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NEW YORK (AP) — Miguel Cabrera has a Most Valuable Player award to go with his Triple Crown. And Buster Posey has an MVP prize to put alongside his second World Series ring.
The pair of batting champions won baseball's top individual honors Thursday by large margins.
Cabrera, the first Triple Crown winner in 45 years, won the AL MVP by receiving 22 of 28 first-place votes and 362 points from a panel of Baseball Writers' Association of America.
The Detroit third baseman easily beat Los Angeles Angels rookie center fielder Mike Trout, who had six firsts and 281 points.
Cabrera hit .330 with 44 homers and 139 RBIs to become the first Triple Crown winner since Boston's Carl Yastrzemski in 1967. Cabrera also led the league with a .606 slugging percentage for the AL champion Tigers.
Some of the more sabermetric-focused fans supported Trout, who hit .326 with 30 homers and 83 RBIs, and he led the majors with 129 runs and 49 steals and topped all players in WAR — Wins Above Replacement. Trout won AL Rookie of the Year earlier in the week.
"I was a little concerned. I thought the new thing about computer stuff, I thought Trout's going to win because they put his numbers over me," Cabrera said. "I was like relax. ... if he wins, it's going to be fair because he had a great season."
His victory is a win for the traditional statistics.
"At the end of the game, it's going to be the same baseball played back in the day," Cabrera said.
Posey, at a charity event at his mother's school in Leesburg, Va., followed the AL debate and Googled to find out the winner.
"I think it intrigued everybody," he said. "As a fan of the game, it was a fun race to watch."
With three fewer hits or two less homers, Cabrera would have fallen short of the Triple Crown. The last four Triple Crown winners have been voted MVP, including Mickey Mantle in 1956 and Frank Robinson in 1966.
"I think winning the Triple Crown had a lot to do with me winning this honor," he said.
Cabrera became the second straight Detroit player voted MVP, following pitcher Justin Verlander in 2011, and was the first Venezuelan to earn the honor. Countryman Pablo Sandoval took home World Series MVP honors last month.
Before the season, Cabrera switched from first base to third to make way for Prince Fielder, who signed with Detroit as a free agent.
"I focused too much in spring training about defense, defense, defense," Cabrera said. "I forgot a little bit about hitting, about getting in the cage like I normally do."
In spring training, Posey's focus was just to get back on the field. His 2011 season was cut short by a collision with the Marlins' Scott Cousins on May 25 that resulted in a fractured bone in Posey's lower left leg and three torn ankle ligaments.
Posey not only returned, he became the first catcher in 70 years to win the NL batting title and helped San Francisco win its second World Series championship in three seasons.
"I definitely have a deeper appreciation for being able to play baseball," he said. "I've seen that it can be taken away quick."
The first catcher in four decades to win the NL award, Posey got 27 of 32 firsts and 422 points to outdistance 2011 winner Ryan Braun of Milwaukee, who was second with 285 points.
Pittsburgh outfielder Andrew McCutchen (245) was third, followed by St. Louis catcher Yadier Molina (241).
Posey, a boyish-looking 25, was the 2010 NL Rookie of the Year as the Giants won their first World Series since 1954. This year he set career highs with a .336 average, 24 homers and 103 RBIs as San Francisco won again.
Posey took the NL batting title after teammate Melky Cabrera requested a rules change that disqualified him. Cabrera, who hit .346, missed the final 45 games of the regular-season while serving a suspension for a positive testosterone test and would have won the batting crown if the rule hadn't been changed.
Ernie Lombardi had been the previous catcher to capture the NL batting championship, in 1942.
"I think anybody that has caught before understands the grind of catching, not only the physical, the nicks, the wear and tear of squatting for nine innings night in, day out, but just the mental grind of working a pitching staff," Posey said. "It's demanding."
NOTES: In his first season with the Angels, Albert Pujols didn't finish among the top 10 for the first time in his career. While with St. Louis, he won three times, was second four times and also finished third, fourth, fifth and ninth. ... Catchers have won the NL MVP just eight times, with Posey joining Gabby Hartnett (1935), Lombardi (1938), Roy Campanella (1951, 1953, 1955) and Johnny Bench (1970, 1972). Posey became the first Giants player to win since Barry Bonds was voted his record seventh MVP award in 2004. ... Cabrera earned a $500,000 bonus, Adrian Beltre $150,000 for finishing third in the AL and Josh Hamilton $50,000 for fifth place. Braun gets a $75,000 bonus, and McCutchen and Molina $50,000 each. The Yankees' Derek Jeter finished seventh in the AL, one place below the level where his 2014 player option would have increased by $2 million to $10 million.
Joshua Lott for The New York Times
Awilda Jimenez got a scan for Alzheimer’s after she started forgetting things. It was positive.
When Awilda Jimenez started forgetting things last year, her husband, Edwin, felt a shiver of dread. Her mother had developed Alzheimer’s in her 50s. Could his wife, 61, have it, too?
He learned there was a new brain scan to diagnose the disease and nervously agreed to get her one, secretly hoping it would lay his fears to rest. In June, his wife became what her doctor says is the first private patient in Arizona to have the test.
“The scan was floridly positive,” said her doctor, Adam S. Fleisher, director of brain imaging at the Banner Alzheimer’s Institute in Phoenix.
The Jimenezes have struggled ever since to deal with this devastating news. They are confronting a problem of the new era of Alzheimer’s research: The ability to detect the disease has leapt far ahead of treatments. There are none that can stop or even significantly slow the inexorable progression to dementia and death.
Families like the Jimenezes, with no good options, can only ask: Should they live their lives differently, get their affairs in order, join a clinical trial of an experimental drug?
“I was hoping the scan would be negative,” Mr. Jimenez said. “When I found out it was positive, my heart sank.”
The new brain scan technology, which went on the market in June, is spreading fast. There are already more than 300 hospitals and imaging centers, located in most major metropolitan areas, that are ready to perform the scans, according to Eli Lilly, which sells the tracer used to mark plaque for the scan.
The scans show plaques in the brain — barnaclelike clumps of protein, beta amyloid — that, together with dementia, are the defining feature of Alzheimer’s disease. Those who have dementia but do not have excessive plaques do not have Alzheimer’s. It is no longer necessary to wait until the person dies and has an autopsy to learn if the brain was studded with plaques.
Many insurers, including Medicare, will not yet pay for the new scans, which cost several thousand dollars. And getting one comes with serious risks. While federal law prevents insurers and employers from discriminating based on genetic tests, it does not apply to scans. People with brain plaques can be denied long-term care insurance.
The Food and Drug Administration, worried about interpretations of the scans, has required something new: Doctors must take a test showing they can read them accurately before they begin doing them. So far, 700 doctors have qualified, according to Eli Lilly. Other kinds of diagnostic scans have no such requirement.
In another unusual feature, the F.D.A. requires that radiologists not be told anything about the patient. They are generally trained to incorporate clinical information into their interpretation of other types of scans, said Dr. R. Dwaine Rieves, director of the drug agency’s Division of Medical Imaging Products.
But in this case, clinical information may lead radiologists to inadvertently shade their reports to coincide with what doctors suspect is the underlying disease. With Alzheimer’s, Dr. Rieves said, “clinical impressions have been misleading.”
“This is a big change in the world of image interpretation,” he said.
Like some other Alzheimer’s experts, Dr. Fleisher used the amyloid scan for several years as part of a research study that led to its F.D.A. approval. Subjects were not told what the scans showed. Now, with the scan on the market, the rules have changed.
Dr. Fleisher’s first patient was Mrs. Jimenez. Her husband, the family breadwinner, had lost his job as a computer consultant when the couple moved from New York to Arizona to take care of Mrs. Jimenez’s mother. Paying several thousand dollars for a scan was out of the question. But Dr. Fleisher found a radiologist, Dr. Mantej Singh Sra of Sun Radiology, who was so eager to get into the business that he agreed to do Mrs. Jimenez’s scan free. His plan was to be the first in Arizona to do a scan, and advertise it.
After Dr. Sra did the scan, the Jimenezes returned to Dr. Fleisher to learn the result.
Dr. Fleisher, sad to see so much plaque in Mrs. Jimenez’s brain, referred her to a psychiatrist to help with anxiety and suggested she enter clinical trials of experimental drugs.
But Mr. Jimenez did not like that idea. He worried about unexpected side effects.
“Tempting as it is, where do you draw the line?” he asks. “At what point do you take a risk with a loved one?”
At Mount Sinai Medical Center in New York, Dr. Samuel E. Gandy found that his patients — mostly affluent — were unfazed by the medical center’s $3,750 price for the scan. He has been ordering at least one a week for people with symptoms ambiguous enough to suggest the possibility of brain plaques.
Most of his patients want their names kept confidential, fearing an inability to get long-term care insurance, or just wanting privacy.
Publishers and broadcasters have long tried to offer advertisers the right audience for their products. Want to sell pick-ups to people who like sports? Buy ads at halftime during a football game. Selling luggage or airline tickets? Buy ads in the travel section of a newspaper or Web site.
In digital advertising, that formula is being increasingly tested by fast-paced, algorithmic bidding systems that target individual consumers rather than the aggregate audience publishers serve up. In the world of “programmatic buying” technologies, context matters less than tracking those consumers wherever they go. And that kind of buying is the reason that shoe ad follows you whether you’re on Weather.com or on a local news blog.
That shift is punishing traditional online publishers, like newspaper, broadcast and magazine sites, who are receiving a much lower percentage of ad dollars as marketers use programmatic buying across a much broader canvas. Some sites, like CNN.com, refuse to even accept advertising through programmatic buying because they do not want to cede control over what ads will appear.
“It’s allowing advertisers to assign value to media rather than publishers,” said Ben Winkler, the chief digital officer at OMD, an agency in the Omnicom Media Group. Publishers, he said, “can’t control the price, but they can control the quality of the content and the audience on that site.”
About 10 percent of the display ads that consumers see online have been sold through programmatic bidding channels, according to Walter Knapp, the executive vice president of platform revenue and operations at Federated Media, one of the world’s largest digital advertising networks.
Advertisers like Nike, Comcast, Progressive and Procter & Gamble are now using the programmatic buying, and luxury advertisers are starting to follow. According to data from Forrester Research, all ads traded on exchanges, as programmatic ads are, increased more than 17.5 percent to about 629 billion impressions (the number of times an ad appears) in 2012, from 535 billion in 2011.
That growth is affecting publishers of all stripes, but few are willing to discuss their internal numbers. “For a publisher to admit they’ve been hurt is tough for the big guys,” said John Ebbert, the executive editor and publisher of the Web site AdExchanger.
When The New York Times Company announced its earnings last month, the company posted a profit, but said that digital advertising fell 2.2 percent. Jim Follo, the company’s senior vice president and chief financial officer, attributed the dip, in part, on a “shift toward ad exchanges, real-time bidding and other programmatic buying channels that allow advertisers to buy audience at scale.”
Programmatic buying began as a way for advertisers to place lower-cost ads for products like teeth-whitening products and belly fat pills that filled up the back pages of Web sites. But the practice has gained in sophistication and breadth, with major advertisers and many of the world’s largest ad agencies creating private exchanges to automate the buying and selling of ads.
Programmatic buying includes a number of different technologies and strategies, but it essentially allows advertisers to bid, often in real time, on ad space largely based on the value they have assigned to the consumer on the other side of the screen. Say, for example, that Nike wants to sell running gear to a particular consumer who has a high likelihood of buying shoes based on the data it has collected, including the type of Web sites that consumer typically visits. Because the ad-buying is done through computer trading, the price for that space can change rapidly.
“Accessing media is a commodity now,” said Sheldon Gilbert, the founder and chief executive of Proclivity Media, a company that specializes in digital advertising technologies. “Instead of having to commit four months in advance, you can now bid and buy an individual impression in real time.”
In the short run, the growth in programmatic buying has forced overall ad prices to fall. A media buyer who would have once spent $50,000 worth of advertising on a publisher’s site, at, say, an $8 cost-per-thousand, can now buy ad impressions on any Web site on which they happen to find their intended audience and pay less per ad, Mr. Ebbert said.
“There is no scarcity of premium online,” said Dan Salmon, an equity research analyst at BMO Capital Markets. “There’s only one Super Bowl, but there are lots of different places to buy banner ads online.”
While the “halo effect” of buying an ad against premium content has not disappeared entirely — many advertisers still want front-page placement on popular Web sites — the shift is prompting publishers to rethink how they sell their ads.
Clark Fredricksen, the vice president for communications at eMarketer, a data company, said that publishers were “going to have to double down to prove the value of their inventory as they compete with other, cheaper inventory.”
And some publishers are jumping into the game themselves. During the most recent AOL earnings call, Tim Armstrong, the company’s chairman and chief executive, said it was bullish on programmatic buying, despite being a publisher itself with properties that include TechCrunch and The Huffington Post. The company trades its ads through its own ad network, Ad.com, and others like it.
“We will continue to invest in people and technology to capture the programmatic business of advertising,” Mr. Armstrong said.
Like AOL, Weather.com is also aggressively moving into programmatic bidding. “Instead of thinking of us a publisher, think of us as a marketing engine,” said Curt Hecht, the chief global revenue officer for the Weather Company.
Neal Mohan, the vice president for product management at Google, which sells advertising though its DoubleClick network, says that in the long run, publishers could see higher returns from programmatic advertising. In the last year, the number of advertisers and publishers using the DoubleClick platform has doubled, Mr. Mohan said, while the rates for those using the platform have increased 11 percent. But that means publishers will have to play by different rules.
“Context still matters and so does placement,” Mr. Ebbert said. “But it’s only one element.”
KIRYAT MALACHI, Israel — Israel and Hamas widened their increasingly deadly conflict over Gaza on Thursday, as a militant rocket killed three civilians in an apartment block in this small southern town. The deaths were likely to lead Israel to intensify its military offensive on Gaza, now in its second day of airstrikes.
In Gaza, the Palestinian death toll rose to 11 as Israel struck what the military described as medium- and long-range rocket and infrastructure sites and rocket-launching squads. The military said it had dispersed leaflets over Gaza warning residents to stay away from Hamas operatives and facilities, suggesting that more was to come.
The regional perils of the situation sharpened, meanwhile, as President Mohamed Morsi of Egypt warned on Thursday that his country stood by the Palestinians against what he termed Israeli aggression, echoing similar condemnation on Wednesday.
“The Egyptian people, the Egyptian leadership, the Egyptian government, and all of Egypt is standing with all its resources to stop this assault, to prevent the killing and the bloodshed of Palestinians,” Mr. Morsi said in nationally televised remarks before a crisis meeting of senior ministers. He also instructed his prime minister to lead a delegation to Gaza on Friday and said he had contacted President Obama to discuss strategies to “stop these acts and doings and the bloodshed and aggression.”
In language that reflected the upheaval in the political dynamics of the Middle East since the overthrow of Hosni Mubarak last year, Mr. Morsi said: “Israelis must realize that we don’t accept this aggression and it could only lead to instability in the region and has a major negative impact on stability and security in the region.”
The thrust of Mr. Morsi’s words seemed confined to diplomatic maneuvers, including calls to the United Nations secretary general, Ban Ki-moon, the head of the Arab League and President Obama.
The 120-nation Nonalignmed Movement, the biggest bloc at the United Nations, added its condemnation of the Gaza airstrikes in a statement released by Iran, the group’s rotating president and one of Israel’s most ardent foes. “Israel, the occupying power, is, once more, escalating its military campaign against the Palestinian people, particularly in the Gaza Strip,” the group’s coordinating bureau said in the statement. The group made no mention of the Palestinian rocket fire but condemned what it called “this act of aggression by the Israelis and their resort to force against the defenseless people” and demanded “decisive action by the U.N. Security Council.”
In his conversation with Mr. Obama, Mr. Morsi said, he “clarified Egypt’s role and Egypt’s position; our care for the relations with the United States of America and the world; and at the same time our complete rejection of this assault and our rejection of these actions, of the bloodshed, and of the siege on Palestinians and their suffering.”
Mr. Obama had agreed to speak with Israeli leaders, Mr. Morsi said.
The Thursday’ deaths in Kiryat Malachi were the first casualties on the Israeli side since Israel launched its assault on Gaza, the most ferocious in four years, in response to persistent Palestinian rocket fire.
Southern Israel has been struck by more than 750 rockets fired from Gaza this year that have hit homes and caused injuries. On Thursday, a rocket smashed into the top floor of an apartment building in Kiryat Malachi, about 15 miles north of Gaza. Two men and one woman were killed, according to witnesses at the scene. A baby was among the injured and several Israelis were hospitalized with shrapnel wounds after rockets hit other southern cities and towns, they said.The apartment house was close to a field in a blue-collar neighborhood and the rocket tore open top-floor apartments, leaving twisted metal window frames and bloodstains.
Nava Chayoun, 40, who lives on the second floor, said her husband, Yitzhak, ran up the stairs immediately after the rocket struck and saw the body of a woman on the floor. He rescued two children from the same apartment and afterward, she said, she and her family “read psalms.”
NEW YORK (AP) — R.A. Dickey languished in the minors for 14 years, bouncing from one team to another before finally perfecting that perplexing knuckleball that made him a major league star.
David Price was the top pick in the draft and an ace by age 25, throwing 98 mph heat with a left arm live enough to make the most hardened scout sing.
Raised only 34 miles apart in central Tennessee, Dickey and Price won baseball's Cy Young awards on Wednesday — one by a wide margin, the other in a tight vote.
Two paths to the pantheon of pitching have rarely been more different.
"Isn't that awesome?" said Dickey, the first knuckleballer to win a Cy Young. "It just shows you there's not just one way to do it, and it gives hope to a lot of people."
Dickey said he jumped up and yelled in excitement, scaring one of his kids, when he saw on television that Price edged Justin Verlander for the American League prize. Both winners are represented by Bo McKinnis, who watched the announcements with Dickey at his home in Nashville, Tenn.
"I guess we can call him Cy agent now," Price quipped on a conference call.
The hard-throwing lefty barely beat out Verlander in balloting by the Baseball Writers' Association of America, preventing the Detroit Tigers' ace from winning consecutive Cy Youngs.
Runner-up two years ago, Price was the pick this time. He received 14 of 28 first-place votes and finished with 153 points to 149 for Verlander, chosen first on 13 ballots.
"It means a lot," Price said. "It's something that I'll always have. It's something that they can't take away from me."
Other than a 1969 tie between Mike Cuellar and Denny McLain, it was the closest race in the history of the AL award.
Rays closer Fernando Rodney got the other first-place vote and came in fifth.
The 38-year-old Dickey was listed first on 27 of 32 National League ballots and totaled 209 points, 113 more than 2011 winner Clayton Kershaw of the Los Angeles Dodgers. Washington lefty Gio Gonzalez finished third.
Cincinnati right-hander Johnny Cueto and Atlanta closer Craig Kimbrel each received a first-place vote, as did Gonzalez. Kershaw had two.
Dickey joined Dwight Gooden (1985) and three-time winner Tom Seaver as the only Mets to win the award. The right-hander went 20-6 with a 2.73 ERA, making him the club's first 20-game winner since Frank Viola in 1990, and became the first major leaguer in 24 years to throw consecutive one-hitters.
Perhaps most impressive, Dickey did it all during a season when the fourth-place Mets finished 74-88.
"It just feels good all over," he said on MLB Network.
Dickey switched from conventional pitcher to full-time knuckleballer in a last-ditch effort to save his career. It took him years to finally master the floating, darting pitch, which he often throws harder (around 80 mph) and with more precision than almost anyone who used it before him.
"I knew what I was going to be up against in some regard when I embraced this pitch," Dickey said.
He was the first cut at Mets spring training in 2010 but earned a spot in the big league rotation later that season and blossomed into a dominant All-Star this year. He led the NL in strikeouts (230), innings (233 2-3), complete games (five) and shutouts (three) — pitching through an abdominal injury most of the way.
"I am not a self-made man by any stretch of the imagination," Dickey said. "The height of this story, it's mind-blowing to me, it really is."
A member of the 1996 U.S. Olympic team and a first-round draft pick out of Tennessee, Dickey was devastated when the Texas Rangers reduced their signing-bonus offer from more than $800,000 to $75,000 after they discovered during a physical that he was missing a major ligament in his pitching elbow.
Undeterred, perseverance got him to the big leagues anyway. When he failed, the knuckleball brought him back.
Among those he thanked ceaselessly for helping him on that long and winding road to success were all his proud knuckleball mentors, including Charlie Hough, Tim Wakefield and Hall of Famer Phil Niekro.
"It brings a real degree of legitimacy I think to the knuckleball fraternity and I'm glad to represent them and I'm certainly grateful to all those guys," Dickey said. "This was a victory for all of us."
Dickey said he received 127 text messages and 35-40 phone calls in the moments immediately following the Cy Young announcement.
The only call he took was from Niekro, a 318-game winner from 1964-87. The first texts Dickey responded to were from Wakefield and Hough.
"Most well-deserved," Niekro said in a comment provided by the Hall of Fame. "I'm super proud of him, as a pitcher and as an individual."
Dickey has one year left on his contract at $5.25 million and New York general manager Sandy Alderson has said signing the pitcher to a multiyear deal is one of his top offseason priorities. Alderson, however, would not rule out trading his unlikely ace.
"I believe the Mets are going to be a lot better and I want to be part of the solution," Dickey said, adding that he hopes the sides can strike a deal and he'd be happy to end his career in New York.
"I want to be loyal to an organization that's given me an opportunity," he said. "At the same time, you don't want to be taken advantage of. I've been on that side of it, too, as a player."
Price went 20-5 to tie Jered Weaver for the American League lead in victories and winning percentage. The 27-year-old lefty had the lowest ERA at 2.56 and finished sixth in strikeouts with 205.
Verlander, also the league MVP a year ago, followed that up by going 17-8 with a 2.64 ERA and pitching the Detroit Tigers to the World Series. He led the majors in strikeouts (239), innings (238 1-3) and complete games (six).
Price tossed 211 innings in 31 starts, while Verlander made 33. One factor that could have swung some votes, however, was this: Price faced stiffer competition in the rugged AL East than Verlander did in the AL Central.
"I guess it's a blessing and a curse at the same time," Price said. "There's not an easy out in the lineups every game. It feels like a postseason game."
The No. 1 pick in the 2007 amateur draft out of Vanderbilt, Price reached the majors the following year and has made three straight All-Star teams.
Despite going 19-6 with a 2.72 ERA in 2010, he finished a distant second in Cy Young voting to Felix Hernandez, who won only 13 games for last-place Seattle but dominated most other statistical categories that year.
The two MVP awards will be announced Thursday. Verlander's teammate, Triple Crown winner Miguel Cabrera, is a leading contender in the American League.
NOTES: The last AL pitcher to win back-to-back Cy Youngs was Boston's Pedro Martinez in 1999 and 2000. San Francisco RHP Tim Lincecum did it in the National League in 2008-09. ... Price and Dickey became the fourth pair of Cy Young winners born in the same state, according to STATS. The others were Jim Lonborg and Mike McCormick in 1967 (California), Viola and Orel Hershiser in 1988 (New York) and Pat Hentgen and John Smoltz in 1996 (Michigan). ... Niekro and his brother, Joe, both finished second in Cy Young voting, as did fellow knuckleballer Wilbur Wood.
Greg Norman, winner of 91 tournaments worldwide, remembers a time when panic attacks on the elite golf circuit were often alleviated with the illicit use of a common heart and blood pressure medicine, the beta blocker.
“In my day, lots of guys were on beta blockers,” Norman, 57, said in an interview at the P.G.A. Championship in August. “It wasn’t openly acknowledged, but it was obvious to the rest of us. A guy’s personality would change. In practice rounds or friendly matches, we’d see the real guy under stress. Then in competition, he was like a different, calmer person. Those guys were trying to take the nerves out of the game. But nerves are very much a part of the game.”
Norman was far from the only one with the tacit understanding that beta blockers, also prescribed for stage fright, were part of big-time golf. So in 2008, when the PGA and L.P.G.A. Tours were establishing their antidoping programs, beta blockers were included on the banned substance lists.
The little pill that inadvertently, or not so inadvertently, soothes the jitters and helps settle the bets in a recreational weekend match — nearly one in three Americans have high blood pressure, so it might be resolving a lot of $5 wagers — is strictly policed when the PGA Tour paydays top $1 million.
The permissibility of beta blockers in golf’s top level has come into focus anew this week. Charlie Beljan won a PGA Tour event Sunday, two days after being hospitalized with a panic attack. Beljan, who said that this week he was going to consult doctors near his home in Arizona, might be treated with medication to prevent future panic attacks. But in competition, he will not be allowed to take certain medications, like beta blockers, without applying for a therapeutic use exemption, which requires a review by an independent panel of doctors.
Dr. Nicole Danforth, a psychiatrist, the medical director of Massachusetts General Hospital’s sports psychology program and a former professional golfer, said, “I think beta blockers could treat the yips, and I think the tours think so, too, or they wouldn’t ban them.”
Beta blockers are prohibited in many sports other than golf, including Olympic sports. The PGA Tour took its lead from the United States Anti-Doping Agency and the World Anti-Doping Agency in adding beta blockers to its list.
“One of the many pharmacological uses of beta blockers is the steadying of hand tremors,” said Andy Levinson, the executive director of the PGA Tour’s antidoping program. “Anything requiring fine motor skills could be affected, something necessary in sports like archery or golf.”
At the 2008 Beijing Olympics, Kim Jong-su of North Korea had to return the silver medal he won in the 50-meter pistol event and the bronze he won in the 10-meter air pistol event after testing positive for propranolol, a beta blocker.
For millions of Americans who take beta blockers, enhancing athletic performance is far from the purpose. Beta blockers are heart medicines meant to control blood pressure, slow the heartbeat and treat a variety of other heart conditions. That they might help calm nerves in a pressure situation is almost an accidental side effect.
“It so happens that the response to an anxiety-producing situation is also driven by the sympathetic nervous system that the beta blocker is trying to control for the good of the patient’s heart,” said Dr. Binoy K. Singh, the associate chief of cardiology at Lenox Hill Hospital in New York.
But Singh said he knew of no long-term, randomized clinical trials measuring beta blockers’ effectiveness in resolving anxiety or improving performance in pressure situations, even if he has had patients tell him they have noticed a calmness in those settings.
There is, in fact, no universal agreement on whether beta blockers help or hurt in some athletic situations.
“Some level of anxiety is good for performance,” said Richard Ginsburg, a sports psychologist at the Harvard Medical School and Massachusetts General Hospital. “It keeps you on your game. A beta blocker can take away some edge, mellow you too much.”
Danforth, who twice played in the United States Women’s Open, agreed, though she added that beta blockers, purely from a golf perspective, had been likened to the stabilizing advantage some find using a long putter.
There are medical concerns for those who acquire beta blockers without a prescription, perhaps through the plethora of Web sites selling the drugs. Singh said there was a serious risk for people using beta blockers without a genuine, long-term medical need for them.
“They are a very powerful class of drugs that have enormous impact on essential bodily functions,” he said. “They are not without adverse effects.”
Beta blockers are far from the primary treatment for panic attacks. There are a variety of medications, doctors said, and there are multiple treatments that do not involve drugs. Among the most effective treatments has been cognitive behavioral therapy. Some anti-anxiety drugs, like Xanax or Valium, are not on most prohibited substance lists, including the one used by the PGA Tour.
But if a golfer on the PGA or L.P.G.A. Tours can prove a documented medical condition that requires the use of a prohibited substance, an exemption is granted. Levinson said a beta blocker exemption had been granted.
When it comes to the recreational golfing community, no doctors said they had a patient who requested a beta blocker prescription to help with the frustrations and strain of playing golf. Singh, who said he was a golfer who had played in stressful weekend matches, was asked if he had ever been tempted to take a beta blocker for the benefits it might bring to his scorecard.
“No, but I would have benefited from a better golf game,” he said.
LONDON — BP, the British oil company, said Thursday it would pay $4.5 billion in fines and other payments to the United States government and plead guilty to 14 criminal charges in connection with the giant oil spill in the Gulf of Mexico two years ago.
An explosion in 2010 on the Deepwater Horizon drilling rig in the Gulf of Mexico that was connected to a well owned by BP killed 11 workers and spilled millions of barrels of oil.
The payments include a $4 billion fine to be paid over five years, with much of it to go to government environmental agencies, BP said in a statement.
As part of the settlement, BP pleaded guilty to 11 felony misconduct or neglect charges related to the deaths of 11 people in the Deepwater Horizon accident in 2010, which unleashed millions of barrels of oil into the gulf.
A law enforcement official familiar with the case also said that two BP employees would be charged with manslaughter in the case. The United States attorney general, Eric H. Holder Jr., was scheduled to hold a news conference in New Orleans later Thursday.
“Today’s agreement is consistent with BP’s position in the ongoing civil litigation that this was an accident resulting from multiple causes, involving multiple parties, as found by other official investigations,” the company said in a news release.
The company said earlier Thursday it was in advanced talks with the United States about settling all criminal claims stemming from the spill.
Even with a settlement on the criminal claims, BP would still be subject to other claims, including federal civil claims and claims for damages to natural resources.
In particular, this settlement does not include what is potentially the largest penalty: fines under the Clean Water Act. The potential fine for the spill under the Clean Water Act is $1,100 to $4,300 per barrel spilled. That means the fine could be as much as $21 billion, according to Peter Hutton of RBC Capital Markets in London.
BP repeatedly said it would like to reach a settlement with claimants if the terms were reasonable. The unresolved issue of the claims has been weighing on BP’s share price as the oil company has been under pressure from investors to move on from the disastrous oil spill that had hurt the company’s reputation and finances.
An explosion in 2010 on the Deepwater Horizon drilling rig in the Gulf of Mexico that was connected to a well owned by BP killed 11 oil workers and spilled millions of barrels of oil into the surrounding water.
BP in March agreed with the lawyers for plaintiffs to settle claims on economic loss, including from the local seafood industry, and medical claims stemming from the oil spill. BP said at the time it expected the cost of that settlement to be about $7.8 billion, which it will pay from a trust the company set aside to cover such costs.
The company returned to profitability in the third quarter and increased its dividend, it said in October. It has been shrinking as it sold assets to raise funds to pay for costs related to the oil spill.
Stanley Reed contributed reporting from London. Charlie Savage contributed from Washington.
Reuters
Palestinians extinguished a fire after an Israeli airstrike on a car carrying Ahmed al-Jabari, who ran Hamas's military wing, on Wednesday in Gaza City.
GAZA — The Israeli military carried out multiple airstrikes in Gaza on Wednesday and blew up a car carrying the commander of the Hamas military wing, making him the most senior official of the group to be killed by the Israelis since their invasion of Gaza four years ago. Hamas announced that Israel would “pay a high price.”
The death of the commander, Ahmed al-Jabari, 52, who was on Israel’s most-wanted list of Palestinian militants, was confirmed by Hamas and Israeli officials. The Israeli military said it had ordered the airstrikes as part of a response to days of rocket fire launched from Gaza into Israeli territory.
Mr. Jabari’s death signaled a further escalation in the renewed hostility between Israel and Hamas, the militant organization regarded by Israel as a terrorist group sworn to Israel’s destruction. The Israeli attacks could also further complicate Israel’s fragile relations with Egypt, where the new government has established closer ties with Hamas and had been acting as a mediator to restore calm between Israel and Gaza-based militant groups.
Hamas reacted furiously, saying in a statement that it considered the Israeli attacks to be the basis for a “declaration of war” against Israel. A spokesman for Hamas, Fawzi Barhoum, said the Israelis had “committed a dangerous crime and broke all redlines,” and that “the Israeli occupation will regret and pay a high price.”
Military officials in Israel, which announced responsibility for the death of Mr. Jabari, later said in a statement that their forces had carried out additional airstrikes in Gaza targeting what they described as “a significant number of long-range rocket sites” owned by Hamas that had stored rockets capable of reaching 25 miles into Israel. The statement said the airstrikes had dealt a “significant blow to the terror organization’s underground rocket-launching capabilities.”
Yisrael Katz, a minister from Israel’s governing Likud Party, issued a statement saying that the operation had sent a message to the Hamas political leaders in Gaza “that the head of the snake must be smashed. Israel will continue to kill and target anyone who is involved in the rocket attacks.”Hamas and medical officials in Gaza said both Mr. Jabari and a companion were killed by the airstrike on his car in Gaza City. Israeli news media said the companion was Mr. Jabari’s son, but there was no immediate confirmation.
The Israel Defense Forces said in a statement that Mr. Jabari had been targeted because he “served in the upper echelon of the Hamas command and was directly responsible for executing terror attacks against the state of Israel in the past number of years.”
The statement said the purpose of the attack was to “severely impair the command and control chain of the Hamas leadership as well as its terrorist infrastructure.”
The statement did not specify how the Israelis knew Mr. Jabari was in the car but said the operation had been “implemented on the basis of concrete intelligence and using advanced capabilities.”
Hamas has controlled Gaza since 2007, a year after the Israelis withdrew from the territory captured in the 1967 Arab-Israeli war. But Israeli forces went back into Gaza in the winter of 2008-09 in response to what they called a terrorist campaign by Palestinian militants there to launch rockets into Israel. The three-week military campaign killed as many as 1,400 Palestinians, including hundreds of civilians, and was widely condemned internationally.
Israel has long said it would hold Hamas responsible for attacks launched from Gaza on its forces and population, regardless of which group was behind them. Like the United States and Europe, Israel defines Hamas as a terrorist organization. Hamas refuses to recognize Israel’s right to exist.
Mr. Jabari became the acting leader of the Hamas military wing after Israel had severely wounded Muhammad Deif, the top commander, in an assassination attempt in 2003. Mr. Jabari had survived several previous Israeli raids. In 2004, Israeli planes attacked his house killing one of his sons and three other relatives.
Shin Bet, the Israeli security agency, considered Mr. Jabari responsible for what it called “all anti-Israeli terror activity” emanating from Gaza.
He was also known for having played a major role in negotiations that led to the release of Gilad Shalit, an Israeli soldier captured by Gaza militants in a cross-border raid in 2006. Mr. Jabari personally escorted Mr. Shalit to a handover to Egyptian intermediaries last year as part of a prisoner exchange for hundreds of Palestinians held in Israeli jails. Video of the handoff to Egypt showed Mr. Jabari standing near Mr. Shalit.
Lt. Col. Avital Leibovich, a spokeswoman for the Israeli military, acknowledged Mr. Jabari’s role in that prisoner exchange during a conference call with journalists on Wednesday announcing the airstrike on Mr. Jabari’s car. She also said Mr. Jabari had “a lot of blood on his hands.”
PITTSBURGH (AP) — The Pittsburgh Steelers will be playing for first place in the AFC North without quarterback Ben Roethlisberger.
The team announced Wednesday that backup Byron Leftwich will start against the Baltimore Ravens on Sunday in place of Roethlisberger, who sprained his right shoulder in Monday night's victory over the Kansas City Chiefs.
The Steelers (6-3) have won four straight to pull within a game of first-place Baltimore (7-2), but Roethlisberger left the 16-13 overtime win over the Chiefs in the third quarter after getting slammed to the ground by a pair of Kansas City linebackers.
The two-time Super Bowl winner underwent extensive testing Tuesday to determine the extent of the injury to his throwing shoulder. It's still unknown how long Roethlisberger will be sidelined. Pittsburgh faces the Ravens twice in the next three weeks.
Leftwich completed 7 of 14 passes for 73 yards after replacing Roethlisberger. He will be making his first start since 2009 when he played for the Tampa Bay Buccaneers.
The former first-round pick has been plagued by injuries the last two seasons and said he felt a little rusty after seeing his first regular season action in nearly two years, though coach Mike Tomlin anticipates the rust to wear off this week.
"I'll trust his assessment if that's his assessment, but I'm not overly concerned about it," Tomlin said. "We got a lot of ball in front of us this week. If he is the guy, he'll get a great opportunity to prepare and we'll expect him to play winning football."
The Steelers have managed to survive without Roethlisberger before. They are 7-5 in games without their franchise quarterback since 2005, including a 4-1 mark over the last two seasons. Roethlisberger missed the first four games of the 2010 season after being suspended for violating the league's personal conduct policy, but Pittsburgh started 3-1 behind Dennis Dixon and Charlie Batch, who will serve at Leftwich's backup on Sunday.
Batch filled in nicely last December when Roethlisberger was sidelined with an ankle injury, throwing for 208 yards in a 27-0 win over the St. Louis Rams.
Leftwich is 0-6 in his last six games as a starter, his last victory coming on Oct. 8, 2006 while playing the Jacksonville Jaguars, who selected Leftwich with the seventh overall pick of the 2003 draft.
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