his wife. She hurried out of bed, took one look at him and called 911.

The Patient’s History:

By the time the man arrived at Huntsville Hospital, in Alabama, the twitching in his legs had subsided and his breathing had returned to normal. Still, he had been discharged from that same hospital for similar symptoms just two weeks earlier. They hadn’t figured out what was going on then, so they weren’t going to send him home now.

The patient considered himself pretty healthy, but the past year or so had been tough. In 2011, at the age of 54, he had had a mild stroke. He had no medical problems that put him at risk for stroke — no high blood pressure, no high cholesterol, no diabetes. A work-up at that time showed that he had a hole in his heart that allowed a tiny clot from somewhere in his body to travel to the brain and cause the stroke. He was discharged on a couple of blood thinners to keep his blood from making more clots. He hadn’t really felt completely well, though, ever since. His balance seemed a little off, and he was subject to these weird panic attacks, in which his heart would pound and he would feel short of breath whenever he got too stressed. Mostly he could manage them by just walking away and focusing on his breathing. Still, he never felt as if he was the kind of guy to panic.

And he had always been quick on his feet. The first half of his career he had been in the steel business — building huge metal trusses and supports. He and his team put together 60-plus tons of steel structures every day. For the past decade he had been machining car parts. After his stroke, work seemed to get a lot harder.

The Dizziness:

A few weeks ago, he stood up and wham — suddenly the whole world went off-kilter. He felt as if he was constantly about to fall over in a world that no longer lay down flat. His first thought was that he was having another stroke. He went straight to his doctor’s office. The doctor wasn’t sure what was going on and sent him to that same emergency room at Huntsville Hospital. After three days of testing and being evaluated by lots of specialists, his doctors still were not sure what was going on. He hadn’t had a heart attack; he hadn’t had a stroke. There was no sign of infection. All the tests they could think of were normal.

The only abnormal finding was that when he stood up, his blood pressure dropped. Why this happened wasn’t clear, but the doctors in the hospital gave him compression stockings and a pill — both could help keep his blood pressure in the normal range. Then they sent him home. He was also started on an antidepressant to help with the panic attacks he continued to have from time to time.

You can read the report from that hospital admission below.

You can also read the consultation and discharge notes from that hospital visit here.

He had been home for nearly two weeks and still he felt no better. He tried to go back to work after a week or so at home, but after driving for less than five miles, he felt he had to turn around. He wasn’t sure what was wrong; he just knew he didn’t feel right. Then his legs started jumping around, and he ended up back in the hospital.

The Doctor’s Exam:

It was nearly dawn by the time Dr. Jeremy Thompson, the first-year resident on duty that night, saw the patient. Awake but tired, the patient told his story one more time. He had been at home, watching TV, when his legs started jumping on their own and he started feeling short of breath. His wife sat at the bedside. She looked just as worried and exhausted as he did. She told the resident that when he spoke that night at home, his speech was slurred. And when the ambulance came, he could barely walk. He has never missed this much work, she told the young doctor. It’s not like him. Can’t you figure out what’s wrong?

The resident had already reviewed the records from the patient’s previous hospital admissions. He asked a few more questions: the patient had never smoked and rarely drank; his father died at age 80; his mother was still alive and well. The patient exam was normal, as were the studies done in the E.R.

The first E.R. doctor thought that his symptoms were a result of anxiety, culminating in a full-blown panic attack. The resident thought that was probably right. In any case he would discuss the case with the attending in a couple of hours during rounds on the new patients. Till then, he told the worried couple, they should just try to get a little sleep.

An Important Clue:

Dr. Robert Centor was definitely a morning person. His cheerful enthusiasm about teaching and taking care of patients made him a favorite among residents. At 7:30 that morning, he stood outside the patient’s door as Dr. Thompson relayed the somewhat frustrating case of the middle-aged man with worsening dizziness and panic attacks. Then they went into the room to meet the patient. He was a big guy, tall and muscular with the first signs of middle-aged thickening around his middle. His complexion had the look of someone who spent a lot of time outdoors. Dr. Centor introduced himself and pulled up a chair as the rest of the team watched. He asked the patient what brought him to the hospital.

“Every time I get up, I get dizzy,” the man replied. Sure, he had had some balance problems ever since his stroke, he explained, but this felt different – somehow worse. He could hardly walk, he told the doctor. He just felt too unstable.

“Can you get up and show us how you walk?” Dr. Centor asked.

“Don’t let me fall,” the patient responded. He carefully swung his legs over the side of the bed. The resident and intern stood on either side as he slowly rose. He stood with his feet far apart. When asked to close his eyes as he stood there, he wobbled and nearly fell over. When he took a few steps, his heel and toes hit the ground at the same time, making a strange slapping sound.

Seeing that, Dr. Centor knew where the problem lay and ordered a few tests to confirm his diagnosis.

You can see the review report and notes for the patient’s second hospital visit below.

Solving the Mystery:

What tests did Dr. Centor order? Do you know what is making this middle-aged man wobble? Enter your guesses below. I’ll post the answer tomorrow.


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

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Island Air is Ellison's latest buy









How do you follow the purchase of an island in Hawaii?


If you're Oracle Chief Executive Larry Ellison, you buy an airline so you can hop to and from your tropical paradise.


Ellison has been on a shopping spree lately, buying 98% of the island of Lanai in June from Los Angeles billionaire David Murdock and then, in November, buying a beachfront Malibu home from film and TV producer Jerry Bruckheimer.





Ellison's most risky acquisition may be Island Air, which he bought Wednesday through a holding company.


The exact purchase prices of Ellison's recent deals have not been disclosed, but local observers value the 141-square-mile island at more than $500 million and the three-bedroom, three-bath Malibu pad at more than $3.65 million. The details of the airline deal were not announced.


Island Air, a regional carrier serving airports on all major Hawaiian islands, has 245 employees and three turboprop planes, with 224 weekly flights between the islands of Oahu, Maui, Molokai, Lanai and Kauai.


Lanai, the sixth-largest Hawaiian island, was once a pineapple plantation and is still sparsely inhabited. It includes two resort hotels and two golf courses with clubhouses, according to Hawaii's Public Utilities Commission.


But Ellison did not buy the airline just to get to and from his island, airline officials say.


He hopes to expand the businesses to serve locals visiting relatives on the islands and to fly mainland and foreign tourists throughout the island state, airline officials said. The airline plans to retire two 1980s-era planes and expand to four or five new ATR 72 turboprops by the end of the year.


But Ellison should not get his hopes up about pocketing big profits, said Ray Neidl, an aviation analyst for Nexa Capital Partners in Washington, D.C.


"It's a high-risk situation with no significant margins, at least initially," he said of owning an airline.


And if Ellison hopes to expand the business, he should expect to get some resistance from the big carrier on the island, Hawaiian Airlines, Neidl added. "It really depends on what Hawaiian does."


Island Air began in 1980 as Princeville Airways, carrying passengers from Kauai to Honolulu. The history of the carrier has not always been blue skies and soft landings.


"In our 30-plus years, we had our ups and downs, pardon the pun," said Michael Rodyniuk, a senior consultant to the airline.


Like most airlines across the country, he said, Island Air struggled during the economic turmoil between 2008 and 2012 but expects to thrive with a surge in tourism that Hawaii has been enjoying in the past year or so.


The state welcomed a record 8 million visitors in 2012, surpassing the previous high of 7.6 million visitors in 2006.


"All major markets are up," Rodyniuk said.


The previous owner of the airline, California businessman Charles Willis IV, had been looking for a buyer for the airline and had put all 245 employees on notice that layoffs could begin as soon as March 11 if a buyer was not found, he said. "So Mr. Ellison saved 245 jobs," Rodyniuk said.


Forbes ranks Ellison as the third-richest American, with a net worth of $36 billion. He has cut big checks in the past on high-priced properties in Malibu, Lake Tahoe, Rancho Mirage and other locations.


But unlike real estate, air carriers are an investment that can give investors nightmares.


Virgin America, a California-based airline partly owned by millionaire Richard Branson, has been operating for more than five years without recording a profitable year.


California Pacific Airlines is the brainchild of Encinitas businessman Ted Vallas, who has already invested more than $6 million of his own money but has spent the last year trying to clear federal red tape so he can begin selling tickets.


And then there are the 11 other airlines — including American, Delta, United and US Airways — that have filed for bankruptcy since 2000.


"The profit margins on airlines, even though they are improving, are not that attractive," Neidl said.


hugo.martin@latimes.com





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Race for L.A. city controller heats up









A previously low-profile race for Los Angeles city controller has begun to heat up as opponents of City Councilman Dennis Zine accuse him of "double dipping" the city's payroll and question why he is considering lucrative tax breaks for a Warner Center developer.


Zine, who for 12 years has represented a district in the southeast San Fernando Valley, is the better known of the major candidates competing to replace outgoing Controller Wendy Greuel.


The others are Cary Brazeman, a marketing executive, and lawyer Ron Galperin. Zine has raised $766,000 for his campaign, more than double that of Galperin, the next-highest fundraiser, and has the backing of several of the city's powerful labor unions.





He also has been endorsed by Mayor Antonio Villaraigosa and several of his council colleagues. Galperin is backed by the Service Employees International Union, one the city's largest labor groups, and Brazeman is supported by retired Rep. Diane Watson and several neighborhood council representatives.


With the primary ballot less than a week away, Brazeman and Galperin have turned up the heat on Zine, hoping to push the race beyond the March 5 vote. If no one wins more than 50% of the ballots cast, the top two vote-getters will face a runoff in the May general election.


In a recent debate, Zine's opponents criticized him for receiving a $100,000 annual pension for his 33 years with the Los Angeles Police Department and a nearly $180,000 council salary. Brazeman and Galperin called it an example of "double dipping" that should be eliminated.


That brought a forceful response from Zine, who shot back that he gives a big portion of his police pension check to charities.


"I am so tired of hearing 'double dipping,' " he said. "I worked 33 years on the streets of Los Angeles. I have given over $300,000 to nonprofits that need it.... That's what's happened with that pension."


In the same debate, Brazeman accused Zine of cozying up to a Warner Center developer by pushing for tax breaks on a project that already has been approved. The nearly 30-acre Village at Westfield Topanga project would add 1 million square feet of new shops, restaurants, office space and a hotel to a faded commercial district on Topanga Canyon Boulevard.


"The councilman proposed to give developers at Warner Center tens of millions of dollars in tax breaks even though it's a highly successful project," he said. "He wants to give it away."


City records show that less than a month after the development was approved in February 2012, Zine asked the council for a study looking at possible "economic development incentives" that could be given to Westfield in return for speeding up street and landscaping enhancements to the project's exterior.


The motion's language notes that similar tax breaks have been awarded to large projects in the Hollywood and downtown areas, and that "similar public investment in the Valley has been lacking." Westfield is paying for the $200,000 study.


Zine defended his decision before the debate audience, saying if the study finds that the city will not benefit, no tax breaks will be awarded. "If there's nothing there, then they get nothing," Zine said.


The controller serves as a public watchdog over the city's $7.3-billion annual operation, auditing the general fund, 500 special fund accounts and the performance of city departments. Those audits often produce recommendations for reducing waste, fraud and abuse.


But the mayor and the council are not obligated to adopt those recommendations, and as a result the job is part accountant, part scolder in chief. All the candidates say they will use their elective position not only to perform audits but also to turn them into action.


Their challenge during the campaign has been explaining how they will do that.


Zine, 65, says his City Hall experience has taught him how to get things done by working with his colleagues. He won't be afraid to publicly criticize department managers, he said, but thinks collaboration works better than being combative.


"You can rant and rave and people won't work with you," he said. "Or you can sit down and talk it out, and you can accomplish things."


Galperin, 49, considers himself a policy wonk who relishes digging into the details to come up with ways to become more efficient with limited dollars and to find ways to raise revenue using the city's sprawling assets. For instance, the city owns two asphalt plants that could expand production and sell some of its material to raise money to fix potholes, he said.


He's served on two city commissions, including one that found millions of dollars in savings by detailing ways to be more efficient. Zine is positioning himself as a "tough guy for tough times," but the controller should be more than that, Galperin said.


"What we really need is some thoughtfulness and some smarts and some effectiveness," he said. "Just getting up there and saying we need to be tough is not going to accomplish what needs to be done."


Brazeman, 46, started his own marketing and public relations firm in West Los Angeles a decade ago and became active in city politics over his discontent with a development project near his home. He has pushed the council to change several initiatives over the last five years, including changes to the financing of the Farmers Field stadium proposal that will save taxpayer dollars, he said.


As controller, he would pick and choose his battles, and, Brazeman said, be "the right combination of constructive, abrasive and assertive."


catherine.saillant@latimes.com





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Greek man charged in NY Dali theft pleads guilty


NEW YORK (AP) — A Greek man has admitted to stealing a Salvador Dali painting from a New York City gallery, only to return it in the mail.


Phivos Istavrioglou pleaded guilty on Tuesday following his arrest in the theft of a work titled "Cartel de Don Juan Tenorio."


Prosecutors say the fashion industry publicist walked into the Manhattan gallery in June, put the painting valued at about $150,000 in a shopping bag and walked out. He anonymously mailed the piece back to the United States from Greece after seeing news coverage of the theft.


Under the plea deal, Istavrioglou avoids additional jail time if he remains incarcerated until his formal sentencing on March 12. He also must pay more than $9,000 in restitution.


His lawyer said it was a stupid thing to do.


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The New Old Age Blog: Is the Pope Frail?

White-haired at 85, Pope Benedict XVI looks a bit hunched in photos. He has had a pacemaker for years, the Vatican recently confirmed for the first time — an indicator of long-standing heart problems. His older brother has said that age is taking its toll.

Observers have noticed the pope’s reduced energy. The Times has reported that he was ferried to the altar at St. Peter’s for Midnight Mass Christmas Eve on a “wheeled platform,” then appeared to doze off during the service.

Visiting Mexico last year, he awoke at night and couldn’t locate a light switch in his room, then fell — such a familiar scenario for caregivers of old people — and bloodied his head when he hit the bathroom sink.

Beyond these few facts, we know very little about the health problems that have led Benedict to announce his retirement after his final audience on Wednesday. We don’t even really know if his flagging stamina — “the certainty that my strengths, due to an advanced age, are no longer suited to an adequate exercise” of leading the church, as he put it — was the true reason behind his resignation. But people have been describing him as tired and increasingly frail.

In geriatrics, “frailty” has a specific meaning: It’s a syndrome, a collection of physiological symptoms that drain people’s reserves, leaving them less able to withstand stressors — like a long trek through St. Peter’s Basilica or around a foreign country.

Geriatricians diagnose frailty when a patient meets three of five criteria: Unintentional weight loss of more than 10 pounds in the past year. Weakness, as measured by a test of handgrip strength. Self-reported exhaustion. Slowness, calculated by how long it takes to walk 15 feet. Low physical activity.

“You feel a sense of vulnerability,” said Linda Fried, dean of the Mailman School of Public Health at Columbia University and a leading frailty researcher for 20 years. With significantly lower energy, “It’s harder to push the envelope.”

Frailty’s prevalence increases with age, “from a tiny proportion of people in their 60s, about three percent, to up to a quarter or a third of people 85 and older,” Dr. Fried said. Doctors have learned to pay attention because of the unhappy consequences. “It’s strongly associated with higher mortality, as well as loss of mobility, falls and other kinds of disability,” she said.

Is Benedict frail? Certainly he is reporting that he is exhausted, but does he fit the other criteria? “The pope has probably never done a grip strength test,” said Ken Covinsky, a geriatrician at the University of California, San Francisco.

But the odds are high that he has health problems, even if they’re unacknowledged by Vatican spokesmen. In the United States, at least, nearly half of those over 65 have two or more chronic diseases, like diabetes, hypertension and emphysema. “It would be a rare 85-year-old with only one thing wrong with him,” Dr. Covinsky said.

And frailty is one of those conditions that indicate all is not well.

People often recognize frailty, even without data on walking speed. “I’ve tested it out myself over the years” when speaking to groups, Dr. Fried reported. “I ask people what they’re seeing, and there’s great consistency between the things they picture and what science has measured.”

Frail elders, people tell her, are thin (although overweight people can also be frail), weak, slow, fragile-looking. “The term people use is, they look like they could be knocked over by a feather,” she said.

So if observers in Vatican City say Benedict looks frail, well, maybe he is.

But I’m pursuing this subject not to ask experts to diagnose the pope from afar, but to point out that paying attention to frailty makes sense for the rest of us and our elders. It’s one of the conditions people can do something about.

In frailty’s early stages, “there’s great potential to reverse it or slow it,” Dr. Fried said. The key is exercise. “You have to walk and move, maintain strength and muscle mass,” she said. “We don’t have a drug to prescribe, but even if we did, there’s no question in my mind that exercise will always be the foundation.”

The pope has said that he plans to move into the Mater Ecclesiae convent within the Vatican once it’s renovated for him. We have to assume the nuns, and perhaps a couple of physical therapists, will provide excellent care there.

“Often, people with frailty can live a pretty good life with good home care and social support, and almost every country does better at that than the United States,” Dr. Covinsky said. Our lack of a workable, affordable system of long-term care for the elderly and disabled poses a national crisis.

This is where being a former pope — something that is so rare that it shocked the world — may be a good way to live out one’s days.

“In the U.S., he could get M.R.I.’s and all kinds of expensive tests,” Dr. Covinsky noted. “But Medicare won’t pay for a home health aide four hours a day.” Luckily, the Vatican probably will provide it.


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

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Deficit hawks' 'generational theft' argument is a sham








Here's a phrase you can expect to be hearing a lot in the national debate over fiscal policy, as we move past the "sequester," which is the crisis du jour, and toward the budget cliff/government shutdown deadline looming at the end of March:


"Generational theft."


The core idea the term expresses is that we're spending so much more on our seniors than our children that future generations are being cheated. An important corollary is that the government debt we incur today will come slamming down upon the shoulders of our children and grandchildren.






The generational theft trope has already been receiving a vigorous workout in the press. Earlier this month, the Washington Post gave great play to a study by the Urban Institute stating that the federal government spends $7 on the elderly for every dollar it spends on kids. As we shall see, this is true as far as it goes, but it doesn't go nearly far enough to render an accurate picture of government spending.


The National Journal, another influential publication in Washington, picked up the theme last week by observing that because the sequester exempts Social Security and Medicare from budget cuts, the automatic spending reductions it mandates will fall disproportionately on education and other such boons to the young. This will "deepen the budget's generational imbalance."


This is also a bedrock argument of the anti-deficit organizations, such as Fix the Debt, associated with hedge fund billionaire Peter G. Peterson. For decades he has pursued a wearisome and spectacularly self-interested campaign to cut Social Security and Medicare benefits for the working class so taxes won't go up too much on the wealthy.


One of those organizations, called "The Can Kicks Back," promotes a "Millennial-driven campaign to fix the national debt." But backstopping its twenty- and thirty-something leaders is an advisory board comprising such Peterson frontmen as Morgan Stanley board member Erskine Bowles and former Sen. Alan Simpson (R-Wyo.). These guys are "millennials" only if we're talking about the last millennium before this one.


So here's the truth about the "generational theft" theme: It's wrong on the numbers and wrong on the implications.


Let's start with that 7-to-1 spending ratio on seniors versus children. Among the flaws in the calculation is that the vast majority of government dollars spent on children comes from state and local governments, which pay most of the cost of education. On a per capita basis, state and local spending on kids swamps the federal government's spending 8 to 1.


Moreover, there are twice as many children 18 and under as seniors 65 and over (this 2008 figure also comes from the Urban Institute report). Put the numbers together and you discover that spending by governments at all levels in 2008 came to about $1 trillion on seniors and $936 billion on children. In other words, very close to 1 to 1.


The notion underlying the comparison of spending on seniors and children is that "if you save a dollar on Social Security it would be transferred automatically to children," observes Theodore R. Marmor, an emeritus professor of public policy at Yale and a long-term student of social welfare programs. He traces this notion to deficit hawks and dismisses it as "not naive, but cynical."


That's because most of the spending on seniors is in Social Security and Medicare, and therefore has been largely paid for by those very beneficiaries over the course of their working lives.


Payroll taxes have more than covered what today's average retiree will receive back from Social Security. They won't cover the average payout on Medicare, but that's an artifact of uncontrolled healthcare costs, not of the structure of Medicare itself. Changing the terms of that program, say by raising the eligibility age (currently 65) won't save money and may actually raise costs.


In other ways, treating Social Security and Medicare spending on the one hand and spending on kids on the other as though they're opposite sides of a zero-sum game is just an act of ideological legerdemain aimed at undermining those programs.


If America wants to spend more on children, it's plenty rich enough to do so without eating away at the income of their grandparents. The money can come from the defense budget, farm supports or dozens of other places, even higher income taxes.


Let's not forget, too, that the people who will really suffer from gutting Social Security won't be today's seniors, who will escape the worst of the cutbacks — they'll be today's young people, for whom Social Security would become much less supportive when they retire.


What about the debt load we're supposedly imposing on future generations? This is another transparently Petersonian feat of sleight of hand, based on the assertion that while it's we who incur the debt, it's our children who will have to pay if off.


All the hand-wringing over today's borrowing conveniently assumes that the debt buys nothing, which makes it easier for debt hawks to pretend that it's only an expense and not an investment.


But money borrowed for the stimulus has bought jobs and unemployment benefits, which have helped sustain families through the Great Recession. (At least a few of those families have children, wouldn't you guess?)


In a larger sense, money borrowed by every generation is typically invested in programs and infrastructure — highway, schools, research and conservation, for example — that will add to future generations' wealth.


It's the persistence of the "generational theft" claim, which bubbles up every few years, that exposes its ideological roots.


It's a fundamental piece of a decades-long campaign to distract Americans into thinking that the threat to their way of life comes from a war of old against young, rather than an intra-generational class war in which the vast majority of economic gains from improvements in worker's productivity has flowed to the wealthy, not to the workers.


The economist Dean Baker observes, for example, if the federal hourly minimum wage had merely kept up with productivity growth after 1969 rather than stagnating (and getting eaten away by inflation) it would be more than $16.54, and we wouldn't be arguing about whether the country can "afford" an increase to $9.


The "generational theft" argument is a sham. It's an attempt to get around the fact, so distasteful to the enemies of government social programs, that Social Security and Medicare are hugely popular. As Marmor observes, if you can't put across the case that these programs are undesirable, "you have to make them look uncontrollable, ungovernable, and therefore unaffordable."


The argument has been tried out on several generations in the past, and they've seen through it. Today's generation should see through it too.


Michael Hiltzik's column appears Sundays and Wednesdays. Reach him at mhiltzik@latimes.com, read past columns at latimes.com/hiltzik, check out facebook.com/hiltzik and follow @latimeshiltzik on Twitter.






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Mike Piazza softens stance on Dodgers' Vin Scully









PHOENIX—





— Calling Vin Scully "a class act" and saying he had "the utmost respect" for him, Mike Piazza on Monday defended what he wrote in his recently released autobiography about the Hall of Fame broadcaster.


In his book, "Long Shot," Piazza described Scully as instrumental in turning the fans of Los Angeles against him during the contract stalemate that led to his trade to the Florida Marlins in 1998. Piazza wrote that Scully "was crushing me" on the air, a charge Scully vehemently denied.





"I can't say that I have regrets," Piazza said. "I was just trying to explain the situation."


The former All-Star catcher was at the Dodgers' spring-training facility with Italy's World Baseball Classic team, for which he is a coach. Scully was also at the complex, to call the Dodgers' 7-6 victory over the Chicago Cubs.


"I'd love to see him," Piazza said.


The two didn't meet.


"I always liked him," Scully said. "I admired him. I think either he made a mistake or got some bad advice. I still think of him as a great player and I hope he gets into the Hall of Fame. I really do. Whatever disappointment I feel, I'll put aside."


Scully declined to comment further on Piazza or his book.


Piazza complimented Scully as he tried to defend what he wrote.


"Vin is a class act; he's an icon," Piazza said. "To this day, I have the utmost respect for him. But the problem is, you have to go back in time and understand that at that point in time in my career with the Dodgers was a very tumultuous time. I was more or less telling my version of the story, at least what I was experiencing. And I said at the end of the book, it's not coming from a place of malice or anger. I think anybody who remembers that time knows it was a very tumultuous time."


Piazza said his intent wasn't to blame Scully.


"I don't think anybody who read the passage from start to finish felt that way," Piazza said. "Anybody who reads it knows it wasn't me blaming. That was definitely not the only factor. There were other factors. The team made the mistake, I made the mistake, of speaking publicly."


Piazza acknowledged that he never heard Scully's broadcasts and that his impressions of them were based on what he heard from others.


"My perception was that he was given the Dodgers' versions of the negotiations, which, I feel, wasn't 100% accurate," Piazza said.


In his book, Piazza also took issue with how Scully asked him about his contract demands during a spring-training interview. Piazza said Monday that he was "taken aback" by the line of questioning because he previously hadn't talked publicly about the negotiations.


To reach the practice fields at Camelback Ranch on Monday, Piazza had to pass through a gantlet of Dodgers fans. Piazza said he wasn't nervous.


"I did a book signing a couple of weeks ago in Pasadena and the fans were really nice," he said.


Piazza denied that he hadn't returned to Dodger Stadium in recent years out of fear of being booed, as Tom Lasorda told The Times last month.


Piazza said he always associated the Dodgers with the O'Malley family, which sold the team to News Corp. in 1998.


"Since then, obviously, they've taken on a different identity," Piazza said.


Piazza was noncommittal about visiting the ballpark in the future. "We'll see," he said. "I'll never say never."


Wouldn't it be harder to return now that his portrayal of Scully has upset fans?


"I don't know," he said. "I can't answer that."


Piazza also spoke about falling short of being elected to the Hall of Fame in his first year of eligibility.


"I definitely couldn't lie and say I wasn't a little disappointed," he said.


He is hopeful he will one day be inducted. "I trust the process," he said.


Piazza wouldn't say whether he thought Barry Bonds and Roger Clemens deserved to be in the Hall of Fame. Both players, who have been linked to performance-enhancing drugs, also were denied election.


Piazza has denied using performance-enhancing drugs and has never faced detailed allegations that he did. Asked if he was upset that the indiscretions of others might have altered others' perceptions of him, he replied, "Unfortunately, that's the way life is sometimes. I can't control and worry about what people think."


dylan.hernandez@latimes.com





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Singer Morrissey says no to Kimmel, 'Duck Dynasty'


LOS ANGELES (AP) — The TV series "Duck Dynasty" is coming between Morrissey and Jimmy Kimmel.


The singer and animal rights activist says he canceled his appearance Tuesday on ABC's "Jimmy Kimmel Live" because "Duck Dynasty" cast members will be on the talk show.


Morrissey says he can't perform on a show with what he called people who "amount to animal serial killers."


A&E's "Duck Dynasty" reality show follows a Louisiana family with a business selling duck calls and decoys.


A&E did not immediately respond to requests for comment from it and the Robertson family.


A person familiar with the Kimmel show's plans confirmed that Morrissey was to appear. The person lacked authority to discuss the matter publicly and spoke on condition of anonymity.


The person says Morrissey's performance will be rescheduled.


ABC says the Churchill band will perform Tuesday on Kimmel's show but declined comment on the switch.


___


Reach AP Television Writer Lynn Elber at http://www.twitter.com/lynnelber .


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Horse Meat in European Beef Raises Questions on U.S. Exposure





The alarm in Europe over the discovery of horse meat in beef products escalated again Monday, when the Swedish furniture giant Ikea withdrew an estimated 1,670 pounds of meatballs from sale in 14 European countries.




Ikea acted after authorities in the Czech Republic detected horse meat in its meatballs. The company said it had made the decision even though its tests two weeks ago did not detect horse DNA.


Horse meat mixed with beef was first found last month in Ireland, then Britain, and has now expanded steadily across the Continent. The situation in Europe has created unease among American consumers over whether horse meat might also find its way into the food supply in the United States. Here are answers to commonly asked questions on the subject.


Has horse meat been found in any meatballs sold in Ikea stores in the United States?


Ikea says there is no horse meat in the meatballs it sells in the United States. The company issued a statement on Monday saying meatballs sold in its 38 stores in the United States were bought from an American supplier and contained beef and pork from animals raised in the United States and Canada.


“We do not tolerate any other ingredients than the ones stipulated in our recipes or specifications, secured through set standards, certifications and product analysis by accredited laboratories,” Ikea said in its statement.


Mona Liss, a spokeswoman for Ikea, said by e-mail that all of the businesses that supply meat to its meatball maker  issue letters guaranteeing that they will not misbrand or adulterate their products. “Additionally, as an abundance of caution, we are in the process of DNA-testing our meatballs,” Ms. Liss wrote. “Results should be concluded in 30 days.”


Does the United States import any beef from countries where horse meat has been found?


No. According to the Department of Agriculture, the United States imports no beef from any of the European countries involved in the scandal. Brian K. Mabry, a spokesman for the department’s Food Safety and Inspection Service, said: “Following a decision by Congress in November 2011 to lift the ban on horse slaughter, two establishments, one located in New Mexico and one in Missouri, have applied for a grant of inspection exclusively for equine slaughter. The Food Safety and Inspection Service (F.S.I.S.) is currently reviewing those applications.”


Has horse meat been found in ground meat products sold in the United States?


No. Meat products sold in the United States must pass Department of Agriculture inspections, whether produced domestically or imported. No government financing has been available for inspection of horse meat for human consumption in the United States since 2005, when the Humane Society of the United States got a rider forbidding financing for inspection of horse meat inserted in the annual appropriations bill for the Agriculture Department. Without inspection, such plants may not operate legally.


The rider was attached to every subsequent agriculture appropriations bill until 2011, when it was left out of an omnibus spending bill signed by President Obama on Nov. 18. The U.S.D.A.  has not committed any money for the inspection of horse meat.


“We’re real close to getting some processing plants up and running, but there are no inspectors because the U.S.D.A. is working on protocols,” said Dave Duquette, a horse trader in Oregon and president of United Horsemen, a small group that works to retrain and rehabilitate unwanted horses and advocates the slaughter of horses for meat. “We believe very strongly that the U.S.D.A. is going to bring inspectors online directly.”


Are horses slaughtered for meat for human consumption in the United States?


Not currently, although live horses from the United States are exported to slaughterhouses in Canada and Mexico. The lack of inspection effectively ended the slaughter of horse meat for human consumption in the United States; 2007 was the last year horses were slaughtered in the United States. At the time financing of inspections was banned, a Belgian company operated three horse meat processing plants — in Fort Worth and Kaufman, Tex., and DeKalb, Ill. — but exported the meat it produced in them.


Since 2011, efforts have been made to re-establish the processing of horse meat for human consumption in the United States. A small plant in Roswell, N.M., which used to process beef cattle into meat has been retooled to slaughter 20 to 25 horses a day. But legal challenges have prevented it from opening, Mr. Duquette said. Gov. Susana Martinez of New Mexico opposes opening the plant and has asked the U.S.D.A. to block it.


Last month, the two houses of the Oklahoma Legislature passed separate bills to override a law against the slaughter of horses for meat but kept the law’s ban on consumption of such meat by state residents. California, Illinois, New Jersey, Tennessee and Texas prohibit horse slaughter for human consumption.


Is there a market for horse meat in the United States?


Mr. Duquette said horse meat was popular among several growing demographic groups in the United States, including Tongans, Mongolians and various Hispanic populations. He said he knew of at least 10 restaurants that wanted to buy horse meat. “People are very polarized on this issue,” he said. Wayne Pacelle, chief executive of the Humane Society of the United States, disagreed, saying demand in the United States was limited. Italy is the largest consumer of horse meat, he said, followed by France and Belgium.


Is horse meat safe to eat?


That is a matter of much debate between proponents and opponents of horse meat consumption. Mr. Duquette said that horse meat, some derived from American animals processed abroad, was eaten widely around the world without health problems. “It’s high in protein, low in fat and has a whole lot of omega 3s,” he said.


The Humane Society says that because horse meat is not consumed in the United States, the animals’ flesh is likely to contain residues of many drugs that are unsafe for humans to eat. The organization’s list of drugs given to horses runs to 29 pages.


“We’ve been warning the Europeans about this for years,” Mr. Pacelle said. “You have all these food safety standards in Europe — they do not import chicken carcasses from the U.S. because they are bathed in chlorine, and won’t take pork because of the use of ractopamine in our industry — but you’ve thrown out the book when it comes to importing horse meat from North America.”


The society has filed petitions with the Department of Agriculture and Food and Drug Administration, arguing that they should test horse meat before allowing it to be marketed in the United States for humans to eat.


This article has been revised to reflect the following correction:

Correction: February 25, 2013

An earlier version of this article misstated how many pounds of meatballs Ikea was withdrawing from sale in 14 European countries. It is 1,670 pounds, not 1.67 billion pounds.

This article has been revised to reflect the following correction:

Correction: February 25, 2013

An earlier version of this article misstated the last year that horses were slaughtered in the United States. It is 2007, not 2006.




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Coordinated healthcare could save California $110 billion, group says









California could cut $110 billion in healthcare spending over the next decade, saving the average household $800 a year, by quickly moving away from conventional fee-for-service medicine and embracing more coordinated care, a new report says.


These findings released Tuesday come from the Berkeley Forum, a new group of healthcare executives, state officials and academics that studied California's healthcare market for the last year in hopes of finding ways to make care better and more affordable. The main recommendations are not entirely new, and these shifts are already underway in response to the federal healthcare law and pressure from employers to tame runaway medical costs.


But the group's report does quantify how much work remains to be done and the potential savings if major changes are made in how doctors and hospitals are paid. Health-policy experts at UC Berkeley convened this group, which included high-ranking executives from Kaiser Permanente, Anthem Blue Cross, Cedars-Sinai Medical Center and other industry players.





"This could be a game changer in the state," said Stephen Shortell, dean of the School of Public Health at UC Berkeley and a coauthor of the report. "These are the CEOs of big insurers, big health systems and large medical groups saying it's time for a change, and these are the people who can get things done."


The Berkeley Forum calls for a major shift toward "global budgets," in which physicians and hospitals provide care under preset amounts that are adjusted to reflect the health of their patients. These payments would also be tied to providers' performance on several quality measures.


This is similar to the "capitated" payments managed-care companies and HMOs have used for years in California. HMOs already cover 44% of California's population, which is about double the nationwide rate.


Despite that high penetration, the report's authors found that 78% of the state's healthcare costs, or about $245 billion annually, are still paid through fee-for-service arrangements, which can encourage medical providers to perform unnecessary tests and procedures. The report calls for reducing the share of fee-for-service payments to 50% by 2022.


The Berkeley Forum also says California should double the share of the state's population receiving integrated care from medical providers to 60% within the next decade. The most visible example of integrated care in California is Kaiser Permanente, the Oakland nonprofit that coordinates care across its hospitals and physician groups.


Other health insurers, hospitals and doctors are collaborating in similar ways through accountable-care organizations, medical homes and other initiatives that have strong backing from Medicare. Shortell acknowledged that there are "legitimate concerns" about this integration leading to higher prices as hospitals, clinics and physician groups rapidly consolidate.


The $110 billion in healthcare savings targeted by the group would amount to 2.5% of overall spending of $4.4 trillion over 10 years in California, according to the report. Those savings would mean an extra $800 annually for every California household.


Overall, the report found that 53% of the state's healthcare dollars are spent on just 5% of the population, illustrating the high cost of treating certain chronically ill patients.


Pam Kehaly, president of Anthem Blue Cross in California, said this industrywide collaboration "puts us on a path to improving the ailing California healthcare system."


chad.terhune@latimes.com





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Oscars 2013: An 'Argo' night at Academy Awards









For the second straight year, the movie business fell for itself.


"Argo" — in which a Hollywood producer and makeup artist help engineer the rescue of six Americans from Iran — won the top prize at the 85th Academy Awards, one year after the silent film story "The Artist" took the best picture Oscar.


"I never thought I'd be back here. And I am," producer-director Ben Affleck said in accepting the best picture trophy Sunday night, 15 years after he won an original screenplay Oscar for "Good Will Hunting" and then saw his career fall into a tailspin that included "Gigli" and "Daredevil."








FULL COVERAGE: Oscars 2013 | Winners


"It doesn't matter how you get knocked down in life. That's going to happen," said Affleck, who wasn't nominated for directing "Argo," one of nine films in the best picture race. "All that matters is that you've got to get up."


"Argo," which became the first movie to win best picture without its director being nominated since 1989's "Driving Miss Daisy," collected two other Academy Awards, for editing and adapted screenplay. But it was not the evening's most recognized film: That honor went to Ang Lee's "Life of Pi," which won four Oscars — for directing, visual effects, cinematography and score.


"Thank you, movie god," said Lee, whose movie came into the evening with 11 nominations, one behind Steven Spielberg's "Lincoln." The film about the 16th president helped Daniel Day-Lewis make movie history, as he became the only man to ever win three lead actor statuettes. "Lincoln" won one other prize, for production design.


The song-and-dance heavy ceremony, hosted by Seth MacFarlane, hewed closely to a traditional awards show script, but there were several surprises. First Lady Michelle Obama, who joined the ABC telecast from the White House, announced "Argo" as the best picture. And the ceremony featured only the sixth tie in Oscar history and the first since 1994, with the sound editing award split between "Zero Dark Thirty" and "Skyfall." For the first time in Oscar history, six best picture nominees were $100-million blockbusters.


The ceremony was billed as a tribute to music in film, and boasted a number of extravagant musical numbers — including a medley of songs from movie musicals and an appearance by Barbra Streisand, who sang "The Way We Were." The telecast also paid homage to the long running James Bond series, with Adele singing the theme from "Skyfall" and Dame Shirley Bassey performing the theme from 1964's "Goldfinger."


Oscars 2013: Nominee list | Red carpet | Highlights


Jennifer Lawrence, 22, nabbed the lead actress prize for her role as an emotionally unstable widow in "Silver Linings Playbook" — and promptly tripped over her long dress walking up the stairs to accept her statuette. The crowd quickly gave her a standing ovation. "You guys are just standing up because you feel bad that I fell and that's embarrassing," Lawrence said to the applauding crowd at the Dolby Theatre.


The evening's very first award — for supporting actor — was a shocker, with long shot Christoph Waltz winning for his role as bounty hunter Dr. King Schultz in Quentin Tarantino's "Django Unchained" over favored contenders Robert De Niro ("Silver Linings Playbook") and Tommy Lee Jones ("Lincoln"). Waltz, who won the same award three years ago for Tarantino's "Inglourious Basterds," dedicated his prize to his writer-director, who also won the Oscar for original screenplay. "We participated in a hero's journey — the hero being Quentin," Waltz said.


Tarantino pulled off a mild surprise with the screenplay triumph for his slave-revenge tale. He dedicated his award to his eclectic cast of actors. "I actually think if people know my movies 30-50 years from now it's because of the characters I create," Tarantino said.


Anne Hathaway's supporting actress win for her emotionally raw portrayal of a doomed seamstress in "Les Misérables" was hardly as startling. The 30-year-old had been the odds-on favorite to win since the film first screened for members of the Motion Picture Academy in late November. "It came true," she stage-whispered as she picked up her trophy for her performance, the centerpiece of which is the lament "I Dreamed a Dream."


Oscars 2013: Backstage | Quotes | Best & Worst moments


Some of the evening's wins were bittersweet.


The animated feature Oscar was shared by "Brave" directors Mark Andrews and Brenda Chapman, an unusual pairing given that Chapman was fired from the Pixar Animation Studios film and replaced by Andrews in the middle of production. "Making these are a struggle — it's a battle, it's a war," Andrews said backstage. "I was very happy it was him who took my place," Chapman said.


Rhythm & Hues Studios, the company behind "Life of Pi's" visual effects win, recently filed for bankruptcy and laid off hundreds of its employees. As Oscar winner Bill Westenhofer addressed the situation in his acceptance speech, he ran over time and the theme from "Jaws" began to play him off the stage. His microphone was cut off just as he said the words "I urge you all…"


William Goldenberg was a double nominee in the film editing category — he worked on both "Argo" and "Zero Dark Thirty" — and won the prize for Affleck's CIA drama.


"Working at my father's deli, I had to do a million things at one time," Goldenberg said backstage about the best training for his job. "It really does prepare you for the multitasking it takes to be in an editing room."





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‘Bloodless’ Lung Transplants for Jehovah’s Witnesses


Eric Kayne for The New York Times


SHARING HOME AND FAITH A Houston couple hosted Gene and Rebecca Tomczak, center, in October so she could get care nearby.







HOUSTON — Last April, after being told that only a transplant could save her from a fatal lung condition, Rebecca S. Tomczak began calling some of the top-ranked hospitals in the country.




She started with Emory University Hospital in Atlanta, just hours from her home near Augusta, Ga. Then she tried Duke and the University of Arkansas and Johns Hopkins. Each advised Ms. Tomczak, then 69, to look somewhere else.


The reason: Ms. Tomczak, who was baptized at age 12 as a Jehovah’s Witness, insisted for religious reasons that her transplant be performed without a blood transfusion. The Witnesses believe that Scripture prohibits the transfusion of blood, even one’s own, at the risk of forfeiting eternal life.


Given the complexities of lung transplantation, in which transfusions are routine, some doctors felt the procedure posed unacceptable dangers. Others could not get past the ethics of it all. With more than 1,600 desperately ill people waiting for a donated lung, was it appropriate to give one to a woman who might needlessly sacrifice her life and the organ along with it?


By the time Ms. Tomczak found Dr. Scott A. Scheinin at The Methodist Hospital in Houston last spring, he had long since made peace with such quandaries. Like a number of physicians, he had become persuaded by a growing body of research that transfusions often pose unnecessary risks and should be avoided when possible, even in complicated cases.


By cherry-picking patients with low odds of complications, Dr. Scheinin felt he could operate almost as safely without blood as with it. The way he saw it, patients declined lifesaving therapies all the time, for all manner of reasons, and it was not his place to deny care just because those reasons were sometimes religious or unconventional.


“At the end of the day,” he had resolved, “if you agree to take care of these patients, you agree to do it on their terms.”


Ms. Tomczak’s case — the 11th so-called bloodless lung transplant attempted at Methodist over three years — would become the latest test of an innovative approach that was developed to accommodate the unique beliefs of the world’s eight million Jehovah’s Witnesses but may soon become standard practice for all surgical patients.


Unlike other patients, Ms. Tomczak would have no backstop. Explicit in her understanding with Dr. Scheinin was that if something went terribly wrong, he would allow her to bleed to death. He had watched Witness patients die before, with a lifesaving elixir at hand.


Ms. Tomczak had dismissed the prospect of a transplant for most of the two years she had struggled with sarcoidosis, a progressive condition of unknown cause that leads to scarring in the lungs. The illness forced her to quit a part-time job with Nielsen, the market research firm.


Then in April, on a trip to the South Carolina coast, she found that she was too breathless to join her frolicking grandchildren on the beach. Tethered to an oxygen tank, she watched from the boardwalk, growing sad and angry and then determined to reclaim her health.


“I wanted to be around and be a part of their lives,” Ms. Tomczak recalled, dabbing at tears.


She knew there was danger in refusing to take blood. But she thought the greater peril would come from offending God.


“I know,” she said, “that if I did anything that violates Jehovah’s law, I would not make it into the new system, where he’s going to make earth into a paradise. I know there are risks. But I think I am covered.”


Cutting Risks, and Costs


The approach Dr. Scheinin would use — originally called “bloodless medicine” but later re-branded as “patient blood management” — has been around for decades. His mentor at Methodist, Dr. Denton A. Cooley, the renowned cardiac pioneer, performed heart surgery on hundreds of Witnesses starting in the late 1950s. The first bloodless lung transplant, at Johns Hopkins, was in 1996.


But nearly 17 years later, the degree of difficulty for such procedures remains so high that Dr. Scheinin and his team are among the very few willing to attempt them.


In 2009, after analyzing Methodist’s own data, Dr. Scheinin became convinced that if he selected patients carefully, he could perform lung transplants without transfusions. Hospital administrators resisted at first, knowing that even small numbers of deaths could bring scrutiny from federal regulators.


“My job is to push risk away,” said Dr. A. Osama Gaber, the hospital’s director of transplantation, “so I wasn’t really excited about it. But the numbers were very convincing.”


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