Oil Sand Industry in Canada Tied to Higher Carcinogen Level

Todd Korol/Reuters

An oil sands mine Fort McMurray, Alberta.

OTTAWA — The development of Alberta’s oil sands has increased levels of cancer-causing compounds in surrounding lakes well beyond natural levels, Canadian researchers reported in a study released on Monday. And they said the contamination covered a wider area than had previously been believed.

For the study, financed by the Canadian government, the researchers set out to develop a historical record of the contamination, analyzing sediment dating back about 50 years from six small and shallow lakes north of Fort McMurray, Alberta, the center of the oil sands industry. Layers of the sediment were tested for deposits of polycyclic aromatic hydrocarbons, or PAHs, groups of chemicals associated with oil that in many cases have been found to cause cancer in humans after long-term exposure.

“One of the biggest challenges is that we lacked long-term data,” said John P. Smol, the paper’s lead author and a professor of biology at Queen’s University in Kingston, Ontario. “So some in industry have been saying that the pollution in the tar sands is natural, it’s always been there.”

The researchers found that to the contrary, the levels of those deposits have been steadily rising since large-scale oil sands production began in 1978.

Samples from one test site, the paper said, now show 2.5 to 23 times more PAHs in current sediment than in layers dating back to around 1960.

“We’re not saying these are poisonous ponds,” Professor Smol said. “But it’s going to get worse. It’s not too late but the trend is not looking good.” He said that the wilderness lakes studied by the group were now contaminated as much as lakes in urban centers.

The study is likely to provide further ammunition to critics of the industry, who already contend that oil extracted from Canada’s oil sands poses environmental hazards like toxic sludge ponds, greenhouse gas emissions and the destruction of boreal forests.

Battles are also under way over the proposed construction of the Keystone XL pipeline, which would move the oil down through the western United States and down to refineries along the Gulf Coast, or an alternative pipeline that would transport the oil from landlocked Alberta to British Columbia for export to Asia.

The researchers, who included scientists at Environment Canada’s aquatic contaminants research division, chose to test for PAHs because they had been the subject of earlier studies, including one published in 2009 that analyzed the distribution of the chemicals in snowfall north of Fort McMurray. That research drew criticism from the government of Alberta and others for failing to provide a historical baseline.

“Now we have the smoking gun,” Professor Smol said.

He said he was not surprised that the analysis found a rise in PAH deposits after the industrial development of the oil sands, “but we needed the data.” He said he had not entirely expected, however, to observe the effect at the most remote test site, a lake that is about 50 miles to the north.

Asked about the study, Adam Sweet, a spokesman for Peter Kent, Canada’s environment minister, emphasized in an e-mail that with the exception of one lake very close to the oil sands, the levels of contaminants measured by the researchers “did not exceed Canadian guidelines and were low compared to urban areas.”

He added that an environmental monitoring program for the region announced last February 2012 was put into effect “to address the very concerns raised by such studies” and to “provide an improved understanding of the long-term cumulative effects of oil sands development.”

Earlier research has suggested several different ways that the chemicals could spread. Most oil sand production involve large-scale open-bit mining. The chemicals may become wind-borne when giant excavators dig them up and then deposit them into 400-ton dump trucks.

Upgraders at some oil sands projects that separate the oil bitumen from its surrounding sand are believed to emit PAHs. And some scientists believe that vast ponds holding wastewater from that upgrading and from other oil sand processes may be leaking PAHs and other chemicals into downstream bodies of water.

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Alarm in Albuquerque Over Plan to End Methadone for Inmates

Mark Holm for The New York Times

Officials at New Mexico’s largest jail want to end its methadone program. Addicts like Penny Strayer hope otherwise.

ALBUQUERQUE — It has been almost four decades since Betty Jo Lopez started using heroin.

Her face gray and wizened well beyond her 59 years, Ms. Lopez would almost certainly still be addicted, if not for the fact that she is locked away in jail, not to mention the cup of pinkish liquid she downs every morning.

“It’s the only thing that allows me to live a normal life,” Ms. Lopez said of the concoction, which contains methadone, a drug used to treat opiate dependence. “These nurses that give it to me, they’re like my guardian angels.”

For the last six years, the Metropolitan Detention Center, New Mexico’s largest jail, has been administering methadone to inmates with drug addictions, one of a small number of jails and prisons around the country that do so.

At this vast complex, sprawled out among the mesas west of downtown Albuquerque, any inmate who was enrolled at a methadone clinic just before being arrested can get the drug behind bars. Pregnant inmates addicted to heroin are also eligible.

Here in New Mexico, which has long been plagued by one of the nation’s worst heroin scourges, there is no shortage of participants — hundreds each year — who have gone through the program.

In November, however, the jail’s warden, Ramon Rustin, said he wanted to stop treating inmates with methadone. Mr. Rustin said the program, which had been costing Bernalillo County about $10,000 a month, was too expensive.

Moreover, Mr. Rustin, a former warden of the Allegheny County Jail in Pennsylvania and a 32-year veteran of corrections work, said he did not believe that the program truly worked.

Of the hundred or so inmates receiving daily methadone doses, he said, there was little evidence of a reduction in recidivism, one of the program’s main selling points.

“My concern is that the courts and other authorities think that jail has become a treatment program, that it has become the community provider,” he said. “But jail is not the answer. Methadone programs belong in the community, not here.”

Mr. Rustin’s public stance has angered many in Albuquerque, where drug addiction has been passed down through generations in impoverished pockets of the city, as it has elsewhere across New Mexico.

Recovery advocates and community members argue that cutting people off from methadone is too dangerous, akin to taking insulin from a diabetic.

The New Mexico office of the Drug Policy Alliance, which promotes an overhaul to drug policy, has implored Mr. Rustin to reconsider his stance, saying in a letter that he did not have the medical expertise to make such a decision.

Last month, the Bernalillo County Commission ordered Mr. Rustin to extend the program, which also relies on about $200,000 in state financing annually, for two months until its results could be studied further.

“Addiction needs to be treated like any other health issue,” said Maggie Hart Stebbins, a county commissioner who supports the program.

“If we can treat addiction at the jail to the point where they stay clean and don’t reoffend, that saves us the cost of reincarcerating that person,” she said.

Hard data, though, is difficult to come by — hence the county’s coming review.

Darren Webb, the director of Recovery Services of New Mexico, a private contractor that runs the methadone program, said inmates were tracked after their release to ensure that they remained enrolled at outside methadone clinics.

While the outcome was never certain, Mr. Webb said, he maintained that providing methadone to inmates would give them a better chance of staying out of jail once they were released. “When they get out, they won’t be committing the same crimes they would if they were using,” he said. “They are functioning adults.”

In a study published in 2009 in The Journal of Substance Abuse Treatment, researchers found that male inmates in Baltimore who were treated with methadone were far more likely to continue their treatment in the community than inmates who received only counseling.

Those who received methadone behind bars were also more likely to be free of opioids and cocaine than those who received only counseling or started methadone treatment after their release.

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Despite New Health Law, Some See Sharp Rise in Premiums

Health insurance companies across the country are seeking and winning double-digit increases in premiums for some customers, even though one of the biggest objectives of the Obama administration’s health care law was to stem the rapid rise in insurance costs for consumers.

Bob Chamberlin/Los Angeles Times

Dave Jones, the California insurance commissioner, said some insurance companies could raise rates as much as they did before the law was enacted.

Particularly vulnerable to the high rates are small businesses and people who do not have employer-provided insurance and must buy it on their own.

In California, Aetna is proposing rate increases of as much as 22 percent, Anthem Blue Cross 26 percent and Blue Shield of California 20 percent for some of those policy holders, according to the insurers’ filings with the state for 2013. These rate requests are all the more striking after a 39 percent rise sought by Anthem Blue Cross in 2010 helped give impetus to the law, known as the Affordable Care Act, which was passed the same year and will not be fully in effect until 2014.

 In other states, like Florida and Ohio, insurers have been able to raise rates by at least 20 percent for some policy holders. The rate increases can amount to several hundred dollars a month.

The proposed increases compare with about 4 percent for families with employer-based policies.

Under the health care law, regulators are now required to review any request for a rate increase of 10 percent or more; the requests are posted on a federal Web site, healthcare.gov, along with regulators’ evaluations.

The review process not only reveals the sharp disparity in the rates themselves, it also demonstrates the striking difference between places like New York, one of the 37 states where legislatures have given regulators some authority to deny or roll back rates deemed excessive, and California, which is among the states that do not have that ability.

New York, for example, recently used its sweeping powers to hold rate increases for 2013 in the individual and small group markets to under 10 percent. California can review rate requests for technical errors but cannot deny rate increases.

The double-digit requests in some states are being made despite evidence that overall health care costs appear to have slowed in recent years, increasing in the single digits annually as many people put off treatment because of the weak economy. PricewaterhouseCoopers estimates that costs may increase just 7.5 percent next year, well below the rate increases being sought by some insurers. But the companies counter that medical costs for some policy holders are rising much faster than the average, suggesting they are in a sicker population. Federal regulators contend that premiums would be higher still without the law, which also sets limits on profits and administrative costs and provides for rebates if insurers exceed those limits.

Critics, like Dave Jones, the California insurance commissioner and one of two health plan regulators in that state, said that without a federal provision giving all regulators the ability to deny excessive rate increases, some insurance companies can raise rates as much as they did before the law was enacted.

“This is business as usual,” Mr. Jones said. “It’s a huge loophole in the Affordable Care Act,” he said.

While Mr. Jones has not yet weighed in on the insurers’ most recent requests, he is pushing for a state law that will give him that authority. Without legislative action, the state can only question the basis for the high rates, sometimes resulting in the insurer withdrawing or modifying the proposed rate increase.

The California insurers say they have no choice but to raise premiums if their underlying medical costs have increased. “We need these rates to even come reasonably close to covering the expenses of this population,” said Tom Epstein, a spokesman for Blue Shield of California. The insurer is requesting a range of increases, which average about 12 percent for 2013.

Although rates paid by employers are more closely tracked than rates for individuals and small businesses, policy experts say the law has probably kept at least some rates lower than they otherwise would have been.

“There’s no question that review of rates makes a difference, that it results in lower rates paid by consumers and small businesses,” said Larry Levitt, an executive at the Kaiser Family Foundation, which estimated in an October report that rate review was responsible for lowering premiums for one out of every five filings.

Federal officials say the law has resulted in significant savings. “The health care law includes new tools to hold insurers accountable for premium hikes and give rebates to consumers,” said Brian Cook, a spokesman for Medicare, which is helping to oversee the insurance reforms.

“Insurers have already paid $1.1 billion in rebates, and rate review programs have helped save consumers an additional $1 billion in lower premiums,” he said. If insurers collect premiums and do not spend at least 80 cents out of every dollar on care for their customers, the law requires them to refund the excess.

As a result of the review process, federal officials say, rates were reduced, on average, by nearly three percentage points, according to a report issued last September.

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Scare Amplifies Fears That Clinton’s Work Has Taken Heavy Toll

Pool photo by Brendan Smialowski

Hillary Rodham Clinton with Field Marshal Mohamed Hussein Tantawi in Cairo in July.

WASHINGTON — When Secretary of State Hillary Rodham Clinton fractured her right elbow after slipping in a State Department garage in June 2009, she returned to work in just a few days. Her arm in a sling, she juggled speeches and a trip to India and Thailand with physical therapy, rebuilding a joint held together with wire and pins.

It was vivid evidence of Mrs. Clinton’s indomitable stamina and work ethic — as a first lady, senator, presidential candidate and, for the past four years, the most widely traveled secretary of state in American history.

But after a fall at home in December that caused a concussion, and a subsequent diagnosis of a blood clot in her head, it has taken much longer for Mrs. Clinton to bounce back. She was released from a hospital in New York on Wednesday, accompanied by her daughter, Chelsea, and her husband, former President Bill Clinton. On Thursday, she told colleagues that she hoped to be in the office next week.

Her health scare, though, has reinforced the concerns of friends and colleagues that the years of punishing work and travel have taken a heavy toll. Even among her peers at the highest levels of government, Mrs. Clinton, 65, is renowned for her grueling schedule. Over the past four years, she was on the road for 401 days and spent the equivalent of 87 full days on a plane, according to the State Department’s Web site.

In one 48-hour marathon in 2009 that her aides still talk about, she traveled from talks with Palestinian leaders in Abu Dhabi to a midnight meeting with Prime Minister Benjamin Netanyahu in Jerusalem, then boarded a plane for Morocco, staying up all night to work on other issues, before going straight to a meeting of Arab leaders the next morning.

“So many people who know her have urged me to tell her not to work so hard,” said Melanne S. Verveer, who was Mrs. Clinton’s chief of staff when she was first lady and is now the State Department’s ambassador at large for women’s issues. “Well, that’s not easy to do when you’re Hillary Clinton. She doesn’t spare herself.”

It is not just a matter of duty, Ms. Verveer and others said. Mrs. Clinton genuinely relishes the work, pursuing a brand of personal diplomacy that, she argues, requires her to travel to more places than her predecessors.

While there is no medical evidence that Mrs. Clinton’s clot was caused by her herculean work habits, her cascade of recent health problems, beginning with a stomach virus, has prompted those who know her best to say that she desperately needs a long rest. Her first order of business after leaving the State Department in the coming weeks, they say, should be to take care of herself.

Some even wonder whether this setback will — or should — temper the feverish speculation that she will make another run for the White House in 2016.

“I am amazed at the number of women who come up to me and tell me she must run for president,” said Ellen Chesler, a New York author and a friend of Mrs. Clinton’s. “But perhaps this episode will alter things a bit.”

Given Mrs. Clinton’s enduring status as a role model, Ms. Chesler said women would be watching which path she decides to take, as they plan their own transitions out of the working world.

“Do remember that women of our generation are really the first to have worked through the life cycle in large numbers,” she added. “Many seem to be approaching retirement with dread.”

For now, aides say, Mrs. Clinton’s focus is on wrapping up her work at the State Department. She would like to take part in a town hall-style meeting, thank her staff and sit for some interviews. But first she has to get clearance from her doctors, who are watching her to make sure that the blood thinners they have prescribed for her clot are working.

Speaking to a meeting of a foreign policy advisory board from her home in Chappaqua, N.Y., on Thursday, Mrs. Clinton said she was crossing her fingers and encouraging her doctors to let her return next week. “I’m trying to be a compliant patient,” she said, according to a person who was in the room. “But that does require a certain level of patience, which I’ve had to cultivate over the last three and a half weeks.”

While convalescing, Mrs. Clinton has spoken with President Obama and has held a 30-minute call with Senator John Kerry, Democrat of Massachusetts, whom Mr. Obama nominated as her successor.

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Scant Proof Is Found to Back Up Claims by Energy Drinks

Energy drinks are the fastest-growing part of the beverage industry, with sales in the United States reaching more than $10 billion in 2012 — more than Americans spent on iced tea or sports beverages like Gatorade.

Their rising popularity represents a generational shift in what people drink, and reflects a successful campaign to convince consumers, particularly teenagers, that the drinks provide a mental and physical edge.

The drinks are now under scrutiny by the Food and Drug Administration after reports of deaths and serious injuries that may be linked to their high caffeine levels. But however that review ends, one thing is clear, interviews with researchers and a review of scientific studies show: the energy drink industry is based on a brew of ingredients that, apart from caffeine, have little, if any benefit for consumers.

“If you had a cup of coffee you are going to affect metabolism in the same way,” said Dr. Robert W. Pettitt, an associate professor at Minnesota State University in Mankato, who has studied the drinks.

Energy drink companies have promoted their products not as caffeine-fueled concoctions but as specially engineered blends that provide something more. For example, producers claim that “Red Bull gives you wings,” that Rockstar Energy is “scientifically formulated” and Monster Energy is a “killer energy brew.” Representative Edward J. Markey of Massachusetts, a Democrat, has asked the government to investigate the industry’s marketing claims.

Promoting a message beyond caffeine has enabled the beverage makers to charge premium prices. A 16-ounce energy drink that sells for $2.99 a can contains about the same amount of caffeine as a tablet of NoDoz that costs 30 cents. Even Starbucks coffee is cheap by comparison; a 12-ounce cup that costs $1.85 has even more caffeine.

As with earlier elixirs, a dearth of evidence underlies such claims. Only a few human studies of energy drinks or the ingredients in them have been performed and they point to a similar conclusion, researchers say — that the beverages are mainly about caffeine.

Caffeine is called the world’s most widely used drug. A stimulant, it increases alertness, awareness and, if taken at the right time, improves athletic performance, studies show. Energy drink users feel its kick faster because the beverages are typically swallowed quickly or are sold as concentrates.

“These are caffeine delivery systems,” said Dr. Roland Griffiths, a researcher at Johns Hopkins University who has studied energy drinks. “They don’t want to say this is equivalent to a NoDoz because that is not a very sexy sales message.”

A scientist at the University of Wisconsin became puzzled as he researched an ingredient used in energy drinks like Red Bull, 5-Hour Energy and Monster Energy. The researcher, Dr. Craig A. Goodman, could not find any trials in humans of the additive, a substance with the tongue-twisting name of glucuronolactone that is related to glucose, a sugar. But Dr. Goodman, who had studied other energy drink ingredients, eventually found two 40-year-old studies from Japan that had examined it.

In the experiments, scientists injected large doses of the substance into laboratory rats. Afterward, the rats swam better. “I have no idea what it does in energy drinks,” Dr. Goodman said.

Energy drink manufacturers say it is their proprietary formulas, rather than specific ingredients, that provide users with physical and mental benefits. But that has not prevented them from implying otherwise.

Consider the case of taurine, an additive used in most energy products.

On its Web site, the producer of Red Bull, for example, states that “more than 2,500 reports have been published about taurine and its physiological effects,” including acting as a “detoxifying agent.” In addition, that company, Red Bull of Austria, points to a 2009 safety study by a European regulatory group that gave it a clean bill of health.

But Red Bull’s Web site does not mention reports by that same group, the European Food Safety Authority, which concluded that claims about the benefits in energy drinks lacked scientific support. Based on those findings, the European Commission has refused to approve claims that taurine helps maintain mental function and heart health and reduces muscle fatigue.

Taurine, an amino acidlike substance that got its name because it was first found in the bile of bulls, does play a role in bodily functions, and recent research suggests it might help prevent heart attacks in women with high cholesterol. However, most people get more than adequate amounts from foods like meat, experts said. And researchers added that those with heart problems who may need supplements would find far better sources than energy drinks.

Hiroko Tabuchi contributed reporting from Tokyo and Poypiti Amatatham from Bangkok.

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5-Hour Energy’s ‘No Crash Later’ Claim Is Disputed

The distributor of the top-selling energy “shot,” 5-Hour Energy, has long claimed on product labels, in promotions and in television advertisements that the concentrated caffeine drink produced “no crash later” — the type of letdown that consumers of energy drinks often feel when the beverages’ effects wear off.

But an advertising watchdog group said on Wednesday that it had told the company five years ago that the claim was unfounded and had urged it then to stop making it.

An executive of the group, the National Advertising Division, also said that 5-Hour Energy’s distributor, Living Essentials, had publicly misrepresented the organization’s position about the claim and that it planned to start a review that could lead to action against the company by the Federal Trade Commission.

“We recommended that the ‘no crash’ claim be discontinued because their own evidence showed there was a crash from the product,” said Andrea C. Levine, director the National Advertising Division. The organization, which is affiliated with the Council of Better Business Bureaus, reviews ad claims for accuracy.

The emerging dispute between Living Essentials and the National Advertising Division is unusual because the $10 billion energy drink industry is rife with questionable marketing. And Living Essentials, which recently cited the advertising group’s support in seeking to defend the “no crash” claim, may have opened the door to greater scrutiny.

Major producers like 5-Hour Energy, Red Bull, Monster Energy and Rockstar Energy all say their products contain proprietary blends of ingredients that provide a range of mental and physical benefits. But the companies have conducted few studies to show that the costly products provide anything more than a blast of caffeine, a stimulant found in beverages like coffee, tea or cola-flavored sodas.

The dispute over 5-Hour Energy’s claim also comes as regulatory review of the high-caffeine drinks is increasing. The Food and Drug Administration recently disclosed that it had received reports over the last four years citing the possible role of 5-Hour Energy in 13 deaths. The mention of a product in an F.D.A. report does not mean it caused a death or injury. Living Essentials says it knows of no problems related to its products.

The issue surrounding the company’s “no crash” claim dates to 2007, when National Advertising Division began reviewing all of 5-Hour Energy’s marketing claims. That same year, the company conducted a clinical trial of the energy shot that compared it to Red Bull and Monster Energy.

At the time, Living Essentials was already using the “No crash later” claim. An article on Wednesday in The New York Times reported that the study had shown that 24 percent of those who used 5-Hour Energy suffered a “moderately severe” crash hours after consuming it. The study reported higher crash rates for Red Bull and Monster Energy.

When asked how those findings squared with the company’s “no crash” claim, Elaine Lutz, a spokeswoman for Living Essentials, said the company had amended the claim after the 2007 review by the National Advertising Division. In doing so, it added an asterisklike mark after the claim on product labels and in promotions. The mark referred to additional labeling language stating that “no crash means no sugar crash.” Unlike Red Bull and Monster Energy, 5-Hour Energy does not contain sugar.

Ms. Lutz said that based on the modification, the advertising accuracy group “found all of our claims to be substantiated.”

However, Ms. Levine, the advertising group’s director, took sharp exception to that assertion, saying it mischaracterized the group’s decision. And a review of the reports suggested that Living Essentials had simply added language of its choosing to its label rather than doing what the group had recommended — drop the “no crash” claim altogether.

That review concluded that the company’s 2007 study had shown there was evidence to support a “qualified claim that 5-Hour Energy results in less of a crash than Red Bull and Monster” Energy. But it added the study, which showed that 5-Hour Energy users experienced caffeine-related crashes, was inadequate to support a “no crash” claim.

Ms. Levine said Living Essentials had apparently decided to use the parts of the group’s report that it liked and ignore others.

Companies “are not permitted to mischaracterize our decisions or misuse them for commercial purposes,” she said.

She said the group planned to notify Living Essentials that it was reopening its review of the “no crash later” claim. If the company fails to respond or provides an inadequate response, the National Advertising Division will probably refer the matter to the F.T.C., she said.

A Democratic lawmaker, Representative Edward Markey of Massachusetts, has asked that the agency review energy drink marketing claims.

Asked about the position of the National Advertising Division, Ms. Lutz, the 5-Hour Energy spokeswoman, stated in an e-mail that the “no sugar crash” language had been added to address the group’s concern.

This article has been revised to reflect the following correction:

Correction: January 2, 2013

An earlier version of this article misstated the number of deaths in which the Food and Drug Administration said 5-Hour Energy possibly played a role. The number was 13, not 15.

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Drug Makers Losing a Bid to Foil Generic Painkillers

Public officials have long urged makers of powerful painkillers to do more to make the medications harder to crush and abuse. But now that some companies have done so, they want something in return — a ban on generic versions of the drugs they make that do not have such tamper-resistant designs. 

Stuart Isett for The New York Times

Purdue Pharma’s OxyContin

Purdue Pharma LP

Tablets of OxyContin have been made more resistant to abuse. At left, a tablet crushed into powder. Right, a reformulated tablet does not easily turn into powder when it is crushed.

In coming months, generic drug producers are expected to introduce cheaper versions of OxyContin and Opana, two long-acting narcotic painkillers, or opioids, that are widely abused.

But in hopes of delaying the move to generics, the makers of the brand name drugs, Purdue Pharma and Endo Pharmaceuticals, have introduced versions that are more resistant to crushing or melting, techniques abusers use to release the pills’ narcotic payloads.

The two drug makers, which say they are motivated not by profit but by public safety, have also been waging a multifront political and legal war to block sales of generics that are not tamper-resistant.

The companies argue that the older designs will feed street demand for strong painkillers, drugs that are involved in more than 15,000 overdose-related deaths a year. While some experts say the new tamper-resistant products are not a cure-all for the abuse problem, others say they represent an important step forward.

“I think it would be a shame if the government would allow generics to come in without any tamper-resistant properties,” said Dr. Lynn R. Webster, a specialist in Salt Lake City who has consulted with companies developing such safeguards. Over the last year, Purdue Pharma and Endo have backed legislation in Congress that would require many opioids to be tamper-resistant, and lobbied in favor of similar state laws.

They have also urged the Food and Drug Administration to give their tamper-resistant designs a stamp of safety approval that other manufacturers would have to match. The agency does not currently differentiate between drugs that have abuse-resistant qualities and those that do not.

Thus far, the companies’ efforts have failed. In mid-December, a federal judge threw out a lawsuit by Endo that would have blocked the F.D.A. from allowing generic versions of its drug, Opana, to go on sale in January. A recent effort by some doctors and local officials in Canada to deter sales of generic versions of OxyContin there fell flat. While companies like Purdue Pharma insist the public’s health is their main concern, others note that producers introduced tamper-resistant versions of their products just as the drugs were about to lose patent protection. In court papers filed in response to Endo’s lawsuit, the F.D.A. described the company’s action as a “thinly veiled attempt to maintain its market share and block generic competition.”

An F.D.A. official, Dr. Douglas C. Throckmorton, said the agency expected to issue guidance this month that would lay out the types of scientific data that drug producers would have to submit to support a claim that an opioid’s design or formulation helped to deter its abuse.

Companies are developing a variety of methods to do that. The new OxyContin pill turns into a gummy mass when an abuser crushes it, and the Opana pill is designed to break into large pieces when manipulated. Other methods include pills that contain a second drug reversing the opioid’s narcotic effects if taken inappropriately.

“We understand the value in developing appropriate abuse-resistant technology and we want to find a way of incentivizing that,” said Dr. Throckmorton, the F.D.A.’s deputy director for regulatory programs. “But we also understand the value of generics for patients.”

A study published in 2012 in a medical journal, The Journal of Pain, found that the percentage of people treated at drug-abuse clinics who reported abusing OxyContin fell significantly since the introduction of the tamper-resistant version.

Some of those abusers said they had switched to other long-acting opioids that were easier to abuse like Opana — before its reformulation — or to illicit drugs like heroin, according to the study, which was financed by Purdue Pharma.

But the generic versions of OxyContin and Opana are expected to be significantly cheaper than the tamper-resistant versions of those drugs. At time of introduction in late 2010, the price of the new version of OxyContin was about $6 per 40 milligram tablet, the same then as the price that was not tamper-resistant. Since then, the price of the new version has risen to about $6.80 for that strength tablet. Opana costs about the same amount for a pill of the same pain-killing strength.

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Letters: Recovery After Trauma

To the Editor:

Re “A New Focus on the ‘Post’ in Post-Traumatic Stress” (Mind, Dec. 25): Social contexts are well-established predictors of adjustment following trauma. Sexual abuse survivors who are believed and supported following an abuse disclosure fare better than those who are not, and returning veterans’ social support predicts P.T.S.D. over and above the extent of military trauma exposure. Interpersonal traumas cause greater psychological scars than do noninterpersonal traumas like accidents or disasters, with the worst outcomes linked to trauma perpetrated by someone to whom the victim was close.

Rachel Goldsmith

New York

The writer is a clinical psychologist.

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Chinese Firm Is Cleared to Buy American DNA Sequencing Company

Ramin Rahimian for The New York Times

DNA sequencing machines at Complete Genomics in California. The firm dismissed concerns about its acquisition.

The federal government has given national security clearance to the controversial purchase of an American DNA sequencing company by a Chinese firm.

The Chinese firm, BGI-Shenzhen, said in a statement this weekend that its acquisition of Complete Genomics, based in Mountain View, Calif., had been cleared by the federal Committee on Foreign Investment in the United States, which reviews the national security implications of foreign takeovers of American companies. The deal still requires antitrust clearance by the Federal Trade Commission.

Some scientists, politicians and industry executives had said the takeover represented a threat to American competitiveness in DNA sequencing, a technology that is becoming crucial for the development of drugs, diagnostics and improved crops.

The fact that the $117.6 million deal was controversial at all reflects a change in the genomics community.

A decade ago, the Human Genome Project, in which scientists from many nations helped unravel the genetic blueprint of mankind, was celebrated for its spirit of international cooperation. One of the participants in the project was BGI, which was then known as the Beijing Genomics Institute.

But with DNA sequencing now becoming a big business and linchpin of the biotechnology industry, international rivalries and nationalism are starting to move front and center in any acquisition.

Much of the alarm about the deal has been raised by Illumina, a San Diego company that is the market leader in sequencing machines. It has potentially the most to lose from the deal because BGI might buy fewer Illumina products and even become a competitor. Weeks after the BGI deal was announced, Illumina made its own belated bid for Complete Genomics, offering 15 cents a share more than BGI’s bid of $3.15. But Complete Genomics rebuffed Illumina, saying such a merger would never clear antitrust review.

Illumina also hired a Washington lobbyist, the Glover Park Group, to stir up opposition to the deal in Congress. Representative Frank R. Wolf, Republican of Virginia, was the only member of Congress known to have publicly expressed concern.

BGI and Complete Genomics point out that Illumina has long sold its sequencing machines — including a record-setting order of 128 high-end machines — to BGI without raising any security concerns. Sequencing machines have not been subject to export controls like aerospace equipment, lasers, sensors and other gear that can have clear military uses.

“Illumina has never previously considered its business with BGI as ‘sensitive’ in the least,” Ye Yin, the chief operating officer of BGI, said in a November letter to Complete Genomics that was made public in a regulatory filing. In the letter, Illumina was accused of “obvious hypocrisy.”

BGI and Complete said that Illumina was trying to derail the agreement and acquire Complete Genomics itself in order to “eliminate its closest competitor, Complete.”

BGI is already one of the most prolific DNA sequencers in the world, but it buys the sequencing machines it uses from others, mainly Illumina.

Illumina, joined by some American scientists, said it worried that if BGI gained access to Complete’s sequencing technology, the Chinese company might use low prices to undercut the American sequencing companies that now dominate the industry.

Some also said that with Complete Genomics providing an American base, BGI would have access to more DNA samples from Americans, helping it compile a huge database of genetic information that could be used to develop drugs and diagnostic tests. Some also worried about protection of the privacy of genetic information.

“What’s to stop them from mining genomic data of American samples to some unknown nefarious end?” Elaine R. Mardis, co-director of the genome sequencing center at Washington University in St. Louis, said in an e-mail.

Dr. Mardis could not specify what kind of nefarious end she imagined. But opponents of the deal cited a November article in The Atlantic saying that in the future, pathogens could be genetically engineered to attack particular individuals, including the president, based on their DNA sequences.

BGI and Complete Genomics dismissed such concerns as preposterous.

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Surgery Returns to NYU Langone Medical Center

Chang W. Lee/The New York Times

Senator Charles E. Schumer spoke at a news conference Thursday about the reopening of NYU Langone Medical Center.

NYU Langone Medical Center opened its doors to surgical patients on Thursday, almost two months after Hurricane Sandy overflowed the banks of the East River and forced the evacuation of hundreds of patients.

While the medical center had been treating many outpatients, it had farmed out surgery to other hospitals, which created scheduling problems that forced many patients to have their operations on nights and weekends, when staffing is traditionally low. Some patients and doctors had to postpone not just elective but also necessary operations for lack of space at other hospitals.

The medical center’s Tisch Hospital, its major hospital for inpatient services, between 30th and 34th Streets on First Avenue, had been closed since the hurricane knocked out power and forced the evacuation of more than 300 patients, some on sleds brought down darkened flights of stairs.

“I think it’s a little bit of a miracle on 34th Street that this happened so quickly,” Senator Charles E. Schumer of New York said Thursday.

Mr. Schumer credited the medical center’s leadership and esprit de corps, and also a tour of the damaged hospital on Nov. 9 by the administrator of the Federal Emergency Management Agency, W. Craig Fugate, whom he and others escorted through watery basement hallways.

“Every time I talk to Fugate there are a lot of questions, but one is, ‘How are you doing at NYU?’ ” the senator said.

The reopening of Tisch to surgery patients and associated services, like intensive care, some types of radiology and recovery room anesthesia, was part of a phased restoration that will continue. Besides providing an essential service, surgery is among the more lucrative of hospital services.

The hospital’s emergency department is expected to delay its reopening for about 11 months, in part to accommodate an expansion in capacity to 65,000 patient visits a year, from 43,000, said Dr. Andrew W. Brotman, its senior vice president and vice dean for clinical affairs and strategy.

In the meantime, NYU Langone is setting up an urgent care center with 31 bays and an observation unit, which will be able to treat some emergency patients. It will initially not accept ambulances, but might be able to later, Dr. Brotman said. Nearby Bellevue Hospital Center, which was also evacuated, opened its emergency department to noncritical injuries on Monday.

Labor and delivery, the cancer floor, epilepsy treatment and pediatrics and neurology beyond surgery are expected to open in mid-January, Langone officials said. While some radiology equipment, which was in the basement, has been restored, other equipment — including a Gamma Knife, a device using radiation to treat brain tumors — is not back.

The flooded basement is still being worked on, and electrical gear has temporarily been moved upstairs. Mr. Schumer, a Democrat, said that a $60 billion bill to pay for hurricane losses and recovery in New York and New Jersey was nearing a vote, and that he was optimistic it would pass in the Senate with bipartisan support. But the measure’s fate in the Republican-controlled House is far less certain.

The bill includes $1.2 billion for damage and lost revenue at NYU Langone, including some money from the National Institutes of Health to restore research projects. It would also cover Long Beach Medical Center in Nassau County, Bellevue, Coney Island Hospital and the Veterans Affairs hospital in Manhattan.

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7-Eleven Stores Focus on Healthier Food Options

The chain that is home of the Slurpee, Big Gulp and self-serve nachos with chili and cheese is betting that consumers will stop in for yogurt parfaits, crudité and lean turkey on whole wheat bread.

7-Eleven, the convenience store chain, is restocking its shelves with an eye toward health. Over the last year, the retailer has introduced a line of fresh foods for the calorie conscious and trimmed down its more indulgent fare by creating portion-size items.

The change is as much about consumers’ expanding waistlines as the company’s bottom line. By 2015, the retailer aims to have 20 percent of sales come from fresh foods in its American and Canadian stores, up from about 10 percent currently, according to a company spokesman.

“We’re aspiring to be more of a food and beverage company, and that aligns with what the consumer now wants, which is more tasty, healthy, fresh food choices,” said Joseph M. DePinto, the chief executive of 7-Eleven, a subsidiary of the Japanese company, Seven & i Holdings.

Convenience stores have typically been among the most nimble of retailers. In the 1980s, they added Pac-Man arcade games as a way to keep customers in stores longer and to buy more merchandise. They installed A.T.M.’s a decade later, taking a slice of the transaction fees. More recently, they built refrigerated dairy cases, with milk, eggs, cheese and other staples.

But just as they have taken business from traditional supermarkets, convenience stores have faced increased competition from the likes of Dunkin’ Donuts and Starbucks, which offer a basic menu of fresh foods for consumers on the go.

At the same time, a major profit driver for convenience stores — cigarettes — has been in steady decline over the last decade as the rate of smoking has dropped in the United States.

Fresh foods can help offset some of those losses. The markup on such merchandise can be significant, bolstering a store’s overall profits. It’s also a fast-growing category.

“If you can figure out how to deliver consistent quality and the products consumers want, fresh food is attractive because margins are higher, and it addresses some of the competitive issues you’re facing,” said Richard Meyer, a longtime consultant for the convenience store industry. “But it’s not easy to do.”

7-Eleven has been selling fresh food since the late 1990s. But much of its innovation has been limited to the variety of hot dogs spinning on the roller grill or the breakfast sandwiches languishing beneath a heating lamp.

As 7-Eleven refocuses its lineup, the retail chain has assembled a team of culinary and food science experts to study industry trends and develop new products. Such groups have been around for a while at fast-food restaurants like McDonald’s and packaged-goods manufacturers like Kraft. But it’s a relatively new concept for players like 7-Eleven, which have typically relied on their suppliers to provide product innovation.

“We’re working to create a portfolio of fresh foods,” said Anne Readhimer, senior director of fresh food innovation, who joined the company in May from Yum Brands, where she had worked on the KFC and Pizza Hut brands. “Some will be for snacking, some for a quick meal, but we hope everything we offer our guests is convenient and tasty.”

One new menu item just hitting stores is a Bistro Snack Protein Pack, which includes mini pita rounds, cheddar cheese cubes, grapes, celery, baby carrots and hummus. The meal in a box, similar to one carried by Starbucks, is part of a broader menu with healthier items under 400 calories.

The company is also taking existing products and retooling them for single portions. For example, customers can now buy jelly doughnuts and tacos, in mini sizes.

“There are definitely customers who want healthy options, but there are also lots of customers who are excited about the new sandwich options that aren’t low calorie — and minidoughnuts are doing very well,” said Lori Primavera, senior manager of fresh food innovation at 7-Eleven, who previously worked for Food and Drink Resources, a consulting firm for restaurant companies.

Norman Jemal, a franchisee, said sales of the new products are growing steadily in the three 7-Eleven stores that he owns in Manhattan. “At first, people are surprised when they come in here and see a bag of carrots and celery,” Mr. Jemal said. “They say, ‘I came in here for a bag of chips — I can’t believe you have fruit cups or yogurt cups.’ ”

He said the Yoplait Parfait, a cup of vanilla yogurt topped with fresh strawberries or blueberries and granola, is his best-selling fresh food item, while the 7 Smart turkey sandwich is his top sandwich.

The fresh food in Mr. Jemal’s stores and other locations around the country are supplied from a system of 29 commissaries and bakeries that fulfill orders from 7-Eleven. They tailor menu items for specific markets. In the Miami area, they produce a hot Cuban sandwich with ham, cheese, pickles and mustard. The Turkey Gobbler with turkey, stuffing and cranberry sauce sells in Northeastern stores around the holidays.

Each store has a data system that allows it to see exactly what is selling, which helps manage waste. Stores can track consumers’ purchase habits over a month, and adjust their orders based on those behaviors.

“In this 28-day cycle, I know I sold 3,563 bananas to customers in this store,” said Todd Ferguson, who owns five 7-Eleven locations in Las Vegas.

Mr. Ferguson has owned 7-Eleven franchises since 1986, and he said the variety of fresh food options in the stores is far better than before. The category already accounts for 20 percent of his sales, and his goal is to reach a quarter of sales volume.

“We used to be a place for people to buy beer, wine, cigarettes, candy and chips, and people would occasionally ask where they could go to get something to eat,” Mr. Ferguson said. “We’re no longer getting that question because now you can get something to eat right here.”

This article has been revised to reflect the following correction:

Correction: December 27, 2012

An earlier version of this article incorrectly identified a 7-Eleven franchisee in Las Vegas. He is Todd Ferguson, not Tom Ferguson.

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Elwood V. Jensen, Pioneer in Breast Cancer Treatment, Dies at 92

Elwood V. Jensen, a medical researcher whose studies of steroid hormones led to new treatments for breast cancer that have been credited with saving or extending hundreds of thousands of lives, died on Dec. 16 in Cincinnati. He was 92.

The cause was complications of pneumonia, his son, Thomas Jensen, said.

In 2004 Dr. Jensen received the Albert Lasker Basic Medical Research Award, one of the most respected science prizes in the world.

When Dr. Jensen started his research at the University of Chicago in the 1950s, steroid hormones, which alter the functioning of cells, were thought to interact with cells through a series of chemical reactions involving enzymes.

However, Dr. Jensen used radioactive tracers to show that steroid hormones actually affect cells by binding to a specific receptor protein inside them. He first focused on the steroid hormone estrogen.

By 1968, Dr. Jensen had developed a test for the presence of estrogen receptors in breast cancer cells. He later concluded that such receptors were present in about a third of those cells.

Breast cancers that are estrogen positive, meaning they have receptors for the hormone, can be treated with medications like Tamoxifen or with other methods of inhibiting estrogen in a patient’s system, like removal of the ovaries. Women with receptor-rich breast cancers often go into remission when estrogen is blocked or removed.

By the mid-1980s, a test developed by Dr. Jensen and a colleague at the University of Chicago, Dr. Geoffrey Greene, could be used to determine the extent of estrogen receptors in breast and other cancers. That test became a standard part of care for breast cancer patients.

Scientists like Dr. Pierre Chambon and Dr. Ronald M. Evans, who shared the 2004 Lasker prize with Dr. Jensen, went on to show that many types of receptors exist. The receptors are crucial components of the cell’s control system and transmit signals in an array of vital functions, from the development of organs in the womb to the control of fat cells and the regulation of cholesterol.

Dr. Jensen’s work also led to the development of drugs that can enhance or inhibit the effects of hormones. Such drugs are used to treat prostate and other cancers.

Elwood Vernon Jensen was born in Fargo, N.D., on Jan. 13, 1920, to Eli and Vera Morris Jensen. He majored in chemistry at what was then Wittenberg College in Springfield, Ohio, and had begun graduate training in organic chemistry at the University of Chicago when World War II began.

Dr. Jensen wanted to join the Army Air Forces, but his poor vision kept him from becoming a pilot. During the war he synthesized poison gases at the University of Chicago, exposure to which twice put him in the hospital. His work on toxic chemicals, he said, inspired him to pursue biology and medicine.

Dr. Jensen studied steroid hormone chemistry at the Swiss Federal Institute of Technology on a Guggenheim Fellowship after the war. While there, he climbed the Matterhorn, one of the highest peaks in the Alps, even though he had no mountaineering experience. He often equated his successful research to the novel approach taken by Edward Whymper, the first mountaineer to reach the Matterhorn’s summit. Mr. Whymper went against conventional wisdom and scaled the mountain’s Swiss face, after twice failing to reach the summit on the Italian side.

Dr. Jensen joined the University of Chicago as an assistant professor of surgery in 1947, working closely with the Nobel laureate Charles Huggins. He became an original member of the research team at the Ben May Laboratory for Cancer Research (now the Ben May Department for Cancer Research) in 1951, and became the director after Dr. Huggins stepped down.

He came to work at the University of Cincinnati in 2002, and continued to do research there until last year.

His first wife, the former Mary Collette, died in 1982. In addition to his son, Dr. Jensen is survived by his second wife, the former Hiltrud Herborg; a daughter, Karen C. Jensen; a sister, Margaret Brennan; two grandchildren; and three great-grandchildren.

Dr. Jensen’s wife was found to have breast cancer in 2005. She had the tumor removed, he said in an interview, but tested positive for the estrogen receptor and was successfully treated with a medication that prevents estrogen synthesis.

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Op-Ed Contributor: Our Failed Approach to Schizophrenia

TOO many pendulums have swung in the wrong directions in the United States. I am not referring only to the bizarre all-or-nothing rhetoric around gun control, but to the swing in mental health care over the past 50 years: too little institutionalizing of teenagers and young adults (particularly men, generally more prone to violence) who have had a recent onset of schizophrenia; too little education about the public health impact of untreated mental illness; too few psychiatrists to talk about and treat severe mental disorders — even though the medications available in the past 15 to 20 years can be remarkably effective.

Instead we have too much concern about privacy, labeling and stereotyping, about the civil liberties of people who have horrifically distorted thinking. In our concern for the rights of people with mental illness, we have come to neglect the rights of ordinary Americans to be safe from the fear of being shot — at home and at schools, in movie theaters, houses of worship and shopping malls.

“Psychosis” — a loss of touch with reality — is an umbrella term, not unlike “fever.” As with fevers, there are many causes, from drugs and alcohol to head injuries and dementias. The most common source of severe psychosis in young adults is schizophrenia, a badly named disorder that, in the original Greek, means “split mind.” In fact, schizophrenia has nothing to do with multiple personality, a disorder that is usually caused by major repeated traumas in childhood. Schizophrenia is a physiological disorder caused by changes in the prefrontal cortex, an area of the brain that is essential for language, abstract thinking and appropriate social behavior. This highly evolved brain area is weakened by stress, as often occurs in adolescence.

Psychiatrists and neurobiologists have observed biochemical changes and alterations in brain connections in patients with schizophrenia. For example, miscommunications between the prefrontal cortex and the language area in the temporal cortex may result in auditory hallucinations, as well as disorganized thoughts. When the voices become commands, all bets are off. The commands might insist, for example, that a person jump out of a window, even if he has no intention of dying, or grab a set of guns and kill people, without any sense that he is wreaking havoc. Additional symptoms include other distorted thinking, like the notion that something — even a spaceship, or a comic book character — is controlling one’s thoughts and actions.

Schizophrenia generally rears its head between the ages of 15 and 24, with a slightly later age for females. Early signs may include being a quirky loner — often mistaken for Asperger’s syndrome — but acute signs and symptoms do not appear until adolescence or young adulthood.

People with schizophrenia are unaware of how strange their thinking is and do not seek out treatment. At Virginia Tech, where Seung-Hui Cho killed 32 people in a rampage shooting in 2007, professors knew something was terribly wrong, but he was not hospitalized for long enough to get well. The parents and community-college classmates of Jared L. Loughner, who killed 6 people and shot and injured 13 others (including a member of Congress) in 2011, did not know where to turn. We may never know with certainty what demons tormented Adam Lanza, who slaughtered 26 people at an elementary school in Newtown, Conn., on Dec. 14, though his acts strongly suggest undiagnosed schizophrenia.

I write this despite the so-called Goldwater Rule, an ethical standard the American Psychiatric Association adopted in the 1970s that directs psychiatrists not to comment on someone’s mental state if they have not examined him and gotten permission to discuss his case. It has had a chilling effect. After mass murders, our airwaves are filled with unfounded speculations about video games, our culture of hedonism and our loss of religious faith, while psychiatrists, the ones who know the most about severe mental illness, are largely marginalized.

Severely ill people like Mr. Lanza fall through the cracks, in part because school counselors are more familiar with anxiety and depression than with psychosis. Hospitalizations for acute onset of schizophrenia have been shortened to the point of absurdity. Insurance companies and families try to get patients out of hospitals as quickly as possible because of the prohibitively high cost of care.

As documented by writers like the law professor Elyn R. Saks, author of the memoir “The Center Cannot Hold: My Journey Through Madness,” medication and treatment work. The vast majority of people with schizophrenia, treated or untreated, are not violent, though they are more likely than others to commit violent crimes. When treated with medication after a rampage, many perpetrators who have shown signs of schizophrenia — including John Lennon’s killer and Ronald Reagan’s would-be assassin — have recognized the heinousness of their actions and expressed deep remorse.

It takes a village to stop a rampage. We need reasonable controls on semiautomatic weapons; criminal penalties for those who sell weapons to people with clear signs of psychosis; greater insurance coverage and capacity at private and public hospitals for lengthier care for patients with schizophrenia; intense public education about how to deal with schizophrenia; greater willingness to seek involuntary commitment of those who pose a threat to themselves or others; and greater incentives for psychiatrists (and other mental health professionals) to treat the disorder, rather than less dangerous conditions.

Too many people with acute schizophrenia have gone untreated. There have been too many Glocks, too many kids and adults cut down in their prime. Enough already.

Paul Steinberg is a psychiatrist in private practice.

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Gifts That Keep Giving (if Not Exploding)

Gregory Tobias/Chemical Heritage Foundation Collections

A Chemcraft set from the mid-1950s. More Photos »

Ask scientists of a certain age about their childhood memories, and odds are they’ll start yarning about the stink bombs and gunpowder they concocted with their chemistry sets. Dangerous? Yes, but fun.

“Admittedly, I have blown some things up in my time,” said William L. Whittaker, 64, a robotics professor at Carnegie Mellon University who unearthed his first chemistry set, an A. C. Gilbert, in a junkyard around age 8. By 16, he was dabbling in advanced explosives. “There’s no question that I burned some skin off my face,” he recalled.

Under today’s Christmas tree, girls and boys will unwrap science toys of a very different ilk: slime-making kits and perfume labs, vials of a fluff-making polymer called Insta-Snow, “no-chem” chemistry sets (chemical free!), plus a dazzling array of modern telescopes, microscopes and D.I.Y. volcanoes. Nothing in these gifts will set the curtains on fire.

“Basically, you have to be able to eat everything in the science kit,” said Jim Becker, president of SmartLab Toys, who recalled learning the names of chemicals from his childhood chemistry set, which contained substances that have long since been banned from toys.

Some scientists lament the passing of the trial-and-error days that inspired so many careers. “Science kits are a lot less open-ended these days,” said Kimberly Gerson, a science blogger who lives outside Toronto. “Everything is packaged. It’s either ‘yes’ or ‘no.’ If you don’t get the right result, you’ve done it wrong and you’re out of chemicals.”

Others, though, say the new crop of science toys — even with their cartoonish packaging and heavy emphasis on neon goo — actually represent progress. More entertaining, educational and accessible than earlier products, which relied heavily on a child’s inner motivation, these toys may actually help democratize the learning of science and introduce children to scientific methods and concepts at an earlier age.

“I grew up in the 1960s, and a lot of the chemistry sets were kind of boring,” said William Gurstelle, a science and technology writer. “You’d go through the book, and at the end of the experiment you’d get some light precipitate at the bottom of the beaker. Maybe at most it changes color or something.”

Mr. Gurstelle’s books, which include “Whoosh Boom Splat” and “Backyard Ballistics,” teach people how to make dangerous projectiles, like a potato cannon that uses hair spray as launching fluid. But he had high praise for commercial science kits, which show children (among other things) how to make slime.

Jeff Swensen for The New York Times

William L. Whittaker at the Planetary Robotics Lab at Carnegie Mellon University surrounded by the robots he has created.

“Well, that’s a pretty cool thing to have when you’re done,” Mr. Gurstelle said. “You’re not going to really learn to be a chemist from a chemistry set when you’re in seventh grade; you’re just going to be inspired. The point is that new chemistry sets and new toys are just better, because the manufacturers have figured out how to make them more fun.”

Some toy makers, like SmartLab, Mr. Becker’s company, have used this philosophy to give classic toys a makeover. One of SmartLab’s takes on a chemistry set, for instance, is the Extreme Secret Formula Lab, which comes with “squishy-lidded bubble test tubes” and “an abundance of glow-in-the-dark powder.” The game of Mousetrap has been re-envisioned as the Weird and Wacky Contraption Lab, meant to bring out children’s Rube Goldberg talents. And the slot car tracks that Mr. Becker recalls snapping together in his youth have been translated into a robot called ReCon 6.0, which children can program to roam around.

Mike Kane for The New York Times

Jim Becker of SmartLab Toys.

“What we do is give kids the opportunity to learn through problem solving,” Mr. Becker said.

Of course, technology has also remade the experience of learning science. Children may be more likely to click on a science app than to go play outside.

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N.Y.U. and Others Offer Shorter Courses Through Medical School

Training to become a doctor takes so long that just the time invested has become, to many, emblematic of the gravity and prestige of the profession.

But now one of the nation’s premier medical schools, New York University, and a few others around the United States are challenging that equation by offering a small percentage of students the chance to finish early, in three years instead of the traditional four.

Administrators at N.Y.U. say they can make the change without compromising quality, by eliminating redundancies in their science curriculum, getting students into clinical training more quickly and adding some extra class time in the summer.

Not only, they say, will those doctors be able to hang out their shingles to practice earlier, but they will save a quarter of the cost of medical school — $49,560 a year in tuition and fees at N.Y.U., and even more when room, board, books, supplies and other expenses are added in.

“We’re confident that our three-year students are going to get the same depth and core knowledge, that we’re not going to turn it into a trade school,” said Dr. Steven Abramson, vice dean for education, faculty and academic affairs at N.Y.U. School of Medicine.

At this point, the effort involves a small number of students at three medical schools: about 16 incoming students at N.Y.U., or about 10 percent of next year’s entering class; 9 at Texas Tech Health Science Center School of Medicine; and even fewer, for now, at Mercer University School of Medicine’s campus in Savannah, Ga. A similar trial at Louisiana State University has been delayed because of budget constraints.

But Dr. Steven Berk, the dean at Texas Tech, said that 10 or 15 other schools across the country had expressed interest in what his university was doing, and the deans of all three schools say that if the approach works, they will extend the option to larger numbers of students.

“You’re going to see this kind of three-year pathway become very prominent across the country,” Dr. Abramson predicted.

The deans say that getting students out the door more quickly will accomplish several goals. By speeding up production of physicians, they say, it could eventually dampen a looming doctor shortage, although the number of doctors would not increase unless the schools enrolled more students in the future.

The three-year program would also curtail student debt, which now averages $150,000 by graduation, and by doing so, persuade more students to go into shortage areas like pediatrics and internal medicine, rather than more lucrative specialties like dermatology.

The idea was supported by Dr. Ezekiel J. Emanuel, a former health adviser to President Obama, and a colleague, Victor R. Fuchs. In an editorial in the Journal of the American Medical Association in March, they said there was “substantial waste” in the nation’s medical education. “Years of training have been added without evidence that they enhance clinical skills or the quality of care,” they wrote. They suggested that the 14 years of college, medical school, residency and fellowship that it now takes to train a subspecialty physician could be reduced by 30 percent, to 10 years.

That opinion, however, is not universally held. Other experts say that a three-year medical program would deprive students of the time they need to delve deeply into their subjects, to consolidate their learning and to reach the level of maturity they need to begin practicing, while adding even more pressure to a stressful academic environment.

“The downside is that you are really tired,” said Dr. Dan Hunt, co-secretary of the Liaison Committee on Medical Education, the accrediting agency for medical schools in the United States and Canada. But because accreditation standards do not dictate the fine points of curriculum, the committee has approved N.Y.U.’s proposal, which exceeds by five weeks its requirement that schools provide at least 130 weeks of medical education.

The medical school is going ahead with its three-year program despite the damage from Hurricane Sandy, which forced NYU Langone Medical Center to evacuate more than 300 patients at the height of the storm and temporarily shut down three of its four main teaching hospitals.

Dr. Abramson of N.Y.U. said that postgraduate training, which typically includes three years in a hospital residency, and often fellowships after that, made it unnecessary to try to cram everything into the medical school years. Students in the three-year program will have to take eight weeks of class before entering medical school, and stay in the top half of their class academically. Those who do not meet the standards will revert to the four-year program.

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News Analysis: The Perils of Yoga for Men

MEN are famous for ignoring aches and pains. It’s macho. Men get physical exams less often than women. They tend to remain silent if worried about their health. When hurt, their impulse is to shun doctors and rely on home remedies, like avoiding heavy lifting to ease backaches. Male athletes play through injuries. It’s all about virility and manliness.

The stereotype has exceptions, of course. But denial of injury and ill health — from the relatively inconsequential to the grave — is common enough that physicians seek ways to encourage men to be more forthcoming.

So it pays to listen carefully when guys start talking about intolerable pain and upended lives. Doing so led me to an unexpected finding that I have confirmed in a trove of federal data. It suggests that yoga can be remarkably dangerous — for men.

Guys who bend, stretch and contort their bodies are relatively few in number, perhaps one in five out of an estimated 20 million practitioners in the United States and 250 million around the globe. But proportionally, they are reporting damage more frequently than women, and their doctors are diagnosing more serious injuries — strokes and fractures, dead nerves and shattered backs. In comparison, women tell mainly of minor upsets.

Men who are breaking the code of silence are doing so with physicians in hospital emergency rooms, who in turn report their findings to the federal government.

Their outspokenness reveals much about modern yoga and suggests ways it can be made safer. As a practitioner since 1970, I know some of the guy hazards personally and have learned through painful experience how to live with my inflexible body.

The male disclosures help explain one of the central mysteries of modern yoga — why it is largely a feminine pursuit. As Yoga Journal, the field’s top magazine, put the question: “Where Are All the Men?”

Science has long viewed the female body as relatively elastic. Now the new disclosures suggest that women who tie themselves in knots also enjoy a lower risk of damage. It seems like common sense.

Surprisingly, evidence of the male danger has, to my knowledge, never before been made public. Nor has its flip side — that women seem less vulnerable. The subject of male risk merits discussion if only because the booming yoga industry has long targeted men as a smart way to expand its franchise.

Informal observations hint at possible explanations. Yoga experts say women tend to see classes as refuges while men see challenges — their goal at times to impress the opposite sex.

Women say men push themselves too far, too fast. Men admit to liking the intensity but say the problem is pushy teachers who force them into advanced poses while urging them to ignore pain.

I stumbled on the issue after my book, published in February, laid out a century and a half of science and, in its chapter on injuries, contradicted the usual image of yoga as completely safe. The yoga establishment makes billions of dollars by selling itself as a path to healthy perfection. Predictably, it responded with sharp denials.

I also received a surprising number of moving replies from injured yogis — male and female — including stroke victims.

A letter initiated my inquiry. In April, a man told how an agonizing back injury had turned his life into “a living hell.” Too many instructors, he wrote, are “pushing us too hard and having us do dangerous poses.”

The “us” resonated.

Suddenly, I realized his cry sounded familiar.

I raced through a correspondence file and saw that many of the letters about serious damage had come from men.

Tara Stiles, a yoga teacher who runs a popular studio in Manhattan, told me that guys have more muscle (one reason for their relative inflexibility) and can thus force themselves into challenging poses they might otherwise find impossible. It seemed a plausible explanation for blinding pain.

Other teachers echoed her analysis and cited supporting anecdotes.

Yoga poses are unisex. But in my research, I found a world of poorly known information on gender disparity.

“Science of Flexibility,” by Michael J. Alter, explained how the pelvic regions of women are shaped in a way that permits an unusually large range of motion and joint play. In yoga, the pelvis is the central pivot for extreme bending of the legs, spine and torso.

In June, I turned to the Consumer Product Safety Commission and its National Electronic Injury Surveillance System, which monitors hospital emergency rooms. In July, officials sent me 18 years of annual survey data that summarized the admission records for yoga practitioners hurt between 1994 and 2011, the maximum available span.

First, I needed a baseline that would let me compare the guy admissions to males doing yoga in the United States. Figures in the yoga literature described men as making up some 10 percent of practitioners at the beginning of the period and 23 percent at the end. So the middle ground seemed to be roughly 16 percent.

Then I dug into the medical data. The analysis took weeks, but the results spoke volumes.

William J. Broad is a science reporter for The New York Times and the author of “The Science of Yoga: The Risks and the Rewards.”

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Medicare’s Chief Actuary, Richard Foster, Retiring

Carol T. Powers for The New York Times

Richard S. Foster testifying before the House Ways and Means Committee in 2004

WASHINGTON — Richard S. Foster, who as chief actuary of the Medicare program for the last 18 years nettled presidents of both parties with his projections of rapid growth in federal health care spending, will retire next month, the Obama administration said Friday.

Mr. Foster, 63, a career civil servant known for his fierce independence, has been an influential voice on Medicare, Medicaid and the new health care law.

With 100 million people on Medicare or Medicaid and an additional 20 million expected to get federal subsidies for private insurance under President Obama’s health care law, the need for accurate estimates of health spending has never been greater, lawmakers say.

Mr. Foster said that Medicare savings in the 2010 health care law, based on cutbacks in payments to hospitals and other health care providers, were probably unsustainable and could jeopardize access to care for beneficiaries, a judgment that displeased the Obama administration.

In 2003, Mr. Foster found himself in conflict with the Bush administration when he raised questions about the cost of a Republican bill adding a prescription drug benefit to Medicare. Federal investigators later found that a top Medicare official had threatened to fire Mr. Foster if he provided certain cost estimates to Congress.

Marilyn B. Tavenner, acting administrator of the federal Centers for Medicare and Medicaid Services, praised Mr. Foster for “his adherence to the highest levels of professional independence and ethical conduct.” She said he “will be sorely missed by policy makers and officials throughout the administration and Congress.”

Ms. Tavenner said “we will soon begin a national recruitment effort” to find a successor to Mr. Foster, who began working for the federal government 40 years ago.

Proposals to rein in Medicare spending have been at the center of budget negotiations between President Obama and Speaker John A. Boehner. Both sides have relied on data from Mr. Foster’s office.

Congress bolstered the actuary’s independence in a 1997 law stipulating that the holder of the job can be removed from office “only for cause.”

In a report accompanying the law, Congress said that “the office of the actuary has a unique role,” serving both the administration and Congress, and often must work with lawmakers developing legislation.

With help from a staff of nearly 100, the chief actuary issues detailed annual reports on national health spending and the financial outlook for Medicare. In addition, the actuary’s office collects data used to calculate Medicare payment rates for doctors, hospitals and many other health care providers.

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