Google Apps Moving Onto Microsoft’s Business Turf

SAN FRANCISCO — It has taken years, but Google seems to be cutting into Microsoft’s stronghold — businesses.

Google’s software for businesses, Google Apps, consists of applications for document writing, collaboration, and text and video communications — all cloud-based, so that none of the software is on an office worker’s computer. Google has been promoting the idea for more than six years, and it seemed that it was going to appeal mostly to small businesses and tech start-ups.

But the notion is catching on with larger enterprises. In the last year Google has scored an impressive string of wins, including at the Swiss drug maker Hoffmann-La Roche, where over 80,000 employees use the package, and at the Interior Department, where 90,000 use it.

One big reason is price. Google charges $50 a year for each person using its product, a price that has not changed since it made its commercial debut, even though Google has added features. In 2012, for example, Google added the ability to work on a computer not connected to the Internet, as well as security and data management that comply with more stringent European standards. That made it much easier to sell the product to multinationals and companies in Europe.

Many companies that sell software over the cloud add features without raising prices, but also break from traditional industry practice by rarely offering discounts from the list price.

Microsoft’s Office suite of software, which does not include e-mail, is installed on a desktop PC or laptop. In 2013, the list price for businesses will be $400 per computer, but many companies pay half that after negotiating a volume deal.

At the same time, Microsoft has built its business on raising prices for extra features and services. The 2013 version of Office, for example, costs up to $50 more than its predecessor.

“Google is getting traction” on Microsoft, said Melissa Webster, an analyst with IDC. “Its ‘good enough’ product has become pretty good. It looks like 2013 is going to be the year for content and collaboration in the cloud.”

Microsoft has also jumped on the office-in-the-cloud trend. In June 2011, it released Office 365, and now offers its software in both a cloud version and a hybrid version that uses cloud computing and conventional servers. Office 365 starts at a list price of $72 a year, per person, and can cost as much as $240 a person annually, in versions that offer many more features and software development capabilities. Microsoft says it offers more than Google for the money, but the product has not won many converts from Google.

In a recent report, Gartner, the information technology research company, called Google “the only strong competitor” to Microsoft in cloud-based business productivity software, though it warned that “enterprise concerns may not be of paramount importance to the search giant.”

Google is tight-lipped about how many people use Google Apps, saying only that in June more than five million businesses were using it, up from four million in late 2011. Almost all these companies are tiny, but in early December Google announced that even companies with fewer than 10 employees, which used to get Google Apps free, would have to pay.

Google’s revenue from Apps, according to a former executive who asked not to be named in order to maintain good relations with Google, amounted to perhaps $1 billion of the $37.9 billion Google earned in 2011.

Shaw Industries, a carpet maker in Dalton, Ga., with about 30,000 employees, switched to Google Apps this year for communication tools like e-mail and videoconferencing. Jim Nielsen, the company’s manager of enterprise technology, calculated that using Google instead of similar Microsoft products would cost, over seven years, about one-thirteenth Microsoft’s price.

Shaw is a subsidiary of Berkshire Hathaway, run by Warren E. Buffett, but the close friendship of Mr. Buffett and Microsoft’s founder, Bill Gates, did not sway Mr. Nielsen. “When you add it up, the numbers are pretty compelling,” he said.

In addition to the lower price, Google has simplicity in pricing. Mr. Nielsen said he had to sort through 11 pricing models to figure out what he would pay Microsoft.

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Chicken Farms Try Oregano as Antibiotic Substitute

Jessica Kourkounis for The New York Times

Chickens raised for Bell & Evans, like these in Pennsylvania, eat feed laced with oregano oil.

FREDERICKSBURG, Pa. — The smell of oregano wafting from Scott Sechler’s office is so strong that anyone visiting Bell & Evans these days could be forgiven for wondering whether Mr. Sechler has forsaken the production of chicken and gone into pizza.

Oregano lies loose in trays and tied into bunches on tabletops and counters, and a big, blue drum that held oregano oil stands in the corner. “Have you ever tried oregano tea?” Mr. Sechler asked, mashing leaves between his broad fingers.

Off and on over the last three years or so, his chickens have been eating a specially milled diet laced with oregano oil and a touch of cinnamon. Mr. Sechler swears by the concoction as a way to fight off bacterial diseases that plague meat and poultry producers without resorting to antibiotics, which some experts say can be detrimental to the humans who eat the meat. Products at Bell & Evans, based in this town about 30 miles east of Harrisburg, have long been free of antibiotics, contributing to the company’s financial success as consumers have demanded purer foods.

But Mr. Sechler said that nothing he had used as a substitute in the past worked as well as oregano oil.

“I have worried a bit about how I’m going to sound talking about this,” he said. “But I really do think we’re on to something here.”

Skeptics of herbal medicines abound, as any quick Internet search demonstrates. “Oil of oregano is a perennial one, advertised as a cure for just about everything,” said Scott Gavura, a pharmacist in Toronto who writes for the Web site Science-Based Medicine. “But there isn’t any evidence, there are too many unanswered questions and the only proponents for it are the ones producing it.”

Nonetheless, Mr. Gavura said he would welcome a reduction in the use of antibiotics in animals.

At the same time, consumers are growing increasingly sophisticated about the content of the foods that they eat.

Data on sales of antibiotic-free meat is hard to come by, but the sales are a tiny fraction of the overall meat market. Sales in the United States of organic meat, poultry and fish, which by law must be raised without antibiotics, totaled $538 million in 2011, according to the Organic Trade Association. By comparison, sales of all beef that year were $79 billion.

Still, retailers like Costco, Whole Foods and Trader Joe’s, as well as some restaurant chains, complain that they cannot get enough antibiotic-free meat.

Noodles & Company, a fast-growing chain of more than 300 restaurants, recently added antibiotic-free pork to the choices of ingredients that customers can add to their made-to-order pastas. It ensured its supply by ordering cuts of meat that were not in relatively high demand and by committing in advance to buy a year’s worth, said Dan Fogarty, its executive vice president for marketing.

“We’re deliberately voting with our pocketbooks,” he said.

In a nationwide telephone survey of 1,000 adults in March, more than 60 percent told the Consumer Reports National Research Center that they would be willing to pay at least 5 cents a pound more for meat raised without antibiotics.

“Before, it was kind of a nice little business, and while it’s still microscopic in the grand scheme of things, we’re seeing acceptance from retailers across the country, not just in California and on the East Coast,” said Stephen McDonnell, founder and chief executive of Applegate, an organic and natural meats company.

Mr. McDonnell said a confluence of trends, from heightened interest in whole and natural foods to growing concerns about medical problems like diabetes, obesity and gluten allergies, were contributing to the demand for antibiotic-free meat.

There is growing concern among health care experts and policy makers about antibiotic resistance and the rise of “superbugs,” bacteria that are impervious to one or more antibiotics. Those bacteria can be passed on to consumers, who eat meat infected with them and then cannot be treated.

In November, the Centers for Disease Control and Prevention and 25 national health organizations and advocacy groups issued a statement on antibiotics that, among other things, called for “limiting the use of medically important human antibiotics in food animals” and “supporting the use of such antibiotics in animals only for those uses that are considered necessary for assuring animal health.”

In 2011, there were several prominent recalls involving bacterial strains that are resistant to antibiotics, including more than 60 million pounds of ground beef contaminated with salmonella Typhimurium and about 36 million pounds of ground turkey spoiled with salmonella Heidelberg.

Consumer Reports released a study last month that found the bacteria Yersinia enterocolitica in 69 percent of 198 pork chop and ground pork samples bought at stores around the country. Some of the bacteria were resistant to one or more antibiotics.

Analysis of Food and Drug Administration data by the Center for Science in the Public Interest found that 80 percent of all antibiotics sold in the United States are used in animals. The majority of those antibiotics are used to spur growth or prevent infections from spreading in the crowded conditions in which most animal production takes place today.

The European Union has banned the use of antibiotics to accelerate growth, and the European Parliament is pushing to end their use as tools to prevent disease as well.

The oregano oil product Mr. Sechler uses, By-O-Reg Plus, is made by a Dutch company, Ropapharm International. In the late 1990s, Bayer conducted trials on the product, known as Ropadiar in Europe, comparing its ability to control diarrhea in piglets caused by E. coli with that of four of the company’s products.

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No Easy Route If Bashar al-Assad Opts to Go, or Stay

BEIRUT, Lebanon — President Bashar al-Assad of Syria sits in his mountaintop palace as the tide of war licks at the cliffs below.

Explosions bloom over the Damascus suburbs. His country is plunging deeper into chaos. The United Nations’ top envoy for the Syrian crisis, Lakhdar Brahimi, met with Mr. Assad in the palace on Monday in an urgent effort to resolve the nearly two-year-old conflict.

How Mr. Assad might respond to Mr. Brahimi’s entreaty depends on his psychology, shaped by a strong sense of mission inherited from his iron-fisted father and predecessor, Hafez al-Assad; his closest advisers, whom supporters describe as a hard-line politburo of his father’s gray-haired security men; and Mr. Assad’s assessment, known only to himself, about what awaits him if he stays — victory, or death at the hands of his people.

From his hilltop, Mr. Assad can gaze toward several possible futures.

East of the palace lies the airport and a possible dash to exile, a route that some say Mr. Assad’s mother and wife may have already taken. But the way is blocked, not just by bands of rebels, but by a belief that supporters say he shares with his advisers that if he flees, he will betray both his country and his father’s legacy.

He can stay in Damascus and cling to — even die for — his father’s aspirations, to impose a secular Syrian order and act as a pan-Arab leader on a regional and global stage.

Or he can head north to the coastal mountain heartland of his minority Alawite sect, ceding the rest of the country to the uprising led by the Sunni Muslim majority. That would mean a dramatic comedown: reverting to the smaller stature of his grandfather, a tribal leader of a marginalized minority concerned mainly with its own survival.

Mr. Brahimi was closemouthed about the details of his meeting, but has warned in recent weeks that without a political solution, Syria faces the collapse of the state and years of civil war that could dwarf the destruction already caused by the conflict that has taken more than 40,000 lives.

A Damascus-based diplomat said Monday that Mr. Assad, despite official denials, is “totally aware” that he must leave and was “looking for a way out,” though the timetable is unclear.

“More importantly,” said the diplomat, who is currently outside of Syria but whose responsibilities include the country, “powerful people in the upper circle of the ruling elite in Damascus are feeling that an exit must be found.”

Yet others close to Mr. Assad and his circle say any retreat would clash with his deep-seated sense of himself, and with the wishes of increasingly empowered security officials, whom one friend of the president’s has come to see as “hotheads.”

Mr. Assad believes he is “defending his country, his people, and his regime and himself” against Islamic extremism and Western interference, said Joseph Abu Fadel, a Lebanese political analyst who supports Mr. Assad and met with government officials last week in Damascus.

Analysts in Russia, one of Syria’s staunchest allies, say that as rebels try to encircle Damascus and cut off escape routes through Hama province to the coast, the mood in the palace is one of panic, evinced by erratic use of weapons: Scud missiles better used against an army than an insurgency, naval mines dropped from the air instead of laid at sea.

But even if Mr. Assad wanted to flee, it is unclear if the top generals would let him out alive, Russian analysts say, since they believe that if they lay down arms they — and their disproportionately Alawite families — will die in vengeance killings, and need him to rally troops.

“If he can fly out of Damascus,” Semyon A. Bagdasarov, a Middle East expert in Moscow, said — at this, he laughed — “there is also the understanding of responsibility before the people. A person who has betrayed several million of those closest to him.”

Many Syrians still share Mr. Assad’s belief that he is protecting the Syrian state, which helps explain how he has held on this long. At a lavish lunch hosted by a Lebanese politician in Beirut in September, prominent Syrian backers of Mr. Assad — Alawites, Sunnis and Christians — spoke of the president, over copious glasses of Johnnie Walker scotch, as the bulwark of a multicultural, modern Syria.

Reporting was contributed by Kareem Fahim and David D. Kirkpatrick from Beirut, Ellen Barry from Moscow, Sebnem Arsu from Istanbul, Rick Gladstone from New York, and an employee of The New York Times from Tartus, Syria.

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Bits Blog: Instagram Does an About-Face

11:14 p.m. | Updated
SAN FRANCISCO — In the aftermath of the uproar over changes to Instagram’s privacy policy and terms of service earlier this week, the company did an about-face late Thursday.

In a blog post on the company’s site, Kevin Systrom, Instagram’s co-founder, said that where advertising was concerned, the company would revert to its previous terms of service, which have been in effect since October 2010.

“Rather than obtain permission from you to introduce possible advertising products we have not yet developed,” he wrote, “we are going to take the time to complete our plans, and then come back to our users and explain how we would like for our advertising business to work.” Users had been particularly concerned by a clause in Instagram’s policy introduced on Monday that suggested Instagram would share users’ data — like their favorite places, bands, restaurants and hobbies — with Facebook and its advertisers to better target ads.

They also took issue with an update to the company’s terms of service that suggested users’ photos could be used in advertisements, without compensation and even without their knowledge.

The terms of that user agreement said, “You agree that a business or other entity may pay us to display your user name, likeness, photos (along with any associated metadata) and/or actions you take, in connection with paid or sponsored content or promotions, without any compensation to you.”

Following a reaction that included customers defecting to other services, Mr. Systrom told Instagram users on Tuesday that the new policy had been misinterpreted. “It is our mistake that this language is confusing,” he wrote, and he promised an updated agreement.

That statement apparently was not enough. With more people leaving the service, the company, which Facebook bought for $735 million this year, reacted again by returning to the old rules.

Acknowledging those concerns late Thursday, Mr. Systrom wrote: “I want to be really clear: Instagram has no intention of selling your photos, and we never did. We don’t own your photos — you do.”

Mr. Systrom said the company would still be tweaking its privacy policy to quell users’ fears that their photos might pop-up on third-party sites without their consent.

But Mr. Systrom did not clarify how Instagram planned to monetize its service in the future. Facebook is under pressure to make Instagram earn income.

“It’s a free service — they have to monetize somewhere,” said John Casasanta, a principal at Tap Tap Tap, the maker of Camera+, a photo-filter app that has shunned advertising and instead charges users for premium features. “The days of the simple banner ads are gone. Their user data is too valuable.”

It was unclear whether reverting its terms of service would be enough to satisfy high-profile users like National Geographic, which stopped using its Instagram account in light of the moves, or other users who have aired their grievances on Twitter and Facebook.

The controversy has driven traffic and new users to several other photo-sharing applications.

Pheed, an Instagram-like app that gives users the option to monetize their own content by charging followers to see their posts, gained more users than any other app in the United States on Thursday. By Thursday morning, Pheed had jumped to the ninth most downloaded social-networking app in Apple’s iTunes store, just ahead of LinkedIn.

O. D. Kobo, Pheed’s chief executive, said Thursday morning that subscriptions to the service had quadrupled this week and that in the last 24 hours users had uploaded 300,000 new files to the service — more uploads than any other 24-hour-period since Pheed made its debut six weeks ago.

Another runaway success was Flickr, Yahoo’s photo-sharing service, which redesigned its app last week to make it easier to share photos on Twitter. In a stroke of good fortune, it released the app to positive reviews just as Instagram announced it would no longer sync with Twitter, a Facebook rival.

The day before Instagram announced changes to its terms of service, Flickr’s mobile app was ranked at around 175 in Apple’s overall iTunes app charts. Since that day, the application skyrocketed to the high 20s.

Of course, most of these services are still tiny compared to Instagram, which claims to have more than 100 million members who have uploaded upward of 5 billion photos using its service. And it was unclear if the services’ newfound members had also deleted their Instagram accounts or were merely dabbling in other offerings. But the migration, whether temporary or permanent, was a reminder of the volatility of success and that the fall to bottom can sometimes be as swift as the rise to the top.

Facebook and Instagram declined to say whether they had seen any significant number of account deletions or if they were concerned about losing ground in the photo-sharing market to rivals. Some photo apps took direct aim at Instagram. Camera+ even went so far as to include a snide, holiday-themed reference to Instagram’s stumbles in an app update on Wednesday.

“We’ll never do shady things with your shared pics, because it just isn’t right,” the update noted. “On that note, happy Christmas to all, and to all a good night!”

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News Analysis: Getting Polio Campaigns Back on Track

How in the world did something as innocuous as the sugary pink polio vaccine turn into a flash point between Islamic militants and Western “crusaders,” flaring into a confrontation so ugly that teenage girls — whose only “offense” is that they are protecting children — are gunned down in the streets?

Nine vaccine workers were killed in Pakistan last week in a terrorist campaign that brought the work of 225,000 vaccinators to a standstill. Suspicion fell immediately on factions of the Pakistani Taliban that have threatened vaccinators in the past, accusing them of being American spies.

Polio eradication officials have promised to regroup and try again. But first they must persuade the killers to stop shooting workers and even guarantee safe passage.

That has been done before, notably in Afghanistan in 2007, when Mullah Muhammad Omar, spiritual head of the Afghan Taliban, signed a letter of protection for vaccination teams. But in Pakistan, the killers may be breakaway groups following no one’s rules.

Vaccination efforts are also under threat in other Muslim regions, although not this violently yet.

In Nigeria, another polio-endemic country, the new Islamic militant group Boko Haram has publicly opposed it, although the only killings that the news media have linked to polio were those of two police officers escorting vaccine workers. Boko Haram has killed police officers on other missions, unrelated to polio vaccinations.

In Mali, extremists took over half of the country in May, declaring an Islamic state. Vaccination is not an issue yet, but Mali had polio cases as recently as mid-2011, and the virus sometimes circulates undetected.

Resistance to polio vaccine springs from a combination of fear, often in marginalized ethnic groups, and brutal historical facts that make that fear seem justified. Unless it is countered, and quickly, the backlash threatens the effort to eradicate polio in the three countries where it remains endemic: Pakistan, Afghanistan and Nigeria.

In 1988, long before donors began delivering mosquito nets, measles shots, AIDS pills, condoms, deworming drugs and other Western medical goods to the world’s most remote villages, Rotary International dedicated itself to wiping out polio, and trained teams to deliver the vaccine.

But remote villages are often ruled by chiefs or warlords who are suspicious not only of Western modernity, but of their own governments.

The Nigerian government is currently dominated by Christian Yorubas. More than a decade ago, when word came from the capital that all children must swallow pink drops to protect them against paralysis, Muslim Hausas in the far-off north could be forgiven for reacting the way the fundamentalist Americans of the John Birch Society did in the 1960s when the government in far-off Washington decreed that, for the sake of children’s teeth, all drinking water should have fluoride.

The northerners already had grievances. In 1996, the drug company Pfizer tested its new antibiotic, Trovan, during a meningitis outbreak there. Eleven children died. Although Pfizer still says it was not to blame, the trial had irregularities, and last year the company began making payments to victims.

Other rumors also spring from real events.

In Pakistan, resistance to vaccination, low over all, is concentrated in Pashtun territory along the Afghan border and in Pashtun slums in large cities. Pashtuns are the dominant tribe in Afghanistan but a minority in Pakistan among Punjabis, Sindhis, Baluchis and other ethnic groups. Many are Afghan refugees and are often poor and dismissed as medieval and lawless.

Pakistan’s government is friendly with the United States while the Pashtuns’ territory in border areas has been heavily hit by American Taliban-hunting drones, which sometimes kill whole families.

So, when the Central Intelligence Agency admitted sponsoring a hepatitis vaccination campaign as a ruse to get into a compound in Pakistan to confirm that Osama bin Laden was there, and the White House said it had contemplated wiping out the residence with a drone missile, it was not far-fetched for Taliban leaders to assume that other vaccinators worked for the drone pilots.

Even in friendly areas, the vaccine teams have protocols that look plenty suspicious. If a stranger knocked on a door in Brooklyn, asked how many children under age 5 were at home, offered to medicate them, and then scribbled in chalk on the door how many had accepted and how many refused — well, a parent might worry.

In modern medical surveys — though not necessarily on polio campaigns — teams carry GPS devices so they can find houses again. Drones use GPS coordinates.

The warlords of Waziristan made the connection specific, barring all vaccination there until Predator drones disappeared from the skies.

Dr. Bruce Aylward, a Canadian who is chief of polio eradication for the World Health Organization, expressed his frustration at the time, saying, “They know we don’t have any control over drone strikes.”

The campaign went on elsewhere in Pakistan — until last week.

The fight against polio has been hampered by rumors that the vaccine contains pork or the virus that causes AIDS, or is a plot to sterilize Muslim girls. Even the craziest-sounding rumors have roots in reality.

The AIDS rumor is a direct descendant of Edward Hooper’s 1999 book, “The River,” which posited the theory — since discredited — that H.I.V. emerged when an early polio vaccine supposedly grown in chimpanzee kidney cells contaminated with the simian immunodeficiency virus was tested in the Belgian Congo.

The sterilization claim was allegedly first made on a Nigerian radio station by a Muslim doctor upset that he had been passed over for a government job. The “proof” was supposed to be lab tests showing it contained estrogen, a birth control hormone.

The vaccine virus is grown in a broth of live cells; fetal calf cells are typical. They may be treated with a minute amount of a digestive enzyme, trypsin — one source of which is pig pancreas, which could account for the pork rumor.

In theory, a polio eradicator explained, if a good enough lab tested the vaccine used at the time the rumor started, it might have detected estrogen from the calf’s mother, but it would have been far less estrogen than is in mother’s milk, which is not accused of sterilizing anyone. The trypsin is supposed to be washed out.

In any case, polio vaccine is now bought only from Muslim countries like Indonesia, and Muslim scholars have ruled it halal — the Islamic equivalent of kosher.

Reviving the campaign will mean quelling many rumors. It may also require adding other medical “inducements,” like deworming medicine, mosquito nets or vitamin A, whose immediate benefits are usually more obvious.

But changing mind-sets will be a crucial step, said Dr. Aylward, who likened the shootings of the girls to those of the schoolchildren in Newtown, Conn.

More police involvement — what he called a “bunkerized approach” — would not solve either America’s problem or Pakistan’s, he argued. Instead, average citizens in both countries needed to rise up, reject the twisted thinking of the killers and “generate an understanding in the community that this kind of behavior is not acceptable.”

Read More..

News Analysis: Getting Polio Campaigns Back on Track

How in the world did something as innocuous as the sugary pink polio vaccine turn into a flash point between Islamic militants and Western “crusaders,” flaring into a confrontation so ugly that teenage girls — whose only “offense” is that they are protecting children — are gunned down in the streets?

Nine vaccine workers were killed in Pakistan last week in a terrorist campaign that brought the work of 225,000 vaccinators to a standstill. Suspicion fell immediately on factions of the Pakistani Taliban that have threatened vaccinators in the past, accusing them of being American spies.

Polio eradication officials have promised to regroup and try again. But first they must persuade the killers to stop shooting workers and even guarantee safe passage.

That has been done before, notably in Afghanistan in 2007, when Mullah Muhammad Omar, spiritual head of the Afghan Taliban, signed a letter of protection for vaccination teams. But in Pakistan, the killers may be breakaway groups following no one’s rules.

Vaccination efforts are also under threat in other Muslim regions, although not this violently yet.

In Nigeria, another polio-endemic country, the new Islamic militant group Boko Haram has publicly opposed it, although the only killings that the news media have linked to polio were those of two police officers escorting vaccine workers. Boko Haram has killed police officers on other missions, unrelated to polio vaccinations.

In Mali, extremists took over half of the country in May, declaring an Islamic state. Vaccination is not an issue yet, but Mali had polio cases as recently as mid-2011, and the virus sometimes circulates undetected.

Resistance to polio vaccine springs from a combination of fear, often in marginalized ethnic groups, and brutal historical facts that make that fear seem justified. Unless it is countered, and quickly, the backlash threatens the effort to eradicate polio in the three countries where it remains endemic: Pakistan, Afghanistan and Nigeria.

In 1988, long before donors began delivering mosquito nets, measles shots, AIDS pills, condoms, deworming drugs and other Western medical goods to the world’s most remote villages, Rotary International dedicated itself to wiping out polio, and trained teams to deliver the vaccine.

But remote villages are often ruled by chiefs or warlords who are suspicious not only of Western modernity, but of their own governments.

The Nigerian government is currently dominated by Christian Yorubas. More than a decade ago, when word came from the capital that all children must swallow pink drops to protect them against paralysis, Muslim Hausas in the far-off north could be forgiven for reacting the way the fundamentalist Americans of the John Birch Society did in the 1960s when the government in far-off Washington decreed that, for the sake of children’s teeth, all drinking water should have fluoride.

The northerners already had grievances. In 1996, the drug company Pfizer tested its new antibiotic, Trovan, during a meningitis outbreak there. Eleven children died. Although Pfizer still says it was not to blame, the trial had irregularities, and last year the company began making payments to victims.

Other rumors also spring from real events.

In Pakistan, resistance to vaccination, low over all, is concentrated in Pashtun territory along the Afghan border and in Pashtun slums in large cities. Pashtuns are the dominant tribe in Afghanistan but a minority in Pakistan among Punjabis, Sindhis, Baluchis and other ethnic groups. Many are Afghan refugees and are often poor and dismissed as medieval and lawless.

Pakistan’s government is friendly with the United States while the Pashtuns’ territory in border areas has been heavily hit by American Taliban-hunting drones, which sometimes kill whole families.

So, when the Central Intelligence Agency admitted sponsoring a hepatitis vaccination campaign as a ruse to get into a compound in Pakistan to confirm that Osama bin Laden was there, and the White House said it had contemplated wiping out the residence with a drone missile, it was not far-fetched for Taliban leaders to assume that other vaccinators worked for the drone pilots.

Even in friendly areas, the vaccine teams have protocols that look plenty suspicious. If a stranger knocked on a door in Brooklyn, asked how many children under age 5 were at home, offered to medicate them, and then scribbled in chalk on the door how many had accepted and how many refused — well, a parent might worry.

In modern medical surveys — though not necessarily on polio campaigns — teams carry GPS devices so they can find houses again. Drones use GPS coordinates.

The warlords of Waziristan made the connection specific, barring all vaccination there until Predator drones disappeared from the skies.

Dr. Bruce Aylward, a Canadian who is chief of polio eradication for the World Health Organization, expressed his frustration at the time, saying, “They know we don’t have any control over drone strikes.”

The campaign went on elsewhere in Pakistan — until last week.

The fight against polio has been hampered by rumors that the vaccine contains pork or the virus that causes AIDS, or is a plot to sterilize Muslim girls. Even the craziest-sounding rumors have roots in reality.

The AIDS rumor is a direct descendant of Edward Hooper’s 1999 book, “The River,” which posited the theory — since discredited — that H.I.V. emerged when an early polio vaccine supposedly grown in chimpanzee kidney cells contaminated with the simian immunodeficiency virus was tested in the Belgian Congo.

The sterilization claim was allegedly first made on a Nigerian radio station by a Muslim doctor upset that he had been passed over for a government job. The “proof” was supposed to be lab tests showing it contained estrogen, a birth control hormone.

The vaccine virus is grown in a broth of live cells; fetal calf cells are typical. They may be treated with a minute amount of a digestive enzyme, trypsin — one source of which is pig pancreas, which could account for the pork rumor.

In theory, a polio eradicator explained, if a good enough lab tested the vaccine used at the time the rumor started, it might have detected estrogen from the calf’s mother, but it would have been far less estrogen than is in mother’s milk, which is not accused of sterilizing anyone. The trypsin is supposed to be washed out.

In any case, polio vaccine is now bought only from Muslim countries like Indonesia, and Muslim scholars have ruled it halal — the Islamic equivalent of kosher.

Reviving the campaign will mean quelling many rumors. It may also require adding other medical “inducements,” like deworming medicine, mosquito nets or vitamin A, whose immediate benefits are usually more obvious.

But changing mind-sets will be a crucial step, said Dr. Aylward, who likened the shootings of the girls to those of the schoolchildren in Newtown, Conn.

More police involvement — what he called a “bunkerized approach” — would not solve either America’s problem or Pakistan’s, he argued. Instead, average citizens in both countries needed to rise up, reject the twisted thinking of the killers and “generate an understanding in the community that this kind of behavior is not acceptable.”

Read More..

Syrian Airstrikes Reportedly Kill Dozens at Bakery

BEIRUT, Lebanon — Bombs that antigovernment activists said were dropped by a Syrian warplane on Sunday killed dozens of people at a bakery in the central town of Halfaya where residents had lined up for bread after the town received its first flour delivery in days.

The New York Times

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

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

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

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

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

The attack on Sunday occurred as the international envoy to Syria, Lakhdar Brahimi, arrived in the capital, Damascus, where he was expected to meet with President Bashar al-Assad. His visit had been rumored but not previously announced, signaling concerns about security as the fighting between opposition fighters and the government intensified in the capital.

Mr. Brahimi made no public comment on Sunday, and the Syrian information minister said during a news conference that he had no knowledge of the envoy’s visit. Mr. Brahimi traveled by land from Beirut because of fighting between the rebels and government forces near the airport in Damascus, Lebanese airport officials told The Associated Press.

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

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

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

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

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

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

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

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

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

Hala Droubi contributed reporting from Jidda, Saudi Arabia.

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E-Book Price War Has Yet to Arrive

Thor Swift for The New York Times

A Google e-reader is displayed at a bookstore. Sales of e-books for the devices have slowed this year.

Right about now, just as millions of e-readers and tablets are being slipped under Christmas trees, there was supposed to be a ferocious price war over e-books.

Last spring, the Justice Department sued five major publishers and Apple on e-book price-fixing charges. The case was a major victory for Amazon, and afterward there were widespread expectations — fueled by Amazon — that the price of e-books would plunge.

The most extreme outcome went like this: Digital versions of big books selling for $9.99 or less would give Amazon complete domination over the e-book market. As sales zoomed upward, even greater numbers of consumers would abandon physical books. The major publishers and traditional bookstores were contemplating a future that would pass them by.

But doomsday has not arrived, at least not yet. As four of the publishers have entered into settlements with regulators and revised the way they sell e-books, prices have selectively fallen but not as broadly or drastically as anticipated.

The $10 floor that publishers fought so hard to maintain for popular new novels is largely intact. Amazon, for instance, is selling Michael Connelly’s new mystery, “The Black Box,” for $12.74. New best sellers by David Baldacci and James Patterson cost just over $11.

One big reason for the lack of fireworks is that the triumph of e-books over their physical brethren is not happening quite as fast as forecast.

“The e-book market isn’t growing at the caffeinated level it was,” said Michael Norris, a Simba Information analyst who follows the publishing industry. “Even retailers like Amazon have to be wondering, how far can we go — or should we go — to make our prices lower than the other guys if it’s not helping us with market share?”

Adult e-book sales through August were up 34 percent from 2011, an impressive rate of growth if you forget that sales have doubled every year for the last four years. And there have been more recent signs of a market pausing for breath.

Macmillan, the only publisher that has not settled with the Justice Department, said last week as part of a statement from John Sargent, its chief executive, that “our e-book business has been softer of late, particularly for the last few weeks, even as the number of reading devices continues to grow.” His laconic conclusion: “Interesting.”

Mr. Norris said Simba, which regularly surveys e-book buyers, has been noticing what it calls “commitment to content” issues.

“A lot of these e-book consumers aren’t behaving like lab rats at a feeder bar,” the analyst said. “We have found that at any given time about a third of e-book users haven’t bought a single title in the last 12 months. I have a feeling it is the digital equivalent of the ‘overloaded night stand’ effect; someone isn’t going to buy any more books until they make a dent in reading the ones they have already acquired.”

Another, more counterintuitive possibility is that the 2011 demise of Borders, the second-biggest chain, dealt a surprising blow to the e-book industry. Readers could no longer see what they wanted to go home and order. “The print industry has been aiding and assisting the e-book industry since the beginning,” Mr. Norris said.

It is possible that Amazon, which controls about 60 percent of the e-book market, is merely holding back with price cuts for the right moment. The next few weeks are when e-book sales traditionally take a big jump, as all those newly received devices are loaded up with content.

Amazon declined to comment beyond saying, “We have lowered prices for customers from the prices publishers set on a broad assortment of Kindle books.” Barnes & Noble declined to comment on its pricing strategy.

The question of the proper price for e-books has shadowed the industry ever since Amazon introduced the Kindle in late 2007 and created the first truly popular portable reading device. Amazon had a natural impulse to build a market and was an aggressive retailer in any case, so it took best sellers that cost $25 in independent bookstores and sold them for $9.99 as e-books. Consumers liked that. E-book adoption soared.

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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 the production of physicians, they say, it could eventually dampen a looming doctor shortage, although the number of doctors would not increase unless the schools admitted 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.

Read More..

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 the production of physicians, they say, it could eventually dampen a looming doctor shortage, although the number of doctors would not increase unless the schools admitted 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.

Read More..