Doctors Supercharge Their iPads With Box.net

Doctors love their iPads — even more than you might think.

Over in Winston-Salem, North Carolina, a group of more than 60 doctors have revamped their mobile phones and iPads for use in emergency departments across the region with a little help from a familiar application: the popular Box.net file-sharing services. Using Box, they’ve built a new system that lets them share procedures, journal articles and — perhaps most importantly — conversations.

It’s a small step, but doctors like Iltifat Husain at the Wake Forest Baptist Medical Center love the thing.

Husain is a big advocate of mobile devices. He edits a website for iPad-loving doctors called iMedicalApps.com. But the collaborative cloud computing thing really clicked for Husain — an emergency medicine resident physician at Wake Forest — when he was still testing the service back in October. He was at a remote emergency room in Greensboro, North Carolina, where a patient came in with fluid on the belly. Husain needed to perform a procedure called an abdominal paracentesis to drain the fluid. It’s not the kind of procedure that most doctors do every day, so Husain gave himself a quick refresher on the procedure.

A year earlier, this would have meant trudging over to the ER’s workstation and looking up a PDF on the hospital’s intranet. Instead, he tapped open the Box software on his mobile phone and looked it up right there.

It saved maybe a handful of minutes. But for Husain, minutes count. “In the ER, the faster I can do something, the more time I can spend with other patients,” he says.

Doctors may be the people who change our lives most profoundly with cutting-edge science and drugs, but the sad truth is that medicine is only just starting to enter the digital era, says Eric J.Topol, director of the Scripps Translational Science Institute and the author of, Creative Destruction of Medicine, a 2012 book about how digital technology is changing health care. “Medicine is ultra-conservative, historically.”

But it’s also an area that’s most primed for change. As the digital walls go down, doctors are becoming better about sharing information with their patients, and with other doctors.

Last year, a startup called Doximity launched a kind of social network for doctors — letting them share information, ask each other questions, and even provide referrals. It now has more than 100,000 doctors.

At Wake Forest, the Box set-up isn’t a full-fledged social network. It’s a document sharing workhorse. And with hundreds of journal articles and procedures — all uploaded, available via mobile phone and set up for comments — the system has in just a few short months become an important tool for the doctors who use it.

More than that, it’s also a great learning tool for residents, says James O’Neill, an M.D. and assistant professor with the hospital’s department of emergency medicine.

Online discussions have enhanced the residents monthly “Journal Club” meetings, where doctors meet do discuss the latest medical research. The system gives them an easy-to-use discussion platform where doctors and residents can debate what works and what does not work, direct from the emergency department. “When the residents find something that works for them, they can get it up there,” O’Neill says.

“We’ve been able to create this community in the cloud among residents,” says Husain. “You can literally have free flowing comments using Box, which really has the potential to change the way medical education is done.”

Topol says that this kind of social document sharing is only the beginning of a bigger shift that he’d like to see as the medical profession takes a cue from everyone else on the Internet and becomes better about collaborating and sharing information. “It’s a nice baby step, but it’s not a giant thing in the way that medicine is going to be shifting,” he says.

“We just have to take the walls down and we haven’t even started to do that yet.”

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Cellar victim Kampusch raped, starved in film of ordeal

VIENNA (Reuters) – A new film based on the story of Austrian kidnap victim Natascha Kampusch shows her being repeatedly raped by the captor who beat and starved her during the eight-and-a-half years that he kept her in a cellar beneath his house.

Kampusch was snatched on her way to school at the age of 10 by Wolfgang Priklopil and held in a windowless cell under his garage near Vienna until she escaped in 2006, causing a sensation in Austria and abroad. Priklopil committed suicide.

Kampusch had always refused to respond to claims that she had had sex with Priklopil, but in a German television interview on her 25th birthday last week said she had decided to reveal the truth because it had leaked out from police files.

The film, “3,096 Days” – based on Kampusch’s autobiography of the same name – soberly portrays her captivity in a windowless cellar less than 6 square metres (65 square feet) in area, often deprived of food for days at a time.

The emaciated Kampusch – who weighed just 38 kg (84 pounds) at one point in 2004 – keeps a diary written on toilet paper concealed in a box.

One entry reads: “At least 60 blows in the face. Ten to 15 nausea-inducing fist blows to the head. One strike with the fist with full weight to my right ear.”

The movie shows occasional moments that approach tenderness, such as when Priklopil presents her with a cake for her 18th birthday or buys her a dress as a gift – but then immediately goes on to chide her for not knowing how to waltz with him.

GREY AREAS

Antonia Campbell-Hughes, who plays the teenaged Kampusch, said she had tried to portray “the strength of someone’s soul, the ability of people to survive… but also the grey areas within a relationship that people don’t necessarily understand.”

The British actress said she had not met Kampusch during the making of the film or since. “It was a very isolated time, it was a bubble of time, and I wanted to keep that very focused,” she told journalists as she arrived for the Vienna premiere.

Kampusch herself attended the premiere, looking composed as she posed for pictures but declining to give interviews.

In an interview with Germany’s Bild Zeitung last week, she said: “Yes, I did recognize myself, although the reality was even worse. But one can’t really show that in the cinema, since it wasn’t supposed to be a horror film.”

The movie, made at the Constantin Film studios in Bavaria, Germany, also stars Amy Pidgeon as the 10-year-old Kampusch and Danish actor Thure Lindhardt as Priklopil.

“I focused mainly on playing the human being because… we have to remember it was a human being. Monsters do not exist, they’re only in cartoons,” Lindhart said.

“It became clear to me that it’s a story about survival, and it’s a story about surviving eight years of hell. If that story can be told then I can also play the bad guy.”

The director was German-American Sherry Hormann, who made her English-language debut with the 2009 move “Desert Flower”, an adaptation of the autobiography of Somali-born model and anti-female circumcision activist Waris Dirie.

“I’m a mother and I wonder at the strength of this child, and it was important for me to tell this story from a different perspective, to tell how this child using her own strength could survive this atrocious martyrdom,” Hormann said.

The Kampusch case was followed two years later by that of Josef Fritzl, an Austrian who held his daughter captive in a cellar for 24 years and fathered seven children with her.

The crimes prompted soul-searching about the Austrian psyche, and questions as to how the authorities and neighbors could have let such crimes go undetected for so long.

The film goes on general release on Thursday.

(Reporting by Georgina Prodhan, Editing by Paul Casciato)

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Global Health: After Measles Success, Rwanda to Get Rubella Vaccine

Rwanda has been so successful at fighting measles that next month it will be the first country to get donor support to move to the next stage — fighting rubella too.

On March 11, it will hold a nationwide three-day vaccination campaign with a combined measles-rubella vaccine, hoping to reach nearly five million children up to age 14. It will then integrate the dual vaccine into its national health service.

Rwanda can do so “because they’ve done such a good job on measles,” said Christine McNab, a spokeswoman for the Measles and Rubella Initiative. M.R.I. helped pay for previous vaccination campaigns in the country and the GAVI Alliance is helping financing the upcoming one.

Rubella, also called German measles, causes a rash that is very similar to the measles rash, making it hard for health workers to tell the difference.

Rubella is generally mild, even in children, but in pregnant women, it can kill the fetus or cause serious birth defects, including blindness, deafness, mental retardation and chronic heart damage.

Ms. McNab said that Rwanda had proved that it can suppress measles and identify rubella, and it would benefit from the newer, more expensive vaccine.

The dual vaccine costs twice as much — 52 cents a dose at Unicef prices, compared with 24 cents for measles alone. (The MMR vaccine that American children get, which also contains a vaccine against mumps, costs Unicef $1.)

More than 90 percent of Rwandan children now are vaccinated twice against measles, and cases have been near zero since 2007.

The tiny country, which was convulsed by Hutu-Tutsi genocide in 1994, is now leading the way in Africa in delivering medical care to its citizens, Ms. McNab said. Three years ago, it was the first African country to introduce shots against human papilloma virus, or HPV, which causes cervical cancer.

In wealthy countries, measles kills a small number of children — usually those whose parents decline vaccination. But in poor countries, measles is a major killer of malnourished infants. Around the world, the initiative estimates, about 158,000 children die of it each year, or about 430 a day.

Every year, an estimated 112,000 children, mostly in Africa, South Asia and the Pacific islands, are born with handicaps caused by their mothers’ rubella infection.

Thanks in part to the initiative — which until last year was known just as the Measles Initiative — measles deaths among children have declined 71 percent since 2000. The initiative is a partnership of many health agencies, vaccine companies, donors and others, but is led by the American Red Cross, the United Nations Foundation, the Centers for Disease Control and Prevention, Unicef and the World Health Organization.

This article has been revised to reflect the following correction:

Correction: February 27, 2013

An earlier version of this article misstated the source of the financing for the upcoming vaccination campaign in Rwanda. It is being financed by the GAVI Alliance, not the Measles and Rubella Initiative.

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DealBook: Obama’s Nominee for S.E.C. Tries to Allay Skepticism

Mary Jo White’s path to the Securities and Exchange Commission has reached a crucial juncture: the Congressional charm campaign.

Lawmakers are scrutinizing Ms. White ahead of her Senate confirmation hearing, raising questions about the former prosecutor’s lack of regulatory experience and the challenge of policing Wall Street firms she recently defended in private practice. But Ms. White is seeking to quell concerns about potential conflicts of interest.

She recently scheduled meetings with Senate Banking Committee members, who must clear her nomination, and answered a 20-page boilerplate questionnaire detailing her qualifications, according to a copy provided to The New York Times. The document sheds new light on her list of Wall Street clients, including little-known work performed for HSBC’s former chief executive. It also describes her ties to New York Democratic causes and laurels she earned both as a defense lawyer and federal prosecutor.

The questionnaire, created by the banking committee, focused significant attention on her movement through the revolving door between government service and private practice, a concern that has loomed since President Obama nominated Ms. White in January.

“As a government official, I believe I have an established track record and the reputation of being tough, but fair,” she said in the document.

Ms. White also offered a previously undisclosed concession, vowing “as far as can be foreseen,” never to return to Debevoise & Plimpton, where she had built a lucrative legal practice. To avert potential conflicts stemming from her work on behalf of Wall Street giants, Ms. White had already agreed to recuse herself for one year from most matters that involve former clients.

While Ms. White’s nomination is expected to sail through the committee before receiving full Senate approval, four Congressional officials who spoke anonymously warned that some Democrats have lingering reservations.

The Democrats note that her husband, John W. White, is co-chairman of the corporate governance practice at Cravath, Swaine & Moore, where he represents many of the companies that the S.E.C. regulates. They also question whether Ms. White’s recusals, even if well-intentioned, could cripple her ability to run the agency.

In a meeting on Tuesday with Senator Sherrod Brown, Democrat of Ohio, Ms. White did little to alleviate the fears.

“Senator Brown respects Ms. White’s credentials and experience, but is concerned with Washington’s long-held bias toward Wall Street,” his spokeswoman, Meghan Dubyak, said in a statement. “He pushed Ms. White,” to explain “whether her previous employment or her spouse’s current employment could cause her to recuse herself from key business facing the S.E.C.” The agency has already fallen behind in writing dozens of new rules for Wall Street.

Ms. White’s supporters counter that, before the White House announced the appointment, the Office of Government Ethics vetted her disclosures. The nonpartisan officials concluded that, even with her recusals, Ms. White could effectively run the agency.

Her supporters also trumpet her long tenure as a tenacious prosecutor. During stints as a federal prosecutor in Brooklyn and as the first woman United States attorney in Manhattan, she helped oversee the prosecution of the crime figure John Gotti and directed the case against those responsible for the 1993 World Trade Center bombing. The cases won her praise from several lawmakers.

Ms. White still has time to win over remaining skeptics. Her confirmation hearing is not expected until the week of March 11, Congressional officials briefed on the matter said.

Until then, Ms. White is blitzing through the halls of Congress, a routine practice for nominees. She began her charm offensive at the top of the banking committee’s roster, visiting this month with the Democratic chairman, Senator Tim Johnson, of South Dakota. A Congressional official briefed on the matter said Ms. White performed well at the gathering, and no major issues arose.

In the next round of meetings, she will face off with a more liberal arm of the committee known to scrutinize nominees. After meeting Mr. Brown, Ms. White is scheduled to see Senator Jeff Merkley, Democrat of Oregon. She also will meet Elizabeth Warren, the Massachusetts Democrat who is an outspoken critic of Wall Street, Ms. Warren’s office confirmed on Tuesday.

Even if Ms. White fails to satisfy lawmakers’ concerns, the meetings are an important step in clearing the way for her appointment.

“Senators will have a chance to size Mary Jo up, and I believe will come away with a great sense of comfort that she’s a candidate of true quality,” said Harvey Pitt, who passed through the confirmation process in 2001 to lead the S.E.C.

He noted that additional disclosures could bolster her candidacy. “I do think she will need to provide a level of comfort to the committee that she is aware of the issue, has a definitive plan for navigating through the potential conflict issues, and will be completely open about when she has a potential recusal issue, and how she has handled it,” he said.

Ms. White, a political independent, assured lawmakers in her questionnaire that she was “completely independent of political or personal influences.” She did disclose, however, $13,000 in campaign donations to Democratic candidates. She also served on the campaign committee of a Democrat who had run for New York attorney general.

Her ties to Debevoise — and its clients — are more significant; she represented JPMorgan Chase, UBS and Michael Geoghegan, the former head of HSBC.

Ms. White, 65, said this month said that she would retire from Debevoise after taking over the S.E.C. and would forgo the firm’s typical retirement perks: office space and a free BlackBerry. She also will sever financial ties to the firm during her term at the S.E.C., taking an upfront lump-sum retirement payment rather than collecting a monthly installment of $42,500.

Her husband has also offered concessions. He agreed to convert his partnership at Cravath, Swaine & Moore from equity to nonequity status and promised not to “communicate directly” with the S.E.C. about rule-making. Ms. White will not participate in a matter with a direct effect on his compensation.

In line with a standard move for federal appointees, Ms. White further agreed to recuse herself for one year from voting on enforcement cases involving Debevoise clients. There are limitations to the policy, though, in case it is “in the public interest” and a “reasonable” person would not object.

Some lawmakers dismiss questions about her potential conflicts, but still question her mastery of regulatory minutiae. While Ms. White is a skilled litigator, she lacks experience in financial rule-writing, unlike a predecessor, Mary Schapiro, a lifelong regulator who ran the S.E.C. for nearly four years.

In her questionnaire, Ms. White highlighted her role as a director of the Nasdaq exchange and other experiences that she said gave her “a firm grounding” in securities laws.

She also, inadvertently, drew a connection to Ms. Schapiro. Like Ms. Schapiro, Ms. White is an animal lover, currently serving as a board member of the American Society for the Prevention of Cruelty to Animals.

She agreed to step down from the board once she is sworn in at the S.E.C.

A version of this article appeared in print on 02/27/2013, on page B1 of the NewYork edition with the headline: Nominee For S.E.C. Tries to Allay Skepticism.

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Gaza militants break cease-fire with rocket attack into Israel

Israeli police remove the remains of a rocket in the town of Ashkelon. (EPA / February 26, 2013)

By Edmund Sanders

February 26, 2013, 12:05 a.m.

JERUSALEM -- Palestinian unrest spread Tuesday to the Gaza Strip, where militants fired a rocket into southern Israel, shattering one of the longest periods of quiet along that border in recent memory.

It was the first rocket fired since the signing of a November cease-fire agreement between Israel and the Palestinian militant group Hamas, ending their eight-day clash.

The morning attack came as Palestinians in the West Bank protest the death of 30-year-old Arafat Jaradat, a gas station attendant who died suddenly in Israeli custody after being arrested for throwing rocks at an Israeli settler.

Palestinians claim Jaradat was tortured to death. Israelis say the exact cause of his Feb. 23 death has not yet been determined.

The Grad rocket fired early Tuesday landed in an open area near the Israeli city of Ashkelon, causing no damage or injuries.

ALSO:

Palestinians at funeral protest death of prisoner

Syria ready to talk to rebels, foreign minister says

U.S. military denies abducting, killing civilians in Afghan province

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The Court of Public Opinion Is About Mob Justice and Reputation as Revenge

Recently, Elon Musk and The New York Times took to Twitter and the internet to argue the data – and their grievances — over a failed road test and car review. Meanwhile, an Applebee’s server is part of a Change.org petition to get her job back after posting a pastor’s no-tip receipt comment online. And when he wasn’t paid quickly enough, a local Fitness SF web developer rewrote the company’s webpage to air his complaint.

All of these “cases” are seeking their judgments in the court of public opinion. The court of public opinion has a full docket; even brick-and-mortar establishments aren’t immune.

More and more individuals — and companies — are augmenting, even bypassing entirely, traditional legal process hoping to get a more favorable hearing in public.

Every day we have to interact with thousands of strangers, from people we pass on the street to people who touch our food to people we enter short-term business relationships with. Even though most of us don’t have the ability to protect our interests with physical force, we can all be confident when dealing with these strangers because — at least in part — we trust that the legal system will intervene on our behalf in case of a problem. Sometimes that problem involves people who break the rules of society, and the criminal courts deal with them; when the problem is a disagreement between two parties, the civil courts will. Courts are an ancient system of justice, and modern society cannot function without them.

What matters in this system are the facts and the laws. Courts are intended to be impartial and fair in doling out their justice, and societies flourish based on the extent to which we approach this ideal. When courts are unfair — when judges can be bribed, when the powerful are treated better, when more expensive lawyers produce more favorable outcomes — society is harmed. We become more fearful and less able to trust each other. We are less willing to enter into agreement with strangers, and we spend more effort protecting our own because we don’t believe the system is there to back us up.

The court of public opinion is an alternate system of justice. It’s very different from the traditional court system: This court is based on reputation, revenge, public shaming, and the whims of the crowd. Having a good story is more important than having the law on your side. Being a sympathetic underdog is more important than being fair. Facts matter, but there are no standards of accuracy. The speed of the internet exacerbates this; a good story spreads faster than a bunch of facts.

This court delivers reputational justice. Arguments are measured in relation to reputation. If one party makes a claim against another that seems plausible, based on both of their reputations, then that claim is likely to be received favorably. If someone makes a claim that clashes with the reputations of the parties, then it’s likely to be disbelieved. Reputation is, of course, a commodity, and loss of reputation is the penalty this court imposes. In that respect, it less often recompenses the injured party and more often exacts revenge or retribution. And while those losses may be brutal, the effects are usually short-lived.

Reputation is, of course, a commodity, and loss of reputation is the penalty this court imposes.

The court of public opinion has significant limitations. It works better for revenge and justice than for dispute resolution. It can punish a company for unfairly firing one of its employees or lying in an automobile test drive, but it’s less effective at unraveling a complicated patent litigation or navigating a bankruptcy proceeding.

In many ways, this is a return to a medieval notion of “fama,” or reputation. In other ways, it’s like mob justice: sometimes benign and beneficial, sometimes terrible (think French Revolution). Trial by public opinion isn’t new; remember Rodney King and O.J. Simpson?

Mass media has enabled this system for centuries. But the internet, and social media in particular, has changed how it’s being used.

Now it’s being used more deliberately, more often, by more and more powerful entities as a redress mechanism. Perhaps because it’s perceived to be more efficient or perhaps because one of the parties feels they can get a more favorable hearing in this new court, but it’s being used instead of lawsuits. Instead of a sideshow to actual legal proceedings, it is turning into an alternate system of dispute resolution and justice.

Part of this trend is because the internet makes taking a case in front of the court of public opinion so much easier. It used to be that the injured party had to convince a traditional media outlet to make his case public; now he can take his case directly to the people. And while it’s still a surprise when some cases go viral while others languish in obscurity, it’s simply more effective to present your case on Facebook or Twitter.

Instead of a sideshow to actual legal proceedings, the court of public opinion is turning into an alternate system of dispute resolution and justice.

Another reason is that the traditional court system is increasingly viewed as unfair. Today, money can buy justice: not by directly bribing judges, but by hiring better lawyers and forcing the other side to spend more money than they are able to. We know that the courts treat the rich and the poor differently, that corporations can get away with crimes individuals cannot, and that the powerful can lobby to get the specific laws and regulations they want — irrespective of any notions of fairness.

Smart companies have already prepared for battles in the court of public opinion. They’ve hired policy experts. They’ve hired firms to monitor Facebook, Twitter, and other internet venues where these battles originate. They have response strategies and communications plans in place. They’ve recognized that while this court is very different from the traditional legal system, money and power does count and that there are ways to tip the outcomes in their favor: For example, fake grassroots movements can be just as effective on the internet as they can in the offline world.

It’s time we recognize the court of public opinion for what it is — an alternative crowd-enabled system of justice. We need to start discussing its merits and flaws; we need to understand when it results in justice, and how it can be manipulated by the powerful. We also need to have a frank conversation about the failings of the traditional justice scheme, and why people are motivated to take their grievances to the public. Despite 24-hour PR firms and incident-response plans, this is a court where corporations and governments are at an inherent disadvantage. And because the weak will continue to run ahead of the powerful, those in power will prefer to use the more traditional mechanisms of government: police, courts, and laws.

Social-media researcher Danah Boyd had it right when she wrote here in Wired: “In a networked society, who among us gets to decide where the moral boundaries lie? This isn’t an easy question and it’s at the root of how we, as a society, conceptualize justice.” It’s not an easy question, but it’s the key question. The moral and ethical issues surrounding the court of public opinion are the real ones, and ones that society will have to tackle in the decades to come.

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Cellar victim Kampusch raped, starved in film of ordeal

VIENNA (Reuters) – A new film based on the story of Austrian kidnap victim Natascha Kampusch shows her being repeatedly raped by the captor who beat and starved her during the eight-and-a-half years that he kept her in a cellar beneath his house.

Kampusch was snatched on her way to school at the age of 10 by Wolfgang Priklopil and held in a windowless cell under his garage near Vienna until she escaped in 2006, causing a sensation in Austria and abroad. Priklopil committed suicide.

Kampusch had always refused to respond to claims that she had had sex with Priklopil, but in a German television interview on her 25th birthday last week said she had decided to reveal the truth because it had leaked out from police files.

The film, “3,096 Days” – based on Kampusch’s autobiography of the same name – soberly portrays her captivity in a windowless cellar less than 6 square metres (65 square feet) in area, often deprived of food for days at a time.

The emaciated Kampusch – who weighed just 38 kg (84 pounds) at one point in 2004 – keeps a diary written on toilet paper concealed in a box.

One entry reads: “At least 60 blows in the face. Ten to 15 nausea-inducing fist blows to the head. One strike with the fist with full weight to my right ear.”

The movie shows occasional moments that approach tenderness, such as when Priklopil presents her with a cake for her 18th birthday or buys her a dress as a gift – but then immediately goes on to chide her for not knowing how to waltz with him.

GREY AREAS

Antonia Campbell-Hughes, who plays the teenaged Kampusch, said she had tried to portray “the strength of someone’s soul, the ability of people to survive… but also the grey areas within a relationship that people don’t necessarily understand.”

The British actress said she had not met Kampusch during the making of the film or since. “It was a very isolated time, it was a bubble of time, and I wanted to keep that very focused,” she told journalists as she arrived for the Vienna premiere.

Kampusch herself attended the premiere, looking composed as she posed for pictures but declining to give interviews.

In an interview with Germany’s Bild Zeitung last week, she said: “Yes, I did recognize myself, although the reality was even worse. But one can’t really show that in the cinema, since it wasn’t supposed to be a horror film.”

The movie, made at the Constantin Film studios in Bavaria, Germany, also stars Amy Pidgeon as the 10-year-old Kampusch and Danish actor Thure Lindhardt as Priklopil.

“I focused mainly on playing the human being because… we have to remember it was a human being. Monsters do not exist, they’re only in cartoons,” Lindhart said.

“It became clear to me that it’s a story about survival, and it’s a story about surviving eight years of hell. If that story can be told then I can also play the bad guy.”

The director was German-American Sherry Hormann, who made her English-language debut with the 2009 move “Desert Flower”, an adaptation of the autobiography of Somali-born model and anti-female circumcision activist Waris Dirie.

“I’m a mother and I wonder at the strength of this child, and it was important for me to tell this story from a different perspective, to tell how this child using her own strength could survive this atrocious martyrdom,” Hormann said.

The Kampusch case was followed two years later by that of Josef Fritzl, an Austrian who held his daughter captive in a cellar for 24 years and fathered seven children with her.

The crimes prompted soul-searching about the Austrian psyche, and questions as to how the authorities and neighbors could have let such crimes go undetected for so long.

The film goes on general release on Thursday.

(Reporting by Georgina Prodhan, Editing by Paul Casciato)

Movies News Headlines – Yahoo! News

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The ConsUmer: Questions About a Robotic Surgery

Ever since it was approved by the Food and Drug Administration in 2005, robotic surgery for hysterectomy has been heavily advertised. Surgeons promise that using the da Vinci robotic device will bring better results and an easier recovery, and many hospitals claim that patients will experience less pain and fewer complications, getting back on their feet faster.

The company that makes da Vinci robotic surgery equipment promoted it last May at free health workshops organized by the federal Office on Womens’ Health. On Sunday, the Liberty Science Museum in Jersey City will host its first “Let’s Operate Day,” offering guests “hands-on” practice peering into video monitors and using da Vinci’s robot arms to pick up and manipulate small objects.

The cost of the new technology is rarely mentioned. But last week, a new study that evaluated outcomes in more than a quarter of a million American women raised questions about the manufacturer’s claims. The paper, published in The Journal of the American Medical Association, compared outcomes in 264,758 women who had either laparoscopic or robotically assisted hysterectomy at 441 hospitals between 2007 and 2010. Both methods are minimally invasive and involve smaller incisions than open abdominal surgery.

The researchers found no overall difference in complication rates between the two groups, and no difference in the rates of blood transfusion, even though one of the claims regarding robotic surgery is that it causes less blood loss.

But the researchers did find a big difference in cost. Robotically assisted surgery for hysterectomy costs on average about one-third more than laparoscopic surgery.

“It’s important to separate the marketing from the data,” said Dr. Jason D. Wright, the study’s lead author, an assistant professor of obstetrics and gynecology at Columbia University Medical Center. “For the surgeon, there is a greater degree of movement and control of the instruments and the visualization is better.

“But the ultimate question is, does this change outcomes for patients? This study suggests that there really is not a lot of difference as far as quantifiable outcomes.”

The majority of patients in both groups left the hospital in less than two days, though patients who had robotic surgery were slightly more likely to go home that early: 80 percent went home in less than two days, compared with 75 percent of those who had laparoscopic surgery.

But the cost of robotic surgeries was significantly higher, with a median cost to the hospital of $8,868, compared with $6,679 for laparoscopic hysterectomy. The study did not look at the difference in patients’ bills, but according to Newchoicehealth.com, the average patient price for a laparoscopic hysterectomy ranges from $7,700 in Dallas to $11,600 in Los Angeles.

With laparoscopic surgery — sometimes called keyhole surgery — narrow instruments and a small video camera are inserted through tiny incisions; the surgeon sees the image on a monitor and can cut and sew tissue with the instruments. With robotically assisted surgery, the surgeon sits at a console with a 3-dimensional view of the surgical site, and computer technology translates his or her hand movements into precise, scaled movements of the instruments.

Even without offering clear advantages the proportion of hysterectomies performed robotically has increased rapidly, up to nearly 10 percent of hysterectomies in 2010 from less than 1 percent in 2007, Dr. Wright said. Minimally invasive surgeries for hysterectomies are increasing across the board, he found, even at hospitals not performing robotic surgery.

Dr. Myriam J. Curet, chief medical adviser to Intuitive Surgical, which makes the da Vinci systems, did not dispute the study’s findings, but said the important message was that more women were able to receive minimally invasive surgeries because more options were available.

“That’s good for patients and for the health care system,” Dr. Curet said. Women who are not candidates for laparoscopic surgery might still be candidates for robotically-assisted surgery, she added.

Right now, however, it is not clear how to identify which women would benefit from robotic surgery and which would do well with a less expensive method.

The growing use of robotic surgery in hospitals will continue to drive up health costs, said Joel S. Weissman, of Brigham and Women’s Hospital and a co-author of an editorial published with the study.

“Once you have that robot, the tendency is to use it for all kinds of things, for which it may or may not have great value,” Dr. Weissman said. Studies like this one, he said, demonstrate the waste of health care dollars on “something that costs a lot more and doesn’t offer any added benefit over current treatment options.”

Each year approximately 600,000 American women have hysterectomies, according to the Centers for Disease Control and Prevention. By age 60, one in three American women has had her uterus removed, often along with her ovaries and cervix.

Critics who say far too many hysterectomies are done in the United States worry that all the attention to surgical method distracts from the question of whether patients should be having the surgery at all.

Most hysterectomies are prescribed for conditions that are not life-threatening, and advocates worry that women are not fully informed of the long-term harms, which may include a loss of sexual responsiveness, depression and chronic constipation, and higher risk for osteoporosis and heart disease, said Nora W. Coffey, the founder of the nonprofit Hysterectomy Educational Resources and Services Foundation.

“That’s the conversation we should be having,” Ms. Coffey said.

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Nora W. Coffey and other experts emphasize that women considering a hysterectomy should discuss all options with their doctors.

¶Ask what the alternatives are and whether watchful waiting is an option. Remember that it is irreversible, regardless of how the surgery is done.

¶Learn about the nonreproductive functions of the uterus, ovaries and cervix, and the potential long-term consequences associated with their removal, as well as the function of the ovaries and cervix.

¶If you proceed, discuss the advantages and disadvantages of different surgical methods with your doctor. Interview several surgeons and inquire about the cost and how much insurance will cover. Your co-pay may vary depending on the surgical method.

¶Tell your surgeon if you do not want your ovaries and cervix removed.

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British Government Seeks to Limit Disclosure in Litvinenko Case

The British government sought on Tuesday to limit the information it is ready disclose at a planned inquest into the death of Alexander V. Litvinenko, a former officer in the K.G.B. who died of radiation poisoning in London more than six years ago, and the coroner hearing the case said it may now be postponed.

“Due to the complexity of the investigation which necessarily precedes the hearings” Sir Robert Owen, the coroner said, the planned May 1 start date for the hearings could represent “a timetable to which it may not be possible to adhere.”

The inquest would be the first — and likely the only — public forum at which witnesses would testify under oath about the killing, which strained Britain’s relationship with the Kremlin and kindled memories of the cold war.

The prospect of a postponement brought charges from Ben Emmerson, a lawyer representing Mr. Litvinenko’s widow, Marina Litvinenko, that the British government was trying to gag the inquiry in order to protect lucrative trade deals with Russia.

Referring to Prime Minister David Cameron, Mr. Emmerson said on Tuesday that “the British government, like the Russian government, is conspiring to get this inquest closed down in exchange for substantial trade interests which we know Mr. Cameron is pursuing."

He added: "One has to ask what is going on at the highest level of Her Majesty’s Government, particularly when the highest levels are building bridges with the Kremlin."

The British government, he said, had “no right to say to an independent judiciary, ’you may not investigate these issues’. That happens in Russia, for sure.”

“This has all the hallmarks of a situation which is shaping up to be a stain on British justice,” the lawyer said.

Sir Robert, the coroner, said he would rule on Wednesday on the government’s application for a so-called Public Interest Immunity Certificate, usually issued on the grounds of national security, which would prevent the inquest from hearing information on topics without explaining what those issues were.

British analysts say they believe Britain is keen to avoid disclosing any information that might link Mr. Litvinenko to the British security services.

Last December, Mr. Emmerson, the lawyer, told a preparatory hearing that that Mr. Litvinenko was a “registered and paid agent and employee of MI6,” as the British Secret Intelligence Service is known. Mr. Litvinenko also worked for the Spanish intelligence service, Mr. Emmerson said, and both the British and Spanish spy agencies made payments into a joint account with his wife. The lawyer added that the inquest should consider whether MI6 failed in its duty to protect the onetime KGB officer against a “real and immediate risk to life.”

Mr. Litvinenko, who fled Russia in 2000 and styled himself a whistle-blower and foe of the Kremlin, died in November 2006, aged 43, weeks after he secured British citizenship. He had ingested polonium 210 — a rare radioactive isotope — at the Pine Bar of the Millennium Hotel in London’ central Grosvenor Square.

Britain’s Crown Prosecution Service is seeking the extradition from Russia of Andrei K. Lugovoi, another former K.G.B. officer, to face trial on murder charges. Mr. Lugovoi denies the accusation and Russia says its Constitution forbids it from sending its citizens to other countries to face trial.

The coroner has said in previous hearings that he will examine what was known about threats to Mr. Litvinenko and would also seek to determine whether the Russian state bore responsibility. In a deathbed statement, Mr. Litvinenko directly blamed President Vladimir V. Putin, who dismissed the accusation. Mr. Emmerson, the lawyer, complained on Tuesday that the preparations for the inquest were becoming “bogged down” by “the government’s attempt to keep a lid on the truth.”

“It is the government’s secret files that are delaying this inquest.”

British media outlets including the BBC and The Guardian newspaper are opposing the government’s effort to restrict evidence. The Guardian said that “the public and media are faced with a situation where a public inquest into a death may have large amounts of highly relevant evidence excluded from consideration by the inquest. Such a prospect is deeply troubling.”

But the Foreign Office said the authorities had made their application in line with their “duty to protect national security” and the coroner would rule according to “the overall public interest.”

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Oscars 2013: An 'Argo' night at Academy Awards

For the second straight year, the movie business fell for itself.

"Argo" — in which a Hollywood producer and makeup artist help engineer the rescue of six Americans from Iran — won the top prize at the 85th Academy Awards, one year after the silent film story "The Artist" took the best picture Oscar.

"I never thought I'd be back here. And I am," producer-director Ben Affleck said in accepting the best picture trophy Sunday night, 15 years after he won an original screenplay Oscar for "Good Will Hunting" and then saw his career fall into a tailspin that included "Gigli" and "Daredevil."

FULL COVERAGE: Oscars 2013 | Winners

"It doesn't matter how you get knocked down in life. That's going to happen," said Affleck, who wasn't nominated for directing "Argo," one of nine films in the best picture race. "All that matters is that you've got to get up."

"Argo," which became the first movie to win best picture without its director being nominated since 1989's "Driving Miss Daisy," collected two other Academy Awards, for editing and adapted screenplay. But it was not the evening's most recognized film: That honor went to Ang Lee's "Life of Pi," which won four Oscars — for directing, visual effects, cinematography and score.

"Thank you, movie god," said Lee, whose movie came into the evening with 11 nominations, one behind Steven Spielberg's "Lincoln." The film about the 16th president helped Daniel Day-Lewis make movie history, as he became the only man to ever win three lead actor statuettes. "Lincoln" won one other prize, for production design.

The song-and-dance heavy ceremony, hosted by Seth MacFarlane, hewed closely to a traditional awards show script, but there were several surprises. First Lady Michelle Obama, who joined the ABC telecast from the White House, announced "Argo" as the best picture. And the ceremony featured only the sixth tie in Oscar history and the first since 1994, with the sound editing award split between "Zero Dark Thirty" and "Skyfall." For the first time in Oscar history, six best picture nominees were $100-million blockbusters.

The ceremony was billed as a tribute to music in film, and boasted a number of extravagant musical numbers — including a medley of songs from movie musicals and an appearance by Barbra Streisand, who sang "The Way We Were." The telecast also paid homage to the long running James Bond series, with Adele singing the theme from "Skyfall" and Dame Shirley Bassey performing the theme from 1964's "Goldfinger."

Oscars 2013: Nominee list | Red carpet | Highlights

Jennifer Lawrence, 22, nabbed the lead actress prize for her role as an emotionally unstable widow in "Silver Linings Playbook" — and promptly tripped over her long dress walking up the stairs to accept her statuette. The crowd quickly gave her a standing ovation. "You guys are just standing up because you feel bad that I fell and that's embarrassing," Lawrence said to the applauding crowd at the Dolby Theatre.

The evening's very first award — for supporting actor — was a shocker, with long shot Christoph Waltz winning for his role as bounty hunter Dr. King Schultz in Quentin Tarantino's "Django Unchained" over favored contenders Robert De Niro ("Silver Linings Playbook") and Tommy Lee Jones ("Lincoln"). Waltz, who won the same award three years ago for Tarantino's "Inglourious Basterds," dedicated his prize to his writer-director, who also won the Oscar for original screenplay. "We participated in a hero's journey — the hero being Quentin," Waltz said.

Tarantino pulled off a mild surprise with the screenplay triumph for his slave-revenge tale. He dedicated his award to his eclectic cast of actors. "I actually think if people know my movies 30-50 years from now it's because of the characters I create," Tarantino said.

Anne Hathaway's supporting actress win for her emotionally raw portrayal of a doomed seamstress in "Les Misérables" was hardly as startling. The 30-year-old had been the odds-on favorite to win since the film first screened for members of the Motion Picture Academy in late November. "It came true," she stage-whispered as she picked up her trophy for her performance, the centerpiece of which is the lament "I Dreamed a Dream."

Oscars 2013: Backstage | Quotes | Best & Worst moments

Some of the evening's wins were bittersweet.

The animated feature Oscar was shared by "Brave" directors Mark Andrews and Brenda Chapman, an unusual pairing given that Chapman was fired from the Pixar Animation Studios film and replaced by Andrews in the middle of production. "Making these are a struggle — it's a battle, it's a war," Andrews said backstage. "I was very happy it was him who took my place," Chapman said.

Rhythm & Hues Studios, the company behind "Life of Pi's" visual effects win, recently filed for bankruptcy and laid off hundreds of its employees. As Oscar winner Bill Westenhofer addressed the situation in his acceptance speech, he ran over time and the theme from "Jaws" began to play him off the stage. His microphone was cut off just as he said the words "I urge you all…"

William Goldenberg was a double nominee in the film editing category — he worked on both "Argo" and "Zero Dark Thirty" — and won the prize for Affleck's CIA drama.

"Working at my father's deli, I had to do a million things at one time," Goldenberg said backstage about the best training for his job. "It really does prepare you for the multitasking it takes to be in an editing room."

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