All the World’s a Game, and Business Is a Player

Congratulations. Reading the first paragraph of this article has earned you a badge.

If this made-up award makes you feel good about yourself, then you are on your way to understanding gamification, a business trend — some would say fad — that aims to infuse otherwise mundane activities with the excitement and instant feedback of video games.

Many businesses are using these game tricks to try to get people hooked on their products and services — and it is working, thanks to smartphones and the Internet.

Buying a cup of coffee? Foursquare, the social networking app that helped popularize the gamification idea, gives people virtual badges for checking in at a local cafe or restaurant.

Conserving energy? More than 75 utilities have begun using a service from a company called Opower that awards badges to customers when they reduce their energy consumption. Customers can compare their progress with their neighbors’ and broadcast their achievements on Facebook.

“I’m not going to lie — I hate those online game apps on Facebook. I delete them,” said Brett Little, who works for an environmental nonprofit group in Grand Rapids, Mich., and has been known to share his energy-saving progress online. “This one I really enjoy.”

Of course, people and businesses have long added game elements to parts of regular life. Parents reward their children for household work with gold-star stickers. Business travelers pump their fists when they hit elite traveler status on an airline.

But digital technologies like smartphones and cheap sensors have taken the phenomenon to a new level, especially among adults. Now, game concepts like points, badges and leader boards are so mainstream that they have become powerful motivators in many settings, even some incongruous ones. At a time when games are becoming ever more realistic, reality is becoming more gamelike.

“We have a tendency to be dismissive about games, but what we’re learning is that games in general are wonderfully powerful tools that can be applied in all sorts of serious contexts,” said Kevin Werbach, an associate professor at the Wharton School at the University of Pennsylvania, who teaches a course on how businesses can use games and recently wrote a book on the subject.

The adoption of games has found particular resonance in the workplace, where games are no longer just a way to goof off.

Employers like Reed Elsevier, the publishing company, are using a Web-based game service from a company called Keas that encourages workers to stay healthy by grouping themselves into teams of six and collecting points for achieving mental and physical fitness goals. Among the challenges Keas assigns: laughing randomly for 30 seconds. The members of winning teams at Reed each get $200 gift cards.

Restaurants are using a service from a Boston start-up company called Objective Logistics to rank the performances of waiters on a leader board, rewarding the good ones with plum shifts and more lucrative tables. The company plans to add “karma points” that waiters can earn for picking up shifts from colleagues or otherwise being good teammates.

Even the Israel Defense Forces has embraced the concept as it tries to rally global support for its operations. Recently it raised eyebrows with a system that awards points and badges to visitors to its Web site if they share its messages on social networks, passing along blog posts like “How Does the I.D.F. Minimize Harm to Palestinian Civilians?”

Some tech bloggers criticized the system when they discovered it after the beginning of Israel’s recent military confrontation with Hamas, saying war and games did not mix.

Capt. Eytan Buchman, a spokesman for the I.D.F., said the game system was introduced in July, months before the conflict. It was intended to “expand the vibrant community of followers who are actively engaged in sharing and promoting I.D.F. content,” he said.

Doling out badges and points has its skeptics. Ian Bogost, a game designer and professor of interactive computing at the Georgia Institute of Technology, says the increasing use of games is little more than a fad promoted by marketing hucksters.

“It’s a concept being invented and mastered by speakers, conference organizers and business consultants in order to provide them with a short-lived burst of success,” said Dr. Bogost, who last year wrote an essay that, in its off-color title, bluntly dismissed gamification.

Gabe Zichermann, a gamification consultant and conference organizer, says he likes Dr. Bogost but, unsurprisingly, has a different point of view. He says making activities more like games is a kind of “homeopathic remedy” that, for example, can engage children who might otherwise be distracted by traditional video games.

“Games have made it hard for kids to focus to some extent and to do things like their chores,” Mr. Zichermann said. “We use game concepts to get them to focus on things.”

Kyle Kroll fits that description. After graduating from high school, Mr. Kroll said, he was unhappy, overweight, living at home and playing World of Warcraft at least six hours a day. He turned things around after starting to work out at a gym regularly with the help of a fitness app on his iPhone called Fitocracy, in which badges are awarded by a robot named Fred.

Mr. Kroll, who has lost about 75 pounds, says he plays video games less frequently now, but he still enjoys the gamelike challenges that the app sets for him at the gym. He said the game gave him “the same satisfaction of getting points and leveling up” that he gets from games.

Sheli Snawder and her 9-year-old daughter, Emma, also know how well embracing games can work. Ms. Snawder signed up for a service called Zamzee to encourage Emma to be more physically active.

Throughout the day, Emma wears a small motion sensor that records her activity level and rewards points for a brisk walk, an impromptu dance party in the living room and any other activity that gets her pulse thumping.

In her home in Salem, Ore., recently, Emma showed off the digital treats that the service’s Web site uses to inspire her, including a Persistence badge and Level 3 bronze medal status.

She can also use the virtual currency that she earns through exercising to get tangible rewards, like a video game system, from the site. “It’s very, very effective,” said her mother, who is studying to be a nurse.

Jesse Schell, a game designer and assistant professor of entertainment technology at Carnegie Mellon University, said game ideas were creeping into “every nook and cranny of everything” because reward systems are satisfying. “Our affluence has allowed us to move to a place where we tend to make things pleasurable, as opposed to efficient,” he said.

Read More..

The New Old Age Blog: Fudging the Facts, for Peace of Mind

Lou, my beloved grandfather, lived almost 101 years and obsessively worried every single day of his adult life — probably because his adult life began before it should have. As a child in Russia, he watched helplessly as his mother and sister were killed during a vicious pogrom in their village.

Lou (I called him Zadie) made his way to America, and immediately began imagining the worst about his fate, and his family’s fate, in his new country. I believe Zadie lived as long as he did because he was afraid of what would happen to his children, grandchildren, and great-grandchildren if he wasn’t here to protect them.

When I was a third-year medical student in New York City, he called from Denver very early one morning, waking me and my roommates. He had been listening to his transistor radio on one of his many sleepless nights of worry, and had heard that a Staten Island Ferry boat had crashed, injuring numerous passengers.

There were more than seven million people in the city, and Zadie called at 4 a.m. to make sure I wasn’t one of those injured. It was from him we learned the importance of telling white lies and omitting certain truths with our elderly parents and grandparents.

Before accusing me of infantilizing and patronizing my older family members, hear me out. Anxiety disorders can be debilitating for the elderly. A comprehensive review of the subject found 10 to14 percent of those 65 and older meet the criteria for these diagnoses, a significantly higher figure than for the more widely recognized depression syndromes in the same demographic.

Indeed, depression and anxiety disorders often occur together. Anxiety disorders are underdiagnosed in the elderly, largely because the symptoms are often assumed to be just another manifestation of aging. Additionally, the clinical assessment of the elderly for anxiety is more complicated than for younger patients because the signs may differ from those classically described in the diagnostic manuals.

A large national study showed an increased incidence of general anxiety disorder beginning after age 55, and the National Alliance on Mental Illness notes that, like depression, obsessive-compulsive disorder tends to worsen in old age. Factors contributing to the prevalence and severity of anxiety disorders in the elderly include a host of concomitant medical problems that interact with anxiety in a complicated way.

From the review article cited earlier:

The co-morbidity between medical illness and anxiety disorders poses difficulties for…diagnosis and detection of anxiety. Researchers have suggested that older adults may be more likely to attribute physical symptoms related to anxiety to medical issues… In turn, many physical conditions, such as cardiovascular disease, respiratory disease, hyperthyroidism, and pulmonary and vestibular difficulties, can mimic the symptoms of anxiety…making it difficult to establish the underlying cause…

Furthermore, the symptoms that result from medical illnesses may produce fearful bodily sensations that may result in the subsequent development of anxiety disorders.

As an example, more than 40 percent of patients with Parkinson’s disease meet the criteria for an anxiety disorder. Dementia is also associated with anxiety in a bidirectional way — anxiety can accelerate cognitive decline, which in turn can increase symptoms of anxiety. Added to this morass are the side effects, which can include anxiety, of many medications taken by older patients.

The elderly clearly are an at-risk population for anxiety disorders. Which brings us back to white lies. Zadie’s well-earned anxieties, obsessions and worries accelerated greatly as he got older, and we realized they could largely be prevented if we simply didn’t share the complete truth with him all the time. This became known in our family as the Zadie Filter.

When we took our children to the mountains, we told him we were headed to Colorado Springs; he’d been to Colorado Springs many times and knew it was a flat highway drive from Denver. No high mountain passes or narrow roads without guardrails.

When he begged my sons to become doctors so they would serve behind the front lines in the event they were drafted (this was long after the military draft ended, which was still not reassuring enough for Zadie), they so promised. When our daughter started driving, Zadie warned her it wasn’t safe for a girl to drive alone in case she had car trouble; she promised she would always have company in the car.

Zadie died when his great-grandchildren were still teenagers, and so he never had to know that the boys didn’t go into medicine and that his great-granddaughter drives alone.

My mother, Zadie’s daughter, inherited his anxieties, and as she has entered her mid-80s her symptoms have also markedly increased. On the other side of the family, my mother-in-law’s issues with anxiety began with her Parkinson’s disease and have worsened as her neurological condition has progressed.

With our mothers, we also rely on the Zadie Filter. Our white lies and omissions reduce their worries — which is not to say we can protect them from all triggers (they still read the newspaper and watch the nightly news), but even a bit of relief for them is relief for us as well.

Our parents live for the most part on fixed incomes, so when we’re able to cover some of their expenses without their knowing, we do so, and they worry a little less about their bills. All it takes is a little white lie: “The apartment manager waived your heating bill this month because you’ve been such a good long-term tenant,” or, “Of course I used your credit card when I paid for your medicines.”

My mother accidentally found out that our son broke his finger (playing flag football during finals week!) when a well-intentioned friend asked her how her grandson was doing after his injury. She was upset we hadn’t told her — but only for a few moments, until we explained that it had happened a week before, that he was all splinted up and was in no pain. All of which was 100 percent true, and she didn’t lose a minute of sleep worrying about it.

Last week, after pressing our law student son (he of the broken finger) about a school transcript issue I’ve been worried about for him, he assured me it had been taken care of. Our daughter in grad school goes into bars only when she’s with a large group of friends, and our college son is the designated driver for all of his fraternity functions.

And so it begins.

---

Dr. Harley A. Rotbart is professor and vice chairman of pediatrics at the University of Colorado School of Medicine and the author of “No Regrets Parenting.”

Read More..

The New Old Age Blog: Fudging the Facts, for Peace of Mind

Lou, my beloved grandfather, lived almost 101 years and obsessively worried every single day of his adult life — probably because his adult life began before it should have. As a child in Russia, he watched helplessly as his mother and sister were killed during a vicious pogrom in their village.

Lou (I called him Zadie) made his way to America, and immediately began imagining the worst about his fate, and his family’s fate, in his new country. I believe Zadie lived as long as he did because he was afraid of what would happen to his children, grandchildren, and great-grandchildren if he wasn’t here to protect them.

When I was a third-year medical student in New York City, he called from Denver very early one morning, waking me and my roommates. He had been listening to his transistor radio on one of his many sleepless nights of worry, and had heard that a Staten Island Ferry boat had crashed, injuring numerous passengers.

There were more than seven million people in the city, and Zadie called at 4 a.m. to make sure I wasn’t one of those injured. It was from him we learned the importance of telling white lies and omitting certain truths with our elderly parents and grandparents.

Before accusing me of infantilizing and patronizing my older family members, hear me out. Anxiety disorders can be debilitating for the elderly. A comprehensive review of the subject found 10 to14 percent of those 65 and older meet the criteria for these diagnoses, a significantly higher figure than for the more widely recognized depression syndromes in the same demographic.

Indeed, depression and anxiety disorders often occur together. Anxiety disorders are underdiagnosed in the elderly, largely because the symptoms are often assumed to be just another manifestation of aging. Additionally, the clinical assessment of the elderly for anxiety is more complicated than for younger patients because the signs may differ from those classically described in the diagnostic manuals.

A large national study showed an increased incidence of general anxiety disorder beginning after age 55, and the National Alliance on Mental Illness notes that, like depression, obsessive-compulsive disorder tends to worsen in old age. Factors contributing to the prevalence and severity of anxiety disorders in the elderly include a host of concomitant medical problems that interact with anxiety in a complicated way.

From the review article cited earlier:

The co-morbidity between medical illness and anxiety disorders poses difficulties for…diagnosis and detection of anxiety. Researchers have suggested that older adults may be more likely to attribute physical symptoms related to anxiety to medical issues… In turn, many physical conditions, such as cardiovascular disease, respiratory disease, hyperthyroidism, and pulmonary and vestibular difficulties, can mimic the symptoms of anxiety…making it difficult to establish the underlying cause…

Furthermore, the symptoms that result from medical illnesses may produce fearful bodily sensations that may result in the subsequent development of anxiety disorders.

As an example, more than 40 percent of patients with Parkinson’s disease meet the criteria for an anxiety disorder. Dementia is also associated with anxiety in a bidirectional way — anxiety can accelerate cognitive decline, which in turn can increase symptoms of anxiety. Added to this morass are the side effects, which can include anxiety, of many medications taken by older patients.

The elderly clearly are an at-risk population for anxiety disorders. Which brings us back to white lies. Zadie’s well-earned anxieties, obsessions and worries accelerated greatly as he got older, and we realized they could largely be prevented if we simply didn’t share the complete truth with him all the time. This became known in our family as the Zadie Filter.

When we took our children to the mountains, we told him we were headed to Colorado Springs; he’d been to Colorado Springs many times and knew it was a flat highway drive from Denver. No high mountain passes or narrow roads without guardrails.

When he begged my sons to become doctors so they would serve behind the front lines in the event they were drafted (this was long after the military draft ended, which was still not reassuring enough for Zadie), they so promised. When our daughter started driving, Zadie warned her it wasn’t safe for a girl to drive alone in case she had car trouble; she promised she would always have company in the car.

Zadie died when his great-grandchildren were still teenagers, and so he never had to know that the boys didn’t go into medicine and that his great-granddaughter drives alone.

My mother, Zadie’s daughter, inherited his anxieties, and as she has entered her mid-80s her symptoms have also markedly increased. On the other side of the family, my mother-in-law’s issues with anxiety began with her Parkinson’s disease and have worsened as her neurological condition has progressed.

With our mothers, we also rely on the Zadie Filter. Our white lies and omissions reduce their worries — which is not to say we can protect them from all triggers (they still read the newspaper and watch the nightly news), but even a bit of relief for them is relief for us as well.

Our parents live for the most part on fixed incomes, so when we’re able to cover some of their expenses without their knowing, we do so, and they worry a little less about their bills. All it takes is a little white lie: “The apartment manager waived your heating bill this month because you’ve been such a good long-term tenant,” or, “Of course I used your credit card when I paid for your medicines.”

My mother accidentally found out that our son broke his finger (playing flag football during finals week!) when a well-intentioned friend asked her how her grandson was doing after his injury. She was upset we hadn’t told her — but only for a few moments, until we explained that it had happened a week before, that he was all splinted up and was in no pain. All of which was 100 percent true, and she didn’t lose a minute of sleep worrying about it.

Last week, after pressing our law student son (he of the broken finger) about a school transcript issue I’ve been worried about for him, he assured me it had been taken care of. Our daughter in grad school goes into bars only when she’s with a large group of friends, and our college son is the designated driver for all of his fraternity functions.

And so it begins.

---

Dr. Harley A. Rotbart is professor and vice chairman of pediatrics at the University of Colorado School of Medicine and the author of “No Regrets Parenting.”

Read More..

All the World’s a Game, and Business Is a Player

Congratulations. Reading the first paragraph of this article has earned you a badge.

If this made-up award makes you feel good about yourself, then you are on your way to understanding gamification, a business trend — some would say fad — that aims to infuse otherwise mundane activities with the excitement and instant feedback of video games.

Many businesses are using these game tricks to try to get people hooked on their products and services — and it is working, thanks to smartphones and the Internet.

Buying a cup of coffee? Foursquare, the social networking app that helped popularize the gamification idea, gives people virtual badges for checking in at a local cafe or restaurant.

Conserving energy? More than 75 utilities have begun using a service from a company called Opower that awards badges to customers when they reduce their energy consumption. Customers can compare their progress with their neighbors’ and broadcast their achievements on Facebook.

“I’m not going to lie — I hate those online game apps on Facebook. I delete them,” said Brett Little, who works for an environmental nonprofit group in Grand Rapids, Mich., and has been known to share his energy-saving progress online. “This one I really enjoy.”

Of course, people and businesses have long added game elements to parts of regular life. Parents reward their children for household work with gold-star stickers. Business travelers pump their fists when they hit elite traveler status on an airline.

But digital technologies like smartphones and cheap sensors have taken the phenomenon to a new level, especially among adults. Now, game concepts like points, badges and leader boards are so mainstream that they have become powerful motivators in many settings, even some incongruous ones. At a time when games are becoming ever more realistic, reality is becoming more gamelike.

“We have a tendency to be dismissive about games, but what we’re learning is that games in general are wonderfully powerful tools that can be applied in all sorts of serious contexts,” said Kevin Werbach, an associate professor at the Wharton School at the University of Pennsylvania, who teaches a course on how businesses can use games and recently wrote a book on the subject.

The adoption of games has found particular resonance in the workplace, where games are no longer just a way to goof off.

Employers like Reed Elsevier, the publishing company, are using a Web-based game service from a company called Keas that encourages workers to stay healthy by grouping themselves into teams of six and collecting points for achieving mental and physical fitness goals. Among the challenges Keas assigns: laughing randomly for 30 seconds. The members of winning teams at Reed each get $200 gift cards.

Restaurants are using a service from a Boston start-up company called Objective Logistics to rank the performances of waiters on a leader board, rewarding the good ones with plum shifts and more lucrative tables. The company plans to add “karma points” that waiters can earn for picking up shifts from colleagues or otherwise being good teammates.

Even the Israel Defense Forces has embraced the concept as it tries to rally global support for its operations. Recently it raised eyebrows with a system that awards points and badges to visitors to its Web site if they share its messages on social networks, passing along blog posts like “How Does the I.D.F. Minimize Harm to Palestinian Civilians?”

Some tech bloggers criticized the system when they discovered it after the beginning of Israel’s recent military confrontation with Hamas, saying war and games did not mix.

Capt. Eytan Buchman, a spokesman for the I.D.F., said the game system was introduced in July, months before the conflict. It was intended to “expand the vibrant community of followers who are actively engaged in sharing and promoting I.D.F. content,” he said.

Doling out badges and points has its skeptics. Ian Bogost, a game designer and professor of interactive computing at the Georgia Institute of Technology, says the increasing use of games is little more than a fad promoted by marketing hucksters.

“It’s a concept being invented and mastered by speakers, conference organizers and business consultants in order to provide them with a short-lived burst of success,” said Dr. Bogost, who last year wrote an essay that, in its off-color title, bluntly dismissed gamification.

Gabe Zichermann, a gamification consultant and conference organizer, says he likes Dr. Bogost but, unsurprisingly, has a different point of view. He says making activities more like games is a kind of “homeopathic remedy” that, for example, can engage children who might otherwise be distracted by traditional video games.

“Games have made it hard for kids to focus to some extent and to do things like their chores,” Mr. Zichermann said. “We use game concepts to get them to focus on things.”

Kyle Kroll fits that description. After graduating from high school, Mr. Kroll said, he was unhappy, overweight, living at home and playing World of Warcraft at least six hours a day. He turned things around after starting to work out at a gym regularly with the help of a fitness app on his iPhone called Fitocracy, in which badges are awarded by a robot named Fred.

Mr. Kroll, who has lost about 75 pounds, says he plays video games less frequently now, but he still enjoys the gamelike challenges that the app sets for him at the gym. He said the game gave him “the same satisfaction of getting points and leveling up” that he gets from games.

Sheli Snawder and her 9-year-old daughter, Emma, also know how well embracing games can work. Ms. Snawder signed up for a service called Zamzee to encourage Emma to be more physically active.

Throughout the day, Emma wears a small motion sensor that records her activity level and rewards points for a brisk walk, an impromptu dance party in the living room and any other activity that gets her pulse thumping.

In her home in Salem, Ore., recently, Emma showed off the digital treats that the service’s Web site uses to inspire her, including a Persistence badge and Level 3 bronze medal status.

She can also use the virtual currency that she earns through exercising to get tangible rewards, like a video game system, from the site. “It’s very, very effective,” said her mother, who is studying to be a nurse.

Jesse Schell, a game designer and assistant professor of entertainment technology at Carnegie Mellon University, said game ideas were creeping into “every nook and cranny of everything” because reward systems are satisfying. “Our affluence has allowed us to move to a place where we tend to make things pleasurable, as opposed to efficient,” he said.

Read More..

Envoy to Syria Brahimi Meets With President Assad

BEIRUT, Lebanon — The international envoy Lakhdar Brahimi met with President Bashar al-Assad of Syria on Monday and said he had presented “steps” to de-escalate the war, which he described as “still a reason for worry.”

The New York Times

A Syrian warplane was reported to have conducted airstrikes that killed dozens of people in Hilfaya, according to antigovernment activists in the area.

“We hope that all sides will work toward a solution, as the Syrian people want,” Mr. Brahimi said afterward in brief comments to reporters, according to the Reuters news agency.

Mr. Brahimi did not give any details of a specific proposal, but a member of Syria’s political opposition who said he had spoken with Mr. Brahimi’s aides said he was advocating a plan for a negotiated solution first proposed in June. The opposition member, Mohamed Sarmini, said the proposal would temporarily leave Mr. Assad in power while curbing his authority and creating a transitional government — an arrangement that the opposition has so far been unwilling to accept.

“It does not meet the demands of the revolution,” Mr. Sarmini said.

After the meeting, the official Syrian state news agency said Mr. Assad “stressed the Syrian government’s keenness” to pursue efforts that “preserve the sovereignty and independence of the homeland.”

Mr. Brahimi arrived in Damascus on Sunday as residents of the town of Halfaya, in western Syria, reported that dozens of people had been killed when a Syrian warplane dropped bombs on a bakery in the town.

The attack, and the number of casualties, could not be immediately confirmed. A local activist said he ran to the bakery soon after he heard a warplane and then explosions and the sound of ambulances. “There were bodies everywhere,” said the activist, who gave his name as Samer.

Photographs he took after the attack showed bodies in a heap on a bloody sidewalk outside a low-slung building, which was damaged but still standing. Amateur video of what the activists said was the aftermath of the attack showed a man sitting near a motorcycle, his arm twisted around his back, struggling to stand as people around him screamed. Roughly a dozen people could be seen on the ground, covered in dirt or debris from the building; some were wounded, and several appeared to be dead. Armed men wearing camouflage outfits were helping to move the bodies, which were placed on truck beds.

The reasons for the attack were unclear, but activists speculated that it was a government response to the arrival of rebel fighters in Halfaya. The rebels occupied the town last week after embarking on a broad offensive to seize territory around the city of Hama, where the government has kept tight control after suppressing protests in the city last year. In several days of fighting, civilians have been caught between the warring sides, a volatile development in a part of the country where members of Syria’s many sects live among one another in neighboring villages.

Human rights groups have accused the government of indiscriminate attacks on or near bakeries in the past, especially in the northern city of Aleppo. In a three-week period in the summer, Human Rights Watch documented 10 separate bombings on bakeries in the city.

Mr. Brahimi’s visit was likely to increase speculation about a deal to remove Mr. Assad from power. The talk has grown as rebel forces have claimed gains near government strongholds.

Russia, one of Syria’s most reliable allies, has recently sent signals that it is distancing itself from the Syrian president. On Saturday, the Russian foreign minister, Sergey V. Lavrov, said several countries in the region had offered Mr. Assad asylum, but he added that Moscow would not mediate on their behalf.

It was the third visit to Syria by Mr. Brahimi since he assumed his post in August, and it occurred as fighting grew worse in the eastern and southern suburbs of Damascus, where rebel commanders say they are trying to establish staging grounds for attacks on the capital.

West-central Syria has become the latest front in the war, with the rebels attacking government checkpoints and other positions in an effort to disrupt the military’s supply lines and to push south from opposition strongholds in northern Syria. The offensive has led to growing fears for civilians in the area.

On Friday, a group of rebel fighters posted a video in which they threatened to shell Christian villages unless residents forced government loyalists to leave. Local church leaders have pleaded for peace and an end to sectarian strife.

Before the bombing on Sunday, Halfaya had been repeatedly shelled from loyalist positions in a nearby village, activists said.

In some photographs that Samer, the activist, said he took at the bakery, one fighter, with his hands resting on his head, stared in shock at the bodies around him. Another carried body parts. Bystanders searched for survivors under the rubble. Another man picked up a piece of bread lying next to someone’s slippers.

In amateur video apparently shot in a hospital, doctors tended to bleeding men lying on the floor, a teenage boy slumped against a wall and a woman lay on her side on a gurney. Antigovernment groups said 60 to 90 people were killed, but the toll was impossible to confirm. The bakery was one of three in the city, activists said. When word spread on Sunday that a flour shipment from Turkey had come in, people began lining up around noon, waiting for their turn at its windows for bread after a stretch of days when the bakeries had been idled.

After the bombings, rebel fighters released a statement vowing revenge.

Hala Droubi contributed reporting from Jidda, Saudi Arabia.

Read More..

Genetic Gamble : Drugs Aim to Make Several Types of Cancer Self-Destruct

C.J. Gunther for The New York Times

Dr. Donald Bergstrom is a cancer specialist at Sanofi, one of three companies working on a drug to restore a tendency of damaged cells to self-destruct.

For the first time ever, three pharmaceutical companies are poised to test whether new drugs can work against a wide range of cancers independently of where they originated — breast, prostate, liver, lung. The drugs go after an aberration involving a cancer gene fundamental to tumor growth. Many scientists see this as the beginning of a new genetic age in cancer research.

Great uncertainties remain, but such drugs could mean new treatments for rare, neglected cancers, as well as common ones. Merck, Roche and Sanofi are racing to develop their own versions of a drug they hope will restore a mechanism that normally makes badly damaged cells self-destruct and could potentially be used against half of all cancers.

No pharmaceutical company has ever conducted a major clinical trial of a drug in patients who have many different kinds of cancer, researchers and federal regulators say. “This is a taste of the future in cancer drug development,” said Dr. Otis Webb Brawley, the chief medical and scientific officer of the American Cancer Society. “I expect the organ from which the cancer came from will be less important in the future and the molecular target more important,” he added.

And this has major implications for cancer philanthropy, experts say. Advocacy groups should shift from fund-raising for particular cancers to pushing for research aimed at many kinds of cancer at once, Dr. Brawley said. John Walter, the chief executive officer of the Leukemia and Lymphoma Society, concurred, saying that by pooling forces “our strength can be leveraged.”

At the heart of this search for new cancer drugs are patients like Joe Bellino, who was a post office clerk until his cancer made him too sick to work. Seven years ago, he went into the hospital for hernia surgery, only to learn he had liposarcoma, a rare cancer of fat cells. A large tumor was wrapped around a cord that connects the testicle to the abdomen. “I was shocked,” he said in an interview this summer.

Companies have long ignored liposarcoma, seeing no market for drugs to treat a cancer that strikes so few. But it is ideal for testing Sanofi’s drug because the tumors nearly always have the exact genetic problem the drug was meant to attack — a fusion of two large proteins. If the drug works, it should bring these raging cancers to a halt. Then Sanofi would test the drug on a broad range of cancers with a similar genetic alteration. But if the drug fails against liposarcoma, Sanofi will reluctantly admit defeat.

“For us, this is a go/no-go situation,” said Laurent Debussche, a Sanofi scientist who leads the company’s research on the drug.

The genetic alteration the drug targets has tantalized researchers for decades. Normal healthy cells have a mechanism that tells them to die if their DNA is too badly damaged to repair. Cancer cells have grotesquely damaged DNA, so ordinarily they would self-destruct. A protein known as p53 that Dr. Gary Gilliland of Merck calls the cell’s angel of death normally sets things in motion. But cancer cells disable p53, either directly, with a mutation, or indirectly, by attaching the p53 protein to another cellular protein that blocks it. The dream of cancer researchers has long been to reanimate p53 in cancer cells so they will die on their own.

The p53 story began in earnest about 20 years ago. Excitement ran so high that, in 1993, Science magazine anointed it Molecule of the Year and put it on the cover. An editorial held out the possibility of “a cure of a terrible killer in the not too distant future.”

Companies began chasing a drug to restore p53 in cells where it was disabled by mutations. But while scientists know how to block genes, they have not figured out how to add or restore them. Researchers tried gene therapy, adding good copies of the p53 gene to cancer cells. That did not work.

Then, instead of going after mutated p53 genes, they went after half of cancers that used the alternative route to disable p53, blocking it by attaching it to a protein known as MDM2. When the two proteins stick together, the p53 protein no longer functions. Maybe, researchers thought, they could find a molecule to wedge itself between the two proteins and pry them apart.

The problem was that both proteins are huge and cling tightly to each other. Drug molecules are typically tiny. How could they find one that could separate these two bruisers, like a referee at a boxing match?

In 1996, researchers at Roche noticed a small pocket between the behemoths where a tiny molecule might slip in and pry them apart. It took six years, but Roche found such a molecule and named it Nutlin because the lab was in Nutley, N.J.

But Nutlins did not work as drugs because they were not absorbed into the body.

Roche, Merck and Sanofi persevered, testing thousands of molecules.

At Sanofi, the stubborn scientist leading the way, Dr. Debussche, maintained an obsession with p53 for two decades. Finally, in 2009, his team, together with Shaomeng Wang at the University of Michigan and a biotech company, Ascenta Therapeutics, found a promising compound.

The company tested the drug by pumping it each day into the stomachs of mice with sarcoma.

Read More..

Genetic Gamble : Drugs Aim to Make Several Types of Cancer Self-Destruct

C.J. Gunther for The New York Times

Dr. Donald Bergstrom is a cancer specialist at Sanofi, one of three companies working on a drug to restore a tendency of damaged cells to self-destruct.

For the first time ever, three pharmaceutical companies are poised to test whether new drugs can work against a wide range of cancers independently of where they originated — breast, prostate, liver, lung. The drugs go after an aberration involving a cancer gene fundamental to tumor growth. Many scientists see this as the beginning of a new genetic age in cancer research.

Great uncertainties remain, but such drugs could mean new treatments for rare, neglected cancers, as well as common ones. Merck, Roche and Sanofi are racing to develop their own versions of a drug they hope will restore a mechanism that normally makes badly damaged cells self-destruct and could potentially be used against half of all cancers.

No pharmaceutical company has ever conducted a major clinical trial of a drug in patients who have many different kinds of cancer, researchers and federal regulators say. “This is a taste of the future in cancer drug development,” said Dr. Otis Webb Brawley, the chief medical and scientific officer of the American Cancer Society. “I expect the organ from which the cancer came from will be less important in the future and the molecular target more important,” he added.

And this has major implications for cancer philanthropy, experts say. Advocacy groups should shift from fund-raising for particular cancers to pushing for research aimed at many kinds of cancer at once, Dr. Brawley said. John Walter, the chief executive officer of the Leukemia and Lymphoma Society, concurred, saying that by pooling forces “our strength can be leveraged.”

At the heart of this search for new cancer drugs are patients like Joe Bellino, who was a post office clerk until his cancer made him too sick to work. Seven years ago, he went into the hospital for hernia surgery, only to learn he had liposarcoma, a rare cancer of fat cells. A large tumor was wrapped around a cord that connects the testicle to the abdomen. “I was shocked,” he said in an interview this summer.

Companies have long ignored liposarcoma, seeing no market for drugs to treat a cancer that strikes so few. But it is ideal for testing Sanofi’s drug because the tumors nearly always have the exact genetic problem the drug was meant to attack — a fusion of two large proteins. If the drug works, it should bring these raging cancers to a halt. Then Sanofi would test the drug on a broad range of cancers with a similar genetic alteration. But if the drug fails against liposarcoma, Sanofi will reluctantly admit defeat.

“For us, this is a go/no-go situation,” said Laurent Debussche, a Sanofi scientist who leads the company’s research on the drug.

The genetic alteration the drug targets has tantalized researchers for decades. Normal healthy cells have a mechanism that tells them to die if their DNA is too badly damaged to repair. Cancer cells have grotesquely damaged DNA, so ordinarily they would self-destruct. A protein known as p53 that Dr. Gary Gilliland of Merck calls the cell’s angel of death normally sets things in motion. But cancer cells disable p53, either directly, with a mutation, or indirectly, by attaching the p53 protein to another cellular protein that blocks it. The dream of cancer researchers has long been to reanimate p53 in cancer cells so they will die on their own.

The p53 story began in earnest about 20 years ago. Excitement ran so high that, in 1993, Science magazine anointed it Molecule of the Year and put it on the cover. An editorial held out the possibility of “a cure of a terrible killer in the not too distant future.”

Companies began chasing a drug to restore p53 in cells where it was disabled by mutations. But while scientists know how to block genes, they have not figured out how to add or restore them. Researchers tried gene therapy, adding good copies of the p53 gene to cancer cells. That did not work.

Then, instead of going after mutated p53 genes, they went after half of cancers that used the alternative route to disable p53, blocking it by attaching it to a protein known as MDM2. When the two proteins stick together, the p53 protein no longer functions. Maybe, researchers thought, they could find a molecule to wedge itself between the two proteins and pry them apart.

The problem was that both proteins are huge and cling tightly to each other. Drug molecules are typically tiny. How could they find one that could separate these two bruisers, like a referee at a boxing match?

In 1996, researchers at Roche noticed a small pocket between the behemoths where a tiny molecule might slip in and pry them apart. It took six years, but Roche found such a molecule and named it Nutlin because the lab was in Nutley, N.J.

But Nutlins did not work as drugs because they were not absorbed into the body.

Roche, Merck and Sanofi persevered, testing thousands of molecules.

At Sanofi, the stubborn scientist leading the way, Dr. Debussche, maintained an obsession with p53 for two decades. Finally, in 2009, his team, together with Shaomeng Wang at the University of Michigan and a biotech company, Ascenta Therapeutics, found a promising compound.

The company tested the drug by pumping it each day into the stomachs of mice with sarcoma.

Read More..

Genetic Gamble : Drugs Aim to Make Several Types of Cancer Self-Destruct

C.J. Gunther for The New York Times

Dr. Donald Bergstrom is a cancer specialist at Sanofi, one of three companies working on a drug to restore a tendency of damaged cells to self-destruct.

For the first time ever, three pharmaceutical companies are poised to test whether new drugs can work against a wide range of cancers independently of where they originated — breast, prostate, liver, lung. The drugs go after an aberration involving a cancer gene fundamental to tumor growth. Many scientists see this as the beginning of a new genetic age in cancer research.

Great uncertainties remain, but such drugs could mean new treatments for rare, neglected cancers, as well as common ones. Merck, Roche and Sanofi are racing to develop their own versions of a drug they hope will restore a mechanism that normally makes badly damaged cells self-destruct and could potentially be used against half of all cancers.

No pharmaceutical company has ever conducted a major clinical trial of a drug in patients who have many different kinds of cancer, researchers and federal regulators say. “This is a taste of the future in cancer drug development,” said Dr. Otis Webb Brawley, the chief medical and scientific officer of the American Cancer Society. “I expect the organ from which the cancer came from will be less important in the future and the molecular target more important,” he added.

And this has major implications for cancer philanthropy, experts say. Advocacy groups should shift from fund-raising for particular cancers to pushing for research aimed at many kinds of cancer at once, Dr. Brawley said. John Walter, the chief executive officer of the Leukemia and Lymphoma Society, concurred, saying that by pooling forces “our strength can be leveraged.”

At the heart of this search for new cancer drugs are patients like Joe Bellino, who was a post office clerk until his cancer made him too sick to work. Seven years ago, he went into the hospital for hernia surgery, only to learn he had liposarcoma, a rare cancer of fat cells. A large tumor was wrapped around a cord that connects the testicle to the abdomen. “I was shocked,” he said in an interview this summer.

Companies have long ignored liposarcoma, seeing no market for drugs to treat a cancer that strikes so few. But it is ideal for testing Sanofi’s drug because the tumors nearly always have the exact genetic problem the drug was meant to attack — a fusion of two large proteins. If the drug works, it should bring these raging cancers to a halt. Then Sanofi would test the drug on a broad range of cancers with a similar genetic alteration. But if the drug fails against liposarcoma, Sanofi will reluctantly admit defeat.

“For us, this is a go/no-go situation,” said Laurent Debussche, a Sanofi scientist who leads the company’s research on the drug.

The genetic alteration the drug targets has tantalized researchers for decades. Normal healthy cells have a mechanism that tells them to die if their DNA is too badly damaged to repair. Cancer cells have grotesquely damaged DNA, so ordinarily they would self-destruct. A protein known as p53 that Dr. Gary Gilliland of Merck calls the cell’s angel of death normally sets things in motion. But cancer cells disable p53, either directly, with a mutation, or indirectly, by attaching the p53 protein to another cellular protein that blocks it. The dream of cancer researchers has long been to reanimate p53 in cancer cells so they will die on their own.

The p53 story began in earnest about 20 years ago. Excitement ran so high that, in 1993, Science magazine anointed it Molecule of the Year and put it on the cover. An editorial held out the possibility of “a cure of a terrible killer in the not too distant future.”

Companies began chasing a drug to restore p53 in cells where it was disabled by mutations. But while scientists know how to block genes, they have not figured out how to add or restore them. Researchers tried gene therapy, adding good copies of the p53 gene to cancer cells. That did not work.

Then, instead of going after mutated p53 genes, they went after half of cancers that used the alternative route to disable p53, blocking it by attaching it to a protein known as MDM2. When the two proteins stick together, the p53 protein no longer functions. Maybe, researchers thought, they could find a molecule to wedge itself between the two proteins and pry them apart.

The problem was that both proteins are huge and cling tightly to each other. Drug molecules are typically tiny. How could they find one that could separate these two bruisers, like a referee at a boxing match?

In 1996, researchers at Roche noticed a small pocket between the behemoths where a tiny molecule might slip in and pry them apart. It took six years, but Roche found such a molecule and named it Nutlin because the lab was in Nutley, N.J.

But Nutlins did not work as drugs because they were not absorbed into the body.

Roche, Merck and Sanofi persevered, testing thousands of molecules.

At Sanofi, the stubborn scientist leading the way, Dr. Debussche, maintained an obsession with p53 for two decades. Finally, in 2009, his team, together with Shaomeng Wang at the University of Michigan and a biotech company, Ascenta Therapeutics, found a promising compound.

The company tested the drug by pumping it each day into the stomachs of mice with sarcoma.

Read More..

Amazon Book Reviews Deleted in a Purge Aimed at Manipulation

Giving raves to family members is no longer acceptable. Neither is writers’ reviewing other writers. But showering five stars on a book you admittedly have not read is fine.

After several well-publicized cases involving writers buying or manipulating their reviews, Amazon is cracking down. Writers say thousands of reviews have been deleted from the shopping site in recent months.

Amazon has not said how many reviews it has killed, nor has it offered any public explanation. So its sweeping but hazy purge has generated an uproar about what it means to review in an era when everyone is an author and everyone is a reviewer.

Is a review merely a gesture of enthusiasm or should it be held to a higher standard? Should writers be allowed to pass judgment on peers the way they have always done offline or are they competitors whose reviews should be banned? Does a groundswell of raves for a new book mean anything if the author is soliciting the comments?

In a debate percolating on blogs and on Amazon itself, quite a few writers take a permissive view on these issues.

The mystery novelist J. A. Konrath, for example, does not see anything wrong with an author indulging in chicanery. “Customer buys book because of fake review = zero harm,” he wrote on his blog.

Some readers differ. An ad hoc group of purists has formed on Amazon to track its most prominent reviewer, Harriet Klausner, who has over 25,000 reviews. They do not see how she can read so much so fast or why her reviews are overwhelmingly — and, they say, misleadingly — exaltations.

“Everyone in this group will tell you that we’ve all been duped into buying books based on her reviews,” said Margie Brown, a retired city clerk from Arizona.

Once a populist gimmick, the reviews are vital to making sure a new product is not lost in the digital wilderness. Amazon has refined the reviewing process over the years, giving customers the opportunity to rate reviews and comment on them. It is layer after layer of possible criticism.

“A not-insubstantial chunk of their infrastructure is based on their reviews — and all of that depends on having reviews customers can trust,” said Edward W. Robertson, a science fiction novelist who has watched the debate closely.

Nowhere are reviews more crucial than with books, an industry in which Amazon captures nearly a third of every dollar spent. It values reviews more than other online booksellers like Apple or Barnes & Noble, featuring them prominently and using them to help decide which books to acquire for its own imprints by its relatively new publishing arm.

So writers have naturally been vying to get more, and better, notices. Several mystery writers, including R. J. Ellory, Stephen Leather and John Locke, have recently confessed to various forms of manipulation under the general category of “sock puppets,” or online identities used to deceive. That resulted in a widely circulated petition by a loose coalition of writers under the banner, “No Sock Puppets Here Please,” asking people to “vote for book reviews you can trust.”

In explaining its purge of reviews, Amazon has told some writers that “we do not allow reviews on behalf of a person or company with a financial interest in the product or a directly competing product. This includes authors.” But writers say that rule is not applied consistently.

In some cases, the ax fell on those with a direct relationship with the author.

“My sister’s and best friend’s reviews were removed from my books,” the author M. E. Franco said in a blog comment. “They happen to be two of my biggest fans.” Another writer, Valerie X. Armstrong, said her son’s five-star review of her book, “The Survival of the Fattest,” was removed. He immediately tried to put it back “and it wouldn’t take,” she wrote.

In other cases, though, the relationship was more tenuous. Michelle Gagnon lost three reviews on her young adult novel “Don’t Turn Around.” She said she did not know two of the reviewers, while the third was a longtime fan of her work. “How does Amazon know we know each other?” she said. “That’s where I started to get creeped out.”

Mr. Robertson suggested that Amazon applied a broad brush. “I believe they caught a lot of shady reviews, but a lot of innocent ones were erased, too,” he said. He figures the deleted reviews number in the thousands, or perhaps even 10,000.

The explosion of reviews for “The 4-Hour Chef” by Timothy Ferriss shows how the system has evolved from something spontaneous to a means of marketing and promotion. On Nov. 20, publication day, dozens of highly favorable reviews immediately sprouted. Other reviewers quickly criticized Mr. Ferriss, accusing him of buying supporters.

He laughed off those suggestions. “Not only would I never do that — it’s unethical — I simply don’t have to,” he wrote in an e-mail, saying he had sent several hundred review copies to fans and potential fans. “Does that stack the deck? Perhaps, but why send the book to someone who would hate it? That doesn’t help anyone: not the reader, nor the writer.”

As a demonstration of social media’s grip on reviewing, Mr. Ferriss used Twitter and Facebook to ask for a review. “Rallying my readers,” he called it. Within an hour, 61 had complied.

A few of his early reviews were written by people who admitted they had not read the book but were giving it five stars anyway because, well, they knew it would be terrific. “I am looking forward to reading this,” wrote a user posting under the name mhpics.

A spokesman for Amazon, which published “The 4-Hour Chef,” offered this sole comment for this article: “We do not require people to have experienced the product in order to review.”

The dispute over reviews is playing out in the discontent over Mrs. Klausner, an Amazon Hall of Fame reviewer for the last 11 years and undoubtedly one of the most prolific reviewers in literary history.

Mrs. Klausner published review No. 28,366, for “A Red Sun Also Rises” by Mark Hodder. Almost immediately, it had nine critical comments. The first accused it of being “riddled with errors in grammar, spelling and punctuation.” The rest were no more kind. The Harriet Klausner Appreciation Society had struck again.

Mrs. Klausner, a 60-year-old retired librarian who lives in Atlanta, has published an average of seven reviews a day for more than a decade. “To watch her in action is unbelievable,” said her husband, Stanley. “You see the pages turning.”

Mrs. Klausner, who says ailments keep her home and insomnia keeps her up, scoffs at her critics. “You ever read a Harlequin romance?” she said. “You can finish it in one hour. I’ve always been a speed reader.” She has a message for her naysayers: “Get a life. Read a book.”

More than 99.9 percent of Mrs. Klausner’s reviews are four or five stars. “If I can make it past the first 50 pages, that means I like it, and so I review it,” she said. But even Stanley said, “She’s soft, I won’t deny that.”

The campaign against Mrs. Klausner has pushed down her reviewer ratings, which in theory makes her less influential. But when everything is subject to review, the battle is never-ending.

Ragan Buckley, an aspiring novelist active in the campaign against Mrs. Klausner under the name “Sneaky Burrito,” is a little weary. “There are so many fake reviews that I’m often better off just walking into a physical store and picking an item off the shelf at random,” she said.

Read More..

India Ink: India Reacts to Tendulkar's Retirement from One-Day Cricket

The Indian batsman Sachin Tendulkar said Sunday that he was retiring from One Day International cricket.

“I have decided to retire from the One Day format of the game. I feel blessed to have fulfilled the dream of being part of a World Cup winning Indian team,” Tendulkar said in a statement released by the Board of Control for Cricket in India.

With the decision, Tendulkar, who enjoys Godlike stature for many in India and abroad, drew the curtain on a 23-year career in the format, called O.D.I., having played 463 O.D.I.s, scored 18,426 runs and made 49 centuries. He holds the record for being the highest run scorer in this format of the game and has also made the largest number of centuries, played the greatest number of games and, along with the former Indian batsman Rahul Dravid, holds the record for highest partnership (331 runs against New Zealand).

Understandably, his decision has left some very distraught Indian cricket fans, who expressed their grief and almost a sense of bereavement on Twitter and other social media platforms.

“Tendulkar retires from ODI. End of an era. For the past 20 years, we were fortunate to watch & enjoy some amazing cricket, thanks to him,” an orthodontist based in Malaysia, who uses the Twitter handle Sabarinathan, tweeted.

“Finally world Ended in 2012,” a reader named Ashish, from Pune, commented on a Times of India story about the retirement.

B.C.C.I. officials, however, seemed less than perturbed.

“Tendulkar’s decision is not a shocker for B.C.C.I. He was waiting for the right time,” Ratnakar Shetty, the chief administrative officer, told reporters. “What he has expressed is his concern that India has to prepare for the next World Cup. From that point of view, he felt that it was time that he retired.”

“A person of his caliber knows what to do. He has always taken the right decision at the right time. He will continue to do that in future as well,” Sanjay Jagdale, the board’s general secretary, told reporters.

Reaction from the cricketing community in India was mixed.

“Sachin tendulkar a great batsman.great human being.a great friend.great man to look up 2.proud indian.Real son of india.I salute u nd love u,” the cricketer Harbhajan Singh tweeted.

“He has done Indian cricket a favor…. He has played a great deal of cricket and noone can compare to him but all I can say is: better late than never,” the former Indian cricketer Kirti Azad said in an interview with the news channel ABP.

Some fans, too, lauded Tendular’s decision as the right move at the right time.

“A late, but correct decision by Tendulkar. He will be missed but time had come,” Imran Asghar, who according to his Twitter profile is a British Pakistani, tweeted.

Tendulkar, it seems, has a special connection with India’s archrival, Pakistan. He made his debut in O.D.I.’s, nearly two decades ago, against Pakistan on Dec. 18, 1989. His last O.D.I. was also against Pakistan, in Dhaka, Bangladesh, during the Asia Cup last March, where he scored 52 runs. India won the match.

Coincidentally his announcement came on a day that the Indian team for the two T20s and three O.D.I.’s with Pakistan, which will start next week, was announced.

“Sachin’s announcement has come as a big surprise,” Krishnamachari Srikkanth, former chairman of the selection committee for the Indian team, told news channel CNN-IBN. “I thought he would play in the one-day series against Pakistan.”

Despite a string of poor performances recently, Tendulkar bid adieu to his home audience in style. His last O.D.I. played in India was the World Cup final match against Sri Lanka in his hometown, Mumbai. India won the match and World Cup 2011, following a nearly three-decade wait after its 1983 World Cup victory.

“I would like to wish the team all the very best for the future. I am eternally grateful to all my well wishers for their unconditional support and love over the years,” he said in his statement.

However, he has announced no plans to retire from Test matches, the longer five-day format of the game.

Read More..