<em>Times</em> Reporter Disputes Tesla's Claims, 'Cannot Account' for Data Conflict

New York Times reporter John Broder responded in detail Thursday to Tesla president Elon Musk’s data-driven takedown of Broder’s review of the Model S sedan. And it’s becoming clear that in the credibility battle between a veteran reporter’s notebook and Tesla’s hard data, data has the edge.

In Broder’s second follow-up piece about his trip, he addresses Elon Musk’s blog post point-by-point. He easily dispatches Musk’s claim that the Model S never ran out of juice. The Model S logs analyzed by Tesla may have shown that the battery still had some charge in it, but it’s undisputed that the car announced to Broder that it was shutting down. As Broder writes, “The car’s display screen said the car was shutting down, and it did.” That the battery still had some residual charge left is irrelevant. Score this one to Broder.

But on other points, details in Broder’s original article are plainly at odds with Tesla’s data, and Broder’s explanations are unsatisfying. Take this passage from his review:

I began following Tesla’s range-maximization guidelines, which meant dispensing with such battery-draining amenities as warming the cabin and keeping up with traffic. I turned the climate control to low — the temperature was still in the 30s — and planted myself in the far right lane with the cruise control set at 54 miles per hour (the speed limit is 65). Buicks and 18-wheelers flew past, their drivers staring at the nail-polish-red wondercar with California dealer plates.

Musk disputes that Broder turned down the heat, but as Broder points out accurately, Tesla’s logs show that he did just that. But the logs also show that Broder never cruised as slow as 54 miles per hour, nor did he later slog along at 45 miles an hour in a desperate effort to reach a charging station. Broder’s response Thursday relies on his memory, and some shoulder-shrugging.

I do recall setting the cruise control to about 54 m.p.h., as I wrote. The log shows the car traveling about 60 m.p.h. for a nearly 100-mile stretch on the New Jersey Turnpike. I cannot account for the discrepancy, nor for a later stretch in Connecticut where I recall driving about 45 m.p.h., but it may be the result of the car being delivered with 19-inch wheels and all-season tires, not the specified 21-inch wheels and summer tires. That just might have impacted the recorded speed, range, rate of battery depletion or any number of other parameters.

He goes on:

Certainly, and as Tesla’s logs clearly show, much of my driving was at or well below the 65 m.p.h. speed limit, with only a single momentary spike above 80. Most drivers are aware that cars can speed up, even sometimes when cruise control is engaged, on downhill stretches.

That strains credulity a bit. Modern cruise control systems generally maintain vehicle speed even on downhill slopes. They aren’t prone to a 15 mile per hour speed boost.

Tesla’s charging data notes that during one of the charging stops, Broder plugged in for 47 minutes, but he claims in his article that he spent 58 minutes plugged in. “According to my notes,” Broder writes, “I plugged into the Milford Supercharger at 5:45 p.m. and disconnected at 6:43 p.m.”

None of these unresolved discrepancies go to the root of Broder’s original article, or the trouble the Model S had on the drive. The root of the problem was that when Broder tucked in for the night in Groton, Connecticut, the car showed it was good for another 90 miles. By morning that number had dropped to 25 miles as a result of nothing more than cold weather.

That’s a dramatic loss in range, and in his new response Broder takes Tesla to task for not providing him with enough detail about driving the Model S in colder climes. Tesla spokeswoman Shanna Hendriks disputes that too, and insists the automaker offered to find Broder a hotel where he could charge the electric sedan overnight, which would have started him off with the electrical equivalent of a full tank.

But this grudge match is no longer about the Model S’s suitability for road trips. It’s about old-school reporting, based on note-taking and memory, peppered with color and craft, versus the precision of numbers and data. And the Times is now obliged to address it on those terms. Because in the end, Broder either set his cruise control for 54, or he didn’t.

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Doctor and Patient: Afraid to Speak Up to Medical Power

The slender, weather-beaten, elderly Polish immigrant had been diagnosed with lung cancer nearly a year earlier and was receiving chemotherapy as part of a clinical trial. I was a surgical consultant, called in to help control the fluid that kept accumulating in his lungs.

During one visit, he motioned for me to come closer. His voice was hoarse from a tumor that spread, and the constant hissing from his humidified oxygen mask meant I had to press my face nearly against his to understand his words.

“This is getting harder, doctor,” he rasped. “I’m not sure I’m up to anymore chemo.”

I was not the only doctor that he confided to. But what I quickly learned was that none of us was eager to broach the topic of stopping treatment with his primary cancer doctor.

That doctor was a rising superstar in the world of oncology, a brilliant physician-researcher who had helped discover treatments for other cancers and who had been recruited to lead our hospital’s then lackluster cancer center. Within a few months of the doctor’s arrival, the once sleepy department began offering a dazzling array of experimental drugs. Calls came in from outside doctors eager to send their patients in for treatment, and every patient who was seen was promptly enrolled in one of more than a dozen well-documented treatment protocols.

But now, no doctors felt comfortable suggesting anything but the most cutting-edge, aggressive treatments.

Even the No. 2 doctor in the cancer center, Robin to the chief’s cancer-battling Batman, was momentarily taken aback when I suggested we reconsider the patient’s chemotherapy plan. “I don’t want to tell him,” he said, eyes widening. He reeled off his chief’s vast accomplishments. “I mean, who am I to tell him what to do?”

We stood for a moment in silence before he pointed his index finger at me. “You tell him,” he said with a smile. “You tell him to consider stopping treatment.”

Memories of this conversation came flooding back last week when I read an essay on the problems posed by hierarchies within the medical profession.

For several decades, medical educators and sociologists have documented the existence of hierarchies and an intense awareness of rank among doctors. The bulk of studies have focused on medical education, a process often likened to military and religious training, with elder patriarchs imposing the hair shirt of shame on acolytes unable to incorporate a profession’s accepted values and behaviors. Aspiring doctors quickly learn whose opinions, experiences and voices count, and it is rarely their own. Ask a group of interns who’ve been on the wards for but a week, and they will quickly raise their hands up to the level of their heads to indicate their teachers’ status and importance, then lower them toward their feet to demonstrate their own.

It turns out that this keen awareness of ranking is not limited to students and interns. Other research has shown that fully trained physicians are acutely aware of a tacit professional hierarchy based on specialties, like primary care versus neurosurgery, or even on diseases different specialists might treat, like hemorrhoids and constipation versus heart attacks and certain cancers.

But while such professional preoccupation with privilege can make for interesting sociological fodder, the real issue, warns the author of a courageous essay published recently in The New England Journal of Medicine, is that such an overly developed sense of hierarchy comes at an unacceptable price: good patient care.

Dr. Ranjana Srivastava, a medical oncologist at the Monash Medical Centre in Melbourne, Australia, recalls a patient she helped to care for who died after an operation. Before the surgery, Dr. Srivastava had been hesitant to voice her concerns, assuming that the patient’s surgeon must be “unequivocally right, unassailable, or simply not worth antagonizing.” When she confesses her earlier uncertainty to the surgeon after the patient’s death, Dr. Srivastava learns that the surgeon had been just as loath to question her expertise and had assumed that her silence before the surgery meant she agreed with his plan to operate.

“Each of us was trying our best to help a patient, but we were also respecting the boundaries and hierarchy imposed by our professional culture,” Dr. Srivastava said. “The tragedy was that the patient died, when speaking up would have made all the difference.”

Compounding the problem is an increasing sense of self-doubt among many doctors. With rapid advances in treatment, there is often no single correct “answer” for a patient’s problem, and doctors, struggling to stay up-to-date in their own particular specialty niches, are more tentative about making suggestions that cross over to other doctors’ “turf.” Even as some clinicians attempt to compensate by organizing multidisciplinary meetings, inviting doctors from all specialties to discuss a patient’s therapeutic options, “there will inevitably be a hierarchy at those meetings of who is speaking,” Dr. Srivastava noted. “And it won’t always be the ones who know the most about the patient who will be taking the lead.”

It is the potentially disastrous repercussions for patients that make this overly developed awareness of rank and boundaries a critical issue in medicine. Recent efforts to raise safety standards and improve patient care have shown that teams are a critical ingredient for success. But simply organizing multidisciplinary lineups of clinicians isn’t enough. What is required are teams that recognize the importance of all voices and encourage active and open debate.

Since their patient’s death, Dr. Srivastava and the surgeon have worked together to discuss patient cases, articulate questions and describe their own uncertainties to each other and in patients’ notes. “We have tried to remain cognizant of the fact that we are susceptible to thinking about hierarchy,” Dr. Srivastava said. “We have tried to remember that sometimes, despite our best intentions, we do not speak up for our patients because we are fearful of the consequences.”

That was certainly true for my lung cancer patient. Like all the other doctors involved in his care, I hesitated to talk to the chief medical oncologist. I questioned my own credentials, my lack of expertise in this particular area of oncology and even my own clinical judgment. When the patient appeared to fare better, requiring less oxygen and joking and laughing more than I had ever seen in the past, I took his improvement to be yet another sign that my attempt to talk about holding back chemotherapy was surely some surgical folly.

But a couple of days later, the humidified oxygen mask came back on. And not long after that, the patient again asked for me to come close.

This time he said: “I’m tired. I want to stop the chemo.”

Just before he died, a little over a week later, he was off all treatment except for what might make him comfortable. He thanked me and the other doctors for our care, but really, we should have thanked him and apologized. Because he had pushed us out of our comfortable, well-delineated professional zones. He had prodded us to talk to one another. And he showed us how to work as a team in order to do, at last, what we should have done weeks earlier.

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DealBook: Confidence on Upswing, Mergers Make Comeback

The mega-merger is back.

For the corporate takeover business, the last half-decade was a fallow period. Wall Street deal makers and chief executives, brought low by the global financial crisis, lacked the confidence to strike the audacious multibillion-dollar acquisitions that had defined previous market booms.

Cycles, however, turn, and in the opening weeks of 2013, merger activity has suddenly roared back to life. On Thursday, Berkshire Hathaway, the conglomerate run by Warren E. Buffett, said it had teamed up with Brazilian investors to buy the ketchup maker H. J. Heinz for about $23 billion. And American Airlines and US Airways agreed to merge in a deal valued at $11 billion.

Those transactions come a week after a planned $24 billion buyout of the computer company Dell by its founder, Michael S. Dell, and private equity backers. And Liberty Global, the company controlled by the billionaire media magnate John C. Malone, struck a $16 billion deal to buy the British cable business Virgin Media.

“Since the crisis, one by one, the stars came into alignment, and it was only a matter of time before you had a week like we just had,” said James B. Lee Jr., the vice chairman of JPMorgan Chase.

Still, bankers and lawyers remain circumspect, warning that it is still too early to declare a mergers-and-acquisitions boom like those during the junk bond craze of 1989, the dot-com bubble of 1999 and the leveraged buyout bonanza of 2007. They also say that it is important to pay heed to the excesses that developed during these moments of merger mania, which all ended badly.

A confluence of factors has driven the recent deals. Most visibly, the stock market has been on a tear, with the Standard & Poor’s 500-stock index this week briefly hitting its highest levels since November 2007. Higher share prices have buoyed the confidence of chief executives, who now, instead of retrenching, are looking for ways to expand their businesses.

A number of clouds that hovered over the markets last year have also been removed, eliminating the uncertainty that hampered deal making. Mergers and acquisitions activity in 2012 remained tepid as companies took a wait-and-see approach over the outcome of the presidential election and negotiations over the fiscal cliff. The problems in Europe, which began in earnest in 2011, shut down a lot of potential transactions, but the region has since stabilized.

“When we talk to our corporate clients as well as the bankers, we keep hearing them talk about increased confidence,” said John A. Bick, a partner at the law firm Davis Polk & Wardwell, who advised Heinz on its acquisition by Mr. Buffett and his partners.

Mr. Bick said that mega-mergers had a psychological component, meaning that once transactions start happening, chief executives do not want to be left behind. “In the same way that success breeds success, deals breed more deals,” he said.

A central reason for the return of big transactions is the mountain of cash on corporate balance sheets. After the financial crisis, companies hunkered down, laying off employees and cutting costs. As a result, they generated savings. Today, corporations in the S.& P. 500 are sitting on more than $1 trillion in cash. With interest rates near zero, that money is earning very little in bank accounts, so executives are looking to put it to work by acquiring businesses.

The private equity deal-making machine is also revving up again. The world’s largest buyout firms have hundreds of billions of dollars of “dry powder” — money allotted to deals in Wall Street parlance — and they are on the hunt. The proposed leveraged buyout of Dell, led by Mr. Dell and the investment firm Silver Lake Partners, was the largest private equity transaction since July 2007, when the Blackstone Group acquired the hotel chain Hilton Worldwide for $26 billion just as the credit markets were seizing up.

But perhaps the single biggest factor driving the return of corporate takeovers is the banking system’s renewed health. Corporations often rely on bank loans for financing acquisitions, and the ability of private equity firms to strike multibillion-dollar transactions depends on the willingness of banks to lend them money.

For years, banks, saddled by the toxic mortgage assets weighing on their balance sheets, turned off the lending spigot. But with the housing crisis in the rearview mirror and economic conditions slowly improving, banks are again lining up to provide corporate loans at record-low interest rates to finance acquisitions.

The banks, of course, are major beneficiaries of megadeals, earning big fees from both advising on the transactions and lending money to finance them. Mergers and acquisitions in the United States total $158.7 billion so far this year, according to Thomson Reuters data, more than double the amount in the same period last year. JPMorgan, for example, has benefited from the surge, advising on four big deals in recent weeks, including the Dell bid and Comcast’s $16.7 billion offer for the rest of NBCUniversal that it did not already own.

Mr. Buffett, in a television interview last month, declared that the banks had repaired their businesses and no longer posed a threat to the economy. “The capital ratios are huge, the excesses on the asset aside have been largely cleared out,” said Mr. Buffett, whose acquisition of Heinz will be his second-largest acquisition, behind his $35.9 billion purchase of a majority stake in the railroad company Burlington Northern Santa Fe in 2009.

While Wall Street has an air of giddiness over the year’s start, most deal makers temper their comments about the current environment with warnings about undisciplined behavior like overpaying for deals and borrowing too much to pay for them.

Though private equity firms were battered by the financial crisis, they made it through the downturn on relatively solid ground. Many of their megadeals, like Hilton, looked destined for bankruptcy after the markets collapsed, but they have since recovered. The deals have benefited from an improving economy, as well as robust lending markets that allowed companies to push back the large amounts of debt that were to have come due in the next few years.

But there are still plenty of cautionary tales about the consequences of overpriced, overleveraged takeovers. Consider Energy Future Holdings, the biggest private equity deal in history. Struck at the peak of the merger boom in October 2007, the company has suffered from low natural gas prices and too much debt, and could be forced to restructure this year. Its owners, a group led by Kohlberg Kravis Roberts and TPG, are likely to lose billions.

Even Mr. Buffett made a mistake on Energy Future Holdings, having invested $2 billion in the company’s bonds. He admitted to shareholders last year that the investment was a blunder and would most likely be wiped out.

“In tennis parlance,” Mr. Buffett wrote, “this was a major unforced error.”

Michael J. de la Merced contributed reporting.

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Federal appeals court weighs overturning Barry Bonds' conviction

SAN FRANCISCO —A federal appeals court wrestled Wednesday with whether to overturn slugger Barry Bonds' felony conviction for obstruction of justice.

The three-judge panel of the U.S. 9th Circuit Court of Appeals weighed whether Bonds broke the law by being evasive in a 52-word answer he gave a federal grand jury in 2003. The grand jury was investigating illegal distribution of performance-enhancing drugs.

Bonds was asked in the grand jury session whether his personal trainer had ever given him a substance that required a syringe to inject. In his response, Bonds rambled on about his childhood and his friendship with the trainer before finally telling the grand jury that he had not received an injectable substance.

The grand jury eventually indicted Bonds, and he was tried in 2011 on three counts of perjury and one count of obstruction. The trial jury convicted him of obstruction of justice, based on that meandering answer, but it deadlocked on the perjury charges.

How the three-judge panel was leaning after Wednesday's hearing was nearly as difficult to parse as Bonds' answer. Judge Michael Daly Hawkins appeared troubled by the fact that Bonds eventually answered the grand jury query: "Can a grand jury witness obstruct justice by giving a series of evasive answers and then giving a direct answer that is not evasive?" Hawkins asked.

Assistant U.S. Atty. Merry Jean Chan, however, said Bond's rambling response was intended to deceive. She argued that the obstruction conviction was not limited to those 52 words but reflected evasion throughout Bonds' testimony.

Hawkins then questioned why prosecutors, if they thought Bonds was being evasive, did not go before a judge to ask that Bonds be ordered to answer the grand jury's questions.

Dennis Riordan, an attorney for Bonds, told the court that the grand jury was not troubled by the 52-word passage that led to the trial jury's conviction years later.

"There is one thing we know for sure," Riordan said. "This grand jury did not consider those 52 words were criminal activity.... That is a dagger in the heart of this conviction."

Chan countered that Bonds' testimony was "littered with multiple examples" of misleading testimony.

Bonds' conviction came at the end of a 12-day trial. He was sentenced to two years probation, 250 hours of community service, a $4,000 fine and a month of monitored home confinement, all of which have been put on hold pending his appeal.

The 9th Circuit panel, which included Judges Mary Schroeder and Mary Murguia, did not indicate when it might rule.

maura.dolan@latimes.com

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Domestic-Drone Industry Prepares for Big Battle With Regulators

For a day, a sandy-haired Virginian named Jeremy Novara was the hero of the nascent domestic drone industry.

Novara went to the microphone at a ballroom in a Ritz-Carlton outside Washington, D.C. on Wednesday and did something many in his business want to do: tenaciously challenge the drone regulators at the Federal Aviation Administration to loosen restrictions on unmanned planes over the United States. Judging from the reaction he received, and from the stated intentions of the drone advocates who convened the forum, the domestic-drone industry expects to do a lot more of that in the coming months.

There’s been a lot of hype around unmanned drones becoming a fixture over U.S. airspace, both for law enforcement use and for operations by businesses as varied as farmers and filmmakers. All have big implications for traditional conceptions of privacy, as unmanned planes can loiter over people’s backyards and snap pictures for far longer than piloted aircraft. The government is anticipating that drone makers could generate a windfall of cash as drones move from a military to a civilian role: Jim Williams of the Federal Aviation Administration told the Wednesday conclave of the Association for Unmanned Vehicle Systems International (AUVSI) that the potential market for government and commercial drones could generate “nearly $90 billion in economic activity” over the next decade. $90 billion.

But there’s an obstacle: the Federal Aviation Administration.

The FAA has been reluctant to grant licenses to drone makers, out of the fear that the drones — which maneuver poorly, have alarming crash rates, are spoofable, and don’t have the sensing capacity to spot approaching aircraft — will complicate and endanger U.S. airspace. (Nor has it been transparent about the licenses it grants: The Electronic Frontier Foundation had to file a Freedom of Information Act request to learn who’s operating drones in America.) A push last year by Congress and the Obama administration directing the FAA to fully integrate unmanned aircraft into American skies hasn’t been nearly enough for the drone makers: The FAA is months late in designating six test sites for drones around the country.

“When will the test site selection begin? I’m sure that’s what all of you are asking now,” Williams, the head of the FAA’s drone integration department, told the AUVSI crowd. (It’ll start at the end of the month.)

Drone makers are also frustrated by the logic of existing FAA regulations. Currently, a drone weighing under 55 pounds, flying below 400 feet within an operator’s line of sight and away from an airport is considered a model airplane, and cleared to fly without a license. That is, if it’s not engaging in any for-profit activity — sort of. “A farmer can be a modeller if they operate their aircraft as a hobby or for recreational purposes,” Williams said.

Enter Novara, a 31-year old who owns a small drone business in Falls Church, Va. called Vanilla Aircraft. “If a farmer, who hopefully is profit-minded, can fly as a hobbyist an unmanned aircraft,” Novara challenged Williams, “why can’t I, as the owner of an unmanned aircraft company, fly as a hobbyist my own unmanned aircraft over property that I own? The guidelines before this [2012 legislation] were that any commercial intent is prohibited, but–”

“I didn’t change any guidelines,” Williams interrupted. “I didn’t say that any guidelines changed. I said that if a farmer as an individual wants to operate an unmanned aircraft according to the modeling rules, they can do that. The FAA rules are very clear about for-compensation and hire. If you’re going to operate an aircraft for compensation or hire, there’s a different set of rules that apply. So, you know, I’m not gonna split hairs over whether the farmer is making a profit or not, nor are we going to go look for him, but the bottom line is the rules are the rules and we have to enforce them until they’re changed.”

“So unmanned aircraft companies can operate R&D as long as they’re within the modeling guidelines?” Novara continued. Laughter and applause broke out among the hundreds of drone enthusiasts inside the Tyson’s Corner Ritz-Carlton.

“That’s why we have experimental certificates, to allow manufacturers–”

“The farmer doesn’t need an experimental certificate,” Novara pressed, “and everyone knows the experimental certificate process is available but not actually functional.”

Williams conceded that the current FAA rules “need to change,” since they were written for manned aircraft, “and that’s why we’re working hard to get the small unmanned aircraft rule out that will help resolve these issues. Until such time, we have to enforce the rules that are in place.”

“Is everyone else clear on this?” Novara asked, to bales of laughter. Some in the crowd shouted “No!” It felt like pent-up frustrations were being taken out on Williams, to the point where Novara added, apologetically, “I’m not trying to put this on you.”

But to the crowd at AUVSI, Novara was a hero. Outside the hall as he walked by, an older man slapped him on the shoulder and laughed, “Hey, troublemaker! I need to talk to you later!”

Expect a lot more troublemaking over the coming months. And if the domestic drone industry doesn’t succeed in getting the FAA to move fast enough for it, it’s prepared to pressure Congress to kick the FAA into gear. “Every company needs to call their Congressman,” said Peter Bale, the chairman of the board of AUVSI. April 9 is the organization’s “Day on The Hill,” when the drone industry intends to put the screws to legislators and their staff.

Novara says that he’s pessimistic that the lobbying will do any good for him: he expects it to benefit the aviation giants with established drone businesses with the government instead. (Especially as they’re the ones that make the campaign contributions.) He’s sympathetic to the FAA’s commitment to aviation safety: “I’m not advocating anarchy in the skies,” he says. But Novara sees a potential for the commercial domestic drone sector to get regulated out of business before a domestic drone boom actually starts.

“If we were all smart guys, we’d be in consumer products, right?” Novara tells Danger Room. “It’s what I like doing. There’s just no money in it.”

As the domestic-drone industry gets ready to press the FAA and Congress to loosen regulations on unmanned planes in U.S. airspace, there’s something to keep in mind. The FAA’s mandate is to protect the safety of air travel — not the privacy rights of Americans.

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Well: Straining to Hear and Fend Off Dementia

At a party the other night, a fund-raiser for a literary magazine, I found myself in conversation with a well-known author whose work I greatly admire. I use the term “conversation” loosely. I couldn’t hear a word he said. But worse, the effort I was making to hear was using up so much brain power that I completely forgot the titles of his books.

A senior moment? Maybe. (I’m 65.) But for me, it’s complicated by the fact that I have severe hearing loss, only somewhat eased by a hearing aid and cochlear implant.

Dr. Frank Lin, an otolaryngologist and epidemiologist at Johns Hopkins School of Medicine, describes this phenomenon as “cognitive load.” Cognitive overload is the way it feels. Essentially, the brain is so preoccupied with translating the sounds into words that it seems to have no processing power left to search through the storerooms of memory for a response.

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Katherine Bouton speaks about her own experience with hearing loss.

A transcript of this interview can be found here.

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Over the past few years, Dr. Lin has delivered unwelcome news to those of us with hearing loss. His work looks “at the interface of hearing loss, gerontology and public health,” as he writes on his Web site. The most significant issue is the relation between hearing loss and dementia.

In a 2011 paper in The Archives of Neurology, Dr. Lin and colleagues found a strong association between the two. The researchers looked at 639 subjects, ranging in age at the beginning of the study from 36 to 90 (with the majority between 60 and 80). The subjects were part of the Baltimore Longitudinal Study of Aging. None had cognitive impairment at the beginning of the study, which followed subjects for 18 years; some had hearing loss.

“Compared to individuals with normal hearing, those individuals with a mild, moderate, and severe hearing loss, respectively, had a 2-, 3- and 5-fold increased risk of developing dementia over the course of the study,” Dr. Lin wrote in an e-mail summarizing the results. The worse the hearing loss, the greater the risk of developing dementia. The correlation remained true even when age, diabetes and hypertension — other conditions associated with dementia — were ruled out.

In an interview, Dr. Lin discussed some possible explanations for the association. The first is social isolation, which may come with hearing loss, a known risk factor for dementia. Another possibility is cognitive load, and a third is some pathological process that causes both hearing loss and dementia.

In a study last month, Dr. Lin and colleagues looked at 1,984 older adults beginning in 1997-8, again using a well-established database. Their findings reinforced those of the 2011 study, but also found that those with hearing loss had a “30 to 40 percent faster rate of loss of thinking and memory abilities” over a six-year period compared with people with normal hearing. Again, the worse the hearing loss, the worse the rate of cognitive decline.

Both studies also found, somewhat surprisingly, that hearing aids were “not significantly associated with lower risk” for cognitive impairment. But self-reporting of hearing-aid use is unreliable, and Dr. Lin’s next study will focus specifically on the way hearing aids are used: for how long, how frequently, how well they have been fitted, what kind of counseling the user received, what other technologies they used to supplement hearing-aid use.

What about the notion of a common pathological process? In a recent paper in the journal Neurology, John Gallacher and colleagues at Cardiff University suggested the possibility of a genetic or environmental factor that could be causing both hearing loss and dementia — and perhaps not in that order. In a phenomenon called reverse causation, a degenerative pathology that leads to early dementia might prove to be a cause of hearing loss.

The work of John T. Cacioppo, director of the Social Neuroscience Laboratory at the University of Chicago, also offers a clue to a pathological link. His multidisciplinary studies on isolation have shown that perceived isolation, or loneliness, is “a more important predictor of a variety of adverse health outcomes than is objective social isolation.” Those with hearing loss, who may sit through a dinner party and not hear a word, frequently experience perceived isolation.

Other research, including the Framingham Heart Study, has found an association between hearing loss and another unexpected condition: cardiovascular disease. Again, the evidence suggests a common pathological cause. Dr. David R. Friedland, a professor of otolaryngology at the Medical College of Wisconsin in Milwaukee, hypothesized in a 2009 paper delivered at a conference that low-frequency loss could be an early indication that a patient has vascular problems: the inner ear is “so sensitive to blood flow” that any vascular abnormalities “could be noted earlier here than in other parts of the body.”

A common pathological cause might help explain why hearing aids do not seem to reduce the risk of dementia. But those of us with hearing loss hope that is not the case; common sense suggests that if you don’t have to work so hard to hear, you have greater cognitive power to listen and understand — and remember. And the sense of perceived isolation, another risk for dementia, is reduced.

A critical factor may be the way hearing aids are used. A user must practice to maximize their effectiveness and they may need reprogramming by an audiologist. Additional assistive technologies like looping and FM systems may also be required. And people with progressive hearing loss may need new aids every few years.

Increasingly, people buy hearing aids online or from big-box stores like Costco, making it hard for the user to follow up. In the first year I had hearing aids, I saw my audiologist initially every two weeks for reprocessing and then every three months.

In one study, Dr. Lin and his colleague Wade Chien found that only one in seven adults who could benefit from hearing aids used them. One deterrent is cost ($2,000 to $6,000 per ear), seldom covered by insurance. Another is the stigma of old age.

Hearing loss is a natural part of aging. But for most people with hearing loss, according to the National Institute on Deafness and Other Communication Disorders, the condition begins long before they get old. Almost two-thirds of men with hearing loss began to lose their hearing before age 44. My hearing loss began when I was 30.

Forty-eight million Americans suffer from some degree of hearing loss. If it can be proved in a clinical trial that hearing aids help delay or offset dementia, the benefits would be immeasurable.

“Could we do something to reduce cognitive decline and delay the onset of dementia?” he asked. “It’s hugely important, because by 2050, 1 in 30 Americans will have dementia.

“If we could delay the onset by even one year, the prevalence of dementia drops by 15 percent down the road. You’re talking about billions of dollars in health care savings.”

Should studies establish definitively that correcting hearing loss decreases the potential for early-onset dementia, we might finally overcome the stigma of hearing loss. Get your hearing tested, get it corrected, and enjoy a longer cognitively active life. Establishing the dangers of uncorrected hearing might even convince private insurers and Medicare that covering the cost of hearing aids is a small price to pay to offset the cost of dementia.

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Katherine Bouton is the author of the new book, “Shouting Won’t Help: Why I — and 50 Million Other Americans — Can’t Hear You,” from which this essay is adapted.

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This post has been revised to reflect the following correction:

Correction: February 14, 2013

An article on Tuesday about hearing loss and dementia misidentified the city in which the Medical College of Wisconsin is located. It is in Milwaukee, not in Madison.

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Japanese Economy Contracts and Remains in Recession

TOKYO (AP) — Japan’s economy remained mired in recession late last year, shrinking 0.4 percent in annualized terms for the third straight quarter of contraction on feeble demand at home and overseas.

The government reported Thursday that growth for all of 2012 was 1.9 percent, after a 0.6 percent contraction in 2011 and a 4.7 percent increase in 2010 and a 5.5 percent contraction in 2009.

The figures were worse than expected, as many analysts had forecast the economy may have emerged from recession late last year as the Japanese yen weakened against other major currencies, giving a boost to Japanese export manufacturers.

Prime Minister Shinzo Abe, who took office in late December, is championing aggressive spending and monetary stimulus to help get growth back on track. He has lobbied the central bank to set an inflation target of 2 percent, aimed at breaking out of Japan’s long bout of deflation, or falling prices, that he says are inhibiting corporate investment and growth.

But the Bank of Japan was not expected to announce any major new initiatives from a policy meeting on Thursday. The current central bank governor, Masaaki Shirakawa, is due to leave office on March 19, and Mr. Abe is expected to appoint as his successor an expert who favors his more activist approach to monetary policy.

Last year began on an upbeat note with annual growth in the first quarter at 6 percent as strong government spending on reconstruction from the March 2011 tsunami disaster helped spur demand. But the economy contracted in the second quarter and deteriorated further as frictions with China over a territorial dispute hurt exports to one of Japan’s largest overseas markets.

Despite the dismal data for last year, many in Japan expect at least a temporary bump to growth from higher government spending on public works and other programs. An index measuring consumer confidence, released this week, jumped to its highest level since 2007, the biggest increase in a single month.

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Obama issues order to bolster cyber-defenses

WASHINGTON — President Obama issued an executive order Tuesday that seeks to shore up the nation's cyber-defenses by improving how classified information is shared between the government and the owners and operators of crucial infrastructure, including electric utilities, dams and mass transit.

The long-expected order, which Obama announced in his State of the Union speech, is a stopgap measure that follows Congress' failure last year to pass legislation to create comprehensive standards for the private sector to help thwart digital attacks. Many Republicans and business leaders had decried that bill as unnecessary regulation, while civil liberties groups warned of privacy concerns.

"We know hackers steal people's identities and infiltrate private email," Obama said. "We know foreign countries and companies swipe our corporate secrets. Now our enemies are also seeking the ability to sabotage our power grid, our financial institutions and our air-traffic control systems. We cannot look back years from now and wonder why we did nothing in the face of real threats to our security and our economy."

The executive order comes amid growing concern about foreign-based theft of government and other sensitive computer data and sophisticated digital attacks capable of causing physical damage to national infrastructure, from water treatment plants to traffic systems.

A senior administration official, who spoke on condition of anonymity to brief reporters before the announcement, called cyber-attacks "a grave threat to the United States that requires a new approach based on public-private partnerships."

He said Obama decided to act because the risk remained high and congressional action was uncertain. The president will continue to push for new legislation, the official said.

The order includes two main features. One will expand a program that allows the government to share classified cyber-threat information, including malware signatures, with private companies that pass a security clearance process. The effort now is mostly limited to Internet companies and defense contractors, but it would add crucial infrastructure companies.

"The government provides classified information about cyber-threats to Internet service providers and cyber-security companies … they use that to protect their customers," a second senior administration official said. "We're going to expand the pool of companies that are able to benefit from these cyber-security services."

The order also requires the National Institute of Standards and Technology, a federal agency, to help write voluntary standards so companies can reinforce their network defenses to detect and repel cyber-attacks.

The U.S. intelligence community is preparing a National Intelligence Estimate on cyber-attacks aimed at the United States. Officials say the classified document will highlight the role of Chinese government entities in stealing American intellectual property through hacking, and will outline other cyber-threats overseas.

U.S. officials believe Iran is behind recent cyber-attacks against American banks, for example, in retaliation for the United States' suspected role in a cyber-attack on Iran aimed at slowing its nuclear program. Russia is also active in cyber-espionage, U.S. officials say.

Most American infrastructure is controlled by computer networks connected to the Internet, and some of those networks are vulnerable to dangerous hacking attacks, experts say. A cyber-attack on the electrical power grid, for example, could have severe consequences.

"We're talking about a subset of companies that, if something really bad happens to them in cyberspace, something really bad happens to an awful lot of people," a third administration official said.

Leon E. Panetta, the outgoing secretary of Defense, warned in a speech Feb. 9 that "it is very possible the next Pearl Harbor could be a cyber-attack. That would have one hell of an impact on the United States of America. That is something we have to worry about and protect against."

ken.dilanian@latimes.com

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Executive Order Aims to Facilitate Sharing of Information on Threats

President Barack Obama signed an executive order on Tuesday designed to make it easier to disseminate classified information on threats against critical infrastructure systems and to lay the groundwork for obtaining information from the private sector that would help the government protect critical infrastructures in the U.S.

The order, which runs eight pages (.pdf), directs the Attorney General’s office, the office of Homeland Security Secretary Janet Napolitano and the Director of National Intelligence to issue instructions to their agencies that would “ensure the timely production of unclassified reports of cyberthreats to the U.S. homeland that identify a specific targeted entity” to Congress and also develop a program for providing “classified cyber threat and technical information from the Government to eligible critical infrastructure companies or commercial service providers that offer security services to critical infrastructure,” according to the document.

To that end, the order also calls for the government to expedite security clearances to appropriate personnel employed by critical infrastructure owners and operators, so that they can receive information necessary to protect their systems.

“It is the policy of the United States Government to increase the volume, timeliness, and quality of cyber threat information shared with U.S. private sector entities so that these entities may better protect and defend themselves against cyber threats,” the order states.

The order, published in conjunction with a new Presidential Directive on cybersecurity (.pdf), follows numerous failed attempts by Capitol Hill to pass controversial cybersecurity legislation that would have given private companies legal immunity to share information with the government.

The order still allows the private sector to share information with the government, but references established safeguards — such as the Fair Information Practice Principles — for protecting the privacy of customers whose information is shared and also carries some built-in limitations for the kind of information that companies will likely share. The order requires DHS’s chief privacy officer and its officer for civil rights and civil liberties to assess the privacy and civil liberties risks of the programs.

Civil liberties advocates praised the executive order in this regard, but said they will withhold judgment until they see how the information-sharing gets played out in practice.

“A lot of what this shows is that the president can do a lot without cybersecurity legislation,” said Mark Jaycox, policy analyst and legislative assistant for the Electronic Frontier Foundation, who points out that the executive order satisfies the need for information sharing without the privacy problems that existed under legislative proposals where loopholes would have allowed companies to dump large amounts of data on the government in an effort to obtain legal immunities. Without those immunities, companies will by nature be more circumspect about what they provide the government, thus limiting what they hand over Jaycox said.

“An [executive order] can’t grant broad immunities to companies … so it will tighten the information that can be shared, and the government won’t be on the receiving end of tons of tons of information,” Jaycox said. “Companies will be more mindful about what they share.”

Although the order comes after a number of failed attempts by Congress last year to pass cybersecurity legislation, the White House has indicated that it doesn’t see the executive order as a substitute for legislation, and the order even indicates that further legislation is not ruled out in addressing the critical infrastructure issue.

Not everyone is happy with the order, however. Sen. Charles E. Grassley (R-Iowa) told the Washington Post that the president was out of line in bypassing legislation.

“It is a very dangerous road he’s going down contrary to the spirit of the Constitution,” Sen. Grassley said. “Just because Congress doesn’t act doesn’t mean the president has a right to act.”

The Cyber Intelligence Sharing and Protection Act, which passed the House last year but failed to gain support in the Senate, was one piece of legislation that garnered a lot of criticism from civil liberties groups who were happy to see it fail. EFF and others criticized the bill for failing to provide enough safeguards to protect the digital privacy of customers when private entities such as ISPs and others shared threat information with the government.

CISPA would have allowed companies to share sensitive and personal data with the National Security Agency and other government agencies without requiring companies to make reasonable efforts to protect their customers’ privacy. The bill also failed to adequately define how the government could use the data, saying only that it would be used for “national security” purposes.

House Intelligence Committee Chairman Mike Rogers (R-Michigan) and Ranking Member C.A. Dutch Ruppersberger (D-Maryland) plan on reintroducing CISPA this week.

Critical infrastructure sectors include chemical, communications, dams, critical manufacturing, emergency services, food and agriculture, energy, defense industrial base, healthcare and public health, government facilities, water and wastewater and transportation, among a few others.

DHS currently oversees the National Cybersecurity and Communications Integration Center, a 24-hour watch center tied in with other federal watch centers that parses threat information that comes in to the center and monitors government civilian networks for signs of cyber threats. DHS, along with the Department of Energy, also operates the Industrial Control System – Computer Emergency Readiness Team, which helps assess industrial control systems for vulnerabilities and maintains a flyaway team to assist critical infrastructure owners in the private sector with responding to suspected attacks on their networks.

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Well: Straining to Hear and Fend Off Dementia

At a party the other night, a fund-raiser for a literary magazine, I found myself in conversation with a well-known author whose work I greatly admire. I use the term “conversation” loosely. I couldn’t hear a word he said. But worse, the effort I was making to hear was using up so much brain power that I completely forgot the titles of his books.

A senior moment? Maybe. (I’m 65.) But for me, it’s complicated by the fact that I have severe hearing loss, only somewhat eased by a hearing aid and cochlear implant.

Dr. Frank Lin, an otolaryngologist and epidemiologist at Johns Hopkins School of Medicine, describes this phenomenon as “cognitive load.” Cognitive overload is the way it feels. Essentially, the brain is so preoccupied with translating the sounds into words that it seems to have no processing power left to search through the storerooms of memory for a response.

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Katherine Bouton speaks about her own experience with hearing loss.

A transcript of this interview can be found here.

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Over the past few years, Dr. Lin has delivered unwelcome news to those of us with hearing loss. His work looks “at the interface of hearing loss, gerontology and public health,” as he writes on his Web site. The most significant issue is the relation between hearing loss and dementia.

In a 2011 paper in The Archives of Neurology, Dr. Lin and colleagues found a strong association between the two. The researchers looked at 639 subjects, ranging in age at the beginning of the study from 36 to 90 (with the majority between 60 and 80). The subjects were part of the Baltimore Longitudinal Study of Aging. None had cognitive impairment at the beginning of the study, which followed subjects for 18 years; some had hearing loss.

“Compared to individuals with normal hearing, those individuals with a mild, moderate, and severe hearing loss, respectively, had a 2-, 3- and 5-fold increased risk of developing dementia over the course of the study,” Dr. Lin wrote in an e-mail summarizing the results. The worse the hearing loss, the greater the risk of developing dementia. The correlation remained true even when age, diabetes and hypertension — other conditions associated with dementia — were ruled out.

In an interview, Dr. Lin discussed some possible explanations for the association. The first is social isolation, which may come with hearing loss, a known risk factor for dementia. Another possibility is cognitive load, and a third is some pathological process that causes both hearing loss and dementia.

In a study last month, Dr. Lin and colleagues looked at 1,984 older adults beginning in 1997-8, again using a well-established database. Their findings reinforced those of the 2011 study, but also found that those with hearing loss had a “30 to 40 percent faster rate of loss of thinking and memory abilities” over a six-year period compared with people with normal hearing. Again, the worse the hearing loss, the worse the rate of cognitive decline.

Both studies also found, somewhat surprisingly, that hearing aids were “not significantly associated with lower risk” for cognitive impairment. But self-reporting of hearing-aid use is unreliable, and Dr. Lin’s next study will focus specifically on the way hearing aids are used: for how long, how frequently, how well they have been fitted, what kind of counseling the user received, what other technologies they used to supplement hearing-aid use.

What about the notion of a common pathological process? In a recent paper in the journal Neurology, John Gallacher and colleagues at Cardiff University suggested the possibility of a genetic or environmental factor that could be causing both hearing loss and dementia — and perhaps not in that order. In a phenomenon called reverse causation, a degenerative pathology that leads to early dementia might prove to be a cause of hearing loss.

The work of John T. Cacioppo, director of the Social Neuroscience Laboratory at the University of Chicago, also offers a clue to a pathological link. His multidisciplinary studies on isolation have shown that perceived isolation, or loneliness, is “a more important predictor of a variety of adverse health outcomes than is objective social isolation.” Those with hearing loss, who may sit through a dinner party and not hear a word, frequently experience perceived isolation.

Other research, including the Framingham Heart Study, has found an association between hearing loss and another unexpected condition: cardiovascular disease. Again, the evidence suggests a common pathological cause. Dr. David R. Friedland, a professor of otolaryngology at the Medical College of Wisconsin in Milwaukee, hypothesized in a 2009 paper delivered at a conference that low-frequency loss could be an early indication that a patient has vascular problems: the inner ear is “so sensitive to blood flow” that any vascular abnormalities “could be noted earlier here than in other parts of the body.”

A common pathological cause might help explain why hearing aids do not seem to reduce the risk of dementia. But those of us with hearing loss hope that is not the case; common sense suggests that if you don’t have to work so hard to hear, you have greater cognitive power to listen and understand — and remember. And the sense of perceived isolation, another risk for dementia, is reduced.

A critical factor may be the way hearing aids are used. A user must practice to maximize their effectiveness and they may need reprogramming by an audiologist. Additional assistive technologies like looping and FM systems may also be required. And people with progressive hearing loss may need new aids every few years.

Increasingly, people buy hearing aids online or from big-box stores like Costco, making it hard for the user to follow up. In the first year I had hearing aids, I saw my audiologist initially every two weeks for reprocessing and then every three months.

In one study, Dr. Lin and his colleague Wade Chien found that only one in seven adults who could benefit from hearing aids used them. One deterrent is cost ($2,000 to $6,000 per ear), seldom covered by insurance. Another is the stigma of old age.

Hearing loss is a natural part of aging. But for most people with hearing loss, according to the National Institute on Deafness and Other Communication Disorders, the condition begins long before they get old. Almost two-thirds of men with hearing loss began to lose their hearing before age 44. My hearing loss began when I was 30.

Forty-eight million Americans suffer from some degree of hearing loss. If it can be proved in a clinical trial that hearing aids help delay or offset dementia, the benefits would be immeasurable.

“Could we do something to reduce cognitive decline and delay the onset of dementia?” he asked. “It’s hugely important, because by 2050, 1 in 30 Americans will have dementia.

“If we could delay the onset by even one year, the prevalence of dementia drops by 15 percent down the road. You’re talking about billions of dollars in health care savings.”

Should studies establish definitively that correcting hearing loss decreases the potential for early-onset dementia, we might finally overcome the stigma of hearing loss. Get your hearing tested, get it corrected, and enjoy a longer cognitively active life. Establishing the dangers of uncorrected hearing might even convince private insurers and Medicare that covering the cost of hearing aids is a small price to pay to offset the cost of dementia.

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Katherine Bouton is the author of the new book, “Shouting Won’t Help: Why I — and 50 Million Other Americans — Can’t Hear You,” from which this essay is adapted.

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This post has been revised to reflect the following correction:

Correction: February 12, 2013

An earlier version of this article misstated the location of the Medical College of Wisconsin. It is in Milwaukee, not Madison.

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