India Ink: Image of the Day: Feb. 22

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Pistorius granted bail pending murder trial


PRETORIA, South Africa (AP) — In an agonizingly slow announcement, a magistrate allowed Oscar Pistorius to go free on bail Friday, nine days after the Paralympian was arrested in the Valentine's Day killing of his girlfriend.


Pistorius' family members and supporters shouted "Yes!" when Chief Magistrate Desmond Nair made his decision after a more than 1 hour and 45 minute explanation of his ruling to a packed courtroom.


Radio stations and a TV news network in South Africa broadcast the audio of the decision live, and even international channels like the BBC and CNN went live with it, underscoring the huge global interest in the case.


Nair banned cameras from Friday's dramatic bail hearing and complained about cameras constantly "flashing" in Pistorius' face the previous three days of hearings, saying the spectacle made the athlete look like "some kind of species the world has never seen before."


Nair set the bail at 1 million rand ($113,000), with $11,300 in cash up front and proof that the rest is available. The magistrate said Pistorius must hand over his passports and also turn in any other guns that he owns. Pistorius also cannot leave the district of Pretoria, South Africa's capital, without the permission of his probation officer, Nair said, nor can he take drugs or drink alcohol.


The double-amputee Olympian's next court appearance was set for June 4. He left the courthouse in a silver Land Rover, sitting in the rear, just over an hour after the magistrate imposed the bail conditions.


The magistrate ruled that Pistorius could not return to his upscale home in a gated community in the eastern suburbs of Pretoria, where the killing of Reeva Steenkamp took place.


Pistorius' uncle, Arnold Pistorius said: "We are relieved at the fact that Oscar got bail today but at the same time we are in mourning for the death of Reeva with her family. As a family, we know Oscar's version of what happened on that tragic night and we know that that is the truth and that will prevail in the coming court case."


Pistorius' senior defense lawyer, Barry Roux, told reporters the defense is satisfied with the bail.


Nair made the ruling after four days of arguments from prosecution and defense in Pistorius' bail hearing. During Friday's long session in Pretoria Magistrate's Court, Pistorius alternately wept and appeared solemn and more composed, especially toward the end as Nair criticized police procedures in the case and as a judgment in Pistorius' favor appeared imminent.


Nair said Pistorius' sworn statement, in which he gave his version of the events of the shooting during the predawn hours of Feb. 14 in a sworn statement, had helped his application for bail.


"I come to the conclusion that the accused has made a case to be released on bail," Nair said.


Pistorius said in the sworn statement that he shot his girlfriend — a model and budding reality TV contestant — accidentally, believing she was an intruder in his house.


Prosecutors say he intended to kill Steenkamp and charged him with premeditated murder, saying the shooting followed a loud argument between the two.


Sharon Steenkamp, Reeva's cousin, had said earlier that the family wouldn't be watching the bail decision and hadn't been following the hearing in Pretoria.


"It doesn't make any difference to the fact that we are without Reeva," she told The Associated Press.


Despite the bail decision, prosecution spokesman Medupe Simasiku said: "We're still confident in our case," outside court.


Pistorius faced the sternest bail requirements in South Africa because of the seriousness of the charge, and his defense lawyers had to prove that he would not flee the country, would not interfere with witnesses or the case, and his release would not cause public unrest.


Nair questioned whether Pistorius would be a flight risk and be prepared to go "ducking and diving" around the world when he stood to lose a fortune in cash, cars, property and other assets. Nair also said that while it had been shown that Pistorius had aggressive tendencies, he did not have a prior record of offenses for violent acts.


He criticized Hilton Botha, the previous lead investigator in the case, for not doing more to uncover evidence that the Olympian had violent tendencies.


"There is ample room and ample time to do that by looking at the background of the accused," he said.


But while Nair leveled harsh criticism at former lead investigator Botha for "errors" and "blunders," he said one man does not represent the state's case and that the state could not be expected to put all the pieces of its puzzle together in such a short time.


Anticipating the shape of the state's case at trial, he said he had serious questions about Pistorius' account: Why he didn't try to locate his girlfriend on fearing an intruder was in the house, why he didn't try to determine who was in the toilet and why he would venture into perceived "danger" - the bathroom area - when he could have taken other steps to ensure his safety.


"There are improbabilities which need to be explored," Nair said, adding that Pistorius could clarify these matters by testifying under oath at trial.


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AP Sports Writer Gerald Imray and AP writer Carley Petesch contributed to this report from Johannesburg.


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Well: Depression May Stifle Shingles Vaccine Response

Depression may lower the effectiveness of the shingles vaccine, a new study found.

The research showed that adults with untreated depression who received the vaccine mounted a relatively weak immune response. But those who were taking antidepressants showed a normal response to the vaccine, even when symptoms of depression persist.

Shingles, an acute and painful rash, strikes a million Americans each year, mostly older adults. Health officials recommend that those over 60 get vaccinated against the condition, which is caused by reactivation of the same virus that causes chickenpox, varicella-zoster.

In the new study, published in the journal Clinical Infectious Diseases, researchers followed a group of 92 older men and women for two years. Forty of the subjects had a major depressive disorder; they were matched with 52 control subjects of similar age. The researchers measured their immune responses to the shingles vaccine and a placebo shot.

Compared with the control patients, those with depression were poorly protected by the vaccine. But the patients who were being treated for their depression showed a boost in immunity — what the researchers called a “normalization” of the immune response. It is unclear why that was the case.

The authors of the study speculated that treatment of older people with depression might increase the effectiveness of the flu shot and other vaccines as well.

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Room for Debate: Should Companies Tell Us When They Get Hacked?












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India Ink: Image of the Day: Feb. 21

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Top detective appointed new Pistorius investigator


PRETORIA, South Africa (AP) — South Africa's top detective was appointed lead investigator in the Oscar Pistorius case Thursday, replacing a veteran policeman who was charged with attempted murder in the latest shock development to hit a case being watched closely by the nation.


National Police Commissioner Riah Phiyega promised that a team of "highly skilled and experienced" officers would investigate the killing of Pistorius' 29-year-old girlfriend. Pistorius, 26, has been charged with premeditated murder in the case.


The decision to put police Lt. Gen. Vinesh Moonoo in charge came soon after word emerged that the initial chief investigator, Hilton Botha, is facing attempted murder charges, and a day after he offered testimony damaging to the prosecution in Pistorius' bail hearing.


Pistorius, an Olympic runner whose lower legs were amputated when he was less than a year old, killed his girlfriend Reeva Steenkamp in the predawn hours of Valentine's Day. He claims he mistook her for an intruder when he shot her through a locked door in a bathroom in his home. Prosecutors say the shooting happened after the couple got into an argument and allege the killing was deliberate, carried out with no mercy.


Botha acknowledged Wednesday in court that nothing in Pistorius' version of the fatal shooting of Steenkamp contradicted what police had discovered, even though there have been some discrepancies. Botha also said that police had left a 9 mm slug in the toilet and had lost track of allegedly illegal ammunition found in Pistorius' home.


"This matter shall receive attention at the national level," Phiyega told reporters soon after the end of proceedings in the third day of Pistorius' bail hearing. The case has riveted South Africa and much of the world and has placed the country's judicial system under close scrutiny.


Bulewa Makeke, spokeswoman for South Africa's National Prosecuting Authority, said the attempted murder charges had been reinstated against Botha on Feb. 4. Police say they found out about it after Botha testified in Pistorius' bail hearing Wednesday.


Botha and two other police officers had seven counts of attempted murder reinstated against them in relation to a 2011 shooting incident. Botha and his two colleagues allegedly fired shots at a minibus they were trying to stop.


Asked about Botha's court performance and handling of the investigation, Phiyega said South Africa's police force "can stand on its own" compared to others around the world.


Makeke, the spokeswoman for the national prosecution office, had said before Botha was dismissed from the Pistorius case that he should be taken off, but added that it was up to the police force to make that decision.


Makeke indicated the charges were reinstated against Botha because more evidence had been gathered. She said the charge against Botha was initially dropped "because there was not enough evidence at the time."


Pistorius' main sponsor Nike, meanwhile, suspended its contract with the multiple Paralympic champion, following eyewear manufacturer Oakley's decision to suspend its sponsorship. Nike said in a brief statement on its website: "We believe Oscar Pistorius should be afforded due process and we will continue to monitor the situation closely."


The judge is still trying to decide whether to grant Pistorius bail, and under what conditions.


During Thursday's bail hearing, Chief Magistrate Desmond Nair asked the defense of Pistorius' bail application: "Do you think there will be some level of shock if the accused is released?"


Defense lawyer Barry Roux responded: "I think there will be a level of shock in this country if he is not released."


Opposing bail, prosecutor Gerrie Nel painted a picture of a man "willing and ready to fire and kill," and said signs of remorse from Pistorius do not mean that the athlete didn't intend to kill his girlfriend.


"Even if you plan a murder, you plan a murder and shoot. If you fire the shot, you have remorse. Remorse might kick in immediately," Nel said.


As Nel summed up the prosecution's case opposing bail, Pistorius began to weep in the crowded courtroom, leading his brother, Carl Pistorius, to reach out and touch his back.


"He (Pistorius) wants to continue with his life like this never happened," Nel went on, prompting Pistorius, who was crying softly, to shake his head. "The reason you fire four shots is to kill," Nel persisted.


Earlier Thursday, Nair questioned Botha over delays in processing records from phones found in Pistorius' house following the killing of Steenkamp, a 29-year-old model and budding reality TV contestant.


"It seems to me like there was a lack of urgency," Nair said as the efficiency of the police investigation was questioned.


Botha is himself to appear in court in May to face seven counts of attempted murder. Botha was dropped from the case but not suspended from the police force, Phiyega said, and could still be called by defense lawyers at trial.


Pisatorius' behavior Thursday reflected the change of mood in the courtroom as his defense lawyers attacked police procedures and maintained his innocence.


Pistorius, in the same gray suit, blue shirt and gray tie combination he has worn throughout the bail hearing, stood ramrod straight in the dock, then sat calmly looking at his hands. On Tuesday and Wednesday, the athlete had been slumped over and sobbing uncontrollably at times as detail was read out of how Steenkamp died in his house.


"The poor quality of the evidence offered by investigative officer Botha exposed the disastrous shortcomings of the state's case," Roux said Thursday. "We cannot sit back and take comfort that he is telling the truth."


Roux also raised issue of intent, saying the killing was not "pre-planned" and referred to a "loving relationship" between the two.


He said an autopsy showed that Steenkamp's bladder was empty, suggesting she had gone to use the toilet as Pistorius had claimed. Prosecutors claim Steenkamp had fled to the toilet to avoid an enraged Pistorius.


"The known forensics is consistent" with Pistorius' statement, Roux said, asking that bail restrictions be eased for Pistorius.


But the prosecutor said Pistorius hadn't given guarantees to the court that he wouldn't leave the country if he was facing a life sentence. Nel also stressed that Pistorius shouldn't be given special treatment.


"I am Oscar Pistorius. I am a world-renowned athlete. Is that a special circumstance? No." Nel said. "His version (of the killing) is improbable."


Nel said the court should focus on the "murder of the defenseless woman."


Botha testified Thursday that he had investigated a 2009 complaint against Pistorius by a woman who claimed the athlete had assaulted her. He said that Pistorius had not hurt her and that the woman had actually injured herself when she kicked a door at Pistorius' home.


The hearing is to continue Friday morning.


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AP Sports Writer Gerald Imray contributed to this report from Johannesburg.


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Well: Getting Patients to Think About Costs

A colleague and I recently got into a heated discussion over health care spending. It wasn’t that he disagreed with me about the need to rein in costs; but he said he was frustrated every time he tried to do so.

Earlier that week, for example, he had tried to avoid ordering a costly M.R.I. scan for a patient who had been suffering from headaches. After a thorough examination, my colleague was convinced the headaches were the result of stress.

But the patient was not.

“She wouldn’t leave until she got that M.R.I.,” my colleague said. Even after he had explained his conclusions several times, proposed a return visit in a month to reassess the situation and ran so far overtime that his office nurse knocked on the door to make sure nothing had gone awry, the patient continued to insist on getting the expensive study.

When my colleague finally evoked cost – telling the woman that while an M.R.I. might ferret out rare causes, it didn’t make sense to spend the enormous fee on something of such marginal benefit – the woman became belligerent. “She yelled that this was her head we were talking about,” he recalled. “And expensive tests like this were the reason she had health insurance.”

Face flushed, he paused to take a deep breath. “Yeah, I may be all for controlling costs,” he finally said. “But are our patients?”

According to a new study in the journal Health Affairs, his concern about patients may not be far off the mark.

A growing number of initiatives aimed at controlling spiraling health care costs have been championed in recent years, aiming to replace the current model in which doctors are reimbursed for every office visit, test or procedure performed. These programs range from pay-for-performance, where doctors can earn more money by meeting predetermined quality “goals” like controlling patients’ blood sugar or high blood pressure, to accountable care organizations, where clinicians and hospitals in partnership are paid a lump sum to cover all care.

Their uninspired monikers aside, all of these plans share one defining feature: doctors are to be the key agents of change. Whether linked with quality measures, bundled payments or satisfaction scores, it is the doctors’ behavior and choice of treatments that result in savings, goes the thinking.

But as the new study reveals, doctors need to take into account more than just symptoms and diseases when deciding what to prescribe and offer. They must also consider their patients’ opinions and willingness to be cost conscious when it comes to their own care.

The researchers conducted more than 20 patient focus groups and asked the participants to imagine themselves with various symptoms and a choice of diagnostic and treatment options that varied only slightly in effectiveness but significantly in cost. They were asked, for example, to choose between an M.R.I. or a CT scan for a severe long-standing headache, with the M.R.I. being much more expensive but also more likely to catch some extremely rare problems.

When it came to their own treatment, “patients for the most part did not want cost to play any role in decision-making,” said Dr. Susan Dorr Goold, one of the study authors and a professor of internal medicine and health management and policy at the University of Michigan in Ann Arbor. Most did not want their doctors to take expenditures into account, and many made it clear that they would ask for the significantly more expensive medications, procedures or diagnostic studies, even if those options were only slightly better than the cheaper alternatives. “That puts doctors, whose primary responsibility is to their individual patients, in a very difficult position.”

A majority of the participants refused to consider the expenses borne by insurers or by society as a whole when making their choices. Some doubted that one individual’s efforts would have any real overall impact and so gave up considering cost-savings altogether. Others said they would go out of their way to choose the more expensive options, viewing such decisions as acts of defiance and a kind of well-deserved “payback” after years of paying insurance premiums.

Underlying all of these comments was the belief that cost was synonymous with quality. Even when the focus group leaders reminded participants that the differences between proposed options were nearly negligible, participants continued to choose the more expensive options as if it were beyond question that they must be more efficacious or foolproof.

The study’s findings are disheartening. But Dr. Goold and her co-investigators believe that public beliefs and attitudes about cost and quality can be changed. They cite the dramatic transformation in attitudes about end-of-life care as an example of how initiatives to improve understanding can lead people to make higher quality and more cost-effective decisions, like choosing hospices over hospitals.

“We need to begin to talk about these issues in a way that doesn’t turn it into a discussion pitting money against life, and we need to find ways of getting people to think about not spending money on things that offer marginal benefit” Dr. Goold said. “Because it’s going to be tough otherwise trying to implement any cost-saving measures, if patients don’t accept them.”

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DealBook: Carlyle's Profit Fell in 4th Quarter as Growth Slowed

11:18 a.m. | Updated Most of the publicly traded private equity giants proudly reported glowing fourth-quarter earnings.

The Carlyle Group isn’t one of them.

The alternative investment giant disclosed on Thursday a 28 percent drop in fourth-quarter profit from the same time a year ago, as the growth of its portfolio companies slowed. That sent the company’s stock down more than 8 percent by midmorning, to $33.70.

Carlyle reported fourth-quarter profit of $182 million, expressed as economic net income, compared with $254 million in the year-earlier period. That amounts to 47 cents per unit. Analysts on average had expected about 66 cents per unit, according to a survey by Capital IQ.

And Carlyle’s distributable earnings, a measure the firm prefers because it tracks actual payouts to its limited partners, fell 24 percent, to $188 million. Using generally accepted accounting principles, Carlyle earned $12 million in net income.

The results fall short of those of rivals like the Blackstone Group and Kohlberg Kravis Roberts have reported. Private equity firms in general have gained from improvements in the markets, which have lifted the valuations of their portfolios and bolstered their core business of buying and selling companies.

Carlyle attributed the decline in economic net income to a smaller appreciation in the value of its portfolio. It reported a 4 percent gain for the quarter, compared with a 7 percent increase in the period a year earlier.

The decision to delay reaping carried interest from its latest mainstay fund, Carlyle Partners V, weighed on distributable earnings. The company opted to hold off, given the relative freshness of the fund and the influx of new investments like the buyouts of the TCW Group and Getty Images.

Carlyle highlighted its strong fund-raising and gains from selling investments. The firm raised $4.6 billion in new money for the quarter and $14 billion for the year, compared with a total of $6.6 billion raised in all of 2011. It generated $6.8 billion in realized proceeds for the quarter and $18.7 billion for the year, compared with $17.6 billion in 2011.

“We had another excellent year,” David M. Rubenstein, one of Carlyle’s co-chief executives, said in a statement. “Our performance over the past two years was marked by steady, continuous progress across our business.”

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IHT Rendezvous: True or False? The Tussle Over Ping Fu's Memoir

Did Ping Fu, a prominent Chinese-American businesswoman and author of a recent memoir, “Bend, not Break,” make up her horrible experiences during the 1966-76 Cultural Revolution in order to gain United States citizenship? Did they help her become an American by claiming political asylum?

That’s what her critics, many of them fellow Chinese-Americans, say. It’s an accusation that can stick. As a recent New York Times investigation showed, claiming persecution has spawned an immigration industry involving lawyers prepping clients to make false asylum claims.

As I write in my Letter from China this week, Ms. Fu is being accused of making up a lot of things in her memoir. She’s also a successful entrepreneur: the U.S. government honored Ms. Fu, the founder of the software company Geomagic (in the process of being sold to 3D Systems), with a “2012 Outstanding American by Choice” award.

Ms. Fu is on the board of the White House’s National Advisory Council on Innovation and Entrepreneurship, and is a member of the National Council on Women in Technology, according to the Web site of the U.S. Citizenship and Immigration Services.

Ms. Fu, who says in her memoir she was “quietly deported” to the U.S. in 1984 for writing about female infanticide while still a college student, denies the accusations. But until now she hadn’t explained in public how she became an American.

In an interview with the International Herald Tribune, she said, apparently for the first time, the reason she kept quiet was she was trying to protect her first husband, an American, whom she does not mention in her memoir. The marriage took place while she was living in California, she said.

“I had a first marriage and that’s how I got my green card,” she said by telephone. She married on Sept. 1, 1986 and divorced three years later. Until now she had kept silent because of a “smear” campaign against her online, mostly by fellow Chinese who accuse her of lying, which extended to real-life harassment, she said: “They smear my name, they try to get my daughter’s name on the Internet, they sent people to Shanghai to surround my family and to Nanjing to harass my neighbors.” She said the accusers, who are “angry” for reasons she doesn’t really understand, contacted U.S. immigration authorities to challenge her award and her citizenship, as well as shareholders of 3D Systems to warn them she was a “liar,” and not to buy Geomagic. Her second husband, Herbert Edelsbrunner, whom she has since divorced, received many “hate e-mails,” she said. “I just don’t want to hurt innocent people.”

If a first, unpublicized marriage might lay to rest one contentious issue, there are others. Some were the result of exaggeration or unclear communication with her ghostwriter, MeiMei Fox of Los Angeles, she said.

In the interview, she volunteered an example of an error: a widely criticized account of the ‘‘period police,’’ the authorities who checked a woman’s menstrual cycle to ensure she wasn’t pregnant in the early days of the one-child policy. To stop women substituting others’ sanitary pads for inspection, they were sometimes required to use their own finger to show blood. Through a misunderstanding with Ms. Fox, Ms. Fu said this was portrayed as the use of other people’s fingers — an invasion of the woman’s body.

Ms. Fox “wrote it wrong,’’ she said. ‘‘I corrected it three times but it didn’t get corrected.’’ Women used their own finger to show blood, she said, but the mistake went into print anyway.

In general, Ms. Fox may have ‘‘just made some searches on the Internet that maybe weren’t correct,’’ Ms. Fu said.

Chiefly the errors involved use of the words ‘‘all, never, any,’’ that generalized unacceptably, Ms. Fu said. And, ‘‘She doesn’t know China’s geography,’’ she said.

At the beginning of her memoir, Ms. Fu writes of being kidnapped by a Vietnamese-American on arrival in the U.S. state of New Mexico and locked in his apartment to care for his very young children, whose mother had left, in a bizarre incident. A spokeswoman at the Albuquerque Police Department’s Records Office, where the alleged kidnapping took place, said she could not locate such an incident in their records. Asked about it, Ms. Fu repeated that she did not press charges as, fresh from China, she was terrified of all police, “So I don’t know how they keep records, if there is no criminal charges or record.”

And in an e-mail to me, she admitted she made mistakes about a magazine she said she helped edit, called Wugou, or “No Hook,” produced in 1979 by students at her college, then called the Jiangsu Teacher’s College (later it changed its name to Suzhou University, she said.) It was not that magazine but another one, This Generation, that was taken to a meeting in Beijing of student magazine writers from around the country, she wrote in the e-mail. “A good case that shows everyone’s memory can be wrong,” she wrote.

But bigger questions about the scale of the online vitriol from parts of the Chinese and Chinese-American community remain. “I really haven’t known China for 20-something years, and it didn’t occur to me that what I wrote would generate so much anger,” she said. In the last years, “as China got stronger, nationalistic views got stronger,” she said, making a “civil conversation” about disagreements apparently harder.

Additional reporting by Cindy Hao in Seattle.

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Armstrong facing Wednesday deadline with USADA


AUSTIN, Texas (AP) — Lance Armstrong is facing a Wednesday deadline to decide whether he will meet with U.S. Anti-Doping Agency officials and talk with them under oath about what he knows about performance-enhancing drug use in cycling.


The agency has said Armstrong's cooperation in its cleanup effort is the only path open to Armstrong if his lifetime ban from sports is to be reduced.


Armstrong has given mixed signals about whether he plans to talk with USADA officials. Armstrong attorney Tim Herman previously suggested Armstrong would not meet with USADA before the agency's original Feb. 6 deadline. The two sides then agreed to give Armstrong another two weeks to work out an interview with investigators.


Armstrong previously denied using performance-enhancing drugs, but in January admitted doping to win seven Tour de France titles.


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