Sign Language Researchers Broaden Science Lexicon

Imagine trying to learn biology without ever using the word “organism.” Or studying to become a botanist when the only way of referring to photosynthesis is to spell the word out, letter by painstaking letter.

For deaf students, this game of scientific Password has long been the daily classroom and laboratory experience. Words like “organism” and “photosynthesis” — to say nothing of more obscure and harder-to-spell terms — have no single widely accepted equivalent in sign language. This means that deaf students and their teachers and interpreters must improvise, making it that much harder for the students to excel in science and pursue careers in it.

“Often times, it would involve a lot of finger-spelling and a lot of improvisation,” said Matthew Schwerin, a physicist with the Food and Drug Administration who is deaf, of his years in school. “For the majority of scientific terms,” Mr. Schwerin and his interpreter for the day would “try to find a correct sign for the term, and if nothing was pre-existing, we would come up with a sign that was agreeable with both parties.”

Now thanks to the Internet — particularly the boom in online video — resources for deaf students seeking science-related signs are easier to find and share. Crowdsourcing projects in both American Sign Language and British Sign Language are under way at several universities, enabling people who are deaf to coalesce around signs for commonly used terms.

This year, one of those resources, the Scottish Sensory Centre’s British Sign Language Glossary Project, added 116 new signs for physics and engineering terms, including signs for “light-year,”  (hold one hand up and spread the fingers downward for “light,” then bring both hands together in front of your chest and slowly move them apart for “year”), “mass” and “X-ray” (form an X with your index fingers, then, with the index finger on the right hand, point outward). 

The signs were developed by a team of researchers at the center, a division of the University of Edinburgh in Scotland that develops learning tools for students with visual and auditory impairments. The researchers spent more than a year soliciting ideas from deaf science workers, circulating lists of potential signs and ultimately gathering for “an intense weekend” of final voting, said Audrey Cameron, science adviser for the project. (Dr. Cameron is also deaf, and like all non-hearing people interviewed for this article, answered questions via e-mail.)

Whether the Scottish Sensory Centre’s signs will take hold among its audience remains to be seen. “Some will be adopted, and some will probably never be accepted,” Dr. Cameron said. “We’ll have to wait and see what happens.”

Ideally, the standardization of signs will make it easier for deaf students to keep pace with their hearing classmates during lectures. “I can only choose to look at one thing at a time,” said Mr. Schwerin of the F.D.A., recalling his science education, “and it often meant choosing between the interpreter, the blackboard/screen/material, or taking notes. It was like, pick one, and lose out on the others.”

The problem doesn’t end at graduation. In fact, it only intensifies as new discoveries add unfamiliar terms to the scientific lexicon. “I’ve had numerous meetings where I couldn’t participate properly because the interpreters were not able to understand the jargon and they did not know any scientific signs,” Dr. Cameron said.

One general complaint about efforts to standardize signs for technical terms is the idea that, much like spoken language, sign language should be allowed to develop organically rather than be dictated from above.

“Signs that are developed naturally — i.e., that are tested and refined in everyday conversation — are more likely to be accepted quickly by the community,” said Derek Braun, director of the molecular genetics laboratory at Gallaudet University in Washington, D.C., which he said was the first biological laboratory designed and administered by deaf scientists.

This article has been revised to reflect the following correction:

Correction: December 4, 2012

An earlier version of this article misstated the origin of the ASL-STEM Forum.  It was developed by researchers at the University of Washington, not Gallaudet University.  Researchers at Gallaudet and the National Technical Institute for the Deaf at Rochester Institute of Technology work with the University of Washington to provide content and help the forum grow.

This article has been revised to reflect the following correction:

Correction: December 4, 2012

An earlier version of a correction with this article misstated the name of an institute that works on the ASL-STEM Forum. It is the National Technical Institute for the Deaf at Rochester Institute of Technology not the National Institute for the Deaf. 

Read More..

Sign Language Researchers Broaden Science Lexicon

Imagine trying to learn biology without ever using the word “organism.” Or studying to become a botanist when the only way of referring to photosynthesis is to spell the word out, letter by painstaking letter.

For deaf students, this game of scientific Password has long been the daily classroom and laboratory experience. Words like “organism” and “photosynthesis” — to say nothing of more obscure and harder-to-spell terms — have no single widely accepted equivalent in sign language. This means that deaf students and their teachers and interpreters must improvise, making it that much harder for the students to excel in science and pursue careers in it.

“Often times, it would involve a lot of finger-spelling and a lot of improvisation,” said Matthew Schwerin, a physicist with the Food and Drug Administration who is deaf, of his years in school. “For the majority of scientific terms,” Mr. Schwerin and his interpreter for the day would “try to find a correct sign for the term, and if nothing was pre-existing, we would come up with a sign that was agreeable with both parties.”

Now thanks to the Internet — particularly the boom in online video — resources for deaf students seeking science-related signs are easier to find and share. Crowdsourcing projects in both American Sign Language and British Sign Language are under way at several universities, enabling people who are deaf to coalesce around signs for commonly used terms.

This year, one of those resources, the Scottish Sensory Centre’s British Sign Language Glossary Project, added 116 new signs for physics and engineering terms, including signs for “light-year,”  (hold one hand up and spread the fingers downward for “light,” then bring both hands together in front of your chest and slowly move them apart for “year”), “mass” and “X-ray” (form an X with your index fingers, then, with the index finger on the right hand, point outward). 

The signs were developed by a team of researchers at the center, a division of the University of Edinburgh in Scotland that develops learning tools for students with visual and auditory impairments. The researchers spent more than a year soliciting ideas from deaf science workers, circulating lists of potential signs and ultimately gathering for “an intense weekend” of final voting, said Audrey Cameron, science adviser for the project. (Dr. Cameron is also deaf, and like all non-hearing people interviewed for this article, answered questions via e-mail.)

Whether the Scottish Sensory Centre’s signs will take hold among its audience remains to be seen. “Some will be adopted, and some will probably never be accepted,” Dr. Cameron said. “We’ll have to wait and see what happens.”

Ideally, the standardization of signs will make it easier for deaf students to keep pace with their hearing classmates during lectures. “I can only choose to look at one thing at a time,” said Mr. Schwerin of the F.D.A., recalling his science education, “and it often meant choosing between the interpreter, the blackboard/screen/material, or taking notes. It was like, pick one, and lose out on the others.”

The problem doesn’t end at graduation. In fact, it only intensifies as new discoveries add unfamiliar terms to the scientific lexicon. “I’ve had numerous meetings where I couldn’t participate properly because the interpreters were not able to understand the jargon and they did not know any scientific signs,” Dr. Cameron said.

One general complaint about efforts to standardize signs for technical terms is the idea that, much like spoken language, sign language should be allowed to develop organically rather than be dictated from above.

“Signs that are developed naturally — i.e., that are tested and refined in everyday conversation — are more likely to be accepted quickly by the community,” said Derek Braun, director of the molecular genetics laboratory at Gallaudet University in Washington, D.C., which he said was the first biological laboratory designed and administered by deaf scientists.

This article has been revised to reflect the following correction:

Correction: December 4, 2012

An earlier version of this article misstated the origin of the ASL-STEM Forum.  It was developed by researchers at the University of Washington, not Gallaudet University.  Researchers at Gallaudet and the National Technical Institute for the Deaf at Rochester Institute of Technology work with the University of Washington to provide content and help the forum grow.

This article has been revised to reflect the following correction:

Correction: December 4, 2012

An earlier version of a correction with this article misstated the name of an institute that works on the ASL-STEM Forum. It is the National Technical Institute for the Deaf at Rochester Institute of Technology not the National Institute for the Deaf. 

Read More..

DealBook: UBS Described as Near Deal With U.S. and Britain on Rate Rigging

UBS, the Swiss banking giant, is close to reaching settlements with American and British authorities over the manipulation of interest rates, the latest case in a multiyear investigation that has rattled the financial industry and spurred a public outcry for broad reform.

UBS is expected to pay more than $450 million to settle claims that some employees reported false rates to increase the bank’s profit, according to officials briefed on the matter who spoke on the condition of anonymity because the talks were private.

If the bank agrees to the deals with various authorities, the collective penalties would yield the largest total fines to date related to the rate-rigging inquiry and would increase the likelihood that other financial institutions would face stiff penalties. Authorities dealt their first blow in the rate-rigging case in June when the British bank Barclays agreed to a $450 million settlement.

A spokeswoman for UBS declined to comment. The agencies leading the UBS investigation, the Commodity Futures Trading Commission, the Justice Department and Britain’s Financial Services Authority, also declined to comment.

The UBS case will provide a window into systemic problems in the rate-setting process, which affects how consumers and companies borrow money around the world. After reviewing thousands of internal bank e-mails and interviewing dozens of employees, the authorities have uncovered patterns of abuse at the major banks that help set benchmark interest rates.

Libor Explained

The sprawling investigation is focused on benchmarks like the London interbank offered rate, or Libor. The rate, a measure of how much banks charge each other for loans, is used to determine the costs of trillions of dollars of mortgages, credit card charges and student loans.

The authorities claim that UBS traders colluded with rival banks to influence rates in an effort to bolster their profits, according to officials briefed on the matter. Some traders at UBS were suspended this year over the matter.

Given the scope of the case, the UBS settlement is expected to heighten calls for a reform of the Libor system. Lawmakers are pushing to change the way banks report rates, providing more transparency to consumers, companies and investors that rely on the benchmark.

The reform movement gained momentum after global authorities secured the settlement with Barclays. Regulators had accused Barclays of reporting false rates, a scandal that prompted the resignation of the chief executive and other top officials at the bank.

Global authorities are now moving forward with civil and criminal cases, setting up the potential for major fines and regulatory sanctions. Some banks are in advanced settlement talks, including UBS and the Royal Bank of Scotland. The Royal Bank said it expected to disclose penalties before the firm’s next earnings release in February. Deutsche Bank said last month that it had set aside money to cover potential fines, although it was too early to predict the size.

American authorities are hoping to complete a deal with UBS by the middle of the month, according to officials briefed on the matter. The officials noted that the discussions could spill into next year. The talks could also break down, in which case the authorities would file a lawsuit against the bank.

It is unclear whether global authorities will act in tandem on the UBS case. The bank and the regulators would prefer to strike a deal together, but the agencies are proceeding at different speeds.

Investigators say the broader Libor case could go on for years.

Canadian, Swiss and Asian authorities as well as the Justice Department, the Commodity Futures Trading Commission and Britain’s Financial Services Authority are investigating the actions of more than a dozen banks. Along with UBS, the futures commission is focused on potential wrongdoing at two American banks, Citigroup and JPMorgan Chase, the officials said. HSBC is also under scrutiny.

In addition to the regulatory cases, the Justice Department has identified potential criminal wrongdoing by traders at Barclays and other banks. The banks also face private lawsuits from large investors like local governments, which claim to have suffered losses as a result of interest rate manipulation. The New York attorney general has subpoenaed 16 banks over their role in the scandal, an action that could foreshadow civil lawsuits. Analysts predict the financial industry could face penalties of up to $20 billion.

“The evidence that comes out of any future settlement is likely to be enormously helpful for our claims,” said David E. Kovel, a partner at the law firm Kirby McInerney who is representing clients in a potential class-action suit related to Libor.

For UBS, the Libor case comes at a difficult time.

It has faced a series of legal problems since the financial crisis. In 2009, the bank agreed to pay $780 million to settle accusations by American authorities that it helped wealthy clients avoid taxes.

In 2011, it announced a $2.3 billion loss prompted by a rogue trader, Kweku M. Adoboli, who received a seven-year jail sentence for fraud last month. The firm agreed to pay a $47.5 million penalty to the British authorities in connection with the trading loss.

In the Libor case, UBS has been eager to cooperate. It has already reached a conditional immunity deal with the antitrust arm of the Justice Department, which could protect the bank from criminal prosecution under certain conditions. It is also cooperating with Canadian antitrust authorities by handing over e-mails and other documents implicating other banks.

But it did acknowledge publicly that such deals would not shield the bank from potential penalties from other regulators. The Justice Department’s criminal unit, for instance, could still take action against the bank.

UBS disclosed last year that it was the subject of investigations related to Libor, saying it had received subpoenas from American and Japanese authorities. Swiss and British regulators have joined the UBS investigation, which involves a number of currencies in the Libor system.

The timing of the Libor cases against UBS depends in large part on cooperation among regulators.

The Financial Services Authority in Britain has worked closely with its American counterparts. In total, the British regulator has about 160 people working on its various cases against banks, which are at different stages of development.

As the top watchdog of London’s financial services industry, the British regulator has positioned itself as a conduit for document requests from international regulators regarding Libor, which is set daily by banks in London. The agency also organizes interviews for its American counterparts with London-based bankers involved in the inquiries, according to an official with direct knowledge of the matter.

British regulators had been ready to move against UBS a month after officials announced a settlement with Barclays, the person added. The settlement has been delayed, however, as global authorities have tried to pursue a joint agreement with the bank.

“We’ve been going at the pace of the slowest regulator,” the official said.

A version of this article appeared in print on 12/03/2012, on page A1 of the NewYork edition with the headline: Ubs Is Reported To Be Near Deal On Rate Rigging.

Read More..

After Death of Sattar Beheshti, Iranian Blogger, Head of Tehran’s Cybercrimes Unit Is Fired

TEHRAN — Iranian’s national police chief fired the commander of Tehran’s cybercrimes police unit on Saturday for negligence in the death of a blogger in prison.

The dismissal of the commander, Gen. Saeed Shokrian, follows investigations by Parliament and Iran’s judiciary into the unexplained death of the blogger, Sattar Beheshti, 35, who died in early November just a few days after being arrested by the cybercrimes police unit, known here as FATA.

“Tehran’s FATA should be held responsible for the death of Sattar Beheshti,” said Iran’s national police chief, Ismael Ahmadi-Moqaddam, according to the Iranian Labor News Agency.

It is unclear whether General Shokrian will also face judicial charges over the blogger’s death.

The public nature of his dismissal suggests that he will bear most of the responsibility for the death. In similar cases in the past, officials have been punished, but it is rare for them to be named and publicly dismissed on the same day.

Mr. Beheshti’s Web site, My Life for My Iran, criticized Iran’s financial contributions to the Hezbollah movement in Lebanon. Mr. Beheshti posted pictures of Lebanese youths having parties alongside images of Iranians living in poverty.

The exact cause of Mr. Beheshti’s death remains murky. Mr. Ahmadi-Moqaddam said Tuesday that investigations had ruled out torture as a cause of death, saying it was possible that Mr. Beheshti, who in pictures looks big and strong, died of “psychological shock.”

Iranian activists and bloggers say Mr. Beheshti died of injuries following beatings. Iran’s judiciary spokesman, Gholam Hussein Mohseni-Ejei, recently admitted that Mr. Beheshti — while in prison — had lodged a written complaint against an interrogator, in which he accused the man of having beaten him during his detention in Tehran’s Evin prison.

“I, Sattar Beheshti, was arrested by FATA and beaten and tortured with multiple blows to my head and body,” read the document, published by the opposition Kalame Web site. He added, “If anything happens to me, the police are responsible.”

Mr. Ahmadi-Moqaddam said that Mr. Beheshti was given tranquilizers while in the prison’s clinic, but that when handed over to the cybercrimes unit its officers denied him the same tranquilizers. “This might be regarded as neglect,” he said. “However, there were no signs of beatings on his body.”

Official statements on the cause of death have been contradictory. An influential member of Parliament who earlier denied that Mr. Beheshti had been tortured in any way told the Tabnak Web site that the blogger had been beaten, but died of shock and fear.

“Definitely he was beaten inside the FATA detention center,” the lawmaker, Alaeddin Borujerdi, told the Web site, “but he didn’t die as a result of these beatings.” He also stressed that the cybercrimes unit must change the way it deals with prisoners.

Iranian activists who have been in contact with Mr. Beheshti’s family say his relatives were not allowed to see his body before a hurried funeral on Nov. 6 in his hometown, Robat Karim, 30 miles southwest of the capital, Tehran.

In Mr. Beheshti’s final post, on Oct. 29, a day before his arrest, he said he was being threatened by security officials. “They told me that if I didn’t close my big mouth my mother should prepare to wear black clothes,” for mourning.

The Iranian Parliament’s special investigator into the case, Mehdi Davatgari, said he welcomed the commander’s removal. “This move shows the civil rights of our citizens are our top priority,” he said.

Read More..

Software Programs Help Doctors Diagnose, but Can’t Replace Them

SAN FRANCISCO — The man on stage had his audience of 600 mesmerized. Over the course of 45 minutes, the tension grew. Finally, the moment of truth arrived, and the room was silent with anticipation.

At last he spoke. “Lymphoma with secondary hemophagocytic syndrome,” he said. The crowd erupted in applause.

Professionals in every field revere their superstars, and in medicine the best diagnosticians are held in particularly high esteem. Dr. Gurpreet Dhaliwal, 39, a self-effacing associate professor clinical medicine at the University of California, San Francisco, is considered one of the most skillful clinical diagnosticians in practice.

The case Dr. Dhaliwal was presented, at a medical  conference last year, began with information that could have described hundreds of diseases: the patient had intermittent fevers, joint pain, and weight and appetite loss.

To observe him at work is like watching Steven Spielberg tackle a script or Rory McIlroy a golf course. He was given new information bit by bit — lab, imaging and biopsy results. Over the course of the session, he drew on an encyclopedic familiarity with thousands of syndromes. He deftly dismissed red herrings while picking up on clues that others might ignore, gradually homing in on the accurate diagnosis.

Just how special is Dr. Dhaliwal’s talent? More to the point, what can he do that a computer cannot? Will a computer ever successfully stand in for a skill that is based not simply on a vast fund of knowledge but also on more intangible factors like intuition?

The history of computer-assisted diagnostics is long and rich. In the 1970s, researchers at the University of Pittsburgh developed software to diagnose complex problems in general internal medicine; the project eventually resulted in a commercial program called Quick Medical Reference. Since the 1980s, Massachusetts General Hospital has been developing and refining DXplain, a program that provides a ranked list of clinical diagnoses from a set of symptoms and laboratory data.

And I.B.M., on the heels of its triumph last year with Watson, the Jeopardy-playing computer, is working on Watson for Healthcare.

In some ways, Dr. Dhaliwal’s diagnostic method is similar to that of another I.B.M. project: the Deep Blue chess program, which in 1996 trounced Garry Kasparov, the world’s best player at the time, to claim an unambiguous victory in the computer’s relentless march into the human domain.

Although lacking consciousness and a human’s intuition, Deep Blue had millions of moves memorized and could analyze as many each second. Dr. Dhaliwal does the diagnostic equivalent, though at human speed.

Since medical school, he has been an insatiable reader of case reports in medical journals, and case conferences from other hospitals. At work he occasionally uses a diagnostic checklist program called Isabel, just to make certain he hasn’t forgotten something. But the program has yet to offer a diagnosis that Dr. Dhaliwal missed.

Dr. Dhaliwal regularly receives cases from physicians who are stumped by a set of symptoms. At medical conferences, he is presented with one vexingly difficult case and is given 45 minutes to solve it. It is a medical high-wire act; doctors in the audience squirm as the set of facts gets more obscure and all the diagnoses they were considering are ruled out. After absorbing and processing scores of details, Dr. Dhaliwal must commit to a diagnosis. More often than not, he is right.

When working on a difficult case in front of an audience, Dr. Dhaliwal puts his entire thought process on display, with the goal of “elevating the stature of thinking,” he said. He believes this is becoming more important because physicians are being assessed on whether they gave the right medicine to a patient, or remembered to order a certain test.

Without such emphasis, physicians and training programs might forget the importance of having smart, thoughtful doctors. “Because in medicine,” Dr. Dhaliwal said, “thinking is our most important procedure.”

He added: “Getting better at diagnosis isn’t about figuring out if someone has one rare disease versus another. Getting better at diagnosis is as important to patient quality and safety as reducing medication errors, or eliminating wrong site surgery.”

Clinical Precision

Dr. Dhaliwal does half his clinical work on the wards of the San Francisco V. A. Medical Center, and the other half in its emergency department, where he often puzzles through multiple mysteries at a time.

One recent afternoon in the E.R., he was treating a 66-year-old man who was mentally unstable and uncooperative. He complained of hip pain, but routine lab work revealed that his kidneys weren’t working and his potassium was rising to a dangerous level, putting him in danger of an arrhythmia that could kill him — perhaps within hours. An ultrasound showed that his bladder was blocked.

There was work to be done: drain the bladder, correct the potassium level. It would have been easy to dismiss the hip pain as a distraction; it didn’t easily fit the picture. But Dr. Dhaliwal’s instinct is to hew to the ancient rule that physicians should try to come to a unifying diagnosis. In the end, everything — including the hip pain — was traced to metastatic prostate cancer.

“Things can shift very quickly in the emergency room,” Dr. Dhaliwal said. “One challenge of this, whether you use a computer or your brain, is deciding what’s signal and what’s noise.” Much of the time, it is his intuition that helps figure out which is which.

Read More..

Software Programs Help Doctors Diagnose, but Can’t Replace Them

SAN FRANCISCO — The man on stage had his audience of 600 mesmerized. Over the course of 45 minutes, the tension grew. Finally, the moment of truth arrived, and the room was silent with anticipation.

At last he spoke. “Lymphoma with secondary hemophagocytic syndrome,” he said. The crowd erupted in applause.

Professionals in every field revere their superstars, and in medicine the best diagnosticians are held in particularly high esteem. Dr. Gurpreet Dhaliwal, 39, a self-effacing associate professor clinical medicine at the University of California, San Francisco, is considered one of the most skillful clinical diagnosticians in practice.

The case Dr. Dhaliwal was presented, at a medical  conference last year, began with information that could have described hundreds of diseases: the patient had intermittent fevers, joint pain, and weight and appetite loss.

To observe him at work is like watching Steven Spielberg tackle a script or Rory McIlroy a golf course. He was given new information bit by bit — lab, imaging and biopsy results. Over the course of the session, he drew on an encyclopedic familiarity with thousands of syndromes. He deftly dismissed red herrings while picking up on clues that others might ignore, gradually homing in on the accurate diagnosis.

Just how special is Dr. Dhaliwal’s talent? More to the point, what can he do that a computer cannot? Will a computer ever successfully stand in for a skill that is based not simply on a vast fund of knowledge but also on more intangible factors like intuition?

The history of computer-assisted diagnostics is long and rich. In the 1970s, researchers at the University of Pittsburgh developed software to diagnose complex problems in general internal medicine; the project eventually resulted in a commercial program called Quick Medical Reference. Since the 1980s, Massachusetts General Hospital has been developing and refining DXplain, a program that provides a ranked list of clinical diagnoses from a set of symptoms and laboratory data.

And I.B.M., on the heels of its triumph last year with Watson, the Jeopardy-playing computer, is working on Watson for Healthcare.

In some ways, Dr. Dhaliwal’s diagnostic method is similar to that of another I.B.M. project: the Deep Blue chess program, which in 1996 trounced Garry Kasparov, the world’s best player at the time, to claim an unambiguous victory in the computer’s relentless march into the human domain.

Although lacking consciousness and a human’s intuition, Deep Blue had millions of moves memorized and could analyze as many each second. Dr. Dhaliwal does the diagnostic equivalent, though at human speed.

Since medical school, he has been an insatiable reader of case reports in medical journals, and case conferences from other hospitals. At work he occasionally uses a diagnostic checklist program called Isabel, just to make certain he hasn’t forgotten something. But the program has yet to offer a diagnosis that Dr. Dhaliwal missed.

Dr. Dhaliwal regularly receives cases from physicians who are stumped by a set of symptoms. At medical conferences, he is presented with one vexingly difficult case and is given 45 minutes to solve it. It is a medical high-wire act; doctors in the audience squirm as the set of facts gets more obscure and all the diagnoses they were considering are ruled out. After absorbing and processing scores of details, Dr. Dhaliwal must commit to a diagnosis. More often than not, he is right.

When working on a difficult case in front of an audience, Dr. Dhaliwal puts his entire thought process on display, with the goal of “elevating the stature of thinking,” he said. He believes this is becoming more important because physicians are being assessed on whether they gave the right medicine to a patient, or remembered to order a certain test.

Without such emphasis, physicians and training programs might forget the importance of having smart, thoughtful doctors. “Because in medicine,” Dr. Dhaliwal said, “thinking is our most important procedure.”

He added: “Getting better at diagnosis isn’t about figuring out if someone has one rare disease versus another. Getting better at diagnosis is as important to patient quality and safety as reducing medication errors, or eliminating wrong site surgery.”

Clinical Precision

Dr. Dhaliwal does half his clinical work on the wards of the San Francisco V. A. Medical Center, and the other half in its emergency department, where he often puzzles through multiple mysteries at a time.

One recent afternoon in the E.R., he was treating a 66-year-old man who was mentally unstable and uncooperative. He complained of hip pain, but routine lab work revealed that his kidneys weren’t working and his potassium was rising to a dangerous level, putting him in danger of an arrhythmia that could kill him — perhaps within hours. An ultrasound showed that his bladder was blocked.

There was work to be done: drain the bladder, correct the potassium level. It would have been easy to dismiss the hip pain as a distraction; it didn’t easily fit the picture. But Dr. Dhaliwal’s instinct is to hew to the ancient rule that physicians should try to come to a unifying diagnosis. In the end, everything — including the hip pain — was traced to metastatic prostate cancer.

“Things can shift very quickly in the emergency room,” Dr. Dhaliwal said. “One challenge of this, whether you use a computer or your brain, is deciding what’s signal and what’s noise.” Much of the time, it is his intuition that helps figure out which is which.

Read More..

DealBook: UBS Described as Near Deal With U.S. and Britain on Rate Rigging

UBS, the Swiss banking giant, is close to reaching settlements with American and British authorities over the manipulation of interest rates, the latest case in a multiyear investigation that has rattled the financial industry and spurred a public outcry for broad reform.

UBS is expected to pay more than $450 million to settle claims that some employees reported false rates to increase the bank’s profit, according to officials briefed on the matter who spoke on the condition of anonymity because the talks were private.

If the bank agrees to the deals with various authorities, the collective penalties would yield the largest total fines to date related to the rate-rigging inquiry and would increase the likelihood that other financial institutions would face stiff penalties. Authorities dealt their first blow in the rate-rigging case in June when the British bank Barclays agreed to a $450 million settlement.

A spokeswoman for UBS declined to comment. The agencies leading the UBS investigation, the Commodity Futures Trading Commission, the Justice Department and Britain’s Financial Services Authority, also declined to comment.

The UBS case will provide a window into systemic problems in the rate-setting process, which affects how consumers and companies borrow money around the world. After reviewing thousands of internal bank e-mails and interviewing dozens of employees, the authorities have uncovered patterns of abuse at the major banks that help set benchmark interest rates.

Libor Explained

The sprawling investigation is focused on benchmarks like the London interbank offered rate, or Libor. The rate, a measure of how much banks charge each other for loans, is used to determine the costs of trillions of dollars of mortgages, credit card charges and student loans.

The authorities claim that UBS traders colluded with rival banks to influence rates in an effort to bolster their profits, according to officials briefed on the matter. Some traders at UBS were suspended this year over the matter.

Given the scope of the case, the UBS settlement is expected to heighten calls for a reform of the Libor system. Lawmakers are pushing to change the way banks report rates, providing more transparency to consumers, companies and investors that rely on the benchmark.

The reform movement gained momentum after global authorities secured the settlement with Barclays. Regulators had accused Barclays of reporting false rates, a scandal that prompted the resignation of the chief executive and other top officials at the bank.

Global authorities are now moving forward with civil and criminal cases, setting up the potential for major fines and regulatory sanctions. Some banks are in advanced settlement talks, including UBS and the Royal Bank of Scotland. The Royal Bank said it expected to disclose penalties before the firm’s next earnings release in February. Deutsche Bank said last month that it had set aside money to cover potential fines, although it was too early to predict the size.

American authorities are hoping to complete a deal with UBS by the middle of the month, according to officials briefed on the matter. The officials noted that the discussions could spill into next year. The talks could also break down, in which case the authorities would file a lawsuit against the bank.

It is unclear whether global authorities will act in tandem on the UBS case. The bank and the regulators would prefer to strike a deal together, but the agencies are proceeding at different speeds.

Investigators say the broader Libor case could go on for years.

Canadian, Swiss and Asian authorities as well as the Justice Department, the Commodity Futures Trading Commission and Britain’s Financial Services Authority are investigating the actions of more than a dozen banks. Along with UBS, the futures commission is focused on potential wrongdoing at two American banks, Citigroup and JPMorgan Chase, the officials said. HSBC is also under scrutiny.

In addition to the regulatory cases, the Justice Department has identified potential criminal wrongdoing by traders at Barclays and other banks. The banks also face private lawsuits from large investors like local governments, which claim to have suffered losses as a result of interest rate manipulation. The New York attorney general has subpoenaed 16 banks over their role in the scandal, an action that could foreshadow civil lawsuits. Analysts predict the financial industry could face penalties of up to $20 billion.

“The evidence that comes out of any future settlement is likely to be enormously helpful for our claims,” said David E. Kovel, a partner at the law firm Kirby McInerney who is representing clients in a potential class-action suit related to Libor.

For UBS, the Libor case comes at a difficult time.

It has faced a series of legal problems since the financial crisis. In 2009, the bank agreed to pay $780 million to settle accusations by American authorities that it helped wealthy clients avoid taxes.

In 2011, it announced a $2.3 billion loss prompted by a rogue trader, Kweku M. Adoboli, who received a seven-year jail sentence for fraud last month. The firm agreed to pay a $47.5 million penalty to the British authorities in connection with the trading loss.

In the Libor case, UBS has been eager to cooperate. It has already reached a conditional immunity deal with the antitrust arm of the Justice Department, which could protect the bank from criminal prosecution under certain conditions. It is also cooperating with Canadian antitrust authorities by handing over e-mails and other documents implicating other banks.

But it did acknowledge publicly that such deals would not shield the bank from potential penalties from other regulators. The Justice Department’s criminal unit, for instance, could still take action against the bank.

UBS disclosed last year that it was the subject of investigations related to Libor, saying it had received subpoenas from American and Japanese authorities. Swiss and British regulators have joined the UBS investigation, which involves a number of currencies in the Libor system.

The timing of the Libor cases against UBS depends in large part on cooperation among regulators.

The Financial Services Authority in Britain has worked closely with its American counterparts. In total, the British regulator has about 160 people working on its various cases against banks, which are at different stages of development.

As the top watchdog of London’s financial services industry, the British regulator has positioned itself as a conduit for document requests from international regulators regarding Libor, which is set daily by banks in London. The agency also organizes interviews for its American counterparts with London-based bankers involved in the inquiries, according to an official with direct knowledge of the matter.

British regulators had been ready to move against UBS a month after officials announced a settlement with Barclays, the person added. The settlement has been delayed, however, as global authorities have tried to pursue a joint agreement with the bank.

“We’ve been going at the pace of the slowest regulator,” the official said.

A version of this article appeared in print on 12/03/2012, on page A1 of the NewYork edition with the headline: Ubs Is Reported To Be Near Deal On Rate Rigging.

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In Damascus, Tense Anticipation of Strongest Push Yet by Rebels

Joseph Eid/Agence France-Presse — Getty Images

Distant explosions have awakened a sense of foreboding even in the tranquil Old City.

BEIRUT, Lebanon — As Syrian rebels and government forces clashed on the outskirts of Damascus on Saturday, with explosions rumbling in the distance and warplanes screeching overhead, the rebels appeared to be making their strongest push toward the city since the government repelled an offensive there in July.

A quiet tension prevailed downtown. But security checkpoints were proliferating, and there were reports that President Bashar al-Assad was preparing loyal divisions to defend the city, the capital and heart of his power.

Military analysts warned that it was impossible to know whether a decisive battle for Damascus was beginning, especially as Syrians lost access to the Internet for 53 hours, limiting the flow of information, before it was restored on Saturday. But they said that a government fight to defend its core could be the fiercest and most destructive phase yet of the 20-month conflict.

“We’re waiting for the big battle to begin,” said Emile Hokayem, an analyst based in Bahrain for the International Institute for Strategic Studies.

For decades, the Assad family has settled loyal military families, many from its minority Alawite sect, in the western outskirts of Damascus, where the presidential palace sits on a plateau overlooking the city. The current fighting suggested that the government was trying to insulate those areas, along with the city center and airport, from the semicircle of urban sprawl curving from northeast to southwest, where rebels have strengthened their position in recent days, overrunning a string of small bases.

Analysts say that Mr. Assad, knowing that losing Damascus could be a decisive blow, has been conserving his best and most loyal troops and much of his artillery for a battle there.

“We’re not yet at a point where the regime is in total panic mode and can no longer make rational — however nasty — decisions about military strategy,” Mr. Hokayem said. “He has to decide which cities around Damascus to destroy and which cities to keep in hand.”

When Damascus was threatened in July, the government pulled forces from parts of northern and southern Syria — allowing rebels to consolidate gains in the north — and there were reports that something similar was happening now. An activist in Damascus said Saturday that elements of the army’s feared Fourth Division, led by Maher al-Assad, the president’s brother, were at the Aqraba military airport near the Damascus airport. There were unconfirmed reports that other top divisions and special forces were headed for the city, said Joseph Holliday, an analyst at the Institute for the Study of War, in Washington.

“When the rebels score victories in Damascus, it forces the regime to contract more quickly” in the areas that it contests elsewhere, he said.

To some extent that has already happened, said one diplomat, Nasser Judeh, the foreign minister of Jordan. “There are large areas of Syria that are beyond the control of the regime now,” he said Saturday in Washington. “The opposition and the rebel forces are making serious advances. Things are moving in a different direction compared to what they were a few weeks ago.”

Analysts said rebels were unlikely to quickly overrun the government’s positions in the capital. The government has defended chosen strong points, including its most important helicopter base, in the northern province of Idlib, and a base on the road between Damascus and the commercial hub of Aleppo. Rebels have besieged both for months without taking them.

But the encroachment on Damascus has a profound psychological effect that could hasten the crumbling of Mr. Assad’s support — or deepen it among those who fear their fates are tied to his. In July, when rebels briefly held the southern Damascus neighborhood of Midan and bombed a military headquarters downtown, killing four top officials, some government supporters fled to Lebanon and coastal Alawite strongholds, analysts said.

Last month, rebel bombings in Mezze 86, a neighborhood of Alawite military families near the palace, unsettled government supporters amid suspicions of an inside job. In recent weeks, officials have expressed fear of commuting home to the suburbs, worrying that Sunni Muslim conscript soldiers at checkpoints will turn on them, shifting allegiance to the mostly Sunni uprising, said analysts, activists and a foreign reporter recently in Damascus.

Reporting was contributed by Neil MacFarquhar and Hania Mourtada from Beirut; Thomas Erdbrink from Tehran; Hala Droubi from Dubai, United Arab Emirates; and Elisabeth Bumiller from Washington.

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This Life: Maria Popova Has Some Big Ideas

Elizabeth Lippman for The New York Times

Maria Popova is the editor of Brain Pickings, an online grab bag of eclectic information.

SHE is the mastermind of the one of the faster growing literary empires on the Internet, yet she is virtually unknown. She is the champion of old-fashioned ideas, yet she is only 28 years old. She is a fierce defender of books, yet she insists she will never write one herself.

At precisely 9:30 on a chilly Saturday morning, Maria Popova slips out of her apartment in Brooklyn, scurries down a few stairs and enters a small basement gym. A former recreational bodybuilder from Bulgaria, Ms. Popova is the unlikely founder of the exploding online emporium of ideas known as Brain Pickings.

Her exhaustively assembled grab bag of scientific curiosities, forgotten photographs, snippets of old love letters and mash notes to creativity — imagine the high-mindedness of a TED talk mixed with the pop sensibility of P. T. Barnum — spans a blog (500,000 visitors a month), a newsletter (150,000 subscribers) and a Twitter feed (263,000 followers). Her output, which she calls a “human-powered discovery engine for interestingness,” has attracted an eclectic group of devotees including the novelist William Gibson, the singer Josh Groban, the comedian Drew Carey, the neuroscientist David Eagleman, the actress Mia Farrow and the Twitter founders Biz Stone and Evan Williams.

“She’s a celebrator,” said Anne-Marie Slaughter, a Princeton professor and former State Department official. “You feel the tremendous amount of pleasure she takes in finding these things and sharing them. It’s like walking into the Museum of Modern Art and having somebody give you a customized, guided tour.”

Unlike most blogger celebrities, however, Ms. Popova revels in remaining anonymous, which means her followers know almost nothing about her. In an age when many tweet what they put in their morning coffee, she rarely uses the word “I.” Her personal history is almost completely absent. Her photograph is not on the site. “I don’t feel the necessity to be in the public eye that way,” she said after reluctantly agreeing to sit for an interview. “There’s a certain safety in making people feel like you’re an organization and not a person. ”

A fierce creature of habit, she begins every day by working out. On this morning, she alternates 20 chin-ups with 50 push-ups, then performs a series of planks and stretches. Once on the elliptical, she frantically highlights an obscure 1976 book, “The Creativity Question” (Amazon sales ranking: one million-plus), and checks her RSS feed on her iPad.

Exactly 70 minutes later, she returns to her modest one-bedroom apartment to write a brief essay about Freud and daydreaming, file her thrice-daily blog entries and schedule her regimen of 50 Twitter messages a day. She does this while balancing on a wobble board.

“I try to sit still when I work, but my mind goes spiraling elsewhere,” she said in a mild Slavic accent reminiscent of Bond girls in the 1970s. “When my body is moving, it’s almost like it takes the wind out of this mental spinning, and I’m able to focus.” Recently, she came upon a 1942 book on inspiration chronicling others with the same habit. “Mark Twain paced while he dictated,” she said. “Beethoven walked along the river. Maybe there’s a psycho-biological element.”

Ms. Popova traces her discipline to her upbringing behind the Iron Curtain. Her parents met as teenage exchange students in Russia and had her almost immediately. Her father was an engineering student who later became an Apple salesman; her mother was studying library science. “We’re not very much in touch,” she said of her parents today, “but recently we were on Skype, and this whole library science thing came up. I realized a lot of what I do is organizational, almost like a Dewey Decimal System for the Web. My mother got so emotional. It was very funny, and kind of moving.”

Her paternal grandmother was a rabid biblio and had a collection of encyclopedias, Ms. Popova said, and she credits the act of randomly opening volumes and happening upon entries for her passion to discover old knowledge. “The Web has such a presentism bias,” she said, with Facebook updates, tweets and blog entries always appearing with the latest first. By contrast, flipping through the encyclopedia was “an interesting model of learning about the world serendipitously and also guidedely.”

After graduating from an American high school in Bulgaria, she enrolled at the University of Pennsylvania, where she quickly grew bored with what she calls the “industrial model” of education, involving large-scale lectures. While still a student, she was working part time at an advertising firm in 2005, when a colleague sent around an e-mail with clippings of rivals’ work to inspire the team.

Bruce Feiler’s latest book,“The Secrets of Happy Families,” will be published in February. “This Life” appears monthly.

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Opinion: A Health Insurance Detective Story

I’VE had a long career as a business journalist, beginning at Forbes and including eight years as the editor of Money, a personal finance magazine. But I’ve never faced a more confounding reporting challenge than the one I’m engaged in now: What will I pay next year for the pill that controls my blood cancer?

After making more than 70 phone calls to 16 organizations over the past few weeks, I’m still not totally sure what I will owe for my Revlimid, a derivative of thalidomide that is keeping my multiple myeloma in check. The drug is extremely expensive — about $11,000 retail for a four-week supply, $132,000 a year, $524 a pill. Time Warner, my former employer, has covered me for years under its Supplementary Medicare Program, a plan for retirees that included a special Writers Guild benefit capping my out-of-pocket prescription costs at $1,000 a year. That out-of-pocket limit is scheduled to expire on Jan. 1. So what will my Revlimid cost me next year?

The answers I got ranged from $20 a month to $17,000 a year. One of the first people I phoned said that no matter what I heard, I wouldn’t know the cost until I filed a claim in January. Seventy phone calls later, that may still be the most reliable thing anyone has told me.

Like around 47 million other Medicare beneficiaries, I have until this Friday, Dec. 7, when open enrollment ends, to choose my 2013 Medicare coverage, either through traditional Medicare or a private insurer, as well as my drug coverage — or I will risk all sorts of complications and potential late penalties.

But if a seasoned personal-finance journalist can’t get a straight answer to a simple question, what chance do most people have of picking the right health insurance option?

A study published in the journal Health Affairs in October estimated that a mere 5.2 percent of Medicare Part D beneficiaries chose the cheapest coverage that met their needs. All in all, consumers appear to be wasting roughly $11 billion a year on their Part D coverage, partly, I think, because they don’t get reliable answers to straightforward questions.

Here’s a snapshot of my surreal experience:

NOV. 7 A packet from Time Warner informs me that the company’s new 2013 Retiree Health Care Plan has “no out-of-pocket limit on your expenses.” But Erin, the person who answers at the company’s Benefits Service Center, tells me that the new plan will have “no practical effect” on me. What about the $1,000-a-year cap on drug costs? Is that really being eliminated? “Yes,” she says, “there’s no limit on out-of-pocket expenses in 2013.” I tell her I think that could have a major effect on me.

Next I talk to David at CVS/Caremark, Time Warner’s new drug insurance provider. He thinks my out-of-pocket cost for Revlimid next year will be $6,900. He says, “I know I’m scaring you.”

I call back Erin at Time Warner. She mentions something about $10,000 and says she’ll get an estimate for me in two business days.

NOV. 8 I phone Medicare. Jay says that if I switch to Medicare’s Part D prescription coverage, with a new provider, Revlimid’s cost will drive me into Medicare’s “catastrophic coverage.” I’d pay $2,819 the first month, and 5 percent of the cost of the drug thereafter — $563 a month or maybe $561. Anyway, roughly $9,000 for the year. Jay says AARP’s Part D plan may be a good option.

NOV. 9 Erin at Time Warner tells me that the company’s policy bundles United Healthcare medical coverage with CVS/Caremark’s drug coverage. I can’t accept the medical plan and cherry-pick prescription coverage elsewhere. It’s take it or leave it. Then she puts CVS’s Michele on the line to get me a Revlimid quote. Michele says Time Warner hasn’t transferred my insurance information. She can’t give me a quote without it. Erin says she will not call me with an update. I’ll have to call her.

My oncologist’s assistant steers me to Celgene, Revlimid’s manufacturer. Jennifer in “patient support” says premium assistance grants can cut the cost of Revlimid to $20 or $30 a month. She says, “You’re going to be O.K.” If my income is low enough to qualify for assistance.

NOV. 12 I try CVS again. Christine says my insurance records still have not been transferred, but she thinks my Revlimid might cost $17,000 a year.

Adriana at Medicare warns me that AARP and other Part D providers will require “prior authorization” to cover my Revlimid, so it’s probably best to stick with Time Warner no matter what the cost.

But Brooke at AARP insists that I don’t need prior authorization for my Revlimid, and so does her supervisor Brian — until he spots a footnote. Then he assures me that it will be easy to get prior authorization. All I need is a doctor’s note. My out-of-pocket cost for 2013: roughly $7,000.

NOV. 13 Linda at CVS says her company still doesn’t have my file, but from what she can see about Time Warner’s insurance plans my cost will be $60 a month — $720 for the year.

CVS assigns my case to Rebecca. She says she’s “sure all will be fine.” Well, “pretty sure.” She’s excited. She’s been with the company only a few months. This will be her first quote.

NOV. 14 Giddens at Time Warner puts in an “emergency update request” to get my files transferred to CVS.

Frank Lalli is an editorial consultant on retirement issues and a former senior executive editor at Time Warner’s Time Inc.

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