Op-Ed Contributor: Labs, Washed Away





BEDPAN ALLEY is the affectionate name given to a stretch of First Avenue in Manhattan that is packed with more hospitals than many cities possess. This stretch also happened to be right in the flood zone during Hurricane Sandy. Water damage and power failures closed down all three of the New York University teaching hospitals — Bellevue Hospital, Tisch Hospital and the Manhattan V.A. Two months later, they are still not admitting patients, though two are on schedule to begin doing so shortly.




The harrowing evacuation of hundreds of patients made headlines nationwide. The disruption of regular medical care for tens of thousands of outpatients was a clinical nightmare that is finally easing. And the education of hundreds of medical students and residents is being patched back together.


All academic medical centers, however, rest on a tripod — patient care, education and research. The effect of the hurricane on the third leg of that tripod — research — has gotten the least attention, partly because rescuing cell cultures just isn’t as dramatic as carrying an I.C.U. patient on a ventilator down flights of stairs in the dark.


But, of course, there is an incontrovertible link between those cell cultures and that patient. For every medication that a patient takes, someone researched the basic chemistry of the drug, someone designed the clinical trial to test its efficacy, and of course a volunteer stepped forward to be the first to take the pill. Scientific research has engineered the impressive advancements of medical treatment, and every patient is a beneficiary.


When the hospitals were hit by Hurricane Sandy, hundreds of experiments were obliterated by the loss of power. Precious biological samples carefully frozen over years were destroyed. Temperature-sensitive reagents and equipment were ruined. Medications and records for patients in clinical trials were rendered inaccessible. And sadly, many laboratory mice and rats perished (though 600 cages of animals were rescued during the night by staff members who used crowbars on inaccessible doors and carried the cages out through holes cut in the ceiling).


On a slushy, rainy day earlier this month, I sat in on a meeting of N.Y.U.’s research community. Hundreds of scientists packed the chilly lecture hall to discuss what the future might hold. It was clear that the damage to laboratories and samples would not be amenable to easy repair. Some 400 researchers were being relocated to a patchwork of temporary sites so that they could restart their work.


But scientists can’t just walk in to a new space with a lab coat and a notebook; they need centrifuges, deep-freezes, lab animals, electron microscopes, incubators, autoclaves, gamma counters, PET scanners. They come with graduate students, lab techs, post-docs and collaborating investigators. For clinical researchers, there are also the patients enrolled in their clinical trials, with their medications and voluminous records.


Even beyond their eagerness to get back to work, researchers felt a sense of loss, not just in time, money, momentum, samples and grants, but of a part of their lives. Some senior scientists lost decades of archived samples. Others lost irreplaceable mice with genetic mutations for studying how coronary plaques resolve, the role of inflammation in lymphoma and the development of neural networks. At the other end of the spectrum were post-docs whose nascent careers were suddenly up in the air. Some were in tears.


Walking down First Avenue after the meeting, I passed a young researcher pushing a cart laden with cages, transporting lab rats to their new home. There was a blanket over the cages to protect them from the rain, but it kept slipping. She slogged up the wet avenue, one hand pushing the cart, the other struggling to keep the cover over her charges.


The logistical efforts to relocate and reignite such a vast research enterprise are staggeringly complicated. But the administration has cataloged each person’s research needs to match them with available space elsewhere, and hundreds of researchers have successfully rekindled their investigations despite the prodigious challenges.


Bellevue and Tisch are returning to their clinical operations and will be able to admit patients shortly. But even after the hospital wards and clinics are bustling at full capacity, the ribbon won’t feel ready to snip until the researchers are restored to their homes as well. For many patients, the thrum of research within a medical center is invisible. But it is an integral — and very human — part of a hospital. When a hurricane disrupts research, it is a loss that resonates well beyond the laboratories.


Danielle Ofri, an associate professor at New York University School of Medicine, is the editor of the Bellevue Literary Review and the author, most recently, of “Medicine in Translation: Journeys With My Patients.”



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Op-Ed Contributor: Labs, Washed Away





BEDPAN ALLEY is the affectionate name given to a stretch of First Avenue in Manhattan that is packed with more hospitals than many cities possess. This stretch also happened to be right in the flood zone during Hurricane Sandy. Water damage and power failures closed down all three of the New York University teaching hospitals — Bellevue Hospital, Tisch Hospital and the Manhattan V.A. Two months later, they are still not admitting patients, though two are on schedule to begin doing so shortly.




The harrowing evacuation of hundreds of patients made headlines nationwide. The disruption of regular medical care for tens of thousands of outpatients was a clinical nightmare that is finally easing. And the education of hundreds of medical students and residents is being patched back together.


All academic medical centers, however, rest on a tripod — patient care, education and research. The effect of the hurricane on the third leg of that tripod — research — has gotten the least attention, partly because rescuing cell cultures just isn’t as dramatic as carrying an I.C.U. patient on a ventilator down flights of stairs in the dark.


But, of course, there is an incontrovertible link between those cell cultures and that patient. For every medication that a patient takes, someone researched the basic chemistry of the drug, someone designed the clinical trial to test its efficacy, and of course a volunteer stepped forward to be the first to take the pill. Scientific research has engineered the impressive advancements of medical treatment, and every patient is a beneficiary.


When the hospitals were hit by Hurricane Sandy, hundreds of experiments were obliterated by the loss of power. Precious biological samples carefully frozen over years were destroyed. Temperature-sensitive reagents and equipment were ruined. Medications and records for patients in clinical trials were rendered inaccessible. And sadly, many laboratory mice and rats perished (though 600 cages of animals were rescued during the night by staff members who used crowbars on inaccessible doors and carried the cages out through holes cut in the ceiling).


On a slushy, rainy day earlier this month, I sat in on a meeting of N.Y.U.’s research community. Hundreds of scientists packed the chilly lecture hall to discuss what the future might hold. It was clear that the damage to laboratories and samples would not be amenable to easy repair. Some 400 researchers were being relocated to a patchwork of temporary sites so that they could restart their work.


But scientists can’t just walk in to a new space with a lab coat and a notebook; they need centrifuges, deep-freezes, lab animals, electron microscopes, incubators, autoclaves, gamma counters, PET scanners. They come with graduate students, lab techs, post-docs and collaborating investigators. For clinical researchers, there are also the patients enrolled in their clinical trials, with their medications and voluminous records.


Even beyond their eagerness to get back to work, researchers felt a sense of loss, not just in time, money, momentum, samples and grants, but of a part of their lives. Some senior scientists lost decades of archived samples. Others lost irreplaceable mice with genetic mutations for studying how coronary plaques resolve, the role of inflammation in lymphoma and the development of neural networks. At the other end of the spectrum were post-docs whose nascent careers were suddenly up in the air. Some were in tears.


Walking down First Avenue after the meeting, I passed a young researcher pushing a cart laden with cages, transporting lab rats to their new home. There was a blanket over the cages to protect them from the rain, but it kept slipping. She slogged up the wet avenue, one hand pushing the cart, the other struggling to keep the cover over her charges.


The logistical efforts to relocate and reignite such a vast research enterprise are staggeringly complicated. But the administration has cataloged each person’s research needs to match them with available space elsewhere, and hundreds of researchers have successfully rekindled their investigations despite the prodigious challenges.


Bellevue and Tisch are returning to their clinical operations and will be able to admit patients shortly. But even after the hospital wards and clinics are bustling at full capacity, the ribbon won’t feel ready to snip until the researchers are restored to their homes as well. For many patients, the thrum of research within a medical center is invisible. But it is an integral — and very human — part of a hospital. When a hurricane disrupts research, it is a loss that resonates well beyond the laboratories.


Danielle Ofri, an associate professor at New York University School of Medicine, is the editor of the Bellevue Literary Review and the author, most recently, of “Medicine in Translation: Journeys With My Patients.”



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Bits Blog: Instagram Does an About-Face

11:14 p.m. | Updated
SAN FRANCISCO — In the aftermath of the uproar over changes to Instagram’s privacy policy and terms of service earlier this week, the company did an about-face late Thursday.

In a blog post on the company’s site, Kevin Systrom, Instagram’s co-founder, said that where advertising was concerned, the company would revert to its previous terms of service, which have been in effect since October 2010.

“Rather than obtain permission from you to introduce possible advertising products we have not yet developed,” he wrote, “we are going to take the time to complete our plans, and then come back to our users and explain how we would like for our advertising business to work.” Users had been particularly concerned by a clause in Instagram’s policy introduced on Monday that suggested Instagram would share users’ data — like their favorite places, bands, restaurants and hobbies — with Facebook and its advertisers to better target ads.

They also took issue with an update to the company’s terms of service that suggested users’ photos could be used in advertisements, without compensation and even without their knowledge.

The terms of that user agreement said, “You agree that a business or other entity may pay us to display your user name, likeness, photos (along with any associated metadata) and/or actions you take, in connection with paid or sponsored content or promotions, without any compensation to you.”

Following a reaction that included customers defecting to other services, Mr. Systrom told Instagram users on Tuesday that the new policy had been misinterpreted. “It is our mistake that this language is confusing,” he wrote, and he promised an updated agreement.

That statement apparently was not enough. With more people leaving the service, the company, which Facebook bought for $735 million this year, reacted again by returning to the old rules.

Acknowledging those concerns late Thursday, Mr. Systrom wrote: “I want to be really clear: Instagram has no intention of selling your photos, and we never did. We don’t own your photos — you do.”

Mr. Systrom said the company would still be tweaking its privacy policy to quell users’ fears that their photos might pop-up on third-party sites without their consent.

But Mr. Systrom did not clarify how Instagram planned to monetize its service in the future. Facebook is under pressure to make Instagram earn income.

“It’s a free service — they have to monetize somewhere,” said John Casasanta, a principal at Tap Tap Tap, the maker of Camera+, a photo-filter app that has shunned advertising and instead charges users for premium features. “The days of the simple banner ads are gone. Their user data is too valuable.”

It was unclear whether reverting its terms of service would be enough to satisfy high-profile users like National Geographic, which stopped using its Instagram account in light of the moves, or other users who have aired their grievances on Twitter and Facebook.

The controversy has driven traffic and new users to several other photo-sharing applications.

Pheed, an Instagram-like app that gives users the option to monetize their own content by charging followers to see their posts, gained more users than any other app in the United States on Thursday. By Thursday morning, Pheed had jumped to the ninth most downloaded social-networking app in Apple’s iTunes store, just ahead of LinkedIn.

O. D. Kobo, Pheed’s chief executive, said Thursday morning that subscriptions to the service had quadrupled this week and that in the last 24 hours users had uploaded 300,000 new files to the service — more uploads than any other 24-hour-period since Pheed made its debut six weeks ago.

Another runaway success was Flickr, Yahoo’s photo-sharing service, which redesigned its app last week to make it easier to share photos on Twitter. In a stroke of good fortune, it released the app to positive reviews just as Instagram announced it would no longer sync with Twitter, a Facebook rival.

The day before Instagram announced changes to its terms of service, Flickr’s mobile app was ranked at around 175 in Apple’s overall iTunes app charts. Since that day, the application skyrocketed to the high 20s.

Of course, most of these services are still tiny compared to Instagram, which claims to have more than 100 million members who have uploaded upward of 5 billion photos using its service. And it was unclear if the services’ newfound members had also deleted their Instagram accounts or were merely dabbling in other offerings. But the migration, whether temporary or permanent, was a reminder of the volatility of success and that the fall to bottom can sometimes be as swift as the rise to the top.

Facebook and Instagram declined to say whether they had seen any significant number of account deletions or if they were concerned about losing ground in the photo-sharing market to rivals. Some photo apps took direct aim at Instagram. Camera+ even went so far as to include a snide, holiday-themed reference to Instagram’s stumbles in an app update on Wednesday.

“We’ll never do shady things with your shared pics, because it just isn’t right,” the update noted. “On that note, happy Christmas to all, and to all a good night!”

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India Ink: Modi Victory Speech Comes With Apology

Addressing a large crowd of cheering supporters Thursday evening after the Bharatiya Janata Party won a decisive victory in the state elections in Gujarat, its polarizing leader Narendra Modi thanked the state’s voters for coming out in large numbers, even as he appeared to reach out to Indians all over the country.

“Whether they are in Assam or Kerala or Jammu and Kashmir,” Mr. Modi said in a 45-minute speech in Ahmedabad, “this is a victory for all the people of this country who want development.”

Dressed in a saffron kurta, Mr. Modi, who has spoken largely in Gujarati throughout his campaign, chose to speak in Hindi, a sign many commentators say that his victory speech was intended not just for Gujarat’s 60 million residents but for a pan Indian audience.

While few had any doubt that the B.J.P. would return to power in Gujarat – the party won in 115 of 182 constituencies – the margin of victory was being closely watched as a personal test for Mr. Modi, who is widely believed to have prime ministerial ambitions. His speech is being seen as an attempt to recast the powerful regional politician as a national leader capable of replicating Gujarat’s development model across the country at a time when India’s slowing growth is becoming a cause for concern.

“In this country, there has been a belief that good economics is bad politics,” Mr. Modi said. “I am proud that the voters of Gujarat have proved that growth and development can be successful election issues.”

With dozens of cameras trained on him, Mr. Modi, who has long been the subject of intense media scrutiny, projected himself as a tireless leader focused on “bringing development to the doorstep of every poor person, every farmer, every worker,” rather than the politics of religion or caste.

“There was a time when a government could do one good thing in one term and still sail through,” Mr. Modi said. “I can’t rest if I don’t do one new thing every day.”

Mr. Modi said he is serving the country by serving Gujarat. If a Gujarati farmer is doing well, for instance, he is bailing out an Indian elsewhere who is in need of food, Mr Modi said. If a Gujarati doctor or hospital does a good job, he added, people from Rajasthan and Madhya Pradesh will have a place to go to if they need medical care.

He also congratulated the people of Gujarat for showing the rest of the country that the time of “pro-incumbency” has come. Mr. Modi will serve as Chief Minister for a fourth term. At a time in India when state governments come for five years and are quickly replaced by other governments, he said, the people of Gujarat have shown “remarkable maturity.”

“By bringing the same government back, the people are holding it accountable,” he said. “Political stability is important for good governance and development.”

While most expected Mr. Modi’s speech to focus on development, many were surprised by the normally pugnacious and defiant leader’s somewhat conciliatory tone, as he apologized for any mistakes he may have made as the state’s chief. “There may have been a time when I hurt someone or when I made a mistake,” Mr. Modi said. “I ask my 60 million Gujaratis to forgive me.”

Lashing out at “political pundits” for what he characterized as a systematic negative campaign against him, Mr. Modi congratulated his voters for drowning out all the commentary blaring through their television sets. He projected himself as a fighter, battling all odds, including a negative campaign by an “anti-Modi cohort.”

It is widely believed that Mr. Modi needs to repair his image if he is to succeed at the national level. At one point, his euphoric supporters chanted “Delhi Delhi,” willing the chief minister to make a trip to the national capital. Mr. Modi promised to visit Delhi on Dec. 27, a loaded statement which was followed by chants of “P.M., P.M.,” referring to Mr. Modi as Prime Minister.

In Gujarat, Mr. Modi’s victory was celebrated on the streets with music, dance and fireworks. To these supporters, Mr. Modi promised “five more years of prosperity.”

“I promise you that I will never be tired, I will never stop,” Mr. Modi said. “I will fulfill all your dreams with all of my strength.”

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BBC Inquiry Blames Rigid Management for Mishandling Sex Abuse Scandal



The 200-page report by Nick Pollard, a veteran British broadcast executive, strongly criticized the editorial and management decisions that prompted the BBC to cancel a broadcast last year that would have exposed decades of sexual abuse by Jimmy Savile, a BBC fixture who had been one of Britain’s best-known television personalities.


While the scandal led to the resignation and reassignment of several top executives — including George Entwistle, just two months into his tenure in the BBC’s top job as director general — Mr. Pollard absolved top management of applying “undue pressure” in the decision to stop the broadcast.


The report also did not challenge the assertions of Mark Thompson, then head of the BBC, that he had no role in killing the Savile investigation and was unaware of the sexual abuse accusations until he left the BBC this September. Mr. Thompson is now president and chief executive of The New York Times Company.


The report traced in detail what it described as “a chain of events that was to prove disastrous for the BBC.” Its central conclusion was that confusion and mismanagement, not a cover-up, lay at the heart of the decision to drop the Savile segment on “Newsnight,” an investigative program. Mr. Savile died at 84 in October 2011, weeks before the segment was scheduled to run.


“The efforts to get to the truth behind the Savile story proved beyond the combined efforts of the senior management, legal department, corporate communications team and anyone else for well over a month” after a rival channel, ITV, broadcast its own exposé in October 2012.


That segment presented the accounts of five women who said they had been sexually abused as teenagers by Mr. Savile, the report said. “Leadership and organization seemed to be in short supply.”


Mr. Pollard, a former head of the Sky News channel who began his broadcast career as a BBC reporter, dismissed a widely circulated theory that BBC News executives or their superiors pressured the “Newsnight” team to cancel the Savile segment to avoid embarrassing the BBC. Peter Rippon, the program’s editor, said that he canceled the report because he thought the team’s conclusions about Mr. Savile were inadequately substantiated.


“While there clearly were discussions about the Savile story between Mr. Rippon and his managers,” Mr. Pollard said, he does not believe that they went beyond journalistic considerations.


After publication of the report, Tim Davie, the BBC’s acting director general, said that Stephen Mitchell, the deputy director of news, would be taking early retirement and that Mr. Rippon would be moved to another job. Helen Boaden, director of the news division, who along with Mr. Rippon and Mr. Mitchell was suspended while the nine-week Pollard inquiry was in progress, will return to her job, overseeing new editorial leadership at “Newsnight.”


In a statement, the BBC Trust, which oversees the broadcaster, said the report made clear the need for major changes in the BBC’s operation. It said top executives must take initiative and responsibility, share information and embrace criticism, and persuade employees to rid the company of the “insularity and distrust” revealed in the report.


“The BBC portrayed by the Pollard review is not fundamentally flawed, but has been chaotic,” it said. “That now needs to change.”


The report was strongly critical of several news executives who were directly involved in the decision to cancel the Savile program, including Mr. Rippon and the top executives in the BBC’s news division to whom he reported, Ms. Boaden and Mr. Mitchell, saying they had reached a “flawed” conclusion in canceling the “Newsnight” segment that overrode the “cogent evidence” against Mr. Savile that the “Newsnight” team had gathered.


But it paid scant attention to the role of the former director general, Mr. Thompson, and did not fault him for missing opportunities to learn the details of the allegations against Mr. Savile.


After Mr. Thompson was told about the scuttled segment by a BBC reporter at a reception in late December 2011, he said, he asked his news executives about it. According to his testimony to the Pollard inquiry, he “received reassurances” that it had been killed for “editorial or journalistic reasons” and “crossed it off my list and went off to worry about something else.”


Matthew Purdy contributed reporting from New York.



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U.N. Suspends Polio Campaign in Pakistan After Killings of Workers


B.K. Bangash/Associated Press


A Pakistani woman administered polio vaccine to an infant on Wednesday in the slums of Islamabad. Militants have killed eight polio workers over three days.







LAHORE, Pakistan — The front-line heroes of Pakistan’s war on polio are its volunteers: young women who tread fearlessly from door to door, in slums and highland villages, administering precious drops of vaccine to children in places where their immunization campaign is often viewed with suspicion.




Now, those workers have become quarry. After militants stalked and killed eight of them over the course of a three-day, nationwide vaccination drive, the United Nations suspended its anti-polio work in Pakistan on Wednesday, and one of Pakistan’s most crucial public health campaigns has been plunged into crisis.


The World Health Organization and Unicef ordered their staff members off the streets, while government officials reported that some polio volunteers — especially women — were afraid to show up for work.


At the ground level, it is those female health workers who are essential, allowed privileged entrance into private homes to meet and help children in situations denied to men because of conservative rural culture. “They are on the front line; they are the backbone,” said Imtiaz Ali Shah, a polio coordinator in Peshawar.


The killings started in the port city of Karachi on Monday, the first day of a vaccination drive aimed at the worst affected areas, with the shooting of a male health worker. On Tuesday four female polio workers were killed, all gunned down by men on motorcycles in what appeared to be closely coordinated attacks.


The hit jobs then moved to Peshawar, the capital of Khyber-Pakhtunkhwa Province, which, along with the adjoining tribal belt, constitutes Pakistan’s main reservoir of new polio infections. The first victim there was one of two sisters who had volunteered as polio vaccinators. Men on motorcycles shadowed them as they walked from house to house. Once the sisters entered a quiet street, the gunmen opened fire. One of the sisters, Farzana, died instantly; the other was uninjured.


On Wednesday, a man working on the polio campaign was shot dead as he made a chalk mark on the door of a house in a suburb of Peshawar. Later, a female health supervisor in Charsadda, 15 miles to the north, was shot dead in a car she shared with her cousin.


Yet again, Pakistani militants are making a point of attacking women who stand for something larger. In October, it was Malala Yousafzai, a schoolgirl advocate for education who was gunned down by a Pakistani Taliban attacker in the Swat Valley. She was grievously wounded, and the militants vowed they would try again until they had killed her. The result was a tidal wave of public anger that clearly unsettled the Pakistani Taliban.


In singling out the core workers in one of Pakistan’s most crucial public health initiatives, militants seem to have resolved to harden their stance against immunization drives, and declared anew that they consider women to be legitimate targets. Until this week, vaccinators had never been targeted with such violence in such numbers.


Government officials in Peshawar said that they believe a Taliban faction in Mohmand, a tribal area near Peshawar, was behind at least some of the shootings. Still, the Pakistani Taliban have been uncharacteristically silent about the attacks, with no official claims of responsibility. In staying quiet, the militants may be trying to blunt any public backlash like the huge demonstrations over the attack on Ms. Yousafzai.


Female polio workers here make for easy targets. They wear no uniform but are readily recognizable, with clipboards and refrigerated vaccine boxes, walking door to door. They work in pairs — including at least one woman — and are paid just over $2.50 a day. Most days one team can vaccinate 150 to 200 children.


Faced with suspicious or recalcitrant parents, their only weapon is reassurance: a gentle pat on the hand, a shared cup of tea, an offer to seek religious assurances from a pro-vaccine cleric. “The whole program is dependent on them,” said Mr. Shah, in Peshawar. “If they do good work, and talk well to the parents, then they will vaccinate the children.”


That has happened with increasing frequency in Pakistan over the past year. A concerted immunization drive, involving up to 225,000 vaccination workers, drove the number of newly infected polio victims down to 52. Several high-profile groups shouldered the program forward — at the global level, donors like the Bill and Melinda Gates Foundation, the United Nations and Rotary International; and at the national level, President Asif Ali Zardari and his daughter Aseefa, who have made polio eradication a “personal mission.”


On a global scale, setbacks are not unusual in polio vaccination campaigns, which, by dint of their massive scale and need to reach deep inside conservative societies, end up grappling with more than just medical challenges. In other campaigns in Africa and South Asia, vaccinators have grappled with natural disaster, virulent opposition from conservative clerics and sudden outbreaks of mysterious strains of the disease.


Declan Walsh reported from Lahore, and Donald G. McNeil Jr. from New York. Ismail Khan contributed reporting from Peshawar, Pakistan.



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U.N. Suspends Polio Campaign in Pakistan After Killings of Workers


B.K. Bangash/Associated Press


A Pakistani woman administered polio vaccine to an infant on Wednesday in the slums of Islamabad. Militants have killed eight polio workers over three days.







LAHORE, Pakistan — The front-line heroes of Pakistan’s war on polio are its volunteers: young women who tread fearlessly from door to door, in slums and highland villages, administering precious drops of vaccine to children in places where their immunization campaign is often viewed with suspicion.




Now, those workers have become quarry. After militants stalked and killed eight of them over the course of a three-day, nationwide vaccination drive, the United Nations suspended its anti-polio work in Pakistan on Wednesday, and one of Pakistan’s most crucial public health campaigns has been plunged into crisis.


The World Health Organization and Unicef ordered their staff members off the streets, while government officials reported that some polio volunteers — especially women — were afraid to show up for work.


At the ground level, it is those female health workers who are essential, allowed privileged entrance into private homes to meet and help children in situations denied to men because of conservative rural culture. “They are on the front line; they are the backbone,” said Imtiaz Ali Shah, a polio coordinator in Peshawar.


The killings started in the port city of Karachi on Monday, the first day of a vaccination drive aimed at the worst affected areas, with the shooting of a male health worker. On Tuesday four female polio workers were killed, all gunned down by men on motorcycles in what appeared to be closely coordinated attacks.


The hit jobs then moved to Peshawar, the capital of Khyber-Pakhtunkhwa Province, which, along with the adjoining tribal belt, constitutes Pakistan’s main reservoir of new polio infections. The first victim there was one of two sisters who had volunteered as polio vaccinators. Men on motorcycles shadowed them as they walked from house to house. Once the sisters entered a quiet street, the gunmen opened fire. One of the sisters, Farzana, died instantly; the other was uninjured.


On Wednesday, a man working on the polio campaign was shot dead as he made a chalk mark on the door of a house in a suburb of Peshawar. Later, a female health supervisor in Charsadda, 15 miles to the north, was shot dead in a car she shared with her cousin.


Yet again, Pakistani militants are making a point of attacking women who stand for something larger. In October, it was Malala Yousafzai, a schoolgirl advocate for education who was gunned down by a Pakistani Taliban attacker in the Swat Valley. She was grievously wounded, and the militants vowed they would try again until they had killed her. The result was a tidal wave of public anger that clearly unsettled the Pakistani Taliban.


In singling out the core workers in one of Pakistan’s most crucial public health initiatives, militants seem to have resolved to harden their stance against immunization drives, and declared anew that they consider women to be legitimate targets. Until this week, vaccinators had never been targeted with such violence in such numbers.


Government officials in Peshawar said that they believe a Taliban faction in Mohmand, a tribal area near Peshawar, was behind at least some of the shootings. Still, the Pakistani Taliban have been uncharacteristically silent about the attacks, with no official claims of responsibility. In staying quiet, the militants may be trying to blunt any public backlash like the huge demonstrations over the attack on Ms. Yousafzai.


Female polio workers here make for easy targets. They wear no uniform but are readily recognizable, with clipboards and refrigerated vaccine boxes, walking door to door. They work in pairs — including at least one woman — and are paid just over $2.50 a day. Most days one team can vaccinate 150 to 200 children.


Faced with suspicious or recalcitrant parents, their only weapon is reassurance: a gentle pat on the hand, a shared cup of tea, an offer to seek religious assurances from a pro-vaccine cleric. “The whole program is dependent on them,” said Mr. Shah, in Peshawar. “If they do good work, and talk well to the parents, then they will vaccinate the children.”


That has happened with increasing frequency in Pakistan over the past year. A concerted immunization drive, involving up to 225,000 vaccination workers, drove the number of newly infected polio victims down to 52. Several high-profile groups shouldered the program forward — at the global level, donors like the Bill and Melinda Gates Foundation, the United Nations and Rotary International; and at the national level, President Asif Ali Zardari and his daughter Aseefa, who have made polio eradication a “personal mission.”


On a global scale, setbacks are not unusual in polio vaccination campaigns, which, by dint of their massive scale and need to reach deep inside conservative societies, end up grappling with more than just medical challenges. In other campaigns in Africa and South Asia, vaccinators have grappled with natural disaster, virulent opposition from conservative clerics and sudden outbreaks of mysterious strains of the disease.


Declan Walsh reported from Lahore, and Donald G. McNeil Jr. from New York. Ismail Khan contributed reporting from Peshawar, Pakistan.



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State of the Art: Android Cameras From Nikon and Samsung Go Beyond Cellphones - Review




60 Seconds With Pogue: Android Cameras:
David Pogue reviews the Nikon Coolpix S800C and the Samsung Galaxy Camera.







“Android camera.” Wow, that has a weird ring, doesn’t it? You just don’t think of a camera as having an operating system. It’s like saying “Windows toaster” or “Unix jump rope.”




But yes, that’s what it has come to. Ever since cellphone cameras got good enough for everyday snapshots, camera sales have been dropping. For millions of people, the ability to share a fresh photo wirelessly — Facebook, Twitter, e-mail, text message — is so tempting, they’re willing to sacrifice a lot of real-camera goodness.


That’s an awfully big convenience/photo-quality swap. A real camera teems with compelling features that most phones lack: optical zoom, big sensor, image stabilization, removable memory cards, removable batteries and decent ergonomics. (A four-inch, featureless glass slab is not exactly optimally shaped for a hand-held photographic instrument.)


But the camera makers aren’t taking the cellphone invasion lying down. New models from Nikon and Samsung are obvious graduates of the “if you can’t beat ’em, join ’em” school. The Nikon Coolpix S800C ($300) and Samsung’s Galaxy Camera ($500 from AT&T, $550 from Verizon) are fascinating hybrids. They merge elements of the cellphone and the camera into something entirely new and — if these flawed 1.0 versions are any indication — very promising.


From the back, you could mistake both of these cameras for Android phones. The big black multitouch screen is filled with app icons. Yes, app icons. These cameras can run Angry Birds, Flipboard, Instapaper, Pandora, Firefox, GPS navigation programs and so on. You download and run them exactly the same way. (That’s right, a GPS function. “What’s the address, honey? I’ll plug it into my camera.”)


But the real reason you’d want an Android camera is wirelessness. Now you can take a real photo with a real camera — and post it or send it online instantly. You eliminate the whole “get home and transfer it to the computer” step.


And as long as your camera can get online, why stop there? These cameras also do a fine job of handling Web surfing, e-mail, YouTube videos, Facebook feeds and other online tasks. Well, as fine a job as a phone could do, anyway.


You can even make Skype video calls, although you won’t be able to see your conversation partner; the lens has to be pointing toward you.


Both cameras get online using Wi-Fi hot spots. The Samsung model can also get online over the cellular networks, just like a phone, so you can upload almost anywhere.


Of course, there’s a price for that luxury. Verizon charges at least $30 a month if you don’t have a Verizon plan, or $5 if you have a Verizon Share Everything plan. AT&T charges $50 a month or more for the camera alone, or $10 more if you already have a Mobile Share plan.


If you have a choice, Verizon is the way to go. Not only is $5 a month much more realistic than $10 a month, but Verizon’s 4G LTE network is far faster than AT&T’s 4G network. That’s an important consideration, since what you’ll mostly be doing with your 4G cellular camera is uploading big photo files. (Wow. Did I just write “4G cellular camera?”)


These cameras offer a second big attraction, though: freedom of photo software. The Android store overflows with photography apps. Mix and match. Take a shot with one app, crop, degrade and post it with Instagram.


Just beware that most of them are intended for cellphones, so they don’t recognize these actual cameras’ optical zoom controls. Some of the photo-editing apps can’t handle these cameras’ big 16-megapixel files, either. Unfortunately, you won’t really know until you pay the $1.50 or $4 to download these apps.


E-mail: pogue@nytimes.com



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India Ink: Asians: Too Smart for Their Own Good?



AT the end of this month, high school seniors will submit their college applications and begin waiting to hear where they will spend the next four years of their lives. More than they might realize, the outcome will depend on race. If you are Asian, your chances of getting into the most selective colleges and universities will almost certainly be lower than if you are white.


Asian-Americans constitute 5.6 percent of the nation’s population but 12 to 18 percent of the student body at Ivy League schools. But if judged on their merits — grades, test scores, academic honors and extracurricular activities — Asian-Americans are underrepresented at these schools. Consider that Asians make up anywhere from 40 to 70 percent of the student population at top public high schools like Stuyvesant and Bronx Science in New York City, Lowell in San Francisco and Thomas Jefferson in Alexandria, Va., where admissions are largely based on exams and grades.


In a 2009 study of more than 9,000 students who applied to selective universities, the sociologists Thomas J. Espenshade and Alexandria Walton Radford found that white students were three times more likely to be admitted than Asians with the same academic record.


Sound familiar? In the 1920s, as high-achieving Jews began to compete with WASP prep schoolers, Ivy League schools started asking about family background and sought vague qualities like “character,” “vigor,” “manliness” and “leadership” to cap Jewish enrollment. These unofficial Jewish quotas weren’t lifted until the early 1960s, as the sociologist Jerome Karabel found in his 2005 history of admissions practices at Harvard, Yale and Princeton.


In the 1920s, people asked: will Harvard still be Harvard with so many Jews? Today we ask: will Harvard still be Harvard with so many Asians? Yale’s student population is 58 percent white and 18 percent Asian. Would it be such a calamity if those numbers were reversed?


As the journalist Daniel Golden revealed in his 2006 book “The Price of Admission,” far more attention has been devoted to race-conscious affirmative action at public universities (which the Supreme Court has scaled back and might soon eliminate altogether) than to the special preferences elite universities afford to the children of (overwhelmingly white) donors and alumni.


For middle-class and affluent whites, overachieving Asian-Americans pose thorny questions about privilege and power, merit and opportunity. Some white parents have reportedly shied away from selective public schools that have become “too Asian,” fearing that their children will be outmatched. Many whites who can afford it flock to private schools that promote “progressive” educational philosophies, don’t “teach to the test” and offer programs in art and music (but not “Asian instruments,” like piano and violin). At some of these top-tier private schools, too, Asian kids find it hard to get in.


At highly selective colleges, the quotas are implicit, but very real. So are the psychological consequences. At Northwestern, Asian-American students tell me that they feel ashamed of their identity — that they feel viewed as a faceless bunch of geeks and virtuosos. When they succeed, their peers chalk it up to “being Asian.” They are too smart and hard-working for their own good.


Since the 1965 overhaul of immigration law, the United States has lured millions of highly educated, ambitious immigrants from places like Taiwan, South Korea and India. We welcomed these immigrants precisely because they outperformed and overachieved. Yet now we are stigmatizing their children for inheriting their parents’ work ethic and faith in a good education. How self-defeating.


To be clear, I do not seek to perpetuate the “model minority” myth — Asian-Americans are a diverse group, including undocumented restaurant workers and resettled refugees as well as the more familiar doctors and engineers. Nor do I endorse the law professor Amy Chua’s pernicious “Tiger Mother” stereotype, which has set back Asian kids by attributing their successes to overzealous (and even pathological) parenting rather than individual effort.


Some educators, parents and students worry that if admissions are based purely on academic merit, selective universities will be dominated by whites and Asians and admit few blacks and Latinos, as a result of socioeconomic factors and an enduring test-score gap. We still need affirmative action for underrepresented groups, including blacks, Latinos, American Indians and Southeast Asian Americans and low-income students of all backgrounds.


But for white and Asian middle- and upper-income kids, the playing field should be equal. It is noteworthy that many high-achieving kids at selective public magnet schools are children of working-class immigrants, not well-educated professionals. Surnames like Kim, Singh and Wong should not trigger special scrutiny.


We want to fill our top universities with students of exceptional and wide-ranging talent, not just stellar test takers. But what worries me is the application of criteria like “individuality” and “uniqueness,” subjectively and unfairly, to the detriment of Asians, as happened to Jewish applicants in the past. I suspect that in too many college admissions offices, a white Intel Science Talent Search finalist who is a valedictorian and the concertmaster of her high school orchestra would stand out as exceptional, while an Asian-American with the same résumé (and socioeconomic background) would not.


The way we treat these children will influence the America we become. If our most renowned schools set implicit quotas for high-achieving Asian-Americans, we are sending a message to all students that hard work and good grades may be a fool’s errand.



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Shopping Sites Open Brick-and-Mortar Stores


Michael Nagle for The New York Times


Piperlime, the Gap Inc. unit that was online-only for six years, opened a SoHo store this fall.







Andy Dunn was fierce about the Internet-only model of his apparel company, Bonobos, after helping to found it in 2007. He gave a speech, “The End of Apparel as We Know It,” arguing that stores were a bad economic decision. As he told a news channel in 2009: “We keep men out of retail stores when we know that men fundamentally don’t enjoy shopping.”




How times have changed.


Recently, Mr. Dunn was looking with satisfaction around a Bonobos store in Manhattan, one of six the company opened this year. “I was pretty puritanical about e-commerce only,” he said, but found that about half of would-be customers would not order apparel online because they wanted to feel the merchandise. E-commerce is growing fast, he added, but “that doesn’t mean the offline world is going away — it just means it’s changing.”


After years of criticizing physical stores as relics, even e-commerce zealots are acknowledging there is something to a bricks-and-mortar location. EBay and Etsy are testing temporary stores, while Piperlime, the Gap Inc. unit that was online-only for six years, opened a SoHo store this fall. Bonobos plans to keep opening stores, and Warby Parker, the eyeglass brand, will soon open a physical location.


The companies say they are catering to customers who want to see what they are buying in person, and who see shopping as a social event. As they build the locations, though, the retailers are reimagining some long-established rules — carrying less inventory, having fewer staff members and embracing small and out-of-the-way locations. In the process, they are creating what could be a model for efficient in-store operations: the store as a showroom.


“Well over 90 percent of sales still happen in physical stores, so there is a huge, compelling reason to think about the physical store as a driver of sales,” said Sucharita Mulpuru, an analyst at Forrester Research. She said Web retailers had advantages over traditional ones: they are not stuck with old cash registers and sales software, and the weak commercial real estate environment combined with their Web sales history allow them to get leases on good terms.


Faith Hope Consolo, a Manhattan retail real estate broker, said she was seeing more inquiries from online-only retailers about opening shops, particularly in smaller spaces.


“They’ll show them a few products, lure them in and hopefully have them hooked,” she said. “They feel that, yes, people are online, people have apps, but there’s nothing like the spontaneous face-to-face.” Some stores take the revised model to an extreme. An eBay pop-up store in London that opened this holiday season has no actual merchandise, just scannable screens displaying gift suggestions.


Others try to give shoppers a semitraditional experience, but without all the costs. “If you build it backwards, you rethink it,” said Mr. Dunn, the Bonobos chief executive.


Mr. Dunn said the store idea stemmed from customers’ requests to try on items before a purchase.


Though Bonobos suggested that customers order multiple sizes, that didn’t fit with the ethos of good service he wanted. “Clicking on six sizes and having them shipped to me is not a great experience,” he said.


Also, he said, “the cost of marketing a Web site and the cost of free shipping both ways was approximating a store expense,” he said.


Bonobos added two sales representatives in the lobby of its Manhattan office last year to show clothes to customers, and Mr. Dunn said that within six months, each was on track to achieve more than $250,000 in sales. Based on that, this year, Bonobos struck a deal with Nordstrom to carry its clothes in its shop, and opened its first store.


For his own stores, Mr. Dunn did not want a typical retail model that required carrying a heavy inventory, staffing for heavy foot traffic and paying for prime real estate.


Instead, he took 700 square feet in Bonobos’s existing fifth-floor office and converted it into a store, called a Guideshop. Customers make appointments, which generally last 45 minutes, so one or two employees handle the entire store at once.


Most retail stores have to carry each item in a range of colors and sizes, a significant cost, but Bonobos does not, instead using the Web site as its virtual back room. Customers do not leave the store with merchandise; instead, the employees place an online order that is delivered to the customer, often the next day.


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