DNA Analysis, More Accessible Than Ever, Opens New Doors

Matt Roth for The New York Times

Sam Bosley of Frederick, Md., going shopping with his daughter, Lillian, 13, who has a malformed brain and severe developmental delays, seizures and vision problems. More Photos »

Debra Sukin and her husband were determined to take no chances with her second pregnancy. Their first child, Jacob, who had a serious genetic disorder, did not babble when he was a year old and had severe developmental delays. So the second time around, Ms. Sukin had what was then the most advanced prenatal testing.

The test found no sign of Angelman syndrome, the rare genetic disorder that had struck Jacob. But as months passed, Eli was not crawling or walking or babbling at ages when other babies were.

“Whatever the milestones were, my son was not meeting them,” Ms. Sukin said.

Desperate to find out what is wrong with Eli, now 8, the Sukins, of The Woodlands, Tex., have become pioneers in a new kind of testing that is proving particularly helpful in diagnosing mysterious neurological illnesses in children. Scientists sequence all of a patient’s genes, systematically searching for disease-causing mutations.

A few years ago, this sort of test was so difficult and expensive that it was generally only available to participants in research projects like those sponsored by the National Institutes of Health. But the price has plunged in just a few years from tens of thousands of dollars to around $7,000 to $9,000 for a family. Baylor College of Medicine and a handful of companies are now offering it. Insurers usually pay.

Demand has soared — at Baylor, for example, scientists analyzed 5 to 10 DNA sequences a month when the program started in November 2011. Now they are doing more than 130 analyses a month. At the National Institutes of Health, which handles about 300 cases a year as part of its research program, demand is so great that the program is expected to ultimately take on 800 to 900 a year.

The test is beginning to transform life for patients and families who have often spent years searching for answers. They can now start the grueling process with DNA sequencing, says Dr. Wendy K. Chung, professor of pediatrics and medicine at Columbia University.

“Most people originally thought of using it as a court of last resort,” Dr. Chung said. “Now we can think of it as a first-line test.”

Even if there is no treatment, there is almost always some benefit to diagnosis, geneticists say. It can give patients and their families the certainty of knowing what is wrong and even a prognosis. It can also ease the processing of medical claims, qualifying for special education services, and learning whether subsequent children might be at risk.

“Imagine the people who drive across the whole country looking for that one neurologist who can help, or scrubbing the whole house with Lysol because they think it might be an allergy,” said Richard A. Gibbs, the director of Baylor College of Medicine’s gene sequencing program. “Those kinds of stories are the rule, not the exception.”

Experts caution that gene sequencing is no panacea. It finds a genetic aberration in only about 25 to 30 percent of cases. About 3 percent of patients end up with better management of their disorder. About 1 percent get a treatment and a major benefit.

“People come to us with huge expectations,” said Dr. William A. Gahl, who directs the N.I.H. program. “They think, ‘You will take my DNA and find the causes and give me a treatment.' ”

“We give the impression that we can do these things because we only publish our successes,” Dr. Gahl said, adding that when patients come to him, “we try to make expectations realistic.”

DNA sequencing was not available when Debra and Steven Sukin began trying to find out what was wrong with Eli. When he was 3, they tried microarray analysis, a genetic test that is nowhere near as sensitive as sequencing. It detected no problems.

“My husband and I looked at each other and said, ‘The good news is that everything is fine; the bad news is that everything is not fine,' ” Ms. Sukin said.

In November 2011, when Eli was 6, Ms. Sukin consulted Dr. Arthur L. Beaudet, a medical geneticist at Baylor.

“Is there a protein missing?” she recalled asking him. “Is there something biochemical we could be missing?”

By now, DNA sequencing had come of age. Dr. Beaudet said that Eli was a great candidate, and it turned out that the new procedure held an answer.

A single DNA base was altered in a gene called CASK, resulting in a disorder so rare that there are fewer than 10 cases in all the world’s medical literature.

“It really became definitive for my husband and me,” Ms. Sukin said. “We would need to do lifelong planning for dependent care for the rest of his life.”

This article has been revised to reflect the following correction:

Correction: February 19, 2013

An earlier version of this article misstated the name of a medicine taken by two teenagers who have a rare gene mutation. The drug is 5-hydroxytryptophan, not 5-hydroxytryptamine.

Read More..

DNA Analysis, More Accessible Than Ever, Opens New Doors

Matt Roth for The New York Times

Sam Bosley of Frederick, Md., going shopping with his daughter, Lillian, 13, who has a malformed brain and severe developmental delays, seizures and vision problems. More Photos »

Debra Sukin and her husband were determined to take no chances with her second pregnancy. Their first child, Jacob, who had a serious genetic disorder, did not babble when he was a year old and had severe developmental delays. So the second time around, Ms. Sukin had what was then the most advanced prenatal testing.

The test found no sign of Angelman syndrome, the rare genetic disorder that had struck Jacob. But as months passed, Eli was not crawling or walking or babbling at ages when other babies were.

“Whatever the milestones were, my son was not meeting them,” Ms. Sukin said.

Desperate to find out what is wrong with Eli, now 8, the Sukins, of The Woodlands, Tex., have become pioneers in a new kind of testing that is proving particularly helpful in diagnosing mysterious neurological illnesses in children. Scientists sequence all of a patient’s genes, systematically searching for disease-causing mutations.

A few years ago, this sort of test was so difficult and expensive that it was generally only available to participants in research projects like those sponsored by the National Institutes of Health. But the price has plunged in just a few years from tens of thousands of dollars to around $7,000 to $9,000 for a family. Baylor College of Medicine and a handful of companies are now offering it. Insurers usually pay.

Demand has soared — at Baylor, for example, scientists analyzed 5 to 10 DNA sequences a month when the program started in November 2011. Now they are doing more than 130 analyses a month. At the National Institutes of Health, which handles about 300 cases a year as part of its research program, demand is so great that the program is expected to ultimately take on 800 to 900 a year.

The test is beginning to transform life for patients and families who have often spent years searching for answers. They can now start the grueling process with DNA sequencing, says Dr. Wendy K. Chung, professor of pediatrics and medicine at Columbia University.

“Most people originally thought of using it as a court of last resort,” Dr. Chung said. “Now we can think of it as a first-line test.”

Even if there is no treatment, there is almost always some benefit to diagnosis, geneticists say. It can give patients and their families the certainty of knowing what is wrong and even a prognosis. It can also ease the processing of medical claims, qualifying for special education services, and learning whether subsequent children might be at risk.

“Imagine the people who drive across the whole country looking for that one neurologist who can help, or scrubbing the whole house with Lysol because they think it might be an allergy,” said Richard A. Gibbs, the director of Baylor College of Medicine’s gene sequencing program. “Those kinds of stories are the rule, not the exception.”

Experts caution that gene sequencing is no panacea. It finds a genetic aberration in only about 25 to 30 percent of cases. About 3 percent of patients end up with better management of their disorder. About 1 percent get a treatment and a major benefit.

“People come to us with huge expectations,” said Dr. William A. Gahl, who directs the N.I.H. program. “They think, ‘You will take my DNA and find the causes and give me a treatment.' ”

“We give the impression that we can do these things because we only publish our successes,” Dr. Gahl said, adding that when patients come to him, “we try to make expectations realistic.”

DNA sequencing was not available when Debra and Steven Sukin began trying to find out what was wrong with Eli. When he was 3, they tried microarray analysis, a genetic test that is nowhere near as sensitive as sequencing. It detected no problems.

“My husband and I looked at each other and said, ‘The good news is that everything is fine; the bad news is that everything is not fine,' ” Ms. Sukin said.

In November 2011, when Eli was 6, Ms. Sukin consulted Dr. Arthur L. Beaudet, a medical geneticist at Baylor.

“Is there a protein missing?” she recalled asking him. “Is there something biochemical we could be missing?”

By now, DNA sequencing had come of age. Dr. Beaudet said that Eli was a great candidate, and it turned out that the new procedure held an answer.

A single DNA base was altered in a gene called CASK, resulting in a disorder so rare that there are fewer than 10 cases in all the world’s medical literature.

“It really became definitive for my husband and me,” Ms. Sukin said. “We would need to do lifelong planning for dependent care for the rest of his life.”

This article has been revised to reflect the following correction:

Correction: February 19, 2013

An earlier version of this article misstated the name of a medicine taken by two teenagers who have a rare gene mutation. The drug is 5-hydroxytryptophan, not 5-hydroxytryptamine.

Read More..

DealBook: Einhorn Has Edge in Dispute With Apple

In the battle between Apple and David Einhorn, score a point for the hedge fund manager.

A federal judge said on Tuesday that he was leaning toward Mr. Einhorn’s contention in a lawsuit that the iPad maker violated securities regulations by improperly bundling several shareholder proposals into one matter.

The lawsuit by Mr. Einhorn’s Greenlight Capital, filed in Federal District Court in Manhattan, claims that Apple unjustly tied a vote to eliminate the company’s ability to issue preferred stock at will with other initiatives that the hedge fund manager supports.

While the judge overseeing the case, Richard J. Sullivan, didn’t immediately grant Mr. Einhorn’s request for an halt to the vote, he said that the facts of the case favored the investor’s interpretation.

“I think success on the merits lies with Greenlight,” Judge Sullivan said at the end of a two-hour hearing.

He is expected to decide whether to grant a preliminary injunction within days, citing the Feb. 27 cutoff for voting on Apple’s shareholder proposals.

Read More..

As Assad Holds Firm, Obama Could Revisit Arms Policy

WASHINGTON — When President Obama rebuffed four of his top national security officials who wanted to arm the rebels in Syria last fall, it put an end to a months-long debate over how aggressively Washington should respond to the strife there that has now left nearly 70,000 dead.

Reuters

A Free Syrian Army member smokes a cigarette inside a factory producing improvised mortar shells.

But the decision also left the White House with no clear strategy to resolve a crisis that has bedeviled it since a popular uprising erupted against President Bashar al-Assad almost two years ago. Despite an American program of nonlethal assistance to opponents of the Syrian government and $365 million in humanitarian aid, Mr. Obama appears to be running out of options to speed Mr. Assad’s exit.

With conditions continuing to deteriorate, officials said, the president could reopen the question of whether to provide weapons to select members of the resistance in an effort to break the impasse in Syria. The question is whether a wary Mr. Obama, surrounded by a new national security team, would come to a different conclusion.

“This is not a closed decision,” a senior administration official insisted. “As the situation evolves, as our confidence increases, we might revisit it.”

Mr. Obama’s refusal to provide arms when the proposal was broached before the November election, officials said, was driven by his reluctance to get drawn into a proxy war and his fear that the weapons would end up in unreliable hands, where they could be used against civilians or Israeli and American interests.

As the United States struggles to formulate a policy, however, Mr. Assad has given no sign that he is ready to yield power, and the Syrian resistance is adamant that it will not negotiate a transition in which he has a role. Mr. Obama, in his State of the Union address, did not repeat his oft-stated confidence that Mr. Assad’s days are numbered.

Even if Mr. Assad was overthrown, the convulsion could fragment Syria along sectarian and ethnic lines, each supported by competing outside powers, said Paul Salem, who runs the Beirut-based Middle East office for the Carnegie Endowment for International Peace. “Syria,” he said, “is in the process, not of transitioning, but disintegrating.”

The State Department has funneled $50 million of nonlethal assistance to the Syrian opposition, including satellite telephones, radios, broadcasting equipment, computers, survival equipment and the training in how to use them. This support, officials say, has helped Syrians opposed to the Assad regime communicate with one another and the outside world, despite efforts by Syrian forces to target rebel communications using Iranian-supplied equipment. A Syria-wide FM radio network is to connect broadcasting operations in several cities in the next several days. The State Department has also helped train local councils in areas that have freed from the Syrian government’s control.

But the State Department does not provide non-lethal assistance to armed rebel factions. This has greatly limited the influence the United States has with armed groups that are likely to control much of Syria if Mr. Assad is ousted..

“The odds are very high that, for better or worse, armed men will determine Syria’s course for the foreseeable future,” said Frederic C. Hof, a former senior State Department official and a senior fellow at the Atlantic Council. “For the U.S. not to have close, supportive relationships with armed elements, carefully vetted, is very risky.”

Because units of the anti-Assad Free Syria Army have captured prisoners and detained criminals in the areas they control, Mr. Hof said, it is essential that either the United States or an ally train rebel staff officers in judicial procedures and sensitive them to human rights concerns.

While the White House has focused on the risks of providing weapons, other nations have had no such reservations. Russia has continued to provide arms and financial support to the Assad government. Iran has supplied the regime with weapons and Quds Force advisers. Hezbollah has sent militants to Syria to help Mr. Assad’s forces. On the other side of the struggle, anti-government Qaeda-affiliated fighters have been receiving financial and other support from their backers in the Middle East.

The arming plan that was considered last year originated with David H. Petreaus, then the director of the Central Intelligence Agency, and was supported by former Secretary of State Hillary Rodham Clinton. The goal was to create allies in Syria with whom the United States could work during the conflict and if Mr. Assad was removed from power. Each had their reasons for supporting it.

Read More..

The Media Equation: In Omaha Manhole Fire Photo, Logging Off in Search of Some Clues

Stephanie Sands

This image, which was taken after an underground fire cut power in half of downtown Omaha, captivated the Web last month.

When photographs of spontaneous events miraculously appear on the Web, it generally prompts two responses: wonder and skepticism.

Matt Miller/Omaha World-Herald

Matthew Hansen, a columnist at The Omaha World-Herald, showed how to follow a trail. 

So it was with an image of exploding manhole covers in Omaha that took over the Web last month. On Sunday, Jan. 27, an underground fire cut power in half of downtown. A vivid photograph of unknown provenance, showing fire shooting out of manholes on a city street, began popping up on Reddit, where it had 1.5 million views, and Gawker.

The photo — an indifferently composed shot of an event that looks very far away — would not win any Pulitzers, but something incredible seems to be under way at the precise moment it was taken. You can almost hear the sequential explosions emanating below the street: boom, boom, boom as flames appear to shoot up from hell itself.

In this age of Photoshop, it wasn’t long before the debates cropped up, on the Web and in Omaha, about the picture’s authenticity.

Matthew Hansen, a columnist at The Omaha World-Herald, wondered the same thing, and one night found himself in a bar engaged in the real-versus-fake debate. Like many photos on the Web, this one came from everywhere — forwarded, tweeted and blogged — and nowhere — there was no name on the image nor any text to indicate its origin.

Mr. Hansen, intrepid journalist that he is, solved the mystery and wrote a column about it. The photo was real, it turned out, but not in the way people thought. (More on that later.) So, did Mr. Hansen use deep photo analytics or examine metadata to peel back the truth?

Nope. There was a notebook involved, a lawyer, some phone calls, a cursory digital investigation and some street reporting, which included an interview with a man with no pants.

Shoe leather never looked or smelled so good.

Mr. Hansen’s first step in solving what he called the “Great Omaha Manhole Fire Photo of 2013” was to determine from the angle of the photo that it could have been taken from only one apartment building — called the Kensington Tower. He then used an architectural detail to conclude that it was shot from the top floor, on the west side.

He managed to gain entry to the building — that is, he sneaked in — and made his way to the top floor, where he began knocking on doors.

Mr. Hansen found a man named Kenneth who would not let Mr. Hansen in because he was indisposed — he became “Pantsless Kenneth” in the column — but said that he knew the photo in question and thought his neighbor had taken it.

But the neighbor wasn’t home, so Mr. Hansen stuck his business card in the door jamb and left.

When he returned to the office, Mr. Hansen jumped onto Reddit, found the person who had originally posted the photo there and through him found the person, Gwendolyn Olney, who had posted the photo on her Facebook page, the source for the Reddit posting.

Ms. Olney happened to be the associate counsel for The World-Herald. “Omaha is indeed a small town,” Mr. Hansen wrote in his column. He began to follow the pixilated bread crumbs.

“Gwen didn’t take the photo,” he added. “She got it from Rebecca, who didn’t take the photo. She got it from Brandon, who didn’t take the photo. They led me to Gwen’s friend Andrea, who didn’t take the photo, who led me to ... well, she couldn’t remember who she had gotten the photo from.”

Reading the column, you could almost hear his sigh when he wrote, “Dead end.”

Then his phone rang. “I took that photo,” the voice said.

The caller was Stephanie Sands, a graduate student at the University of Nebraska at Omaha. She said that the day after she took the photo, which she had no idea had become a sensation, she learned from her friends that a reporter was asking about it.

“I was impressed that he had sneaked upstairs and put a card in my door, so I called him,” she said in an interview by phone.

Ms. Sands agreed to meet Mr. Hansen and told him that she had heard the explosion and took two photos with her phone. She sent one to friends and thought nothing more of it.

“I was actually disappointed in how it turned out,” she told me. “Because I was shooting at a distance with an iPhone, it didn’t really capture the severity of what I saw and heard.”

This article has been revised to reflect the following correction:

Correction: February 17, 2013

An earlier version of this column misquoted Matthew Hansen, a columnist at The Omaha World-Herald, about the author of a profile on Edna Buchanan, a crime writer. Mr. Hansen said the writer of the profile was Calvin Trillin, not Gay Talese. 

Read More..

Global Update: New Polio Strains That Protect Vaccine Factory Workers

Scientists have created new strains of polio intended to protect workers in factories that make polio vaccine. The new strains have the same ability to invoke an immune reaction as the live viruses now used to make vaccine do, but there is virtually no risk anyone will get polio if one of the new strains somehow escapes.

The research team, at the State University of New York at Stonybrook, is led by Eckard A. F. Wimmer, a molecular geneticist who made headlines in 1991 when he synthesized polio virus in the lab from its chemical components, the first time a virus had been made outside of living cells.

The world is very close to eliminating polio, which is now endemic to only three countries: Afghanistan, Nigeria and Pakistan. But to be sure the disease is gone, children will have to be vaccinated for several years after the last detected case.

Currently, factories making the injectable Salk vaccine used in the United States and Europe start with the dangerous wild-type viruses known as Types 1, 2 and 3. After growing a large batch, vaccine makers “kill” the virus with formaldehyde and prepare it for syringes. The finished product is safe, but if the growing live viruses ever escaped “because of a leak, an explosion, an earthquake, a tsunami, a flood,” Dr. Wimmer said, “the spill could spread like wildfire.”

Right now, polio eradication depends on large sweeps by volunteers putting drops of the oral Sabin vaccine into children’s mouths. It is easy to give, and it produces better immunity because it reaches the intestines, which are lined with receptors for the virus.

The Sabin vaccine has drawbacks, however: it contains a still-live virus that was mutated long ago so that it is usually too weak to produce disease. In rare cases, it can mutate back into a dangerous form that paralyzes or kills. And the vaccine is risky in children with immune-system problems. For those reasons, the World Health Organization plans to eventually phase it out.

Once that happens, factories around the world will have to make millions more doses of the injectable version, so five years ago, the W.H.O. began looking for safer seed strains of virus.

Dr. Wimmer and colleagues took a part of the virus’s RNA that is crucial for growth, mutated it to weaken it, and inserted it in another stretch of RNA that controls how virulent the virus is. That renders the virus less lethal. “If it were to get into the brain, it doesn’t do any harm,” he said.

And, he explained, even if the virus evolved to defeat that virulence-lowering mutation, it would simultaneously cripple its own ability to reproduce.

Now Dr. Wimmer’s team is working with the Crucell vaccine company to prove that the safer strains grow well in Crucell’s proprietary human cell line. Ideally, he said, the new vaccine will eventually be mixed with others like those for measles and diphtheria, and all will be delivered together in one painless shot by a jet injector.

Read More..

Well: Susan Love's Illness Gives New Focus to Her Cause

During a talk last spring in San Francisco, Dr. Susan Love, the well-known breast cancer book author and patient advocate, chided the research establishment for ignoring the needs of people with cancer. “The only difference between a researcher and a patient is a diagnosis,” she told the crowd. “We’re all patients.”

It was an eerily prescient lecture. Less than two months later, Dr. Love was given a diagnosis of acute myelogenous leukemia. She had no obvious symptoms and learned of her disease only after a checkup and routine blood work.

“Little did I know I was talking about myself,” she said in an interview. “It was really out of the blue. I was feeling fine. I ran five miles the day before.”

Dr. Love, a surgeon, is best known as the author of the top-selling “Dr. Susan Love’s Breast Book” (Da Capo Press, 2010) now in its fifth edition. She is also president of the Dr. Susan Love Research Foundation, which focuses on breast cancer prevention and research into eradicating the disease. But after decades of tireless advocacy on behalf of women with breast cancer, Dr. Love found herself in an unfamiliar role with an unfamiliar disease.

“There is a sense of shock when it happens to you,” she said. “In some ways I would have been less shocked if I got breast cancer because it’s so common, but getting leukemia was a world I didn’t know. Even when you’re a physician, when you get shocking news like this you sort of forget everything you know and are scared the same as everybody else.”

Because Dr. Love’s disease was caught early, she had a little time to seek second opinions and choose her medical team. She chose City of Hope in Duarte, Calif., because of its extensive experience in bone marrow transplants. At 65, Dr. Love was startled to learn she was considered among the “elderly” patients for this type of leukemia.

She was admitted to the hospital and underwent chemotherapy. Because her blood counts did not rebound after the treatment, her stay lasted a grueling seven weeks.

She went home for just two weeks, and then returned to the hospital for a bone-marrow transplant, with marrow donated by her younger sister, Elizabeth Love De Graci, 53, who lives in Mexico City.

Although the transplant itself was uneventful, the next four weeks were an ordeal. Dr. Love developed pain and neuropathy from the chemotherapy drugs. Dr. Love’s wife, Dr. Helen Cooksey; daughter, Katie Love-Cooksey, 24; and siblings offered round-the-clock support. Ms. Love-Cooksey slept in the hospital every night. “I wasn’t very articulate during that time, but I always had my family there,” Dr. Love said. “They were great advocates for me.”

The transplant “is quite an amazing thing,” Dr. Love said. Her blood type changed from O positive to B positive, the same type as her sister. She also has inherited her sister’s immune system, and a lifelong allergy to nickel has disappeared. “I can wear cheap jewelry now,” she said. She returned to work last month.

Dr. Love has been told her disease is in remission, though her immune system remains compromised and she is more susceptible to infection. So she avoids crowds, air travel and other potential sources of cold and flu viruses.

While Dr. Love has always been a strong advocate for women undergoing cancer treatment, she says her disease and treatment has strengthened her understanding of what women with breast cancer and other types of cancer go through during treatments.

“There are little things like having numb toes or having less stamina to building muscles back up after a month of bed rest,” she said. “There is significant collateral damage from the treatment that is underestimated by the medical profession. There’s a sense of ‘You’re lucky to be alive, so why are you complaining?’ ”

Dr. Love says her experience has emboldened her in her quest to focus on the causes of disease rather than new drugs to treat it.

“I think I’m more impatient now and in more of a hurry,” she said. “I’ve been reminded that you don’t know how long you have. There are women being diagnosed every day. We don’t have the luxury to sit around and come up with a new marketing scheme. We have to get rid of this disease, and there is no reason we can’t do it.”

People who remain skeptical about the ability to eradicate breast cancer should look to the history of cervical cancer, she said. Decades ago, a woman with an abnormal Pap smear would be advised to undergo hysterectomy. Now a vaccine exists that can protect women from the infection that causes most cervical cancers.

“We need to focus more on the cause of breast cancer,” she said. “I’m still very impressed with the fact that cancer of the cervix went from being a disease that robbed women of their fertility, if not their lives, to having a vaccine to prevent it.”

Dr. Love, who wrote a book called “Live a Little!,” said illness has also made her grateful that she didn’t put off her “bucket list” and that she has traveled the world and focused on work she finds challenging and satisfying.

“It just reminds you that none of us are going to get out of here alive, and we don’t know how much time we have,” she said. “I say this to my daughter, whether it’s changing the world or having a good time, that we should do what we want to do. I drink the expensive wine now.”

Read More..

The Media Equation: In Omaha Manhole Fire Photo, Logging Off in Search of Some Clues

Stephanie Sands

This image, which was taken after an underground fire cut power in half of downtown Omaha, captivated the Web last month.

When photographs of spontaneous events miraculously appear on the Web, it generally prompts two responses: wonder and skepticism.

Matt Miller/Omaha World-Herald

Matthew Hansen, a columnist at The Omaha World-Herald, showed how to follow a trail. 

So it was with an image of exploding manhole covers in Omaha that took over the Web last month. On Sunday, Jan. 27, an underground fire cut power in half of downtown. A vivid photograph of unknown provenance, showing fire shooting out of manholes on a city street, began popping up on Reddit, where it had 1.5 million views, and Gawker.

The photo — an indifferently composed shot of an event that looks very far away — would not win any Pulitzers, but something incredible seems to be under way at the precise moment it was taken. You can almost hear the sequential explosions emanating below the street: boom, boom, boom as flames appear to shoot up from hell itself.

In this age of Photoshop, it wasn’t long before the debates cropped up, on the Web and in Omaha, about the picture’s authenticity.

Matthew Hansen, a columnist at The Omaha World-Herald, wondered the same thing, and one night found himself in a bar engaged in the real-versus-fake debate. Like many photos on the Web, this one came from everywhere — forwarded, tweeted and blogged — and nowhere — there was no name on the image nor any text to indicate its origin.

Mr. Hansen, intrepid journalist that he is, solved the mystery and wrote a column about it. The photo was real, it turned out, but not in the way people thought. (More on that later.) So, did Mr. Hansen use deep photo analytics or examine metadata to peel back the truth?

Nope. There was a notebook involved, a lawyer, some phone calls, a cursory digital investigation and some street reporting, which included an interview with a man with no pants.

Shoe leather never looked or smelled so good.

Mr. Hansen’s first step in solving what he called the “Great Omaha Manhole Fire Photo of 2013” was to determine from the angle of the photo that it could have been taken from only one apartment building — called the Kensington Tower. He then used an architectural detail to conclude that it was shot from the top floor, on the west side.

He managed to gain entry to the building — that is, he sneaked in — and made his way to the top floor, where he began knocking on doors.

Mr. Hansen found a man named Kenneth who would not let Mr. Hansen in because he was indisposed — he became “Pantsless Kenneth” in the column — but said that he knew the photo in question and thought his neighbor had taken it.

But the neighbor wasn’t home, so Mr. Hansen stuck his business card in the door jamb and left.

When he returned to the office, Mr. Hansen jumped onto Reddit, found the person who had originally posted the photo there and through him found the person, Gwendolyn Olney, who had posted the photo on her Facebook page, the source for the Reddit posting.

Ms. Olney happened to be the associate counsel for The World-Herald. “Omaha is indeed a small town,” Mr. Hansen wrote in his column. He began to follow the pixilated bread crumbs.

“Gwen didn’t take the photo,” he added. “She got it from Rebecca, who didn’t take the photo. She got it from Brandon, who didn’t take the photo. They led me to Gwen’s friend Andrea, who didn’t take the photo, who led me to ... well, she couldn’t remember who she had gotten the photo from.”

Reading the column, you could almost hear his sigh when he wrote, “Dead end.”

Then his phone rang. “I took that photo,” the voice said.

The caller was Stephanie Sands, a graduate student at the University of Nebraska at Omaha. She said that the day after she took the photo, which she had no idea had become a sensation, she learned from her friends that a reporter was asking about it.

“I was impressed that he had sneaked upstairs and put a card in my door, so I called him,” she said in an interview by phone.

Ms. Sands agreed to meet Mr. Hansen and told him that she had heard the explosion and took two photos with her phone. She sent one to friends and thought nothing more of it.

“I was actually disappointed in how it turned out,” she told me. “Because I was shooting at a distance with an iPhone, it didn’t really capture the severity of what I saw and heard.”

This article has been revised to reflect the following correction:

Correction: February 17, 2013

An earlier version of this column misquoted Matthew Hansen, a columnist at The Omaha World-Herald, about the author of a profile on Edna Buchanan, a crime writer. Mr. Hansen said the writer of the profile was Calvin Trillin, not Gay Talese. 

Read More..

Protests at Egypt Port Close Offices, but Not Suez Canal

CAIRO — Thousands of demonstrators shut down the administrative buildings of the Suez Canal terminal in the city of Port Said on Sunday, as part of a general strike protesting the death sentences handed down three weeks ago to 21 local soccer fans for their roles in a deadly riot last year.

The protests marked the closest that the chaos in Egypt over the last two years has come to threatening the operations of the Suez Canal, an artery of shipping critical to both international commerce and the battered Egyptian economy.

The administrative facilities were emptied as the protesters approached, residents said, but a military guard protected the port from disruption. President Mohamed Morsi, of the Muslim Brotherhood’s political arm, had deployed the military to protect the city when the protests there started three weeks ago.

The success of the strike, as life had begun to return to the streets, was a vivid reminder that the government in Cairo has not yet restored full control over Port Said, a major city at the Mediterranean head of the Suez Canal with a population of about 600,000. The government essentially backed down from its attempt to impose a curfew, and nothing has diminished the underlying anger behind the riots, first over the initial death sentences and then over the deaths of dozens of protesters in clashes with the police.

The possibility of a threat to the flow of traffic through the canal remains remote, but the Sunday protest raised the specter of such disruption at a critical time. Political turbulence has cut deeply into tourism and economic growth in the two years since the ouster of Hosni Mubarak. And now the political instability keeps delaying a proposed $4.8 billion loan from the International Monetary Fund, whose seal of approval is essential to obtaining the further billions in loans needed to close the country’s deficit.

The Egyptian pound is falling sharply against the dollar. Unemployment is high and prices are rising. The Suez Canal is one of Egypt’s main sources of hard currency, along with tourism, foreign aid, and remittances from Egyptians abroad.

The protest was also a rare example of major civil disobedience in Egypt since the revolution that overthrew Mr. Mubarak in early 2011. It was the first day of the work week here, and Egyptian state media and residents of Port Said said that demonstrators had gathered outside the provincial headquarters at 7 a.m., blocking access to the building.

The protesters urged employees of the provincial government, the court house, the telephone and natural gas utilities, customs offices and other government institutions to quit work and join their strike. Many did, the Web site of the state newspaper Al Ahram reported. Protesters blocked railways. Photographs that circulated on the Internet showed women sitting on desks they had dragged outside in a shutdown of a school, although residents said some schools and courts remained opened.

Al Ahram reported that the demonstrators were demanding legal action against police officers who had killed protesters during last month’s clashes. They also sought a review by a “neutral court” of the death sentences against the local soccer fans delivered in Cairo. The soccer brawl in the case took place at a match between bitter rivals, El Masry of Port Said and Al Ahly of Cairo, both of which have large followings of violent hard-core fans. Many residents of Port Said say they believe the sentencing judge succumbed to pressure from violent Cairo soccer fans who demanded retribution.

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A Game Aims to Draw Attention to Women’s Issues

Social cause gaming, or the use of games to promote awareness of societal problems, has been growing as a result of online projects like Food Force, the United Nations World Food Program’s 2005 game about confronting famine, and Darfur Is Dying, MTV’s 2006 offering in which players navigate the terrors of a Sudanese refugee camp.

Subsequent games have raised awareness of subjects like H.I.V., sex trafficking and political conflicts, among others.

On March 4, a new game on Facebook, inspired by the book “Half the Sky: Turning Oppression into Opportunity for Women Worldwide,” will be introduced, with a focus on raising awareness of female genital mutilation and child prostitution.

Half the Sky Movement: The Game, more than three years in the making, is one of the most ambitious efforts yet to entice a mass audience to social media games with the goal of social change. It is a concept, however, that even its supporters say is largely untested.

The game seeks to engage new audiences not reached by the 2009 book, written by the married team of Nicholas D. Kristof, a columnist for The New York Times, and Sheryl WuDunn, a former Times journalist. A spinoff four-hour documentary was broadcast on PBS in October, drawing 5.1 million viewers over two nights, with a four-hour sequel coming in fall 2014.

Even more directly than is possible with the book and television program, the game’s producers hope to draw in the public — in particular, women with an average age of 39 who play Facebook games.

The central character, an Indian woman named Radhika, faces various challenges with the assistance of players, who can help out with donations of virtual goods, for example. The players can then make equivalent real-world donations to seven nonprofit organizations woven into the game. Ten dollars, for example, will buy a goat for Heifer International; $20 will help support United Nations Foundation immunization efforts.

To further engage players, those who reach predesignated levels unlock donations from Johnson & Johnson and Pearson, which have each contributed $250,000 to buy real-world operations from the Fistula Foundation and books for Room to Read, respectively.

If the Half the Sky game takes off and the money is claimed quickly, the producers hope other sponsors will step in, said Michelle Byrd, co-president of Games for Change, a nonprofit that promotes the creation of so-called social impact games and is the game’s executive producer, along with Show of Force Productions.

Asi Burak, also co-president of Games for Change, said the hope is to draw two million to five million players, persuading 5 percent or more to donate. Players can play at no charge, but they will make faster progress through donations.

Those usage figures would put the game in the top rungs of social cause gaming. Recently, developers of games like the virtual city-building WeTopia have shifted to a Facebook platform, to encourage social sharing, and linked the games to player-controlled real-world donations.

The genre is still new enough that “I think it’s an open question as to whether or not and to what degree people want to play a game that’s focused on a social issue,” said Ken Weber, executive director of Zynga.org, the nonprofit arm of Zynga, the company behind Facebook’s FarmVille game.

Zynga, which has raised $15 million for about 50 causes like Japanese earthquake relief through FarmVille, signed on to support the Half the Sky game, helping in its development and committing to promote it to the nearly 300 million Zynga users.

Zynga felt the game had “a fighting chance,” Mr. Weber said, because the content was compelling, there was already an established book and television property, financing was in hand — producers have raised $1 million — and Games for Change had hired “a commercial-grade developer,” the Canadian company Frima Studio of Quebec City.

Other supporters include the Ford, Rockefeller and United Nations foundations; Intel; and the National Endowment for the Arts, which last spring shifted grant money away from public television to an array of untested games.

The Half the Sky game starts out simply, as Radhika ponders how to afford a doctor visit for her sick daughter (the answer is to harvest mangoes, which players do for her). Each step requires players to answer a question — for example, should Radhika confront her husband or stay silent? Neither answer is wrong, but each takes players on a different route.

As Radhika moves across the globe to Kenya, Vietnam and Afghanistan, her empowerment grows. But many of the game choices get progressively darker. One leads to a mother living and her baby dying, and sometimes Radhika fails.

Still, some of the game’s nonprofit partners have pushed for even more verisimilitude, Ms. Byrd and Mr. Burak said, questioning, for one, why Radhika can read when many women in her situation would be illiterate.

Finding that balance — how much to simplify complicated issues, how much fun to include and how much to focus on positive solutions versus grave challenges — has consumed much of the development process, the producers said.

“It’ll be a very interesting test as to what people’s thresholds are,” said Mr. Weber, of Zynga.

Players who reach the final level learn about sex trafficking in the United States and can donate to an organization in New York called GEMS, or Girls Educational and Mentoring Services, which helps young women leave the commercial sex industry.

Rachel Lloyd, the organization’s founder, said that games were “a brave new world for us, too. We’re watching and seeing how this works, if people really do engage in the way that we’d like them to.”

She says she hopes users will be moved to call for more economic opportunities for women, or become a mentor. “I do think we have to push people to step outside their comfort zone,” she said, “and move outside online into the real world.”

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