A Breakthrough Against Leukemia Using Altered T-Cells

PHILIPSBURG, Pa. — Emma Whitehead has been bounding around the house lately, practicing somersaults and rugby-style tumbles that make her parents wince.

It is hard to believe, but last spring Emma, then 6, was near death from leukemia. She had relapsed twice after chemotherapy, and doctors had run out of options.

Desperate to save her, her parents sought an experimental treatment at the Children’s Hospital of Philadelphia, one that had never before been tried in a child, or in anyone with the type of leukemia Emma had. The experiment, in April, used a disabled form of the AIDS virus to reprogram Emma’s immune system genetically to kill cancer cells.

The treatment very nearly killed her. But she emerged from it cancer-free, and seven months later is still in complete remission. She is the first child and one of the first humans ever in whom new techniques have achieved a long-sought goal — giving a patient’s own immune system the lasting ability to fight cancer.

Emma had been ill with acute lymphoblastic leukemia since 2010, when she was 5, her parents, Kari and Tom, said. She is their only child.

She is among just a dozen patients with advanced leukemia to have received the experimental treatment, which was developed at the University of Pennsylvania. Similar approaches are also being tried at other centers, including the National Cancer Institute and Memorial Sloan-Kettering Cancer Center in New York.

“Our goal is to have a cure, but we can’t say that word,” said Dr. Carl June, who leads the research team at the University of Pennsylvania. He hopes the new treatment will eventually replace bone-marrow transplantation, an even more arduous, risky and expensive procedure that is now the last hope when other treatments fail in leukemia and related diseases.

Three adults with chronic leukemia treated at the University of Pennsylvania have also had complete remissions, with no signs of disease; two of them have been well for more than two years, said Dr. David Porter. Four adults improved but did not have full remissions, and one was treated too recently to evaluate. A child improved and then relapsed. In two adults, the treatment did not work at all. The Pennsylvania researchers are presenting their results on Sunday and Monday in Atlanta at a meeting of the American Society of Hematology.

Despite the mixed results, cancer experts not involved with the research say it has tremendous promise, because even in this early phase of testing it has worked in seemingly hopeless cases.

“I think this is a major breakthrough,” said Dr. Ivan Borrello, a cancer expert and associate professor of medicine at the Johns Hopkins University School of Medicine.

Dr. John Wagner, director of pediatric blood and marrow transplantation at the University of Minnesota, called the Pennsylvania results “phenomenal,” and said they were “what we’ve all been working and hoping for but not seeing to this extent.”

A major drug company, Novartis, is betting on the Penn team, and has committed $20 million to building a research center on the Penn campus to bring the treatment to market.

Hervé Hoppenot, president of Novartis Oncology, called the research “fantastic” and said it had the potential — if the early results hold up — to revolutionize the treatment of leukemia and related blood cancers. Researchers say the same approach, reprogramming the patient’s immune system, may also be used eventually against tumors like breast and prostate cancer.

To perform the treatment, doctors remove millions of the patient’s T-cells — a type of white blood cell — and insert new genes that enable the T-cells to kill cancer cells. The new genes program the T-cells to attack B-cells, a normal part of the immune system that turns malignant in leukemia.

The altered T-cells — called chimeric antigen receptor cells — are then dripped back into the patient’s veins, and if all goes well they multiply like crazy and start destroying the cancer.

The T-cells home in on a protein called CD-19 that is found on the surface of most B-cells, whether they are healthy or malignant.

A sign that the treatment is working is that the patient becomes terribly ill, with raging fevers and chills — a reaction that oncologists call “shake and bake,” Dr. June said. Its medical name is cytokine-release syndrome, or cytokine storm, referring to the natural chemicals that pour out of cells in the immune system as they are being activated, causing fevers and other symptoms. The storm can also flood the lungs and cause perilous drops in blood pressure — effects that nearly killed Emma.

Steroids sometimes ease the reaction, but did not help Emma. Her temperature hit 105. She wound up on a ventilator, unconscious and swollen almost beyond recognition, surrounded by friends and family who had come to say goodbye.

But at the eleventh hour, a battery of blood tests gave the researchers a clue as to what might help save Emma: Her level of one of the cytokines, interleukin-6 or IL-6, had shot up a thousandfold. Doctors had never seen such a spike before and thought it might be what was making her so sick. Dr. June knew that a drug could lower IL-6 — his daughter takes it, for rheumatoid arthritis. It had never been used for a crisis like Emma’s, but there was little to lose. Her oncologist, Dr. Stephan A. Grupp, ordered the drug. The response, he said, was “amazing.”

Within hours, Emma began to stabilize. She woke up a week later, on May 2, the day she turned 7; the intensive-care staff sang “Happy Birthday.”

Since then, the research team has used the same drug, tocilizumab, in several other patients.

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A Breakthrough Against Leukemia Using Altered T-Cells

PHILIPSBURG, Pa. — Emma Whitehead has been bounding around the house lately, practicing somersaults and rugby-style tumbles that make her parents wince.

It is hard to believe, but last spring Emma, then 6, was near death from leukemia. She had relapsed twice after chemotherapy, and doctors had run out of options.

Desperate to save her, her parents sought an experimental treatment at the Children’s Hospital of Philadelphia, one that had never before been tried in a child, or in anyone with the type of leukemia Emma had. The experiment, in April, used a disabled form of the AIDS virus to reprogram Emma’s immune system genetically to kill cancer cells.

The treatment very nearly killed her. But she emerged from it cancer-free, and seven months later is still in complete remission. She is the first child and one of the first humans ever in whom new techniques have achieved a long-sought goal — giving a patient’s own immune system the lasting ability to fight cancer.

Emma had been ill with acute lymphoblastic leukemia since 2010, when she was 5, her parents, Kari and Tom, said. She is their only child.

She is among just a dozen patients with advanced leukemia to have received the experimental treatment, which was developed at the University of Pennsylvania. Similar approaches are also being tried at other centers, including the National Cancer Institute and Memorial Sloan-Kettering Cancer Center in New York.

“Our goal is to have a cure, but we can’t say that word,” said Dr. Carl June, who leads the research team at the University of Pennsylvania. He hopes the new treatment will eventually replace bone-marrow transplantation, an even more arduous, risky and expensive procedure that is now the last hope when other treatments fail in leukemia and related diseases.

Three adults with chronic leukemia treated at the University of Pennsylvania have also had complete remissions, with no signs of disease; two of them have been well for more than two years, said Dr. David Porter. Four adults improved but did not have full remissions, and one was treated too recently to evaluate. A child improved and then relapsed. In two adults, the treatment did not work at all. The Pennsylvania researchers are presenting their results on Sunday and Monday in Atlanta at a meeting of the American Society of Hematology.

Despite the mixed results, cancer experts not involved with the research say it has tremendous promise, because even in this early phase of testing it has worked in seemingly hopeless cases.

“I think this is a major breakthrough,” said Dr. Ivan Borrello, a cancer expert and associate professor of medicine at the Johns Hopkins University School of Medicine.

Dr. John Wagner, director of pediatric blood and marrow transplantation at the University of Minnesota, called the Pennsylvania results “phenomenal,” and said they were “what we’ve all been working and hoping for but not seeing to this extent.”

A major drug company, Novartis, is betting on the Penn team, and has committed $20 million to building a research center on the Penn campus to bring the treatment to market.

Hervé Hoppenot, president of Novartis Oncology, called the research “fantastic” and said it had the potential — if the early results hold up — to revolutionize the treatment of leukemia and related blood cancers. Researchers say the same approach, reprogramming the patient’s immune system, may also be used eventually against tumors like breast and prostate cancer.

To perform the treatment, doctors remove millions of the patient’s T-cells — a type of white blood cell — and insert new genes that enable the T-cells to kill cancer cells. The new genes program the T-cells to attack B-cells, a normal part of the immune system that turns malignant in leukemia.

The altered T-cells — called chimeric antigen receptor cells — are then dripped back into the patient’s veins, and if all goes well they multiply like crazy and start destroying the cancer.

The T-cells home in on a protein called CD-19 that is found on the surface of most B-cells, whether they are healthy or malignant.

A sign that the treatment is working is that the patient becomes terribly ill, with raging fevers and chills — a reaction that oncologists call “shake and bake,” Dr. June said. Its medical name is cytokine-release syndrome, or cytokine storm, referring to the natural chemicals that pour out of cells in the immune system as they are being activated, causing fevers and other symptoms. The storm can also flood the lungs and cause perilous drops in blood pressure — effects that nearly killed Emma.

Steroids sometimes ease the reaction, but did not help Emma. Her temperature hit 105. She wound up on a ventilator, unconscious and swollen almost beyond recognition, surrounded by friends and family who had come to say goodbye.

But at the eleventh hour, a battery of blood tests gave the researchers a clue as to what might help save Emma: Her level of one of the cytokines, interleukin-6 or IL-6, had shot up a thousandfold. Doctors had never seen such a spike before and thought it might be what was making her so sick. Dr. June knew that a drug could lower IL-6 — his daughter takes it, for rheumatoid arthritis. It had never been used for a crisis like Emma’s, but there was little to lose. Her oncologist, Dr. Stephan A. Grupp, ordered the drug. The response, he said, was “amazing.”

Within hours, Emma began to stabilize. She woke up a week later, on May 2, the day she turned 7; the intensive-care staff sang “Happy Birthday.”

Since then, the research team has used the same drug, tocilizumab, in several other patients.

Read More..

As Recovery Inches Ahead, Banks Face a New Reckoning

The nation’s largest banks are facing a fresh torrent of lawsuits asserting that they sold shoddy mortgage securities that imploded during the financial crisis, potentially adding significantly to the tens of billions of dollars the banks have already paid to settle other cases.

Regulators, prosecutors, investors and insurers have filed dozens of new claims against Bank of America, JPMorgan Chase, Wells Fargo, Citigroup and others, related to more than $1 trillion worth of securities backed by residential mortgages.

Estimates of potential costs from these cases vary widely, but some in the banking industry fear they could reach $300 billion if the institutions lose all of the litigation. Depending on the final price tag, the costs could lower profits and slow the economic recovery by weakening the banks’ ability to lend just as the housing market is showing signs of life.

The banks are battling on three fronts: with prosecutors who accuse them of fraud, with regulators who claim that they duped investors into buying bad mortgage securities, and with investors seeking to force them to buy back the soured loans.

“We are at an all-time high for this mortgage litigation,” said Christopher J. Willis, a lawyer with Ballard Spahr.

Efforts by the banks to limit their losses could depend on the outcome of one of the highest-stakes lawsuits to date — the $200 billion case that the Federal Housing Finance Agency, which oversees the housing twins Fannie Mae and Freddie Mac, filed against 17 banks last year, claiming that they duped the mortgage finance giants into buying shaky securities.

Last month, lawyers for some of the nation’s largest banks descended on a federal appeals court in Manhattan to make their case that the agency had waited too long to sue. A favorable ruling could overturn a decision by Judge Denise L. Cote, who is presiding over the litigation and has so far rejected virtually every defense raised by the banks, and would be cheered in bank boardrooms. It could also allow the banks to avoid federal housing regulators’ claims.

At the same time, though, some major banks are hoping to reach a broad settlement with housing agency officials, according to several people with knowledge of the talks. Although the negotiations are at a very tentative stage, the banks are broaching a potential cease-fire.

As the housing market and the nation’s economy slowly recover from the 2008 financial crisis, Wall Street is vulnerable on several fronts, including tighter regulations assembled in the aftermath of the crisis and continuing investigations into possible rigging of a major international interest rate. But the mortgage lawsuits could be the most devastating and expensive, bank analysts say.

“All of Wall Street has essentially refused to deal with the real costs of the litigation that they are up against,” said Christopher Whalen, a senior managing director at Tangent Capital Partners. “The real price tag is terrifying.”

Anticipating painful costs from mortgage litigation, the five major sellers of mortgage-backed securities set aside $22.5 billion as of June 30 just to cushion themselves against demands that they repurchase soured loans from trusts, according to an analysis by Natoma Partners.

But in the most extreme situation, the litigation could empty even more well-stocked reserves and weigh down profits as the banks are forced to pay penance for the subprime housing crisis, according to several senior officials in the industry.

There is no industrywide tally of how much banks have paid since the financial crisis to put the mortgage litigation behind them, but analysts say that future settlements will dwarf the payouts so far. That is because banks, for the most part, have settled only a small fraction of the lawsuits against them.

JPMorgan Chase and Credit Suisse, for example, agreed last month to settle mortgage securities cases with the Securities and Exchange Commission for $417 million, but still face billions of dollars in outstanding claims.

Bank of America is in the most precarious position, analysts say, in part because of its acquisition of the troubled subprime lender Countrywide Financial.

Last year, Bank of America paid $2.5 billion to repurchase troubled mortgages from Fannie Mae and Freddie Mac, and $1.6 billion to Assured Guaranty, which insured the shaky mortgage bonds.

But in October, federal prosecutors in New York accused the bank of perpetrating a fraud through Countrywide by churning out loans at such a fast pace that controls were largely ignored. A settlement in that case could reach well beyond $1 billion because the Justice Department sued the bank under a law that could allow roughly triple the damages incurred by taxpayers.

Bank of America’s attempts to resolve some mortgage litigation with an umbrella settlement have stalled. In June 2011, the bank agreed to pay $8.5 billion to appease investors, including the Federal Reserve Bank of New York and Pimco, that lost billions of dollars when the mortgage securities assembled by the bank went bad. But the settlement is in limbo after being challenged by investors. Kathy D. Patrick, the lawyer representing investors, has said she will set her sights on Morgan Stanley and Wells Fargo next.

Of the more than $1 trillion in troubled mortgage-backed securities remaining, Bank of America has more than $417 billion from Countrywide alone, according to an analysis of lawsuits and company filings. The bank does not disclose the volume of its mortgage litigation reserves.

“We have resolved many Countrywide mortgage-related matters, established large reserves to address these issues and identified a range of possible losses beyond those reserves, which we believe adequately addresses our exposures,” said Lawrence Grayson, a spokesman for Bank of America.

Adding to the legal fracas, the New York attorney general, Eric T. Schneiderman, accused Credit Suisse last month of perpetrating an $11.2 billion fraud by deceiving investors into buying shoddy mortgage-backed securities. According to the complaint, the bank dismissed flaws in the loans packaged into securities even while assuring investors that the quality was sound. The bank disputes the claims.

It is the second time that Mr. Schneiderman — who is also co-chairman of the Residential Mortgage-Backed Securities Working Group, created by President Obama in January — has taken aim at Wall Street for problems related to the subprime mortgage morass. In October, he filed a civil suit in New York State Supreme Court against Bear Stearns & Company, which JPMorgan Chase bought in 2008. The complaint claims that Bear Stearns and its lending unit harmed investors who bought mortgage securities put together from 2005 through 2007. JPMorgan denies the allegations.

Another potentially costly headache for the banks are the demands from a number of private investors who want the banks to buy back securities that violated representations and warranties vouching for the loans.

JPMorgan Chase told investors that as of the second quarter of this year, it was contending with more than $3.5 billion in repurchase demands. In the same quarter, it received more than $1.5 billion in fresh demands. Bank of America reported that as of the second quarter, it was dealing with more than $22 billion in unresolved demands, more than $8 billion of which were received during that quarter.

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Shintaro Ishihara, Right-Wing Japanese Politician, Makes Gains

TOKYO — Shintaro Ishihara has been a rare, flamboyant presence in Japan’s otherwise drab political world for half a century. A novelist turned right-wing firebrand, he has long held celebrity status on the political margins, where he was known for dramatic flourish. He once signed a pact in blood to oppose diplomatic ties with China because of its communist government, and he published a book at the height of Japan’s economic power that lectured his countrymen on the need to end what he considered its postwar servility to the United States.

Now, at 80, Mr. Ishihara is leading a newly formed populist party and has emerged as a contender for prime minister, vowing to turn Japan into a more independent, possibly nuclear-armed nation. While political analysts deem him a long shot, they say the fact that he has gotten this far after decades of pushing what was seen as a fringe agenda is a worrying sign of how desperate this nation is for strong leadership after years of cascading troubles.

With his promises to restore Japan’s battered national pride, Mr. Ishihara has staked out an even more stridently nationalistic position than the current front-runner, Shinzo Abe, the leader of the conservative Liberal Democratic Party, who has called for revising Japan’s pacifist constitution. Analysts worry that if Mr. Ishihara succeeds in his bid to become prime minister, he could weaken relations with the United States, yank Japan to the right and damage ties with China, which is already angered by his almost single-handedly rekindling a territorial dispute over an island chain.

But even in the likely event that Mr. Ishihara loses, they say, his campaign could still have a lasting effect, bringing patriotic populism into the political mainstream of a nation that has shunned such open jingoism since its devastating defeat in World War II.

“This election will be a test of whether Japan is really losing its dovishness,” said Takeshi Sasaki, a politics professor at Gakushuin University in Tokyo. “There is so much irritation at how everything seems to be going wrong, and Japan is losing its pride. Politicians on the right like Ishihara and Abe are trying to fan these flames.”

The rise of the two hard-liners has already contributed to hand-wringing among liberals who are anxious that the foreboding sense that Japan is fast becoming an international has-been has left the Japanese vulnerable to long-suppressed nationalism. Even those who call those fears overblown acknowledge that anti-China feelings, which could be easily exploited, are rising as that country eclipses Japan, builds a formidable military and makes its territorial ambitions clear.

From Mr. Ishihara’s vantage point, those geopolitical realities make now the perfect time for Japan to put him in charge.

“Here I am, the old man who has run amok!” he bellowed to a wave of applause at a recent campaign appearance in front of Shinjuku train station in Tokyo. “I am 80 years old, and I am standing here because I want to break through the indecisive and barren politics that is stifling Japan!”

A tall, bespectacled figure, Mr. Ishihara spent most of his short speech emphasizing what has become the central campaign message of his Japan Restoration Party: offering forceful leadership to end Japan’s long political drift by breaking the grip of bureaucrats and vested interests.

Much of the party’s message, however, has become vintage Ishihara. He goes further than Mr. Abe, calling for an outright scrapping of Japan’s antiwar constitution, written by its postwar American occupiers. He still speaks about ending what he sees as political and cultural subservience to the United States and pledges to resist Chinese territorial appetites, promising to build permanent structures on the disputed islands in a move likely to further antagonize China.

“I cannot allow myself to die until my Japan, which has been made a fool of by China, and seduced as a mistress by the United States, is able to stand up again as a stronger, more beautiful nation,” Mr. Ishihara said last month to reporters, explaining why he resigned after 13 years as Tokyo’s governor to return to national politics. He did so after being asked to lead the fledgling Restoration Party’s slate in this month’s parliamentary election by its founder, the popular mayor of Osaka who did not yet want to run for national office.

So far, polls show that Mr. Ishihara has only limited appeal. His party’s approval ratings are in the low teens, about the same as the unpopular incumbent Democratic Party, but below Mr. Abe’s Liberal Democrats, who poll only slightly better, at around 20 percent. Polls also show that more than half of voters disapprove of Mr. Ishihara and of scrapping the antiwar clause of Japan’s constitution.

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You for Sale: Company Envisions ‘Vaults’ for Personal Data

Peter DaSilva for The New York Times

Michael Fertik, the founder and chief executive of Reputation.com, at its offices in Redwood City, Calif., where he has amassed a database of information collected on millions of consumers.

“YOU are walking around naked on the Internet and you need some clothes,” says Michael Fertik. “I am going to sell you some.”

Naked? Not exactly, but close.

Mr. Fertik, 34, is the chief executive of Reputation.com, a company that helps people manage their online reputations. From his perch here in Silicon Valley, he views the digital screens in our lives, the smartphones and the tablets, the desktops and the laptops, as windows of a house. People go about their lives on the inside, he says, while dozens of marketing and analytics companies watch through the windows, sizing them up like peeping Toms.

By now many Americans are learning that they are living in a surveillance economy. “Information resellers,” also known as “data brokers,” have collected hundreds to thousands of details — what we buy, our race or ethnicity, our finances and health concerns, our Web activities and social networks — on almost every American adult. Other companies that specialize in ranking consumers use computer algorithms to covertly score Internet users, identifying some as “high-value” consumers worthy of receiving pitches for premium credit cards and other offers, while dismissing others as a waste of time and marketing money. Yet another type of company, called an ad-trading platform, profiles Internet users and auctions off online access to them to marketers in a practice called “real-time bidding.”

As these practices have come to light, several members of Congress, and federal agencies, have opened investigations.

At least for now, however, these companies typically do not permit consumers to see the records or marketing scores that have been compiled about them. And that is perfectly legal.

Now, Mr. Fertik, the loquacious, lion-maned founder of Reputation.com, says he has the free-market solution. He calls it a “data vault,” or “a bank for other people’s data.”

Here at Reputation.com’s headquarters, a vast open-plan office decorated with industrial-looking metal struts and reclaimed wood — a discreet homage to the lab where Thomas Edison invented the light bulb — his company has amassed a database on millions of consumers. Mr. Fertik plans to use it to sell people on the idea of taking control of their own marketing profiles. To succeed, he will have to persuade people that they must take charge of their digital personas.

Pointing out the potential hazards posed by data brokers and the like is part of Mr. Fertik’s M.O. Covert online profiling and scoring, he says, may unfairly exclude certain Internet users from marketing offers that could affect their financial, educational or health opportunities — a practice Mr. Fertik calls “Weblining.” He plans to market Reputation.com’s data vault, scheduled to open for business early next year, as an antidote.

“A data privacy vault,” he says, “is a way to control yourself as a person.”

Reputation.com is at the forefront of a nascent industry called “personal identity management.” The company’s business model for its vault service involves collecting data about consumers’ marketing preferences and giving them the option to share the information on a limited basis with certain companies in exchange for coupons, say, or status upgrades. In turn, participating companies will get access both to potential customers who welcome their pitches and to details about the exact products and services those people are seeking. In theory, the data vault would earn money as a kind of authorization supervisor, managing the permissions that marketers would need to access information about Reputation.com’s clients.

To some, the idea seems a bit quixotic.

Reputation.com, with $67 million in venture capital, is not making a profit. Although the company’s “privacy” products, like removing clients’ personal information from list broker and marketing databases, are popular, its reputation management techniques can be controversial. For instance, it offers services meant to make negative commentary about individual or corporate clients less visible on the Web.

And there are other hurdles, like competition. A few companies, like Personal, have already introduced vault services. Also, a number of other enterprises have tried — and quickly failed — to sell consumers on data lockers.

Even so, Mr. Fertik contends Reputation.com has the answer. The company already has several hundred thousand paying customers, he says, and patents on software that can identify consumers’ information online and score their reputations. He intends to show clients their scores and advise them on how to improve them.

“You can’t just build a vault and wish that vendors cared enough about your data to pay for it,” Mr. Fertik says. “You have to build a business that gives you the lift to accumulate a data set and attract consumers, the science to create insights that are valuable to vendors, and the power to impose restrictions on the companies who consume your data.”

THE consumer data trade is large and largely unregulated.

Companies and organizations in the United States spend more than $2 billion a year on third-party data about individuals, according to a report last year on personal identity management from Forrester Research, a market research firm. They spend billions more on credit data, market research and customer data analytics, the report said.

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New Taxes to Take Effect to Fund Health Care Law

WASHINGTON — For more than a year, politicians have been fighting over whether to raise taxes on high-income people. They rarely mention that affluent Americans will soon be hit with new taxes adopted as part of the 2010 health care law.

The new levies, which take effect in January, include an increase in the payroll tax on wages and a tax on investment income, including interest, dividends and capital gains. The Obama administration proposed rules to enforce both last week.

Affluent people are much more likely than low-income people to have health insurance, and now they will, in effect, help pay for coverage for many lower-income families. Among the most affluent fifth of households, those affected will see tax increases averaging $6,000 next year, economists estimate.

To help finance Medicare, employees and employers each now pay a hospital insurance tax equal to 1.45 percent on all wages. Starting in January, the health care law will require workers to pay an additional tax equal to 0.9 percent of any wages over $200,000 for single taxpayers and $250,000 for married couples filing jointly.

The new taxes on wages and investment income are expected to raise $318 billion over 10 years, or about half of all the new revenue collected under the health care law.

Ruth M. Wimer, a tax lawyer at McDermott Will & Emery, said the taxes came with “a shockingly inequitable marriage penalty.” If a single man and a single woman each earn $200,000, she said, neither would owe any additional Medicare payroll tax. But, she said, if they are married, they would owe $1,350. The extra tax is 0.9 percent of their earnings over the $250,000 threshold.

Since the creation of Social Security in the 1930s, payroll taxes have been levied on the wages of each worker as an individual. The new Medicare payroll is different. It will be imposed on the combined earnings of a married couple.

Employers are required to withhold Social Security and Medicare payroll taxes from wages paid to employees. But employers do not necessarily know how much a worker’s spouse earns and may not withhold enough to cover a couple’s Medicare tax liability. Indeed, the new rules say employers may disregard a spouse’s earnings in calculating how much to withhold.

Workers may thus owe more than the amounts withheld by their employers and may have to make up the difference when they file tax returns in April 2014. If they expect to owe additional tax, the government says, they should make estimated tax payments, starting in April 2013, or ask their employers to increase the amount withheld from each paycheck.

In the Affordable Care Act, the new tax on investment income is called an “unearned income Medicare contribution.” However, the law does not provide for the money to be deposited in a specific trust fund. It is added to the government’s general tax revenues and can be used for education, law enforcement, farm subsidies or other purposes.

Donald B. Marron Jr., the director of the Tax Policy Center, a joint venture of the Urban Institute and the Brookings Institution, said the burden of this tax would be borne by the most affluent taxpayers, with about 85 percent of the revenue coming from 1 percent of taxpayers. By contrast, the biggest potential beneficiaries of the law include people with modest incomes who will receive Medicaid coverage or federal subsidies to buy private insurance.

Wealthy people and their tax advisers are already looking for ways to minimize the impact of the investment tax — for example, by selling stocks and bonds this year to avoid the higher tax rates in 2013.

The new 3.8 percent tax applies to the net investment income of certain high-income taxpayers, those with modified adjusted gross incomes above $200,000 for single taxpayers and $250,000 for couples filing jointly.

David J. Kautter, the director of the Kogod Tax Center at American University, offered this example. In 2013, John earns $160,000, and his wife, Jane, earns $200,000. They have some investments, earn $5,000 in dividends and sell some long-held stock for a gain of $40,000, so their investment income is $45,000. They owe 3.8 percent of that amount, or $1,710, in the new investment tax. And they owe $990 in additional payroll tax.

The new tax on unearned income would come on top of other tax increases that might occur automatically next year if President Obama and Congress cannot reach an agreement in talks on the federal deficit and debt. If Congress does nothing, the tax rate on long-term capital gains, now 15 percent, will rise to 20 percent in January. Dividends will be treated as ordinary income and taxed at a maximum rate of 39.6 percent, up from the current 15 percent rate for most dividends.

Under another provision of the health care law, consumers may find it more difficult to obtain a tax break for medical expenses.

Taxpayers now can take an itemized deduction for unreimbursed medical expenses, to the extent that they exceed 7.5 percent of adjusted gross income. The health care law will increase the threshold for most taxpayers to 10 percent next year. The increase is delayed to 2017 for people 65 and older.

In addition, workers face a new $2,500 limit on the amount they can contribute to flexible spending accounts used to pay medical expenses. Such accounts can benefit workers by allowing them to pay out-of-pocket expenses with pretax money.

Taken together, this provision and the change in the medical expense deduction are expected to raise more than $40 billion of revenue over 10 years.

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The Lede Blog: Updates on Protests in Egypt

“@ssaadani: محمد محمود في الإتحادية. http://t.co/cTfsNeKB”my favorite Mohamed Mahmoud graffiti made it to presidential palace

— Abdel-Rahman Hussein (@ElFoulio) 7 Dec 12

The Lede is following the political crisis in Egypt, where supporters and opponents of President Mohamed Morsi rallied on Friday.

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E.U. Panel to Pressure Google on Privacy Rules

BERLIN — European data protection officials are drafting plans to censure Google over its online privacy policy if the company does not eventually meet regulators’ demands to revise it.

In a two-day closed-door meeting this week in Brussels of the European Union’s 27 national data protection officials, the group mapped a preliminary strategy, including the possibility of testing Google's compliance with national privacy laws in countries like Ireland, Belgium and Finland, where the company operates data centers. That was the word from a person close to the discussions, who was not authorized to speak publicly.

The group may issue a public statement next week on the matter.

New guidelines that Google adopted earlier this year for collecting information on individuals have come under sharp criticism in Europe.

In mid-October the French regulator, C.N.I.L., which had been asked by the group to study the matter, released a report criticizing Google’s privacy guidelines as allowing an “uncontrolled combination of data.”

C.N.I.L. said the method of combining information from Google’s search engine, YouTube, Google+ social network and other services “suggests the absence of any limit concerning the scope of collection and the potential uses of the personal data.”

When C.N.I.L. released its report, Google said it would study the analysis. But the company also asserted that its method of handling consumer data was legal under European Union rules. So far the company, which also ran afoul of European regulators in 2010 for its collection of personal data from home Wi-Fi routers, has not responded formally to the C.N.I.L. report.

On Friday, a Google spokesman in Brussels, Alistair Verney, referred to the company’s previous statement in October, which said Google was reviewing the French recommendations.

“Our new privacy policy demonstrates our longstanding commitment to protecting our users’ information and creating great products,” the Google statement said at the time. “We are confident that our privacy notices respect European law.”

When C.N.I.L. presented its analysis in October, the chairwoman of the French regulator, Isabelle Falque-Pierrotin, gave the search engine “three to four months” — roughly until mid-February — to respond to its recommendations.

Among other things, C.N.I.L. asked Google to heed European restrictions on mixing certain data and to heed Europe’s rules for obtaining prior consent from consumers before collecting personal data.

Google users in Europe cannot use the search engine’s services unless they agree to accept the company’s privacy policy.

But C.N.I.L. argued in its review that the opt-in disclaimer, which is legal under United States law, was too broad. It also said consumers should be given clearer information and be allowed to individually authorize or reject the collection of certain kinds of data.

Google announced its new policy, which applies globally and was presented as a way to simplify the user experience, earlier this year.

The company made nearly all of its $37.9 billion in sales revenue in 2011 from Internet advertising, which relies in part on the collection and analysis of user data to produce ads aimed at individual consumers.

While European lawmakers coordinate European Union data protection from Brussels, privacy law is enforced on the national level.

That decentralization is the reason why regulators are considering taking action within a few nations — most likely in countries where Google has physical operations and where national courts could be asked to enforce penalties.

But whether any actions, if they do eventually take place, result in anything other minor sanctions remains to be seen. In general, European national regulators are limited to only a few hundred thousand euros in the privacy-violation fines they can assess against companies or individuals.

A proposed update to European Union data protection law would give regulators the ability to assess much larger fines of as much as 2 percent of a company’s annual sales — which based on Google’s financial performance would equate to $760 million, based on 2011 revenue of $37.9 billion.

But it is unclear how soon, if ever, those higher penalties will be adopted.

Another person with knowledge of the regulators’ discussion this week emphasized that the group was still hoping Google would heed its recommendations and adapt its rules in Europe to conform with the Continent’s restrictions on data mining.

“We still have a lot of time left before we come to this juncture,” said another person with knowledge of the group’s discussions, citing the spring deadline for Google’s formal response. “Let’s wait and see what happens.”

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The New Old Age Blog: A Son Lost, a Mother Found

My friend Yvonne was already at the front door when I woke, so at first I didn’t realize that my mother was missing.

It was less than a week after my son Spencer died. Since that day, a constant stream of friends had been coming and going, bringing casseroles and soup, love, support and chatter. Mom hated it.

My 94-year-old mother, who has vascular dementia, has been living in my home in upstate New York for the past few years. Like many with dementia, mom is courteous but, underneath, irascible. Pride defines her, especially pride in her Phi Beta Kappa intellect. She hates to be confronted with how she has become, as she calls it, “stupid.”

The parade of strangers confused her. She had to be polite, field solicitous questions, endure mundane comments. She could not remember what was going on or why people were there. It must have been stressful and annoying.

That night, like every night since the state troopers brought the news, I woke hourly, tumbling in panic. As if it were not too late to save my son. Mom knew something was wrong, but she could not remember what. As I overslept that morning, she must have decided enough was enough. She was going home.

In a cold sky, the sun blazed over tall pines. As I opened the door, the dogs raced out to greet Yvonne and her two housecleaners. Yvonne often brags about her cleaning duo. They were her gift to me. They were going to clean my house before the funeral reception, which was scheduled for later that week. This was a very big gift because, like my mother before me, I am a very bad housekeeper.

Mom’s door was shut. I cautioned the housecleaners to avoid her room as I showed them around. Yvonne went to the kitchen to listen to the 37 unheard messages on my answering machine; the housecleaners went out to their van to get their instruments of dirt removal.

I ducked into Mom’s room to warn her about the upcoming noise. The bed was unmade; the floor was littered with crumpled tissues; the room was empty.

Normally, I would have freaked out right then. I knew Mom was not in the house, because I had just shown the whole house to the cleaners. Although Mom doesn’t wander like some dementia patients, she does on occasion run away. But I could not muster a shred of anxiety.

“Yvonne,” I called, “did you see my mother outside?”

Yvonne popped her head into the living room, eyebrows raised.“Outside? No!” She was alarmed. “Is she missing?”

“Yeah,” I said wearily, “I’ll look.” I stepped out onto the front porch, tightening the belt of my bathrobe and turning up the collar. Maybe she had walked off into the woods. The dogs danced around my legs, wanting breakfast.

I had no space left in my body to care. Either we would find her, or we would not. Either she was alive, or she was not. My child was gone. How could I care about anything ever again?

Then I saw my car was missing. My mouth fell open and my eyeballs rolled up to the right, gazing blindly at the abandoned bird’s nest on top of the porch light: What had I done with the keys?

Mom likes to run away in the car when she is angry. She used to do it a lot when my father was still alive — every time they fought. Since Mom took off in my car almost a year ago, after we had had a fight, I’d kept the keys hidden. Except for this week; this week, I had forgotten.

I was reverting to old habits. I had left the doors unlocked and the keys in the cupholder next to the driver’s seat. Exactly like Mom used to do.

“Uh-oh,” I said aloud. Mom was still capable of driving, even though she did not know where she was going. I just really, really hoped that she didn’t hurt anybody on the road. I pulled out my cellphone, about to call the police.

“Celia!” Yvonne shouted from the kitchen. She hurried up behind me, excited. “They found your mother. There are two messages on your machine.”

At that very moment, Mom was holed up at the College Diner in New Paltz, a 20-minute drive over the mountain, through the fields, left over the Wallkill River and away down Main Street.

Yvonne called the diner. They promised to keep the car keys until someone arrived. By that time, Yvonne had to go to work. She drove my friend Elizabeth to the diner, and Elizabeth drove Mom home in my car.

Half an hour later, they walked in the front door. Mom’s cheeks were rouged by the chill air and her eyes sparkled, her white hair riffing with static electricity. “Hello, hello,” she sang out. “Here we are.” She was wearing the flannel nightgown and robe I had dressed her in the night before. It was covered by her oversized purple parka, and her bare feet were shoved into sneakers.

I started laughing as soon as I saw her. I couldn’t help it. Elizabeth and Mom started laughing too. “You had a big adventure,” I said, hugging them both. “How are you?”

“I’m just marvelous,” said my mother. Mom always feels great after doing something rakish. We settled her on the sofa with her feet on the ottoman. By the time I got her blanket tucked in around her shoulders, she had fallen asleep.

Elizabeth couldn’t stop laughing as she described the scene. “Your mother was holding court in this big booth. She was sitting there in her nightgown and her parka, talking to everybody, with this plate of toast and coffee and, like, three of the staff hovering around her.”

The waitress said Mom seemed “a little disoriented” when she got there. Mom said she was meeting a friend for breakfast, but since she was wearing a nightgown and didn’t know whom she was meeting or where she lived, the staff thought there might be a problem. They convinced Mom to let them look in the glove compartment of the car, where they found my name and number.

It was then that I realized I was laughing – something I’d thought I would never be able to do again. “Elizabeth, Elizabeth, I’m laughing,” I said.

“Ha, ha, ha,” laughed Elizabeth, holding her belly.

“Ha, ha, ha,” I laughed, rolling on the floor.

And she who gave me life, who had suffered the death of my child and the extinction of her own intellect, snoozed on: oblivious, jubilant, still herself, still mine.

Read More..

The New Old Age Blog: A Son Lost, a Mother Found

My friend Yvonne was already at the front door when I woke, so at first I didn’t realize that my mother was missing.

It was less than a week after my son Spencer died. Since that day, a constant stream of friends had been coming and going, bringing casseroles and soup, love, support and chatter. Mom hated it.

My 94-year-old mother, who has vascular dementia, has been living in my home in upstate New York for the past few years. Like many with dementia, mom is courteous but, underneath, irascible. Pride defines her, especially pride in her Phi Beta Kappa intellect. She hates to be confronted with how she has become, as she calls it, “stupid.”

The parade of strangers confused her. She had to be polite, field solicitous questions, endure mundane comments. She could not remember what was going on or why people were there. It must have been stressful and annoying.

That night, like every night since the state troopers brought the news, I woke hourly, tumbling in panic. As if it were not too late to save my son. Mom knew something was wrong, but she could not remember what. As I overslept that morning, she must have decided enough was enough. She was going home.

In a cold sky, the sun blazed over tall pines. As I opened the door, the dogs raced out to greet Yvonne and her two housecleaners. Yvonne often brags about her cleaning duo. They were her gift to me. They were going to clean my house before the funeral reception, which was scheduled for later that week. This was a very big gift because, like my mother before me, I am a very bad housekeeper.

Mom’s door was shut. I cautioned the housecleaners to avoid her room as I showed them around. Yvonne went to the kitchen to listen to the 37 unheard messages on my answering machine; the housecleaners went out to their van to get their instruments of dirt removal.

I ducked into Mom’s room to warn her about the upcoming noise. The bed was unmade; the floor was littered with crumpled tissues; the room was empty.

Normally, I would have freaked out right then. I knew Mom was not in the house, because I had just shown the whole house to the cleaners. Although Mom doesn’t wander like some dementia patients, she does on occasion run away. But I could not muster a shred of anxiety.

“Yvonne,” I called, “did you see my mother outside?”

Yvonne popped her head into the living room, eyebrows raised.“Outside? No!” She was alarmed. “Is she missing?”

“Yeah,” I said wearily, “I’ll look.” I stepped out onto the front porch, tightening the belt of my bathrobe and turning up the collar. Maybe she had walked off into the woods. The dogs danced around my legs, wanting breakfast.

I had no space left in my body to care. Either we would find her, or we would not. Either she was alive, or she was not. My child was gone. How could I care about anything ever again?

Then I saw my car was missing. My mouth fell open and my eyeballs rolled up to the right, gazing blindly at the abandoned bird’s nest on top of the porch light: What had I done with the keys?

Mom likes to run away in the car when she is angry. She used to do it a lot when my father was still alive — every time they fought. Since Mom took off in my car almost a year ago, after we had had a fight, I’d kept the keys hidden. Except for this week; this week, I had forgotten.

I was reverting to old habits. I had left the doors unlocked and the keys in the cupholder next to the driver’s seat. Exactly like Mom used to do.

“Uh-oh,” I said aloud. Mom was still capable of driving, even though she did not know where she was going. I just really, really hoped that she didn’t hurt anybody on the road. I pulled out my cellphone, about to call the police.

“Celia!” Yvonne shouted from the kitchen. She hurried up behind me, excited. “They found your mother. There are two messages on your machine.”

At that very moment, Mom was holed up at the College Diner in New Paltz, a 20-minute drive over the mountain, through the fields, left over the Wallkill River and away down Main Street.

Yvonne called the diner. They promised to keep the car keys until someone arrived. By that time, Yvonne had to go to work. She drove my friend Elizabeth to the diner, and Elizabeth drove Mom home in my car.

Half an hour later, they walked in the front door. Mom’s cheeks were rouged by the chill air and her eyes sparkled, her white hair riffing with static electricity. “Hello, hello,” she sang out. “Here we are.” She was wearing the flannel nightgown and robe I had dressed her in the night before. It was covered by her oversized purple parka, and her bare feet were shoved into sneakers.

I started laughing as soon as I saw her. I couldn’t help it. Elizabeth and Mom started laughing too. “You had a big adventure,” I said, hugging them both. “How are you?”

“I’m just marvelous,” said my mother. Mom always feels great after doing something rakish. We settled her on the sofa with her feet on the ottoman. By the time I got her blanket tucked in around her shoulders, she had fallen asleep.

Elizabeth couldn’t stop laughing as she described the scene. “Your mother was holding court in this big booth. She was sitting there in her nightgown and her parka, talking to everybody, with this plate of toast and coffee and, like, three of the staff hovering around her.”

The waitress said Mom seemed “a little disoriented” when she got there. Mom said she was meeting a friend for breakfast, but since she was wearing a nightgown and didn’t know whom she was meeting or where she lived, the staff thought there might be a problem. They convinced Mom to let them look in the glove compartment of the car, where they found my name and number.

It was then that I realized I was laughing – something I’d thought I would never be able to do again. “Elizabeth, Elizabeth, I’m laughing,” I said.

“Ha, ha, ha,” laughed Elizabeth, holding her belly.

“Ha, ha, ha,” I laughed, rolling on the floor.

And she who gave me life, who had suffered the death of my child and the extinction of her own intellect, snoozed on: oblivious, jubilant, still herself, still mine.

Read More..