GM, Ford, Toyota post healthy sales as auto industry growth slows

After posting a big gain in January, U.S. auto sales moderated last month with most carmakers reporting steady single-digit gains. 

Industry executives said they still believed the auto segment of the U.S. economy would continue to grow this year, but the rate of growth would be slower than recent years.

“We will see moderate growth as we go throughout the year,” said Jonathan Browning, chief executive of Volkswagen Group of America.

“We do believe the debate on sequestration and the global economic environment does have a drag on consumer confidence,” Browning said.

Sales of Volkswagens rose 2.9% to 31,456 vehicles compared with the same month a year earlier.  It was its best February since 1973.

Even though the leap year made February 2012 one day longer than February 2013, General Motors Co., the nation’s largest automaker, said its sales rose 7% last month to 224,314 vehicles compared with a year earlier.

“The housing sector has now joined auto sales in propelling the U.S. economy forward,” said Kurt McNeil, vice president of GM's U.S. sales operations. “More importantly, the recovery in new home construction is reinforcing the underlying improvement in auto-buying conditions, especially for pickups."

Chrysler Group said its U.S. sales rose 4% last month to 139,015 vehicles compared with the same month a year earlier. It was the company’s best February sales result since 2008.

Ford Motor Co. said its sales grew 9% to 195,822 vehicles. It was the automaker’s best February sales since 2007.

Toyota Motor Corp. said its U.S. sales rose 4.3% to 166,377 vehicles last month.

Hyundai said its sales rose 2% to 52,311. It was the best February for the South Korean automaker since it started selling cars in the U.S. in the 1980s.

“In spite of concerns over reduced consumer confidence related to the end of the payroll tax holiday, we believe these head winds are unlikely to affect the new vehicle market, as we see purchasers of new vehicles as less sensitive to the income reduction,” said Brian Johnson, an analyst with Barclays Capital.

He said the tax increase and economic uncertainly were likely to play a bigger role in the used vehicle market.

Ford analyst Erich Merkle Johnson estimated overall U.S. sales for the month will reach about 1.2 million, a gain of about 2% from the same month a year earlier, and represent an annualized selling pace of well over 15 million.

But while sales were up, the number of incentives and discounts car companies were offering for most anything but pickup trucks declined.

“Automakers enjoyed a month of ideal conditions for profitability in February, with incentives down nearly 4% and sales up,” said Kristen Andersson, analyst for auto price information company TrueCar.com. “We expect incentives spending to track within a narrow range the rest of the year as the supply of vehicles and consumer demand are forecasted to increase at similar levels.”

Other analysts were also upbeat, saying the month represented a continued slow-to-moderate growth trend for automakers.

"Similar to previous months, consumers will be lured to dealer showrooms by low finance rates, affordable lease payments and, most importantly, new and compelling product," said Alec Gutierrez, analyst of for Kelley Blue Book. "

He expected the sales results to be skewed toward smaller, fuel-efficient vehicles because gas prices are averaging about $3.75 a gallon nationally, and that typically changes the mix of cars sold during a given month.

ALSO:

Lexus tops Consumer Reports rankings

Hyundai expands shattering sunroof recall

Follow me on Twitter (@LATimesJerry), Facebook and Google+.

Read More..

DNA science points to better treatment for acne

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

eryn.brown@latimes.com

Read More..

Phys Ed: What Housework Has to Do With Waistlines

Phys Ed

Gretchen Reynolds on the science of fitness.

One reason so many American women are overweight may be that we are vacuuming and doing laundry less often, according to a new study that, while scrupulously even-handed, is likely to stir controversy and emotions.

The study, published this month in PLoS One, is a follow-up to an influential 2011 report which used data from the U.S. Bureau of Labor Statistics to determine that, during the past 50 years, most American workers began sitting down on the job. Physical activity at work, such as walking or lifting, almost vanished, according to the data, with workers now spending most of their time seated before a computer or talking on the phone. Consequently, the authors found, the average American worker was burning almost 150 fewer calories daily at work than his or her employed parents had, a change that had materially contributed to the rise in obesity during the same time frame, especially among men, the authors concluded.

But that study, while fascinating, was narrow, focusing only on people with formal jobs. It overlooked a large segment of the population, namely a lot of women.

“Fifty years ago, a majority of women did not work outside of the home,” said Edward Archer, a research fellow with the Arnold School of Public Health at the University of South Carolina in Columbia, and lead author of the new study.

So, in collaboration with many of the authors of the earlier study of occupational physical activity, Dr. Archer set out to find data about how women had once spent their hours at home and whether and how their patterns of movement had changed over the years.

He found the information he needed in the American Heritage Time Use Study, a remarkable archive of “time-use diaries” provided by thousands of women beginning in 1965. Because Dr. Archer wished to examine how women in a variety of circumstances spent their time around the house, he gathered diaries from both working and non-employed women, starting with those in 1965 and extending through 2010.

He and his colleagues then pulled data from the diaries about how many hours the women were spending in various activities, how many calories they likely were expending in each of those tasks, and how the activities and associated energy expenditures changed over the years.

As it turned out, their findings broadly echoed those of the occupational time-use study. Women, they found, once had been quite physically active around the house, spending, in 1965, an average of 25.7 hours a week cleaning, cooking and doing laundry. Those activities, whatever their social freight, required the expenditure of considerable energy. (The authors did not include child care time in their calculations, since the women’s diary entries related to child care were inconsistent and often overlapped those of other activities.) In general at that time, working women devoted somewhat fewer hours to housework, while those not employed outside the home spent more.

Forty-five years later, in 2010, things had changed dramatically. By then, the time-use diaries showed, women were spending an average of 13.3 hours per week on housework.

More striking, the diary entries showed, women at home were now spending far more hours sitting in front of a screen. In 1965, women typically had spent about eight hours a week sitting and watching television. (Home computers weren’t invented yet.)

By 2010, those hours had more than doubled, to 16.5 hours per week. In essence, women had exchanged time spent in active pursuits, like vacuuming, for time spent being sedentary.

In the process, they had also greatly reduced the number of calories that they typically expended during their hours at home. According to the authors’ calculations, American women not employed outside the home were burning about 360 fewer calories every day in 2010 than they had in 1965, with working women burning about 132 fewer calories at home each day in 2010 than in 1965.

“Those are large reductions in energy expenditure,” Dr. Archer said, and would result, over the years, in significant weight gain without reductions in caloric intake.

What his study suggests, Dr. Archer continued, is that “we need to start finding ways to incorporate movement back into” the hours spent at home.

This does not mean, he said, that women — or men — should be doing more housework. For one thing, the effort involved is such activities today is less than it once was. Using modern, gliding vacuum cleaners is less taxing than struggling with the clunky, heavy machines once available, and thank goodness for that.

Nor is more time spent helping around the house a guarantee of more activity, over all. A telling 2012 study of television viewing habits found that when men increased the number of hours they spent on housework, they also greatly increased the hours they spent sitting in front of the TV, presumably because it was there and beckoning.

Instead, Dr. Archer said, we should start consciously tracking what we do when we are at home and try to reduce the amount of time spent sitting. “Walk to the mailbox,” he said. Chop vegetables in the kitchen. Play ball with your, or a neighbor’s, dog. Chivvy your spouse into helping you fold sheets. “The data clearly shows,” Dr. Archer said, that even at home, we need to be in motion.

Read More..

U.S. economy grew late last year, but barely

WASHINGTON -- The U.S. economy barely grew late last year, thanks largely to a plunge in federal defense spending that in part was likely preparation for the budget cuts under the so-called sequestration.

The nation's gross domestic product, or the total value of all goods and services produced, rose by a measly 0.1% in the fourth quarter, according to the Commerce Department's latest calculations released Thursday. The government's first estimate said inflation-adjusted GDP shrank 0.1% in the final three months of last year.

Analysts were expecting the quarterly GDP growth rate to be brought up to about 0.5% on average. GDP grew by 3.1% annualized in the third quarter of last year.

Still, economists did seem troubled by the modest revision, noting the unusually steep 22% annualized fall in defense spending in the fourth quarter. The stagnant GDP rate also reflected a big slowdown in business inventories, suggesting that companies may produce more in coming months to stock up on goods that have been run down.

Also belying the overall poor GDP growth were strong numbers for business investments, particularly residential investment, which jumped 17.5% at an annual rate. Private spending also increased by a decent 2.1%, slightly better than the third quarter.

Federal Reserve Chairman Ben S. Bernanke said this week that the flattening of the GDP growth rate late last year wasn't a sign of an economy that had stalled. Rather, he attributed it to weather-related disruptions and other transitory factors.

That's the good news. The bad news is that the economy continues to grow at a mediocre pace of about 2%, well below what Bernanke and other experts see as the potential for the economy and what is needed to bring down the unemployment rate more quickly.  

What's more, the fiscal budget cuts set to take effect Friday under the sequester will put further weight on an economy that just can't seem to gain much speed. GDP has grown on average by a little over 2% a year since the Great Recession officially ended in mid-2009.

Many economists expect GDP to advance by no more than that in the the first half of this year, and, if there are no big surprises, to pick up momentum in the second half as the effects of the tax increases this year and budget cuts fade and the economy benefits from a recovering housing market and the improvement in consumer finances and credit flows.

Still, that is a big "if." There's little indication that the political budget battles will ease anytime soon, and higher oil prices and renewed concerns about the Eurozone debt crisis have made the near-term outlook even more uncertain.   

ALSO:

Housing starts fall sharply at start of year

Bernanke warns Congress that budget cuts pose danger

Most economists see 'sequestration' budget cuts as unavoidable

Read More..

Race for L.A. city controller heats up

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

catherine.saillant@latimes.com

Read More..

9/11 victim's mom upset film used son's last words

NEW CANAAN, Conn. (AP) — A Connecticut woman whose son died in the Sept. 11 attacks at the World Trade Center says she's upset the Oscar-winning movie "Zero Dark Thirty" used a recording of his last words without her permission.

Mary Fetchet of New Canaan told CBS News and the Daily News this week that she was shocked the filmmakers didn't ask if they could use the voicemail her son, Bradley Fetchet, left on her phone while he was on the 89th floor of the World Trade Center's south tower.

The movie about the manhunt for Osama bin Laden begins with the voices of 9/11 victims making their last phone calls.

Sony Pictures Entertainment said in a statement that the filmmakers contacted several relatives of 9/11 victims about using the voice recordings.

Read More..

Global Health: After Measles Success, Rwanda to Get Rubella Vaccine

Rwanda has been so successful at fighting measles that next month it will be the first country to get donor support to move to the next stage — fighting rubella too.

On March 11, it will hold a nationwide three-day vaccination campaign with a combined measles-rubella vaccine, hoping to reach nearly five million children up to age 14. It will then integrate the dual vaccine into its national health service.

Rwanda can do so “because they’ve done such a good job on measles,” said Christine McNab, a spokeswoman for the Measles and Rubella Initiative. M.R.I. helped pay for previous vaccination campaigns in the country and the GAVI Alliance is helping financing the upcoming one.

Rubella, also called German measles, causes a rash that is very similar to the measles rash, making it hard for health workers to tell the difference.

Rubella is generally mild, even in children, but in pregnant women, it can kill the fetus or cause serious birth defects, including blindness, deafness, mental retardation and chronic heart damage.

Ms. McNab said that Rwanda had proved that it can suppress measles and identify rubella, and it would benefit from the newer, more expensive vaccine.

The dual vaccine costs twice as much — 52 cents a dose at Unicef prices, compared with 24 cents for measles alone. (The MMR vaccine that American children get, which also contains a vaccine against mumps, costs Unicef $1.)

More than 90 percent of Rwandan children now are vaccinated twice against measles, and cases have been near zero since 2007.

The tiny country, which was convulsed by Hutu-Tutsi genocide in 1994, is now leading the way in Africa in delivering medical care to its citizens, Ms. McNab said. Three years ago, it was the first African country to introduce shots against human papilloma virus, or HPV, which causes cervical cancer.

In wealthy countries, measles kills a small number of children — usually those whose parents decline vaccination. But in poor countries, measles is a major killer of malnourished infants. Around the world, the initiative estimates, about 158,000 children die of it each year, or about 430 a day.

Every year, an estimated 112,000 children, mostly in Africa, South Asia and the Pacific islands, are born with handicaps caused by their mothers’ rubella infection.

Thanks in part to the initiative — which until last year was known just as the Measles Initiative — measles deaths among children have declined 71 percent since 2000. The initiative is a partnership of many health agencies, vaccine companies, donors and others, but is led by the American Red Cross, the United Nations Foundation, the Centers for Disease Control and Prevention, Unicef and the World Health Organization.

This article has been revised to reflect the following correction:

Correction: February 27, 2013

An earlier version of this article misstated the source of the financing for the upcoming vaccination campaign in Rwanda. It is being financed by the GAVI Alliance, not the Measles and Rubella Initiative.

Read More..

Pending home sales rise in January, industry group reports

Pending home sales rose in January in every U.S. region except the West, according to new data.

The National Assn. of Realtors said that its index of pending sales — based on the number of home purchase contracts signed — rose 4.5% in January from the previous month and 9.5% from January 2012.

The index, at 105.9, is at it hits highest reading since April 2010, the month a popular tax credit for buyers was driving the market up.

 “Favorable affordability conditions and job growth have unleashed a pent-up demand,” Lawrence Yun, chief economist for the group, said in a news release.

The group expects higher home sales in the short term but sales growth will be muted because there are not enough homes available for sale, Yun said.

An index level of 100 is equal to the average level of contract activity during 2001, which was the first year to be studied and also considered historically a healthy year of sales volume.

Month over month, pending sales were up 8.2% in the Northeast, 4.5% in the Midwest and 5.9% in the South. They were essentially flat, up just 0.1%, in the West, according to the index data.

ALSO:

One-third of U.S. homeowners have no mortgage

Fewer Americans are stuck in underwater mortgages

Banks step up efforts to forgive mortgage debt in California

Read More..

Gaza militants break cease-fire with rocket attack into Israel

Israeli police remove the remains of a rocket in the town of Ashkelon. (EPA / February 26, 2013)

By Edmund Sanders

February 26, 2013, 12:05 a.m.

JERUSALEM -- Palestinian unrest spread Tuesday to the Gaza Strip, where militants fired a rocket into southern Israel, shattering one of the longest periods of quiet along that border in recent memory.

It was the first rocket fired since the signing of a November cease-fire agreement between Israel and the Palestinian militant group Hamas, ending their eight-day clash.

The morning attack came as Palestinians in the West Bank protest the death of 30-year-old Arafat Jaradat, a gas station attendant who died suddenly in Israeli custody after being arrested for throwing rocks at an Israeli settler.

Palestinians claim Jaradat was tortured to death. Israelis say the exact cause of his Feb. 23 death has not yet been determined.

The Grad rocket fired early Tuesday landed in an open area near the Israeli city of Ashkelon, causing no damage or injuries.

ALSO:

Palestinians at funeral protest death of prisoner

Syria ready to talk to rebels, foreign minister says

U.S. military denies abducting, killing civilians in Afghan province

Comments are filtered for language and registration is required. The Times makes no guarantee of comments' factual accuracy. Readers may report inappropriate comments by clicking the Report Abuse link next to a comment. Here are the full legal terms you agree to by using this comment form.

';
shareDiv.innerHTML = templateHTML;

/* append the new div to the end of the document, which is hidden already with CSS */
document.body.appendChild(shareDiv);

/* Store the div in both a regular JavaScript variable and as a jQuery object so we can reference them faster later */
var shareTip = document.getElementById('shareTip'),
$shareTip = $('#shareTip');

/* This extends our settings object with any user-defined settings passed to the function and returns the jQuery object shareTip
was called on */
return this.each(function() {
if (options) {
$.extend(settings, options);
}

/* This is a hack to make sure the shareTip always fades back to 100% opacity */
var checkOpacity = function (){
if ( $shareTip.css('opacity') !== 1 ){
$shareTip.css({'opacity': 1});
}
};

/* Function that replaces the HTML in the shareTip with the template we defined at the top */
/* It will wipe/reset the links on the social media buttons each time the function is called */
var removeLinks = function (){
shareTip.innerHTML = templateHTML;
};

/* This is the function that makes the links for the Tweet / Share functionality */

var makeURLS = function (link, message){
/* Here we construct the Tweet URL using an array, with values passed to the function */
var tweetConstruct = [
'http://twitter.com/share?url=', link, '&text=', message, '&via=', settings.twitter_account
],
/* Then join the array into one chunk of HTML */
tweetURL = tweetConstruct.join(''),

/* Same story for Facebook */
fbConstruct = [
'http://www.facebook.com/sharer.php?u=', link, '&src=sp'
],

fbURL = fbConstruct.join(''),

newHTML = [
''
],
shareHTML = newHTML.join('');
/* Load in our new HTML */
shareTip.innerHTML = shareHTML;
};

/* Since the shareTip will automatically fade out when the user mouses out of an element */
/* we have to specifically tell the shareTip we want it to stay put when the user mouses over it */
/* This effectively gives the user a 500 ms (or whatever) window to mouse */
/* from the element to the shareTip to prevent it from popping out */
$shareTip.hover(function(){
$shareTip.stop(true, true);
$shareTip.show();
checkOpacity();
}, function(){
$(this).fadeOut(settings.speed);
});

/* This function handles the hover action */
$(this).hover(function(){
/* remove the old links, so someone doesn't accidentally click on them */
removeLinks();

/* If there's already an animation running on the shareTip, stop it */
$shareTip.stop(true, true);

var eso = $(this),
message,
/* Store the width and height of the shareTip and the offset of the element for our calculations */
height = eso.height(),
width = eso.width(),
offset = eso.offset(),
link;


link = eso.children('a').attr('href');
message = escape( eso.find('img').attr('alt') ) || eso.attr(settings.message_attr);

if (link.search('http://') === -1){
link = 'http://www.latimes.com' + link;
}
link = encodeURIComponent(link);

/* If it's at the top of the page, the shareTip will pop under the element */
if (offset.top

Read More..

The ConsUmer: Questions About a Robotic Surgery

Ever since it was approved by the Food and Drug Administration in 2005, robotic surgery for hysterectomy has been heavily advertised. Surgeons promise that using the da Vinci robotic device will bring better results and an easier recovery, and many hospitals claim that patients will experience less pain and fewer complications, getting back on their feet faster.

The company that makes da Vinci robotic surgery equipment promoted it last May at free health workshops organized by the federal Office on Womens’ Health. On Sunday, the Liberty Science Museum in Jersey City will host its first “Let’s Operate Day,” offering guests “hands-on” practice peering into video monitors and using da Vinci’s robot arms to pick up and manipulate small objects.

The cost of the new technology is rarely mentioned. But last week, a new study that evaluated outcomes in more than a quarter of a million American women raised questions about the manufacturer’s claims. The paper, published in The Journal of the American Medical Association, compared outcomes in 264,758 women who had either laparoscopic or robotically assisted hysterectomy at 441 hospitals between 2007 and 2010. Both methods are minimally invasive and involve smaller incisions than open abdominal surgery.

The researchers found no overall difference in complication rates between the two groups, and no difference in the rates of blood transfusion, even though one of the claims regarding robotic surgery is that it causes less blood loss.

But the researchers did find a big difference in cost. Robotically assisted surgery for hysterectomy costs on average about one-third more than laparoscopic surgery.

“It’s important to separate the marketing from the data,” said Dr. Jason D. Wright, the study’s lead author, an assistant professor of obstetrics and gynecology at Columbia University Medical Center. “For the surgeon, there is a greater degree of movement and control of the instruments and the visualization is better.

“But the ultimate question is, does this change outcomes for patients? This study suggests that there really is not a lot of difference as far as quantifiable outcomes.”

The majority of patients in both groups left the hospital in less than two days, though patients who had robotic surgery were slightly more likely to go home that early: 80 percent went home in less than two days, compared with 75 percent of those who had laparoscopic surgery.

But the cost of robotic surgeries was significantly higher, with a median cost to the hospital of $8,868, compared with $6,679 for laparoscopic hysterectomy. The study did not look at the difference in patients’ bills, but according to Newchoicehealth.com, the average patient price for a laparoscopic hysterectomy ranges from $7,700 in Dallas to $11,600 in Los Angeles.

With laparoscopic surgery — sometimes called keyhole surgery — narrow instruments and a small video camera are inserted through tiny incisions; the surgeon sees the image on a monitor and can cut and sew tissue with the instruments. With robotically assisted surgery, the surgeon sits at a console with a 3-dimensional view of the surgical site, and computer technology translates his or her hand movements into precise, scaled movements of the instruments.

Even without offering clear advantages the proportion of hysterectomies performed robotically has increased rapidly, up to nearly 10 percent of hysterectomies in 2010 from less than 1 percent in 2007, Dr. Wright said. Minimally invasive surgeries for hysterectomies are increasing across the board, he found, even at hospitals not performing robotic surgery.

Dr. Myriam J. Curet, chief medical adviser to Intuitive Surgical, which makes the da Vinci systems, did not dispute the study’s findings, but said the important message was that more women were able to receive minimally invasive surgeries because more options were available.

“That’s good for patients and for the health care system,” Dr. Curet said. Women who are not candidates for laparoscopic surgery might still be candidates for robotically-assisted surgery, she added.

Right now, however, it is not clear how to identify which women would benefit from robotic surgery and which would do well with a less expensive method.

The growing use of robotic surgery in hospitals will continue to drive up health costs, said Joel S. Weissman, of Brigham and Women’s Hospital and a co-author of an editorial published with the study.

“Once you have that robot, the tendency is to use it for all kinds of things, for which it may or may not have great value,” Dr. Weissman said. Studies like this one, he said, demonstrate the waste of health care dollars on “something that costs a lot more and doesn’t offer any added benefit over current treatment options.”

Each year approximately 600,000 American women have hysterectomies, according to the Centers for Disease Control and Prevention. By age 60, one in three American women has had her uterus removed, often along with her ovaries and cervix.

Critics who say far too many hysterectomies are done in the United States worry that all the attention to surgical method distracts from the question of whether patients should be having the surgery at all.

Most hysterectomies are prescribed for conditions that are not life-threatening, and advocates worry that women are not fully informed of the long-term harms, which may include a loss of sexual responsiveness, depression and chronic constipation, and higher risk for osteoporosis and heart disease, said Nora W. Coffey, the founder of the nonprofit Hysterectomy Educational Resources and Services Foundation.

“That’s the conversation we should be having,” Ms. Coffey said.

---

Nora W. Coffey and other experts emphasize that women considering a hysterectomy should discuss all options with their doctors.

¶Ask what the alternatives are and whether watchful waiting is an option. Remember that it is irreversible, regardless of how the surgery is done.

¶Learn about the nonreproductive functions of the uterus, ovaries and cervix, and the potential long-term consequences associated with their removal, as well as the function of the ovaries and cervix.

¶If you proceed, discuss the advantages and disadvantages of different surgical methods with your doctor. Interview several surgeons and inquire about the cost and how much insurance will cover. Your co-pay may vary depending on the surgical method.

¶Tell your surgeon if you do not want your ovaries and cervix removed.

Read More..