Tennessee fires football coach Derek Dooley

KNOXVILLE, Tenn. (AP) — Derek Dooley is out at Tennessee.

The university announced the anticipated firing Sunday after Dooley posted the storied program's longest run of consecutive losing seasons in over a century .

Dooley, 44, had a 15-21 record that included an 0-15 mark against Top 25 teams. Dooley was 4-19 in Southeastern Conference competition during his three-year tenure and had lost 14 of his last 15 league games.

The school will hold a news conference Sunday at 2 p.m.

Dooley had four years left on his contract, which includes a $5 million buyout.

"We very much appreciate the effort and energy that Derek Dooley and his staff have poured into our football program at the University of Tennessee," athletic director Dave Hart said in a statement. "Derek and I met early this morning, and I informed him that I believed a change in leadership, despite the positive contributions he has made to the overall health of the program, was in the best long-term interests of Tennessee football. We will immediately begin the search for the best possible candidate to assume this leadership role."

Tennessee (4-7, 0-7 SEC) must beat Kentucky on Saturday to avoid going winless in SEC play for the first time in school history. Offensive coordinator Jim Chaney will serve as the Vols' interim coach for the Kentucky game.

Tennessee's 41-18 loss to Vanderbilt on Saturday guaranteed the Volunteers their third consecutive losing season, which marks the first time they have finished below .500 in three straight years since 1909-11. Tennessee's loss to Vanderbilt marked only the second time in 30 years that the Vols had fallen to their in-state rival.

The Vols will fail to reach a bowl in back-to-back seasons for the first time since being left out four consecutive years from 1975-78.

"I am sorry we could not generate enough wins to create hope for a brighter future," Dooley said in a statement. "Although progress was not reflected in our record, I am proud of the strides we made to strengthen the foundation for future success in all areas of the program. During the last 34 months, I've given my all for Tennessee, and our family appreciates all this University and the Knoxville community has given us."

Dooley's successor will become the Vols' fourth coach in a six-year stretch. Phillip Fulmer was fired in the midst of a 5-7 season in 2008 and ended his 17-year tenure with a 152-52 record. Lane Kiffin stayed for just one year before Southern California hired him away. Now Dooley is leaving after only three seasons.

Tennessee won at least eight games for 16 consecutive seasons from 1989-2004 and posted double-digit wins in nine of those years, but the Vols haven't earned more than seven victories in any of their last five seasons. This will mark their fifth losing season over the last eight years.

"It's real surprising," junior quarterback Tyler Bray said after the Vanderbilt game. "I didn't think we'd have a losing record. I thought we'd only lose a couple of games, maybe two or three, and we've been getting our butts kicked. It's really not fun. "

Tennessee faces some financial issues as it chooses its new coach. The university's athletic department posted a $3.98 million budget deficit for the 2011-12 fiscal year in part because of buyouts it was paying to Fulmer, former athletic director Mike Hamilton, former men's basketball coach Bruce Pearl and former baseball coach Todd Raleigh.

The football program is on probation until August 2015. The NCAA handed Tennessee a two-year extension of its probation Friday after ruling former assistant Willie Mack Garza provided impermissible travel and lodging for an unofficial visit by former prospect Lache Seastrunk, who eventually signed with Oregon and has since transferred to Baylor. Garza worked as an assistant on Kiffin's staff.

Dooley didn't enter an ideal situation when he arrived at Tennessee in January 2010 after going 17-20 in three seasons at Louisiana Tech. Tennessee went a combined 12-13 in the two years leading up to his arrival.

After Dooley led Tennessee to a 6-7 record and Music City Bowl bid in 2010, the Vols went 5-7 last season and closed the year with a 10-7 loss to Kentucky, ending the Vols' 26-game winning streak in that annual series.

Dooley overhauled his coaching staff over the winter, most notably adding Sal Sunseri as defensive coordinator after Justin Wilcox left to take the same position at Washington. The Vols were confident they could turn things around this year. Dooley said during the SEC Media Days that "you're not going to have Tennessee to kick around anymore."

It hasn't worked out that way. The Vols briefly entered the Top 25 after winning their first two games this season, but they've lost seven of nine since.

Although the offense has produced plenty of points, the defense has allowed 37.4 points and 476.8 yards per game. The Vols haven't given up that high a scoring average over the course of a full season since allowing 42.7 per game while playing a six-game schedule in 1893. Tennessee hasn't allowed that many yards per game since at least 1950, the earliest year Tennessee measures that statistic in its media guide.

As the losses piled up, fans started staying away.

Tennessee's average attendance of 94,642 last year was its lowest since 1989. The Vols' average announced attendance through six home games this season is 91,318, more than 11,000 below Neyland Stadium's capacity.

Dooley acknowledged at his Monday news conference that his future as Tennessee's coach was up in the air. Several players spoke out in support of him in the days leading up to the Vanderbilt game. Junior nose guard Daniel Hood noted how Dooley helped him deal with the death of his mother this summer.

"I can't talk to you about X's and O's because the only thing I know is defensive line and offensive line," Hood said. "But I know as a person, he's one of the best people that I've been around in my life, probably the second most important I've had in my life too.

"This summer, going through things with my mom and things like that, I wouldn't be where I am today without someone like Coach Dooley. As a player, it's hard not to take it personal when people are attacking your coach and things like that. It's hard to separate the X's and O's from the actual person."

Dooley often pointed out that the Vols weren't far from turning the corner. They either were ahead or trailed by one score in the second half of losses to Florida, Georgia, Mississippi State, South Carolina and Missouri. But they didn't put up much of a fight Saturday while posting their most one-sided defeat to Vanderbilt since 1954.

"I don't think you can say where this program is on one game," Dooley said after the game. "We've had a lot of really good games that we didn't win this year, so the program is certainly not near where we need to be. It's not anywhere close to where the fans want it to be, but it's probably a little bit better than what people think it is. That's how I would assess it."

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The Neediest Cases: Emerging From a Bleak Life to Become Fabulous Phil

For years, Phillip Johnson was caught in what seemed like an endless trench of bad luck. He was fired from a job, experienced intensifying psychological problems, lost his apartment and spent time in homeless shelters. At one point, he was hospitalized after overdosing on an antipsychotic drug.

“I had a rough road,” he said.

Since his hospital stay two years ago, and despite setbacks, Mr. Johnson, 27, has been getting his life on track. At Brooklyn Community Services, where he goes for daily counseling and therapy, everybody knows him as Fabulous Phil.

“Phillip is a light, the way he evokes happiness in other people,” his former caseworker, Teresa O’Brien, said. “Phillip’s character led directly to his nickname.”

About six months ago, with Ms. O’Brien’s help, Mr. Johnson started an event: Fabulous Phil Friday Dance Party Fridays.

One recent afternoon at the agency, 30 clients and a few counselors were eating cake, drinking soft drinks and juice, and grooving for 45 minutes to Jay-Z and Drake pulsating from a boom box.

Mr. Johnson’s voice rose with excitement when he talked about the party. Clients and counselors, he said, “enjoy themselves.”

“They connect more; they communicate more,” he continued. “Everybody is celebrating and laughing.”

The leadership Mr. Johnson now displays seems to be a far cry from the excruciatingly introverted person he was.

As an only child living with his single mother in public housing in Bedford-Stuyvesant, Brooklyn, he said, he tended to isolate himself. “A lot of kids my age would say, ‘Come outside,’ but I would always stay in my room,” he said. He occupied himself by writing comic books or reading them, his favorites being Batman and Spiderman because, he said, “they were heroes who saved the day.”

After graduating from high school in 2003, he worked odd jobs until 2006, when he took a full-time position at a food court at La Guardia Airport, where he helped to clean up. The steady paycheck allowed him to leave his mother’s apartment and rent a room in Queens.

But the depression and bleak moods that had shadowed him throughout middle and high school asserted themselves.

“My thinking got confused,” he said. “Racing thoughts through my mind. Disorganized thoughts. I had a hard time focusing on one thing.”

In 2008, after two years on the job, Mr. Johnson was fired for loud and inappropriate behavior, and for being “unpredictable,” he said. The boss said he needed counseling. He moved back in with his mother, and in 2009 entered a program at an outpatient addiction treatment service, Bridge Back to Life. It was there, he said, that he received a diagnosis of schizophrenia and help with his depression and marijuana use.

But one evening in May 2010, he had a bout with insomnia.

He realized the antipsychotic medication he had been prescribed, Risperdal, made him feel tired, he said, so he took 12 of the pills, rather than his usual dosage of two pills twice a day. When 12 did not work, he took 6 more.

“The next morning when I woke up, it was hard for me to breathe,” he said.

He called an ambulance, which took to Woodhull Hospital. He was released after about a month.

Not long after, he returned to his mother’s apartment, but by February 2011, they both decided he should leave, and he relocated to a homeless shelter in East New York, where, he said, eight other people were crammed into his cubicle and there were “bedbugs, people lying in your bed, breaking into your locker to steal your stuff.”

In late spring 2011, he found a room for rent in Manhattan, but by Thanksgiving he was hospitalized again. Another stint in a shelter followed in April, when his building was sold.

Finally, in July, Mr. Johnson moved to supported housing on Staten Island, where he lives with a roommate. His monthly $900 Social Security disability check is sent to the residence, which deducts $600 for rent and gives him $175 in spending money; he has breakfast and lunch at the Brooklyn agency. To assist Mr. Johnson with unexpected expenses, a grant of $550 through The New York Times Neediest Cases Fund went to buy him a bed and pay a Medicare prescription plan fee for three months.

“I was so happy I have a bed to sleep on,” he said about the replacement for an air mattress. “When I have a long day, I have a bed to lay in, and I feel good about that.”

Mr. Johnson’s goals include getting his driver’s license — “I already have a learner’s permit,” he said, proudly — finishing his program at the agency, and then entering an apprenticeship program to become a plumber, carpenter or mechanic.

But seeing how his peers have benefited from Fabulous Phil Fridays has made him vow to remain involved with people dealing with mental illnesses or substance abuse.

He was asked at the party: Might he be like the comic-book heroes he loves? A smile spread across his face. He seemed to think so.

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Israel Sticks to Tough Approach in Conflict With Hamas

TEL AVIV — With rockets landing on the outskirts of Tel Aviv and Jerusalem on Friday and the Egyptian prime minister making a solidarity visit to Gaza, the accelerating conflict between Israel and Hamas — reminiscent in many ways of so many previous battles — has the makings of a new kind of Israeli-Palestinian face-off.

The combination of longer-range and far deadlier rockets in the hands of more radicalized Palestinians, the arrival in Gaza and Sinai from North Africa of other militants pressuring Hamas to fight more, and the growing tide of anti-Israel fury in a region where authoritarian rulers have been replaced by Islamists means that Israel is engaging in this conflict with a different set of challenges.

The Middle East of 2012 is not what it was in late 2008, the last time Israel mounted a military invasion to reduce the rocket threat from Gaza. Many analysts and diplomats outside Israel say the country today needs a different approach to Hamas and the Palestinians based more on acknowledging historic grievances and shifting alliances.

“As long as the crime of dispossession and refugeehood that was committed against the Palestinian people in 1947-48 is not redressed through a peaceful and just negotiation that satisfies the legitimate rights of both sides, we will continue to see enhancements in both the determination and the capabilities of Palestinian fighters — as has been the case since the 1930s, in fact,” Rami G. Khouri, a professor at the American University of Beirut, wrote in an online column. “Only stupid or ideologically maniacal Zionists fail to come to terms with this fact.”

But the government in Israel and the vast majority of its people have drawn a very different conclusion. Their dangerous neighborhood is growing still more dangerous, they agree. That means not concessions, but being tougher in pursuit of deterrence, and abandoning illusions that a Jewish state will ever be broadly accepted here.

“There is a theory, which I believe, that Hamas doesn’t want a peaceful solution and only wants to keep the conflict going forever until somehow in their dream they will have all of Israel,” Eitan Ben Eliyahu, a former leader of the Israeli Air Force, said in a telephone briefing. “There is a good chance we will go into Gaza on the ground again.”

What is striking in listening to the Israelis discuss their predicament is how similar the debate sounds to so many previous ones, despite the changed geopolitical circumstances. In most minds here, the changes do not demand a new strategy, simply a redoubled old one.

The operative metaphor is often described as “cutting the grass,” meaning a task that must be performed regularly and has no end. There is no solution to security challenges, officials here say, only delays and deterrence. That is why the idea of one day attacking Iranian nuclear facilities, even though such an attack would set the nuclear program back only two years, is widely discussed as a reasonable option. That is why frequent raids in the West Bank and surveillance flights over Lebanon never stop.

And that is why this week’s operation in Gaza is widely viewed as having been inevitable, another painful but necessary maintenance operation that, officials here say, will doubtless not be the last.

There are also those who believe that the regional upheavals are improving Israel’s ability to carry out deterrence. One retired general who remains close to the military and who spoke on the condition of anonymity said that with Syria torn apart by civil war, Hezbollah in Lebanon discredited because of its support for the Syrian government, and Egypt so weakened economically, Israel should not worry about anything but protecting its civilians.

“Should we let our civilians be bombed because the Arab world is in trouble?” he asked.

So much was happening elsewhere in the region — the Egyptian and Libyan revolutions, the Syrian civil war, dramatic changes in Yemen and elections in Tunisia — that a few rockets a day that sent tens of thousands of Israeli civilians into bomb shelters drew little attention. But in the Israeli view, the necessity of a Gaza operation has been growing steadily throughout the Arab Spring turmoil.

In 2009, after the Israeli invasion pushed Hamas back and killed about 1,400 people in Gaza, 200 rockets hit Israel. The same was true in 2010. But last year the number rose to 600, and before this week the number this year was 700, according to the Israeli military. The problem went beyond rockets to mines planted near the border aimed at Israeli military jeeps and the digging of explosive-filled tunnels.

“In 2008 we managed to minimize rocket fire from Gaza significantly,” said Lt. Col. Avital Leibovich, a military spokeswoman. “We started that year with 100 rockets a week and ended it with two a week. We were able to give people in our south two to three years. But the grass has grown, and other things have as well. Different jihadist ideologies have found their way into Gaza, including quite a few terrorist organizations. More weapons have come in, including the Fajr-5, which is Iranian made and can hit Tel Aviv. That puts nearly our entire population in range. So we reached a point where we cannot act with restraint any longer.”

Gazans see events in a very different light. The problem, they say, comes from Israel: Israeli drones fill the Gazan skies, Israeli gunboats strafe their waters, Palestinian militants are shot at from the air, and the Gaza border areas are declared off limits by Israel with the risk of death from Israeli gunfire.

But there is little dissent in Israel about the Gaza policy. This week leaders of the leftist opposition praised the assassination of Ahmed al-Jabari, the Hamas military commander, on Wednesday. He is viewed here as the equivalent of Osama bin Laden. The operation could go on for many days before there is any real dissent.

The question here, nonetheless, is whether the changed regional circumstances will make it harder to “cut the grass” in Gaza this time and get out. A former top official who was actively involved in the last Gaza war and who spoke on the condition of anonymity said it looked to him as if Hamas would not back down as easily this time.

“They will not stop until enough Israelis are killed or injured to create a sense of equality or balance,” he said. “If a rocket falls in the middle of Tel Aviv, that will be a major success. But this government will go back at them hard. I don’t see this ending in the next day or two.”

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Grizzlies hand Knicks first loss, 105-95

MEMPHIS, Tenn. (AP) — After handing the New York Knicks their first loss of the season, the Memphis Grizzlies now have the NBA's best record.

Zach Randolph had 20 points and 15 rebounds, Marc Gasol added 24 points and the Grizzlies beat the Knicks 105-95 Friday night, ending New York's season-opening eight-game winning streak.

Memphis used a big third-quarter run to increase its lead to 21 points and the advantage dipped into single digits just once in the fourth.

The Grizzlies (7-1) have now beaten the defending champion Miami Heat, the reigning Western Conference champion Oklahoma City Thunder, and the previously undefeated Knicks — all by double digits — this week.

"We are trying to make a statement," said Memphis guard Mike Conley, who scored 16 points and had eight assists. "We are making a statement that we can play with anybody on any given night."

Carmelo Anthony scored 20 points for New York, which was trying to start 7-0 for the first time since the 1993-94 season — when it reached the NBA Finals. Raymond Felton had 18 points and Rasheed Wallace added 13 on 6-for-10 shooting.

The game got away from New York in the third quarter, when the Knicks seemed to lose their composure during Memphis' rally, complaining about calls and drawing technical — including one on Knicks coach Mike Woodson.

"Our guys are competitive. They want to win," Woodson said. "We are on a six-game winning streak. We didn't want that streak to break. But it did, so we have to start a new streak."

The Knicks shot 51 percent for the game, but Memphis had 12 offensive rebounds, leading to a 22-12 advantage in second-chance points.

"We just couldn't rebound the ball," Knicks point guard Jason Kidd said. "We knew that coming in here, we couldn't give those guys second opportunities because they would capitalize on it."

Memphis opened the second half with a 23-7 spurt, a rally that built the advantage to 77-56.

New York cut into the margin slightly, but Memphis still carried an 85-67 lead into the fourth after outscoring the Knicks 31-18 in the third.

The Knicks started a comeback to open the fourth, outscoring Memphis 12-3 to pull to 91-81 with 6:18 left on Felton's jumper in the lane.

New York appeared poised to make a comeback reminiscent of Thursday night's win at San Antonio, when the Knicks outscored the Spurs 27-11 in the final 7:14 for a 104-100 victory.

But New York never got closer than eight the rest of the way.

"The third quarter got away from us," Anthony said. "Techs, they made some shots. We missed some shots. They got the momentum, kind of slowed the game down. We made a run and cut it to eight, but they already had the momentum going, so we were just in an uphill battle from there."

Memphis will try to maintain its winning streak and hold onto the best record in Charlotte on Saturday night when the Grizzlies face the Bobcats in their first back-to-back of the season.

Meanwhile, the Knicks were already thinking about starting a new winning streak Sunday at home against the Indiana Pacers.

But while the talk was of moving on, several Knicks, still stinging from the loss to Memphis, were thinking ahead to the teams' next meeting.

"One thing we're saying," Wallace said of the Grizzlies, "they've got to come to the Garden."

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Well: Meatless Main Dishes for a Holiday Table

Most vegetarian diners are happy to fill their plates with delicious sides and salads, but if you want to make them feel special, consider one of these main course vegetarian dishes from Martha Rose Shulman. All of them are inspired by Greek cooking, which has a rich tradition of vegetarian meals.

I know that Greek food is not exactly what comes to mind when you hear the word “Thanksgiving,” yet why not consider this cuisine if you’re searching for a meatless main dish that will please a crowd? It’s certainly a better idea, in my mind, than Tofurky and all of the other overprocessed attempts at making a vegan turkey. If you want to serve something that will be somewhat reminiscent of a turkey, make the stuffed acorn squashes in this week’s selection, and once they’re out of the oven, stick some feathers in the “rump,” as I did for the first vegetarian Thanksgiving I ever cooked: I stuffed and baked a huge crookneck squash, then decorated it with turkey feathers. The filling wasn’t nearly as good as the one you’ll get this week, but the creation was fun.

Here are five new vegetarian recipes for your Thanksgiving table — or any time.

Giant Beans With Spinach, Tomatoes and Feta: This delicious, dill-infused dish is inspired by a northern Greek recipe from Diane Kochilas’s wonderful new cookbook, “The Country Cooking of Greece.”

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Northern Greek Mushroom and Onion Pie: Meaty portobello mushrooms make this a very substantial dish.

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Roasted Eggplant and Chickpeas With Cinnamon-Tinged Tomato Sauce and Feta: This fragrant and comforting dish can easily be modified for vegans.

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Coiled Greek Winter Squash Pie: The extra time this beautiful vegetable pie takes to assemble is worth it for a holiday dinner.

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Baked Acorn Squash Stuffed With Wild Rice and Kale Risotto: Serve one squash to each person at your Thanksgiving meal: They’ll be like miniature vegetarian (or vegan) turkeys.

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Tensions Escalate in Gaza Conflict

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If I Hire You, What’s Your 100-Day Plan?

John Duffy of 3C Interactive says he asks job candidates to describe what their first months on the job would be like, partly to “learn what their expectations are, and where they think we’re at.”

Find the best job in the New York metro area and beyond.

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Miguel Cabrera, Buster Posey win MVP awards

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.

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For Alzheimer’s, Detection Advances Outpace Treatment Options

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.

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Automated Bidding Systems Test Old Ways of Selling Ads

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.”

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Attacks Resume After Israeli Assault Kills Hamas Leader

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.”

Isabel Kershner reported from Kiryat Malachi, Israel, and Fares Akram from Gaza. Reporting was contributed by Rina Castelnuovo from Kiryat Malachi; Mayy El Sheikh and David D. Kirkpatrick from Cairo; Gabby Sobelman from Jerusalem; Rick Gladstone from New York; and Alan Cowell from Paris.

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