Well: Keeping Blood Pressure in Check

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Since the start of the 21st century, Americans have made great progress in controlling high blood pressure, though it remains a leading cause of heart attacks, strokes, congestive heart failure and kidney disease.

Now 48 percent of the more than 76 million adults with hypertension have it under control, up from 29 percent in 2000.

But that means more than half, including many receiving treatment, have blood pressure that remains too high to be healthy. (A normal blood pressure is lower than 120 over 80.) With a plethora of drugs available to normalize blood pressure, why are so many people still at increased risk of disease, disability and premature death? Hypertension experts offer a few common, and correctable, reasons:

¶ About 20 percent of affected adults don’t know they have high blood pressure, perhaps because they never or rarely see a doctor who checks their pressure.

¶ Of the 80 percent who are aware of their condition, some don’t appreciate how serious it can be and fail to get treated, even when their doctors say they should.

¶ Some who have been treated develop bothersome side effects, causing them to abandon therapy or to use it haphazardly.

¶ Many others do little to change lifestyle factors, like obesity, lack of exercise and a high-salt diet, that can make hypertension harder to control.

Dr. Samuel J. Mann, a hypertension specialist and professor of clinical medicine at Weill-Cornell Medical College, adds another factor that may be the most important. Of the 71 percent of people with hypertension who are currently being treated, too many are taking the wrong drugs or the wrong dosages of the right ones.

Dr. Mann, author of “Hypertension and You: Old Drugs, New Drugs, and the Right Drugs for Your High Blood Pressure,” says that doctors should take into account the underlying causes of each patient’s blood pressure problem and the side effects that may prompt patients to abandon therapy. He has found that when treatment is tailored to the individual, nearly all cases of high blood pressure can be brought and kept under control with available drugs.

Plus, he said in an interview, it can be done with minimal, if any, side effects and at a reasonable cost.

“For most people, no new drugs need to be developed,” Dr. Mann said. “What we need, in terms of medication, is already out there. We just need to use it better.”

But many doctors who are generalists do not understand the “intricacies and nuances” of the dozens of available medications to determine which is appropriate to a certain patient.

“Prescribing the same medication to patient after patient just does not cut it,” Dr. Mann wrote in his book.

The trick to prescribing the best treatment for each patient is to first determine which of three mechanisms, or combination of mechanisms, is responsible for a patient’s hypertension, he said.

¶ Salt-sensitive hypertension, more common in older people and African-Americans, responds well to diuretics and calcium channel blockers.

¶ Hypertension driven by the kidney hormone renin responds best to ACE inhibitors and angiotensin receptor blockers, as well as direct renin inhibitors and beta-blockers.

¶ Neurogenic hypertension is a product of the sympathetic nervous system and is best treated with beta-blockers, alpha-blockers and drugs like clonidine.

According to Dr. Mann, neurogenic hypertension results from repressed emotions. He has found that many patients with it suffered trauma early in life or abuse. They seem calm and content on the surface but continually suppress their distress, he said.

One of Dr. Mann’s patients had had high blood pressure since her late 20s that remained well-controlled by the three drugs her family doctor prescribed. Then in her 40s, periodic checks showed it was often too high. When taking more of the prescribed medication did not result in lasting control, she sought Dr. Mann’s help.

After a thorough work-up, he said she had a textbook case of neurogenic hypertension, was taking too much medication and needed different drugs. Her condition soon became far better managed, with side effects she could easily tolerate, and she no longer feared she would die young of a heart attack or stroke.

But most patients should not have to consult a specialist. They can be well-treated by an internist or family physician who approaches the condition systematically, Dr. Mann said. Patients should be started on low doses of one or more drugs, including a diuretic; the dosage or number of drugs can be slowly increased as needed to achieve a normal pressure.

Specialists, he said, are most useful for treating the 10 percent to 15 percent of patients with so-called resistant hypertension that remains uncontrolled despite treatment with three drugs, including a diuretic, and for those whose treatment is effective but causing distressing side effects.

Hypertension sometimes fails to respond to routine care, he noted, because it results from an underlying medical problem that needs to be addressed.

“Some patients are on a lot of blood pressure drugs — four or five — who probably don’t need so many, and if they do, the question is why,” Dr. Mann said.

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Well: Keeping Blood Pressure in Check

Label:

Since the start of the 21st century, Americans have made great progress in controlling high blood pressure, though it remains a leading cause of heart attacks, strokes, congestive heart failure and kidney disease.

Now 48 percent of the more than 76 million adults with hypertension have it under control, up from 29 percent in 2000.

But that means more than half, including many receiving treatment, have blood pressure that remains too high to be healthy. (A normal blood pressure is lower than 120 over 80.) With a plethora of drugs available to normalize blood pressure, why are so many people still at increased risk of disease, disability and premature death? Hypertension experts offer a few common, and correctable, reasons:

¶ About 20 percent of affected adults don’t know they have high blood pressure, perhaps because they never or rarely see a doctor who checks their pressure.

¶ Of the 80 percent who are aware of their condition, some don’t appreciate how serious it can be and fail to get treated, even when their doctors say they should.

¶ Some who have been treated develop bothersome side effects, causing them to abandon therapy or to use it haphazardly.

¶ Many others do little to change lifestyle factors, like obesity, lack of exercise and a high-salt diet, that can make hypertension harder to control.

Dr. Samuel J. Mann, a hypertension specialist and professor of clinical medicine at Weill-Cornell Medical College, adds another factor that may be the most important. Of the 71 percent of people with hypertension who are currently being treated, too many are taking the wrong drugs or the wrong dosages of the right ones.

Dr. Mann, author of “Hypertension and You: Old Drugs, New Drugs, and the Right Drugs for Your High Blood Pressure,” says that doctors should take into account the underlying causes of each patient’s blood pressure problem and the side effects that may prompt patients to abandon therapy. He has found that when treatment is tailored to the individual, nearly all cases of high blood pressure can be brought and kept under control with available drugs.

Plus, he said in an interview, it can be done with minimal, if any, side effects and at a reasonable cost.

“For most people, no new drugs need to be developed,” Dr. Mann said. “What we need, in terms of medication, is already out there. We just need to use it better.”

But many doctors who are generalists do not understand the “intricacies and nuances” of the dozens of available medications to determine which is appropriate to a certain patient.

“Prescribing the same medication to patient after patient just does not cut it,” Dr. Mann wrote in his book.

The trick to prescribing the best treatment for each patient is to first determine which of three mechanisms, or combination of mechanisms, is responsible for a patient’s hypertension, he said.

¶ Salt-sensitive hypertension, more common in older people and African-Americans, responds well to diuretics and calcium channel blockers.

¶ Hypertension driven by the kidney hormone renin responds best to ACE inhibitors and angiotensin receptor blockers, as well as direct renin inhibitors and beta-blockers.

¶ Neurogenic hypertension is a product of the sympathetic nervous system and is best treated with beta-blockers, alpha-blockers and drugs like clonidine.

According to Dr. Mann, neurogenic hypertension results from repressed emotions. He has found that many patients with it suffered trauma early in life or abuse. They seem calm and content on the surface but continually suppress their distress, he said.

One of Dr. Mann’s patients had had high blood pressure since her late 20s that remained well-controlled by the three drugs her family doctor prescribed. Then in her 40s, periodic checks showed it was often too high. When taking more of the prescribed medication did not result in lasting control, she sought Dr. Mann’s help.

After a thorough work-up, he said she had a textbook case of neurogenic hypertension, was taking too much medication and needed different drugs. Her condition soon became far better managed, with side effects she could easily tolerate, and she no longer feared she would die young of a heart attack or stroke.

But most patients should not have to consult a specialist. They can be well-treated by an internist or family physician who approaches the condition systematically, Dr. Mann said. Patients should be started on low doses of one or more drugs, including a diuretic; the dosage or number of drugs can be slowly increased as needed to achieve a normal pressure.

Specialists, he said, are most useful for treating the 10 percent to 15 percent of patients with so-called resistant hypertension that remains uncontrolled despite treatment with three drugs, including a diuretic, and for those whose treatment is effective but causing distressing side effects.

Hypertension sometimes fails to respond to routine care, he noted, because it results from an underlying medical problem that needs to be addressed.

“Some patients are on a lot of blood pressure drugs — four or five — who probably don’t need so many, and if they do, the question is why,” Dr. Mann said.

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Pentagon to Beef Up Cybersecurity Force to Counter Attacks

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WASHINGTON — The Pentagon is moving toward a major expansion of its cybersecurity force to counter increasing attacks on the nation’s computer networks, as well as to expand offensive computer operations on foreign adversaries, defense officials said Sunday.




The expansion would increase the Defense Department’s Cyber Command by more than 4,000 people, up from the current 900, an American official said. Defense officials acknowledged that a formidable challenge in the growth of the command would be finding, training and holding onto such a large number of qualified people.


The Pentagon “is constantly looking to recruit, train and retain world class cyberpersonnel,” a defense official said Sunday.


“The threat is real and we need to react to it,” said William J. Lynn III, a former deputy defense secretary who worked on the Pentagon’s cybersecurity strategy.


As part of the expansion, officials said the Pentagon was planning three different forces under Cyber Command: “national mission forces” to protect computer systems that support the nation’s power grid and critical infrastructure; “combat mission forces” to plan and execute attacks on adversaries; and “cyber protection forces” to secure the Pentagon’s computer systems.


The move, part of a push by Defense Secretary Leon E. Panetta to bolster the Pentagon’s cyberoperations, was first reported on The Washington Post’s Web site.


In October, Mr. Panetta warned in dire terms that the United States was facing the possibility of a “cyber-Pearl Harbor” and was increasingly vulnerable to foreign computer hackers who could dismantle the nation’s power grid, transportation system, financial network and government. He said that “an aggressor nation” or extremist group could cause a national catastrophe, and that he was reacting to increasing assertiveness and technological advances by the nation’s adversaries, which officials identified as China, Russia, Iran and militant groups.


Defense officials said that Mr. Panetta was particularly concerned about a computer attack last August on the state oil company Saudi Aramco, which infected and made useless more than 30,000 computers. In October, American intelligence officials said they were increasingly convinced that the Saudi attacks originated in Iran. They described an emerging shadow war of attacks and counterattacks already under way between the United States and Iran in cyberspace.


Among American officials, suspicion has focused on the “cybercorps” created in 2011 by Iran’s military, partly in response to American and Israeli cyberattacks on the Iranian nuclear enrichment plan at Natanz. There is no hard evidence, however, that the attacks were sanctioned by the Iranian government.


The attacks emanating from Iran have inflicted only modest damage. Iran’s cyberwarfare capabilities are weaker than those of China and Russia, which intelligence officials believe are the sources of a significant number of attacks on American companies and government agencies.


The expansion of Cyber Command comes as the Pentagon is making cuts elsewhere, including in the size of its conventional armed forces.


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India Ink: Where Science and Religion Coexist

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MUNDGOD, India — Religion and science have not always been easy friends, as Galileo could attest.

But over the last week scientists and Buddhist scholars have been working in this small Tibetan enclave in southern India to prove that these two worlds can not only co-exist — but benefit each another.

It is the 26th edition of the Mind & Life Conference and the first held in a monastery, for thousands of Buddhist monks gathered here. His Holiness the Dalai Lama, the leader of Tibetan Buddhism, greeted the scientists last Friday and introduced the week-long dialogue about science and religion.

The examination is rooted in the personal story of the Dalai Lama. During his secluded training as a child in Tibet, he would gaze at the night sky through a telescope on the roof of the Potala Palace. He looked at the moon with such intensity he realized the shadows and asperities on its surface contradicted the Tibetan belief that it was lit from within. He took his findings to his tutors.

“When I told my tutors of my interest in science, they replied that it made sense,” said the Dalai Lama during his welcome speech to the conference. “However, although we have an interest in science, that doesn’t mean we have to devote all our energy to it. I spend the majority of my time in meditation on love, compassion and wisdom, which is the source of my interest in science.”

It is this interest he is trying to spark in all Tibetan monks by adding science to their instruction.

“In the Buddhist investigation of reality we traditionally employ four principles of reasoning: dependence, function, nature and evidence,” said the Dalai Lama. Not a far stretch from the way scientists look for evidence. “Both approaches seem to work in parallel,” he said.

The thousands of monks of the Mundgod monasteries have been asked to follow the discussions — whose topics range from Quantum physics to neuroscience — in the Drepung Loseling Monastery’s assembly hall here. Monks who can’t fit into the hall watch the discussions on overflow screens outside on the monastery grounds.

With a strong emphasis on training the mind through meditation, looking within and constant questioning, the long and arduous teaching young monks have to follow in the monasteries requires the same attention to analysis and logic as any scientific curriculum. One difference? Isolation. In Tibet, before the Chinese invasion, the monks were kept from the outside world, practicing their faith in seclusion.

According to Rato Khen Rinpoche, the abbot of Rato Drepung, another Mundgod monastery, “Monastic vocation used to be cocooned by a geographic isolation.”

Today, things have changed. “Maintaining that tradition is not the way to form the 21st century monk,” he explained during an interview at the monastery.

Rato Khen Rinpoche, the first Westerner appointed abbot of a Tibetan monastery (his given name is Nicholas Vreeland), became a monk at thirty. Before he turned to Buddhism he studied and worked as a photographer.

His worldliness did not deter him from becoming a geshe — the equivalent of a Ph.D. in Buddhism, which requires up to twenty years of study — and now an abbot.

“Bringing science to Buddhist monks does not mean bending the belief system,” he insists, “they are parallel, there is no attempt to harmonize the two.”

For the science conference, Rato Monastery has transformed its prayer hall into a conference hall where 40 monks are getting together to edit a Tibetan science and Buddhist philosophy compendium.

The monks are Tibetan scholars from all monasteries who followed a multiple-year science course and are now asked by the Dalai Lama to compile what they learned into a book for their fellow monks. “These are monks who have spent from early morning to late night memorizing ancient texts, having them explained by wise elders and debating them long into the night,” says Rato’s abbot. “They had to leave behind Tibetan beliefs in place for centuries and apply the same strict discipline they had in their Buddhist studies to modern science.”

This is the strength of mind required of the modern monk, he says: a capacity for knowledge, open mindedness and debate, carried alongside the absolute belief in Buddha’s words.

The book will cover, along with Buddhist philosophy, the history of Science — from Galileo’s discovery of the planets’ movements to Darwin’s theory on evolution — tackling basic physics, biology and chemistry topics. Once the editing is over, the monks will go back to their respective monasteries and become the first Tibetan monks science teachers for their fellow monks and nuns.

But the curiosity goes both ways. Scientists have long been fascinated by the effect of the Buddhist practice of meditation on the brain. Richard Davidson, director of the laboratory for Affective Neuroscience at the University of Wisconsin-Madison has conducted experiments on a dozen of Tibetan Buddhist monks’ brains.

His findings created a stir in brain science circles by suggesting that after meditating for thousands of hours, monks altered the functioning and structure of their brains.

As part of his ongoing research, Dr. Davidson last year connected French monk Matthieu Ricard to 256 sensors and asked him to meditate on compassion. The scans of his brain showed an extraordinary level of gamma waves (activity linked to consciousness, learning and memory), “levels never reported before in the neuroscience literature”, the scientist said.

The left prefrontal cortex also saw increased activity, proof of a larger capacity for “happiness.”

On Sunday, the topic of discussion between the scientists and the Buddhist scholars was the nature of consciousness. The Dalai Lama asked the scientists where the basis for consciousness lies.

Responses from the scientists differed strongly.

Christof Koch, a University of California neuroscience best know for his work on consciousness, said we could speculate but ultimately we don’t know where it lies beyond the brain, its physical basis. He added that all mammals have consciousness but it is impossible to know where it lies (for example, our immune system can function without it).

Matthieu Ricard, the French monk who was a genetics scientist before taking up the monastic life, turned towards his Buddhist teaching more than his scientific past.

“By honest introspection, by following one line of inquiry which is pure experience,” one can reach an understanding of consciousness, he said.

Ricard then addressed the topic of reincarnation and some individuals’ ability to remember past lives.

Arthur G. Zajonc, a professor emeritus of physics at Amherst College in Massachusetts, doesn’t consider himself a Buddhist he said. Yet, he added, “I meditate and through that, have come to believe in the possibility of reincarnation.”

The benefits of meditation and contemplative practice should not only be reserved to monks, Mr. Zajonc added. He explained that they could contribute to the education of any college undergraduate before quoting Albert Einstein: “He who can no longer pause to wonder and stand rapt in awe, is as good as dead.”

This post has been revised to reflect the following correction:

Correction: January 27, 2013

An earlier version of this post said Arthur G. Zajonc is a professor emeritus of physics at Harvard. He is a professor emeritus of physics at Amherst.

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7 Die in Fire at Factory in Bangladesh

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A.M. Ahad/Associated Press


Firefighters and volunteers worked to extinguish the fire at a small garment factory in Bangladesh’s capital on Saturday.







DHAKA, Bangladesh — In the latest blow to Bangladesh’s garment industry, seven workers died Saturday after a fire swept through a factory here not long after seamstresses had returned from a lunch break. Workers said supervisors had locked one of the factory exits, forcing some people to jump out of windows to save their lives.









Abir Abdullah/European Pressphoto Agency

Relatives mourned beside the bodies of workers killed in the fire at a hospital in Dhaka.






Reuters

People sifted through the wreckage at the Smart Fashions factory.






The fatal fire comes roughly two months after the blaze at the Tazreen Fashions factory left 112 workers dead and focused global attention on unsafe conditions in Bangladesh’s garment industry. Tazreen Fashions, located just outside Dhaka, the capital, had been making clothing for some of the world’s biggest brands and retailers, including Walmart.


In the aftermath of the Tazreen Fashions fire, political and industrial leaders in Bangladesh pledged to quickly improve fire safety and even conducted high-profile, nationwide inspections of many of the country’s 5,000 clothing factories. And global brands promised they would not buy clothes from unsafe factories.


But Saturday’s fire in a densely populated section of Dhaka is a grim reminder that the problems remain. The blaze erupted about 2 p.m. at Smart Garment Export, a small factory that employed about 300 people, most of them young women who were making sweaters and jackets. All seven of the dead workers were women.


Masudur Rahman Akand, a supervisor in the fire department, said the factory’s workers were returning from lunch when the blaze erupted in a storage area. The factory was located on the second floor of a building, above a bakery, and it lacked proper exits and fire prevention equipment, Mr. Akand said.


“We did not find fire extinguishers,” he said. “We did not find any safety measures.”


With smoke filling the factory floor, workers apparently panicked. Mr. Akand said the seven workers who died either suffocated or were trampled by people trying to escape.


Eight other workers were hospitalized with injuries. Some of them told rescuers that many people could not quickly escape because one of the exits was blocked by a locked steel gate. Witnesses said people began jumping out of windows before the gate was unlocked.


Azizul Hoque, a police supervisor, said the investigation was continuing. “We do not know the reason or the source or the origin of the fire,” he said.


It was unclear whether the Smart Garment factory was making clothing for international brands or retailers. Dhaka’s industrial areas are filled with factories, large and small, that produce clothing for much of the Western world.


Julfikar Ali Manik reported from Dhaka, and Jim Yardley from New Delhi.



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Well: Ask Well: Squats for Aging Knees

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You are already doing many things right, in terms of taking care of your aging knees. In particular, it sounds as if you are keeping your weight under control. Carrying extra pounds undoubtedly strains knees and contributes to pain and eventually arthritis.

You mention weight training, too, which is also valuable. Sturdy leg muscles, particularly those at the front and back of the thighs, stabilize the knee, says Joseph Hart, an assistant professor of kinesiology and certified athletic trainer at the University of Virginia, who often works with patients with knee pain.

An easy exercise to target those muscles is the squat. Although many of us have heard that squats harm knees, the exercise is actually “quite good for the knees, if you do the squats correctly,” Dr. Hart says. Simply stand with your legs shoulder-width apart and bend your legs until your thighs are almost, but not completely, parallel to the ground. Keep your upper body straight. Don’t bend forward, he says, since that movement can strain the knees. Try to complete 20 squats, using no weight at first. When that becomes easy, Dr. Hart suggests, hold a barbell with weights attached. Or simply clutch a full milk carton, which is my cheapskate’s squats routine.

Straight leg lifts are also useful for knee health. Sit on the floor with your back straight and one leg extended and the other bent toward your chest. In this position, lift the straight leg slightly off the ground and hold for 10 seconds. Repeat 10 to 20 times and then switch legs.

You can also find other exercises that target the knees in this video, “Increasing Knee Stability.”

Of course, before starting any exercise program, consult a physician, especially, Dr. Hart says, if your knees often ache, feel stiff or emit a strange, clicking noise, which could be symptoms of arthritis.

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Well: Ask Well: Squats for Aging Knees

Label:

You are already doing many things right, in terms of taking care of your aging knees. In particular, it sounds as if you are keeping your weight under control. Carrying extra pounds undoubtedly strains knees and contributes to pain and eventually arthritis.

You mention weight training, too, which is also valuable. Sturdy leg muscles, particularly those at the front and back of the thighs, stabilize the knee, says Joseph Hart, an assistant professor of kinesiology and certified athletic trainer at the University of Virginia, who often works with patients with knee pain.

An easy exercise to target those muscles is the squat. Although many of us have heard that squats harm knees, the exercise is actually “quite good for the knees, if you do the squats correctly,” Dr. Hart says. Simply stand with your legs shoulder-width apart and bend your legs until your thighs are almost, but not completely, parallel to the ground. Keep your upper body straight. Don’t bend forward, he says, since that movement can strain the knees. Try to complete 20 squats, using no weight at first. When that becomes easy, Dr. Hart suggests, hold a barbell with weights attached. Or simply clutch a full milk carton, which is my cheapskate’s squats routine.

Straight leg lifts are also useful for knee health. Sit on the floor with your back straight and one leg extended and the other bent toward your chest. In this position, lift the straight leg slightly off the ground and hold for 10 seconds. Repeat 10 to 20 times and then switch legs.

You can also find other exercises that target the knees in this video, “Increasing Knee Stability.”

Of course, before starting any exercise program, consult a physician, especially, Dr. Hart says, if your knees often ache, feel stiff or emit a strange, clicking noise, which could be symptoms of arthritis.

Read More..

Digital Domain: Republic Wireless’s Plan Melds Wi-Fi and Network Calling

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AN Android smartphone with unlimited calls, unlimited texting, unlimited data and no contract, all for $19 a month? Really?




When I first saw this offer from Republic Wireless, I rubbed my eyes and looked for an asterisk leading to fine print that detailed a huge catch. But Republic, a division of a telecom company called Bandwidth.com, delivers exactly what it advertises. It can do so because the handset technology is a curious hybrid: it uses Wi-Fi when the customer is in a Wi-Fi area and Sprint Nextel’s 3G network when it is not.


The concept brings together the best of two worlds: the low cost of voice calls carried over the Internet and the convenience of making calls to any phone number using a major carrier’s cellular network when Wi-Fi isn’t available.


In my own case, on a typical day, I use my mobile phone mostly when I’m not actually mobile: I’m either at home or at work, perfectly positioned to use Wi-Fi at both locations. And I don’t even use the phone as a phone all that much. I use it mainly for e-mail and texts, neither of which requires enough bandwidth to benefit from the power of the fastest data networks.


If you walk into a Verizon Wireless store and buy an iPhone 5, you’ll pay $60 or more a month for an unlimited talk and texting plan, depending on the data allocation for Internet use that you select to go with it. Some of that monthly charge goes toward repaying the carrier for the discounted price that makes a $649 iPhone seem as if it costs only $200. But most of the charge is for gaining access to the carrier’s wireless network.


“We were looking at a mobile industry that had begun to charge extraordinary amounts of money, and we saw an industry opportunity that everybody else was missing: Wi-Fi is the new mobile,” says David Morken, co-founder and chief executive of Bandwidth, based in Raleigh, N.C.


Smartphone apps that offer voice calls using data plans, not minutes allocated for calls, are plentiful. Just last month, Facebook quietly added an option that lets users of the iPhone version of Facebook Messenger place free voice calls to other Messenger users. But using those apps to make a call means the recipient has to run the same app, an irksome requirement that never comes up when using phones alone.


Republic buys access to Sprint’s network on a wholesale basis for calls made outside of Wi-Fi areas. Its business model assumes, however, that Wi-Fi carries the load a majority of the time its phones are used. The company says that its service, even at $19 a month, is a profitable operation on a per-customer basis.


“We don’t have to force people, or even ask people, how to behave,” Mr. Morken says. “Over 60 percent of the time that the phone is being used, on average, our users are using Wi-Fi and that number is only going up.”


Last month, I tested a Republic handset, a Motorola Defy XT. It’s a light smartphone with a small screen, acceptable sound quality and great battery life.


Republic’s Web site gently warns against acting like a “data hog” and encourages its customers to “play nice and try to use Wi-Fi as much as you can.” But scolding isn’t needed: Wi-Fi is faster than 3G, so users have an incentive to opt for Wi-Fi wherever it is available.


The Motorola handset is the only one now offered by Republic, and it costs $259. The phone runs an older version of Android, and it has some first-generation glitches, like losing a connection when a caller starts out on a Wi-Fi network and then leaves the coverage area. (With a click, the call is resumed using Sprint’s cellular network.)


Today most Wi-Fi access requires a logon. But that shouldn’t prove a great inconvenience: you can simply set up the phone once with Wi-Fi at home, then once more at the office. At other locations, users can ignore Wi-Fi availability and use 3G instead.


Mr. Morken says a solution to the Wi-Fi-to-cellular handoff problem has been worked out in the company’s lab, and should be available midyear. Later this year, he also expects to offer more handset models, including one at the high end; he says they will run the latest version of Android.


Matt Carter, president of the Global Wholesale and Emerging Solutions division at Sprint, asserted that the company was happy to serve as Republic’s supplier. When I asked whether Republic’s Wi-Fi-centric model, with its drastically lower price to the consumer, would pose a serious threat to the incumbent carriers, including Sprint, he said, “If the world operated based on just economic decisions, people wouldn’t go buy the most expensive cars on the planet, right?”


Mr. Carter listed reasons that most consumers would prefer the wireless service obtained directly from a major carrier: a wider range of devices and the convenience of placing a call without having to tinker with Wi-Fi setup.


Republic “will resonate with a sliver of the marketplace,” Mr. Carter said. He compared wireless carriers to the major airline carriers, which still control a majority of the market despite low-priced upstarts like JetBlue or Southwest, which he described as appealing only to “a certain segment of the population.”


Philip Cusick, a J.P. Morgan analyst who covers telecommunications, says he doesn’t expect a major shift of customers to Republic Wireless. The price difference isn’t as great as it first appears, he says, when one considers that 80 percent of customers of AT&T and Verizon are on family or employer-related discount plans.


MR. MORKEN of Bandwidth.com says he knows that his company must lower the price of its handset — the industry rule-of-thumb for no-contract wireless services is that a simple handset cannot cost more than $99 and a smartphone, $149. But if Republic can offer me an Android phone with a generously sized screen for a reasonable price, I don’t see why, with Wi-Fi available at work and home, I should continue to pay an expensive-sports-car price for my wireless service.


“There’s a reason why the carriers around the world don’t want you using Wi-Fi for voice and text,” Mr. Morken says. “You will soon realize you shouldn’t have to pay what you’re paying today.”


Randall Stross is an author based in Silicon Valley and a professor of business at San Jose State University. E-mail: stross@nytimes.com.



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The Lede Blog: Egypt's Soccer Riots, a View From the Ground

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Video posted online appears to show fans of Cairo’s Al Ahly soccer team celebrating a court verdict.

It was one of the world’s deadliest episodes of soccer violence — a clash between fans of the Egyptian team Al Masry, of Port Said, and players and fans from Al Ahly, of Cairo, a year ago that killed 74 and wounded over 1,000.

On Saturday, a court in Cairo handed down death sentences for 21 of those involved in the riots. The violence that the verdict prompted, involving hard-core “ultra” supporters of both teams, killed at least 28 and wounded at least 300, my colleagues David Kirkpatrick and Mayy El Sheikh reported.

Pictures and video from Port Said and Cairo were markedly different. In Cairo, as the video at the top of this post shows, there were widespread celebrations. In Port Said, a city of about 600,000.

Rioters looted and burned a police barracks and set fire to a police station. They attacked members of the news media, damaging television cameras that sought to film the violence and ending their broadcasts. They closed off all roads into Port Said as well as the railroad station, and the Ministry of Electricity and Energy said rioters had attacked a power facility as well.

Video posted online appears to show protesters in Port Said.

In Cairo, Mr. Kirkpatrick and Ms. El Sheikh reported, the families of those killed in the clash last year “held pictures of the victims in the air. Some danced and chanted. A few fainted. And the Cairo ultras celebrated for hours outside their team’s headquarters.”

Video posted online appears to show celebrations in Cairo.

Tara Todras-Whitehill, a photographer in Cairo, posted further pictures of the celebrations on her Twitter account.

It was not immediately clear where the following picture also posted on Twitter, by Tom Gara of The Wall Street Journal, came from. But it apparently shows a man playing an accordion in the midst of one riot.

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Labor Relations Board Rulings Could Be Undone

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By ruling that Mr. Obama’s three recess appointments last January were illegal, the federal appeals court ruling, if upheld, would leave the board with just one member, short of the quorum needed to issue any rulings. The Obama administration could appeal the court ruling, but no announcement was made on Friday.


If the Supreme Court were to uphold Friday’s ruling, issued by the United States Court of Appeals for the District of Columbia Circuit, it would mean that the labor board did not have a quorum since last January and that all its rulings since then should be nullified.


Many Republicans and business groups applauded Friday’s ruling. They often assert that the appointments Mr. Obama made to the board have transformed it into a tool of organized labor. But many Democrats and labor unions say Mr. Obama’s appointments restored ideological balance to the board after it was tipped in favor of business interests under President George W. Bush


Mark G. Pearce, the board’s chairman, issued a statement saying the board disagreed with the ruling and suggested that other appeals courts hearing cases about the constitutionality of Mr. Obama’s appointments could reach a different conclusion.


“In the meantime, the board has important work to do,” said Mr. Pearce, whose agency oversees enforcement of the laws governing strikes and unionization drives. “We will continue to perform our statutory duties and issue decisions.”


Unless the Senate confirms future nominees to the board — Senate Republicans have blocked several of Mr. Obama’s board nominees — Mr. Pearce will be the only member left if Friday’s ruling is upheld. The board has five seats.


Representative Darrell Issa, a California Republican who is the chairman of the Oversight and Government Reform Committee, issued a statement that urged the recess appointees to “do the right thing and step down.” He added, “To avoid further damage to the economy, the N.L.R.B. must take the responsible course and cease issuing any further opinions until a constitutionally sound quorum can be established.”


The three disputed recess appointees included two Democrats, Sharon Block, deputy labor secretary, and Richard Griffin, general counsel to the operating engineers’ union; and one Republican, Terence Flynn, a counsel to a board member. Mr. Flynn resigned last May after being accused of leaking materials about the group’s deliberations. Another Republican member, Brian Hayes, stepped down when his term expired last month.


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