‘Half-Match’ Bone Marrow Transplants Cure Sickle Cell in Trial

In her mid-20s, Yetunde Felix-Ukwu wore a Fentanyl patch that delivered enough narcotic to knock most adults out cold. Yet it barely kept her pain, caused by sickle cell disease, tolerable.

Even with the patch, she was hospitalized almost every month for the pain, which she said was “like being hit with a hammer, searing, throbbing, you name it.”

A debilitating genetic disorder, sickle-cell disease causes blood cells to be shaped like sickles, or crescents, and to be rigid, not pliable. Rather than squeezing in and out of capillaries and blood vessels as normal cells do, the sickle cells jam up, depriving tissues throughout the body of blood and oxygen. That can cause severe organ damage, stroke, blindness and unimaginable pain.

“Imagine heart attack pain all over the body,” said Dr. Robert A. Brodsky, director of the division of hematology at Johns Hopkins University School of Medicine. Many patients don’t live past 50.

A bone marrow transplant could help. The problem is, most patients, including Ms. Felix-Ukwu, cannot get a bone marrow transplant because they don’t have a perfect genetic match. Like a vast majority of others who have sickle cell disease, Ms. Felix-Ukwu is African-American, and the chance of an African-American finding a donor in bone marrow registries is about 10 percent, compared with a 60 to 70 percent chance for Caucasians, Dr. Brodsky said.

Dr. Brodsky and his colleagues at Johns Hopkins, however, began a bone marrow transplant trial using so-called half-match donors. The trial has found that the procedure can cure sickle cell, replacing defective stem cells that produce sickle-shaped cells with normal stem cells that churn out plump, pliable blood cells.

Since almost everyone with a sibling, a parent or a child has a genetic half match, the procedure could make bone marrow transplants available to more than 90 percent of candidates.

“It opens the opportunity for a cure for thousands of adults with the disease who previously had not had any hope of a cure,” said Dr. Michael DeBaun, director of the Center for Excellence in Sickle Cell Disease at Vanderbilt University School of Medicine. Dr. DeBaun was not involved with the half-match trial.

Beginning in high school, Ms. Felix-Ukwu, now 30, had undergone regular transfusions to dilute and temporarily replace the sickle cells in her blood, but the transfusions stopped helping. Half-match donors have been used for about a decade in bone marrow transplants for leukemia and lymphoma patients, and the doctors believed it was now safe enough to use in sickle cell patients.

Ms. Felix-Ukwu, who lives in Lanham, Md., enrolled in the Johns Hopkins study, and her younger sister, Woma Felix-Ukwu, became her half-matched bone marrow donor.

Ms. Felix-Ukwu had to undergo a grueling course of chemotherapy, radiation and immunosuppresants before receiving the transplant.

“Those three days of chemo were the hardest days of my life, including all the pain I had been through with sickle cell,” she said. But it worked. Her body started producing normal blood cells. She continued to have some pain for another 18 months or so, for reasons that are not entirely clear, but now, three years after the transplant, Ms. Felix-Ukwu is disease-free and off all of her pain medications.

“It’s absolutely amazing,” says Dr. Brodsky, who published the study this month in Blood, the journal of the American Society of Hematology. Of the 14 patients in the study who received half-matched transplants, six were cured, meaning that their bone marrow is made up entirely of the donor’s and they are no longer producing sickle cells.

Two additional patients are still taking immunosuppressive drugs, meaning that the donor’s bone marrow took, but they still have some of their own marrow. They still have a chance of being cured.

In a half-match transplant, known medically as haploidentical transplant, only 50 percent of the pertinent genes have to match up. Testing for a bone marrow match entails looking for genes in the human leukocyte antigen, or H.L.A., system, the part of the immune system that recognizes self and not self.

In a full match, 8 to 10 H.L.A. genes need to match between donor and recipient.

“If you have disparities in the H.L.A. system and you transplant stem cells that recognize the patient as foreign, the new immune system will start attacking the patient,” said Dr. Brodsky. In half-match transplants, only half of these H.L.A. genes need to match.

But half-match transplants carry the risk that the donor’s immune cells will attack the host, a potentially deadly complication called graft-versus-host disease.

To reduce this risk, patients receive the chemotherapeutic drug cyclophosphamide after the bone marrow is transplanted. This drug kills the donor’s lymphocytes that would normally attack the recipient, but it spares the donor stem cells, which have an enzyme that makes them immune to it. The stem cells then produce new lymphocytes.

“What happens is that the new cells that are generated become tolerant to the host and will not attack it,” says Dr. Javier Bolaños-Meade, the lead author on the study and associate professor of oncology at Johns Hopkins.

“The biggest paradigm shift was the post-treatment chemo,” added Dr. Brodsky.

The other shift was the trend toward a gentler pre-treatment. In a traditional bone marrow transplant to treat cancer, patients receive high-dose chemotherapy and radiation before the transplant, not only to suppress the immune system but to kill off every last cancer cell in the body. But in sickle cell, the chemotherapy just has to suppress the immune system, so doctors can use a less intense regimen.

This could potentially open it up to many more adults. Bone marrow transplants have largely been offered to children with sickle cell, not adults, who were often too weak or debilitated to endure the more intense pre-treatments.

The half-match transplant is still experimental, and because of its toxicity, it is recommended only for those with advanced disease. It was successful in only about 50 percent of patients.

“You’re putting people through a lot, and to have half of the transplants not take must be heartbreaking,” said Dr. Jane Little, director of the adult sickle cell program at Case Western Reserve University in Cleveland. “It’s exposing patients to risk you can’t take away. But it also really expands the pool of potential recipients.”

The team at Johns Hopkins is tweaking the procedure to improve the success rate without increasing the toxicity, said Dr. Bolaños-Meade. “We are working on transplanting with a higher number of stem cells to help overcome rejection,” he said.

“Clearly it doesn’t cure everyone, but in those patients in which it works, it’s a huge, huge thing,” Dr. Bolaños-Meade said.

This August, Ms. Felix-Ukwu celebrated a year without being in the hospital. She plans to go back to law school next September.

“When I look back, I wonder how I ever made it through all that pain,” she said. “Now I feel like I’m on vacation. I finally have the freedom to be able to live my life.”

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Newton: Jan Perry's path to power

An essential element of a successful political campaign, whether for U.S. president or mayor of Los Angeles, is that it identifies a path to victory. Candidates have to differentiate themselves from competitors and appeal to constituencies sympathetic to their message.

At this point in the Los Angeles mayor's race, Councilwoman Jan Perry lags behind front-runners Wendy Greuel and Eric Garcetti in terms of money and name recognition, but in recent weeks she has found a potentially viable path.

Perry's approach reflects an important feature of the field for this campaign: Controller Greuel and Councilman Garcetti, the leading candidates at this early stage, bring to the campaign virtually identical politics and similar temperaments. Both are personable, smart liberals with strong ties to organized labor. Greuel draws support from the International Brotherhood of Electrical Workers, the union that represents employees of the Los Angeles Department of Water and Power, while Garcetti is close to the Service Employees International Union, which represents some city and county workers and others in service industries.

Those relationships are likely to supply Garcetti and Greuel with volunteers and financial support, both vital to winning. But they also present Perry with an opportunity to set herself apart. Now that County Supervisor Zev Yaroslavsky and businessmen Austin Beutner and Rick Caruso have opted out of the campaign, Perry finds herself with a surprisingly open shot at becoming the favored candidate of business. As one longtime observer of this region's politics remarked to me last week, "It's the only way for her to go."

Last week, Perry demonstrated that she's gotten that message. Speaking to a small but welcoming audience at the Japanese American National Museum, Perry staked out her territory. She said she would oppose increases in sales and documentary transfer taxes — proposals that may appear on the same ballot as the mayoral contest's first round in March. She argued for offloading some city assets, such as the Convention Center and zoo. And she insisted that the city's budget problems — it faces a shortfall of more than $200 million this year, and the prognosis gets worse looking ahead — need to be addressed by asking city employees to contribute more to their medical coverage and pensions. That's just what business wants to hear.

"I am a lifelong Democrat who is a business-friendly Democrat," she said. By contrast, she said, her chief opponents will find it difficult to challenge City Hall's status quo in areas such as rate increases and pension reform. "I think they both will have obligations that they will have to meet, one to IBEW, the other to SEIU."

There is a fourth candidate who could plant his flag in this same area. Lawyer and radio personality Kevin James is campaigning at the race's only true outsider. The same calculations that have raised Perry's possibilities have increased his as well, but she has experience and credentials that will make it hard for him to head her off.

Perry is likable, with a refreshing candor. Last week, she slipped off her shoes as she delivered her speech and took questions from reporters until they had no more. And she didn't exaggerate what is achievable: Asked whether she thought the city could rebound over the next four years, she said, basically, no.

But she has liabilities too. In 2007, she joined council colleagues — including Greuel and Garcetti — in voting for a salary increase that gave city workers more than 25% over five years. The deal was rendered insupportable when the economy tanked the next year, but it doesn't take a Nobel laureate to see that not many workers in 2007 were getting deals that promised them annual salary increases of 5%. When I asked her if she regretted that vote, Perry laughed. "Yes," she said. "Of course."

Perry does have her share of enemies. She is famously stubborn — one joke kicking around the campaign is that she might have dropped out of this race and instead run for controller if only so many people hadn't asked her to. And the demographic dynamics of her base are complicated. She's African American and enjoys strong support from that important but relatively small community. She's also, unbeknownst to many voters, Jewish, which supplies her either with a way to extend her base or to confuse it.

The business elites that supported Richard Riordan in the 1990s had hoped Beutner would run, and they have yet to fall in behind Perry. But they're without a standard-bearer at the moment, and that could leave Perry with a powerful constituency, a coherent message — and a path.

Jim Newton’s column appears Mondays. His latest book is "Eisenhower: The White House Years." Reach him at jim.newton@latimes.com or follow him on Twitter: @newton_jim.

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U2′s Bono to urge U.S. politicians not to cut aid programs

WASHINGTON (Reuters) – Irish rocker and anti-poverty campaigner Bono will appeal to Democrats and Republicans during a visit to Washington this week to spare U.S. development assistance programs from cuts as Congress tries to avert the looming “fiscal cliff” of tax hikes and spending reductions early next year.

The U2 lead singer’s visit comes as the Obama administration and congressional leaders try to forge a deal in coming weeks to avoid the economy hitting the “fiscal cliff” – tax increases and spending cuts worth $ 600 billion starting in January if Congress does not act.

Analysts say the absence of a deal could shock the United States, the world’s biggest economy, back into recession.

Kathy McKiernan, spokeswoman for the ONE Campaign, said Bono will hold talks with congressional lawmakers and senior Obama administration officials during the November 12-14 visit.

During meetings he will stress the effectiveness of U.S. foreign assistance programs and the need to preserve them to avoid putting at risk progress made in fighting HIV/AIDS, tuberculosis and malaria, she said.

Bono, a long-time advocate for the poor, will argue that U.S. government-funded schemes that support life-saving treatments for HIV/AIDS sufferers, nutrition programs for malnourished children, and emergency food aid make up just 1 percent of the U.S. government budget but are helping to save tens of millions of lives in impoverished nations.

The One Campaign would not elaborate which lawmakers and senior Obama administration officials Bono will meet.

On Monday, Bono will discuss the power of social movements with students at Georgetown University. He will also meet new World Bank President Jim Yong Kim for a web cast discussion on Wednesday on the challenges of eradicating poverty.

(Editing by W Simon)

Music News Headlines – Yahoo! News

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Global Update: A Solar Device to Help Sterilize Instruments

Solar power can steam-sterilize surgical instruments, according to a new study — but the contraption needed to do so is not pocket-size.

Sterilizing instruments needed in surgical emergencies like Caesarean births or appendectomies can be a problem in rural clinics in Africa: There may be no electricity, jugs of bleach or tanks of propane.

So a Rice University team recently modified a prototype of an old solar stove to power a simple autoclave, which is a pressure-cooker for instruments, and tested it in the Texas sun.

On all 27 attempts, it reached United States government sterilization standards.

How practical it is awaits African trials; it is nearly 12 feet long and 6 feet tall and has bright curved mirrors to focus sunlight on a water-filled pipe. On sunny days, it can make steam at 150 degrees Celsius (302 degrees Fahrenheit) from about 9 a.m. to 3 p.m.

Douglas A. Schuler, above, a Rice business professor and lead author of the study, published in The American Journal of Tropical Medicine and Hygiene, said he “married into the project.” His French father-in-law designed the solar stove years ago after a student trip to West Africa. But women in Haiti, where they tested it, “just hated cooking on it,” Dr. Schuler said, so they found a different use for it.

The initial setup costs about $2,100. But sunlight costs nothing, making five years of operation about $2,000 cheaper than using propane.

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Report Sees U.S. as Top Oil Producer, Overtaking Saudi Arabia, in 5 Years

Charlie Riedel/Associated Press

A pump jack near Greensburg, Kan. Increased oil production and new policies to improve energy efficiency mean that the United States will become “all but self-sufficient” in energy in about two decades, the International Energy Agency predicted.

The United States will overtake Saudi Arabia as the world’s leading oil producer by about 2017 and will become a net oil exporter by 2030, according to a new report released on Monday by the International Energy Agency.

That increased oil production, combined with new American policies to improve energy efficiency, means that the United States will become “all but self-sufficient” in meeting its energy needs in about two decades — a “dramatic reversal of the trend” in most developed countries, the report says.

“The foundations of the global energy systems are shifting,” said Fatih Birol, chief economist at the Paris-based organization, which produces the annual World Energy Outlook, in an interview before the release. The agency, which advises industrialized nations on energy issues, had previously predicted that Saudi Arabia would be the leading producer until 2035.

The report also predicted that global energy demand would grow by 35 percent to 46 percent between 2010 and 2035, depending on whether policies that have been proposed are actually put in place. Most of that growth will come from China, India and the Middle East, where the consuming class is growing rapidly. The consequences are “potentially far reaching” for global energy markets and trade, the report said.

Dr. Birol noted, for example, that Middle Eastern oil once bound for the United States would probably be rerouted to China. American-mined coal, facing declining demand in its home market, is already heading to Europe and China instead.

There are several components of the sudden shift in the world’s energy supply, but the prime mover is a resurgence of oil and gas production in the United States, particularly the unlocking of new reserves of oil and gas found in shale rock. The widespread adoption of techniques such as hydraulic fracturing and horizontal drilling has made those reserves much more accessible, and in the case of natural gas, resulted in a vast glut that has sent prices plunging.

The report predicted that the United States would overtake Russia as the leading producer of natural gas in 2015.

The strong statements and specific predictions by the energy agency lend new weight to trends that have become increasingly apparent in the last year.

“This striking conclusion confirms a lot of recent projections,” said Michael Levi, senior fellow for energy and environment at the Council on Foreign Relations.

Formed in 1974 after the oil crisis by a group of oil-importing nations, including the United States, the International Energy Agency monitors and analyzes global energy trends to insure safe and sustainable supply.

Mr. Levi said that the I.E.A. report was generally “good news” for the United States because it highlights the nation’s new sources of energy. But he cautioned that being self-sufficient did not mean that the country would be insulated from seesawing energy prices, since those oil prices are set by global markets.

“You may be somewhat less vulnerable to price shocks and the U.S. may be slightly more protected, but it doesn’t give you the energy independence some people claim,” he said.

Also, he noted, the agency’s projection of United States self-sufficiency assumed that the country would push ahead with improving gas mileage in cars and energy efficiency in homes and appliances. “It’s supply and demand together that adds up to this striking conclusion,” Mr. Levi said.

Dr. Birol said the agency’s prediction of increasing American self-sufficiency was 55 percent a reflection of more oil production and 45 percent a reflection of improving energy efficiency in the United States, primarily from the Obama administration’s new fuel economy standards for cars. He added that even stronger policies to promote energy efficiency were needed in the United States and many other countries.

The report said that several other factors could also have a large impact on world energy markets over the next few years. These include the recovery of the Iraqi oil industry, which would lead to new supply, and the decision by some countries, notably Germany and Japan, to move away from nuclear energy in the wake of the Fukushima disaster.

The new energy sources will help the United States economy, Dr. Birol said, providing continued cheap energy relative to the rest of the world. The I.E.A. estimates that electricity prices will be about 50 percent cheaper in the United States than in Europe, largely because of a rise in the number of power plants fueled by cheap natural gas, helping American industries and consumers.

But the message is more sobering for the planet, in terms of climate change. Although natural gas is frequently promoted for being relatively low in carbon emissions compared to oil or coal, the new global energy market could make it even harder to prevent dangerous levels of warming.

The United States’ reduced reliance on coal will just mean that coal moves to other places, the report says. And the use of coal, now the dirtiest fuel, continues to rise elsewhere. China’s coal demand will peak around 2020 and then stay steady until 2035, the report predicted, and in 2025, India will overtake the United States as the world’s second-largest coal user.

The report warns that no more than one-third of the proven reserves of fossil fuels should be used by 2050 to limit global warming to 2 degrees Celsius, as many scientists recommend.

Such restraint is extremely unlikely without a binding international treaty by 2017 that requires countries to limit the growth of their emissions, Dr. Birol said. He added that pushing ahead with technologies that could capture and store carbon dioxide was also crucial.

“The report confirms that, given the current policies, we will blow past every safe target for emissions,” Mr. Levi said. “This should put to rest the idea that the boom in natural gas will save us from that.”

This article has been revised to reflect the following correction:

Correction: November 12, 2012

An earlier version of a photo caption with this article incorrectly identified the equipment used in an oil field in Greensburg, Kan. It is a pump jack, not an oil rig.

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Times investigation: Legal drugs, deadly outcomes

Terry Smith collapsed face-down in a pool of his own vomit.

Lynn Blunt snored loudly as her lungs slowly filled with fluid.

Summer Ann Burdette was midway through a pear when she stopped breathing.

Larry Carmichael knocked over a lamp as he fell to the floor.

Jennifer Thurber was curled up in bed, pale and still, when her father found her.

Karl Finnila sat down on a curb to rest and never got up.

These six people died of drug overdoses within a span of 18 months.

But according to coroners' records, that was not all they had in common. Bottles of prescription medications found at the scene of each death bore the name of the same doctor: Van H. Vu.

After Finnila died, coroner's investigators called Vu to learn about his patient's medical history and why he had given him prescriptions for powerful medications, including the painkiller hydrocodone.

Investigators left half a dozen messages. Vu never called back, coroner's records state.

Over the next four years, 10 more of his patients died of overdoses, the records show. In nine of those cases, painkillers Vu had prescribed for them were found at the scene.

Vu, a pain specialist in Huntington Beach, described himself as a conscientious, caring physician. He declined to comment on individual cases, citing confidentiality laws, but he said he treats many "very, very difficult patients" whose chronic pain is sometimes complicated by substance abuse and depression, anxiety or other mental illness.

"Every single day, I try to do the best I can for every single patient," he said in an interview. "I can't control what they do once they leave my office."

Prescription drug overdoses now claim more lives than heroin and cocaine combined, fueling a doubling of drug-related deaths in the United States over the last decade.

Health and law enforcement officials seeking to curb the epidemic have focused on how OxyContin, Vicodin, Xanax and other potent pain and anxiety medications are obtained illegally, such as through pharmacy robberies or when teenagers raid their parents' medicine cabinets. Authorities have failed to recognize how often people overdose on medications prescribed for them by their doctors.

A Los Angeles Times investigation has found that in nearly half of the accidental deaths from prescription drugs in four Southern California counties, the deceased had a doctor's prescription for at least one drug that caused or contributed to the death.

Reporters identified a total of 3,733 deaths from prescription drugs from 2006 through 2011 in Los Angeles, Orange, Ventura and San Diego counties.

An examination of coroners' records found that:

In 1,762 of those cases — 47%— drugs for which the deceased had a prescription were the sole cause or a contributing cause of death.

A small cadre of doctors was associated with a disproportionate number of those fatal overdoses. Seventy-one — 0.1% of all practicing doctors in the four counties — wrote prescriptions for drugs that caused or contributed to 298 deaths. That is 17% of the total linked to doctors' prescriptions.

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How I Was Drawn Into the Cult of David Petraeus

When it came out that CIA Director David Petraeus had an affair with his hagiographer, I got punked. “It seems so obvious in retrospect. How could you @attackerman?” tweeted @bitteranagram, complete with a link to a florid piece I wrote for this blog when Petraeus retired from the Army last year. (“The gold standard for wartime command” is one of the harsher judgments in the piece.) I was so blind to Petraeus, and my role in the mythmaking that surrounded his career, that I initially missed @bitteranagram’s joke.

But it’s a good burn. Like many in the press, nearly every national politician, and lots of members of Petraeus’ brain trust over the years, I played a role in the creation of the legend around David Petraeus. Yes, Paula Broadwell wrote the ultimate Petraeus hagiography, the now-unfortunately titled All In. But she was hardly alone. (Except maybe for the sleeping-with-Petraeus part.) The biggest irony surrounding Petraeus’ unexpected downfall is that he became a casualty of the very publicity machine he cultivated to portray him as superhuman. I have some insight into how that machine worked.

The first time I met Petraeus, he was in what I thought of as a backwater: the Combined Armed Center at Fort Leavenworth. It’s one of the Army’s in-house academic institutions, and it’s in Kansas, far from the battlefields of Iraq and Afghanistan. In 2005, Petraeus ran the place, and accepted an interview request about his tenure training the Iraqi military, which didn’t go well. Petraeus didn’t speak for the record in that interview, but over the course of an hour, he impressed me greatly with his intelligence and his willingness to entertain a lot of questions that boiled down to isn’t Iraq an irredeemable shitshow. Back then, most generals would dismiss that line of inquiry out of hand, and that would be the end of the interview.

One of Petraeus’ aides underscored a line that several other members of the Petraeus brain trust would reiterate for years: “He’s an academic at heart,” as Pete Mansoor, a retired Army colonel who served as Petraeus’ executive officer during the Iraq surge, puts it. There was a purpose to that line: it implied Petraeus wasn’t particularly ambitious, suggesting he was content at Fort Leavenworth and wasn’t angling for a bigger job. I bought into it, especially after I found Petraeus to be the rare general who didn’t mind responding to the occasional follow-up request.

So when Petraeus got command of the Iraq war in 2007, I blogged that it was all a tragic shame that President Bush would use Petraeus, “the wisest general in the U.S. Army,” as a “human shield” for the irredeemability of the war. And whatever anyone thought about the war, they should “believe the hype” about Petraeus.

I wasn’t alone in this. Petraeus recognized that the spirited back-and-forth journalists like could be a powerful weapon in his arsenal. “His ability to talk to a reporter for 45 minutes, to flow on the record, to background or off-the-record and back, and to say meaningful things and not get outside the lane too much — it was the best I’ve ever seen,” Mansoor reflects. It paid dividends. On the strength of a single tour running the 101st Airborne in Mosul, Newsweek put the relatively unknown general on its cover in 2004 under the headline CAN THIS MAN SAVE IRAQ? (It’s the first of three cover stories the magazine wrote about him.) Petraeus’ embrace of counterinsurgency, with its self-congratulatory stylings as an enlightened form of warfare that deemphasized killing, earned him plaudits as an “intellectual,” unlike those “old-fashioned, gung-ho, blood-and-guts sort of commander[s],” as Time’s Joe Klein wrote in 2007. This media narrative took hold despite the bloody, close-encounter street fights that characterized Baghdad during the surge.

That March, I was embedded with a unit in Mosul when I learned Petraeus was making a surprise visit to its base. The only time he had for an interview was during a dawn workout session with company commanders, I was told, but if I was willing to exercise with everyone else, sure, I could ask whatever I wanted. The next morning, Petraeus came out for his five-mile run and playfully asked: “What the hell is Spencer Ackerman doing in Mosul?” It’s embarrassing to remember that that felt pretty good, but it did. And sure enough, while I sweated my way through a painful run — I had just quit smoking and was in terrible shape — he calmly parried my wheezed questions. I only later realized I didn’t gain any useful or insightful answers, just a crazy workout story that I strained to transform into a metaphor for the war. (“‘This tires you out that day, but it gives you stamina over the long run,’ he noted. ‘And this is about stamina. It’s absolutely grueling.’” Ugh.)

There was another element at work: counterinsurgency seemed to be working to reduce the tensions of Iraq’s civil war, as violence came down dramatically that summer. So when I got the occasional push-back email from Petraeus’ staff that my reporting was too negative or too ideological, I feared they had a point. And I got exclusive documents from them that — surprise, surprise — not only vindicated Petraeus but made the general seem driven by data and not ideology.

To be clear, none of this was the old quid-pro-quo of access for positive coverage. It worked more subtly than that: the more I interacted with his staff, the more persuasive their points seemed. Nor did I write anything I didn’t believe or couldn’t back up — but in retrospect, I was insufficiently critical. And his staff never cut off access when they disagreed with something I’d written. I didn’t realize I was thinking in their terminology, even when I wrote pieces criticizing Petraeus. A 2008 series I wrote on counterinsurgency was filled with florid descriptions like “Petraeus is no stranger to either difficulty or realism.”

Politicians and the press treated Petraeus as a conquering hero. Tom Ricks, then the Washington Post’s senior military correspondent, wrote that Petraeus’ “determination” was the “cornerstone of his personality,” and portrayed the success of surge as that determination beating back the insurgents and the nay-sayers. “The soldiers and marines told us they feel that they now have a superb commander in Gen. David Petraeus,” wrote Brookings Institutions analysts Michael O’Hanlon and Kenneth Pollack after a return from Iraq. “They are confident in his strategy, they see real results, and they feel now they have the numbers needed to make a real difference.” John McCain hugged Petraeus so closely during his 2008 campaign that Post columnist Jackson Diehl dubbed the general “McCain’s Running Mate.”

But by the time President Obama tapped Petraeus to run the Afghanistan war in 2010, something had changed. Petraeus’ mouth was saying “counterinsurgency,” with its focus on protecting civilians from violence, but in practice, he was far more reliant on air strikes and commando raids. He was even touting enemy body counts as measurements of success, which was completely antithetical to counterinsurgency doctrine, and his staff’s insistance that nothing had changed sounded hollow.

But then there was Broadwell to spin the shift away. On Ricks’ blog, she described the complete flattening of a southern Afghan village called Tarok Kolache, confidently asserting that not only was no one killed under 25 tons of U.S. air and artillery strikes, but that the locals appreciated it. Danger Room’s follow-up reporting found that the strikes were even more intense: two other villages that the Taliban had riddled with bombs, were destroyed as well. But Broadwell, who was traveling around Afghanistan and working on a biography of Petraeus, didn’t grapple with the implications of Petraeus shifting away from counterinsurgency, let alone the fortunes of the Afghanistan war.

Broadwell didn’t have a journalistic background, and it seemed a bit odd that she was visibly welcomed into Petraeus’ inner circle. At a Senate hearing Petraeus testified at last year, for instance, I met Broadwell for the first time in person, and noted that she sat with Petraeus’ retinue instead of with the press corps. Some of Petraeus’ old crew found it similarly strange. “I never told General Petraeus this, but I thought it was fairly strange that he would give so much access to someone who had never written a book before,” Mansoor recalls.

At the same time, consider this passage from All In:

Far beyond his influence on the institutions and commands in Iraq and Afghanistan, Petraeus also left an indelible mark on the next generation of military leaders as a role model of soldier-scholar statesman. … Creative thinking and the ability to wrestle with intellectual challenges are hugely important in counterinsurgency but also any campaign’s design and execution, he felt; and equipping oneself with new analytical tools, civilian and academic experiences, and various networks had been invaluable for him and — he hoped — for those whom he’d mentored and led.

The uncomfortable truth is that a lot of us who’ve covered Petraeus over the years could have written that. It’s embarrassingly close to my piece on Petraeus’ legacy that @bitteranagram tweeted. And that’s not something you should fault Petraeus for. It’s something you should fault reporters like me for. Another irony that Petraeus’ downfall reveals is that some of us who egotistically thought our coverage of Petraeus and counterinsurgency was so sophisticated were perpetuating myths without fully realizing it.

None of this is to say that Petraeus was actually a crappy officer whom the press turned into a genius. That would be just as dumb and ultimately unfair as lionizing Petraeus, whose affair had nothing to do with his military leadership or achievements. ”David Petraeus will be remembered as the finest officer of his generation, and as the commander who turned the Iraq War around,” emails military scholar Mark Moyar. But it is to say that a lot of the journalism around Petraeus gave him a pass, and I wrote too much of it. Writing critically about a public figure you come to admire is a journalistic challenge.

Conversations with people close to Petraeus since his resignation from the CIA have been practically funereal. People have expressed shock, and gotten occasionally emotional. It turns out, Mansoor sighed, “David Petraeus is human after all.” I wonder where anyone could have gotten the idea he wasn’t.

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MTV awards bring pop glitz to Frankfurt

FRANKFURT (Reuters) – The MTV Europe Music Awards bring the pop circus to Frankfurt on Sunday, with Barbadian R&B singer Rihanna leading the nominations and the late Whitney Houston to be honored with a Global Icon award.

Houston, who was found dead in a Beverly Hills hotel bathtub on February 11, will be the third artist to be given the award, following Bon Jovi and Queen in 2010 and 2011.

“Whitney Houston may be gone, but her legend lives on,” the organizers said.

MTV said it would transform the inside of the 100-year-old Festhalle venue into a circus arena, and host Heidi Klum said she may swing from a trapeze.

“It will be a magical, visual feast,” the German model and presenter promised ahead of the event.

One of this year’s most eagerly anticipated performances is dance sensation Psy with his record-breaking hit “Gangnam Style“. He will become the first South Korean artist to perform at the annual awards, one of the pop industry’s biggest nights outside the United States.

The song, which is up for the Best Video award, has been viewed more than 670 million times on YouTube and received a record-breaking 4.9 million “likes” on Facebook since being released in mid-July.

Klum, who this year filed for divorce from singer husband Seal, is ready for the horse riding-inspired dance.

“Now I know how to dance Gangnam Style!” she posted on Twitter on Saturday, with a picture of herself and Psy in matching blue tuxedo jackets.

ROCKING THE RED CARPET

Despite being billed as the Europe Music Awards, the majority of nominees are traditionally North American, and 2012 is no exception.

Alongside Psy, acts due to take the stage at the show include country singer Taylor Swift, 14-time Grammy winner Alicia Keys, the Killers, newly reformed No Doubt and Carly Rae Jepsen.

Before the show kicks off, stars taking to the red carpet will include rapper Ludacris, who will debut his new video “Rest of My Life”.

Heading the nominations is party-loving Rihanna, with nods in six categories, including Best Song and Best Video for “We Found Love”.

Following close behind with five nominations is country star Swift, Katy Perry with four, while Lady Gaga, who cleaned up last year with four prizes, is in the running for three awards.

Teen heartthrob Justin Bieber, who has reportedly just broken up with girlfriend Selena Gomez, is up for four awards, including Best Male and Best Pop.

Rihanna is favorite for Best Song and Best Female, according to odds offered by British bookmakers William Hill, while Gangnam Style is tipped to win Best Video.

The EMA awards were last held in Frankfurt in 2001. Last year’s awards in Belfast attracted 23 million viewers on all platforms and 158 million votes worldwide.

Following are the main nominations in 2012:

BEST SONG: Carly Rae Jepsen/Call Me Maybe; Rihanna feat. Calvin Harris/We Found Love; Gotye/Somebody That I Used To Know; Pitbull feat. Chris Brown/International Love; fun. feat. Janelle Monáe/We Are Young

BEST NEW: Rita Ora; fun.; One Direction; Lana Del Rey; Carly Rae Jepsen

BEST FEMALE: Rihanna; Katy Perry; P!nk; Taylor Swift; Nicki Minaj

BEST MALE: Justin Bieber; Kanye West; Flo Rida; Pitbull; Jay-Z

BEST POP: Justin Bieber; No Doubt; Katy Perry; Taylor Swift; Rihanna

BEST LIVE: Taylor Swift; Lady Gaga; Jay-Z & Kanye West; Green Day; Muse

BEST HIP HOP: Jay-Z & Kanye West; Nas; Rick Ross; Drake; Nicki Minaj

BEST ROCK: Linkin Park; Green Day; Muse; The Killers; Coldplay

BEST ELECTRONIC: David Guetta; Swedish House Mafia; Avicii; Skrillex; Calvin Harris

BEST ALTERNATIVE: Jack White; The Black Keys; Arctic Monkeys; Florence + The Machine; Lana Del Rey

BEST VIDEO: M.I.A./Bad Girls; Lady Gaga/Marry The Night; Katy Perry/Wide Awake; Rihanna feat. Calvin Harris/We Found Love; PSY/Gangnam Style.

(Reporting by Victoria Bryan and Maria Sheahan; editing by Mike Collett-White)

Music News Headlines – Yahoo! News

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Mind Faded, Darrell Royal’s Wisdom and Humor Intact Till End

Three days before his death last week at 88, Darrell Royal told his wife, Edith: “We need to go back to Hollis” — in Oklahoma. “Uncle Otis died.”

“Oh, Darrell,” she said, “Uncle Otis didn’t die.”

Royal, a former University of Texas football coach, chuckled and said, “Well, Uncle Otis will be glad to hear that.”

The Royal humor never faded, even as he sank deeper into Alzheimer’s disease. The last three years, I came to understand this as well as anyone. We had known each other for more than 40 years. In the 1970s, Royal was a virile, driven, demanding man with a chip on his shoulder bigger than Bevo, the Longhorns mascot. He rarely raised his voice to players. “But we were scared to death of him,” the former quarterback Bill Bradley said.

Royal won 3 national championships and 167 games before retiring at 52. He was a giant in college football, having stood shoulder to shoulder with the Alabama coach Bear Bryant. Royal’s Longhorns defeated one of Bryant’s greatest teams, with Joe Namath at quarterback, in the 1965 Orange Bowl. Royal went 3-0-1 in games against Bryant.

Royal and I were reunited in the spring of 2010. I barely recognized him. The swagger was gone. His mind had faded. Often he stared aimlessly across the room. I scheduled an interview with him for my book “Courage Beyond the Game: The Freddie Steinmark Story.” Still, I worried that his withering mind could no longer conjure up images of Steinmark, the undersize safety who started 21 straight winning games for the Longhorns in the late 1960s. Steinmark later developed bone cancer that robbed him of his left leg.

When I met with Royal and his wife, I quickly learned that his long-term memory was as clear as a church bell. For two hours, Royal took me back to Steinmark’s recruiting trip to Austin in 1967, through the Big Shootout against Arkansas in 1969, to the moment President Richard M. Nixon handed him the national championship trophy in the cramped locker room in Fayetteville. He recalled the day at M. D. Anderson Hospital in Houston the next week when doctors informed Steinmark that his leg would be amputated if a biopsy revealed cancer. Royal never forgot the determined expression on Steinmark’s face, nor the bravery in his heart.

The next morning, Royal paced the crowded waiting room floor and said: “This just can’t be happening to a good kid like Freddie Steinmark. This just can’t be happening.”

With the love of his coach, Steinmark rose to meet the misfortune. Nineteen days after the amputation, he stood with crutches on the sideline at the Cotton Bowl for the Notre Dame game. After the Longhorns defeated the Fighting Irish, Royal tearfully presented the game ball to Steinmark.

Four decades later, while researching the Steinmark book, I became close to Royal again. As I was leaving his condominium the day of the interview, I said, “Coach, do you still remember me?” He smiled and said, “Now, Jim Dent, how could I ever forget you?” My sense of self-importance lasted about three seconds. Royal chuckled. He pointed across the room to the message board next to the front door that read, “Jim Dent appt. at 10 a.m.”

Edith and his assistant, Colleen Kieke, read parts of my book to him. One day, Royal told me, “It’s really a great book.” But I can’t be certain how much he knew of the story.

Like others, I was troubled to see Royal’s memory loss. He didn’t speak for long stretches. He smiled and posed for photographs. He seemed the happiest around his former players. He would call his longtime friend Tom Campbell, an all-Southwest Conference defensive back from the 1960s, and say, “What are you up to?” That always meant, “Let’s go drink a beer.”

As her husband’s memory wore thin, Edith did not hide him. Instead, she organized his 85th birthday party and invited all of his former players. Quarterback James Street, who engineered the famous 15-14 comeback against Arkansas in 1969, sat by Royal’s side and helped him remember faces and names. The players hugged their coach, then turned away to hide the tears.

In the spring of 2010, I was invited to the annual Mexican lunch for Royal attended by about 75 of his former players. A handful of them were designated to stand up and tell Royal what he meant to them. Royal smiled through each speech as his eyes twinkled. I was mesmerized by a story the former defensive tackle Jerrel Bolton told. He recalled that Royal had supported him after the murder of his wife some 30 year earlier.

“Coach, you told me it was like a big cut on my arm, that the scab would heal, but that the wound would always come back,” Bolton said. “It always did.”

Royal seemed to drink it all in. But everyone knew his mind would soon dim.

The last time I saw him was June 20 at the County Line, a barbecue restaurant next to Bull Creek in Austin. Because Royal hated wheelchairs and walkers, the former Longhorn Mike Campbell, Tom’s twin, and I helped him down the stairs by wrapping our arms around his waist and gripping the back of his belt. I ordered his lunch, fed him his sandwich and cleaned his face with a napkin. He looked at me and said, “Was I a college player in the 1960s?”

“No, Coach,” I said. “But you were a great player for the Oklahoma Sooners in the late 1940s. You quarterbacked Oklahoma to an 11-0 record and the Sooners’ first national championship in 1949.”

He smiled and said, “Well, I’ll be doggone.”

After lunch, Mike Campbell and I carried him up the stairs. We sat him on a bench outside as Tom Campbell fetched the car. In that moment, the lunch crowd began to spill out of the restaurant. About 20 customers recognized Royal. They took his photograph with camera phones. Royal smiled and welcomed the hugs.

“He didn’t remember a thing about it,” Tom Campbell said later. “But it did his heart a whole lot of good.”

Jim Dent is the author of “The Junction Boys” and eight other books.

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Hollywood expects to have a happy holiday season at the box office

Movie theaters posted their worst attendance since 1994 last year, but Hollywood is poised for a big comeback — with the help of a secret agent, a sullen vampire and a hairy-footed hobbit.

Domestic ticket sales are already up by 3% compared with the same period last year, and a bumper crop of strong films this holiday season — including movies that will appeal to both popular and discerning tastes — could push annual box office receipts above $11 billion for the first time.

A strong finish to the year could ease the uncertainty gripping an industry under pressure to cut costs and boost profits, especially as revenue dwindles from once-reliable DVD sales and as more fans turn to video-on-demand and streaming to catch the latest movies.

"We're still facing the same structural issues — the DVD business is declining and there are distractions for the audience — so studios have to rationalize their costs," said Stacey Snider, chief executive of DreamWorks, which is releasing "Lincoln" this weekend. But she points out: "All that doom and gloom people were talking about after the summer ticket sales didn't come to bear."

Snider was referring to the anxiety rampant in Hollywood earlier this year, amid the box office flop of big-budget films including "John Carter" and "Battleship." But those disappointments have been tempered by a handful of certified hits, including "The Avengers," "The Dark Knight Rises," "The Amazing Spider-Man" and "The Hunger Games."

And some movies have performed better than expected. One of those is the Iranian hostage drama "Argo," which has taken in nearly $80 million since opening Oct. 12.

"I'm becoming increasingly concerned about the movie business ... there's the feeling that it could all sort of fall apart or at least be greatly diminished," said Ben Affleck, who directed and stars in "Argo." "But there is a huge crop of really interesting movies coming out in the next couple of months, and I think that's great for the movie business."

The latest James Bond film, the well-reviewed "Skyfall," kicks off the holiday movie season this weekend and is expected to haul in about $100 million, which would be the fourth-highest opening of the year.

Next week, multiplexes across the country will be swarming with young women eager to see Kristen Stewart and Robert Pattinson in "The Twilight Saga: Breaking Dawn Part 2," the fifth and final installment of the vampire franchise. About 1,500 fans are already camped out in downtown Los Angeles for Monday night's premiere.

In December comes "The Hobbit: An Unexpected Journey," a prequel to Peter Jackson's "Lord of the Rings" trilogy, which grossed more than $2.9 billion worldwide.

"There's a good feeling about the business right now," said Amy Pascal, co-chair of Sony Pictures. "It really looks like we have a lot of fantastic movies coming at the end of the year."

In addition to the slew of big-budget films hitting theaters, an above-average array of less costly movies aimed at sophisticated filmgoers could provide a crucial assist for a box-office record: Steven Spielberg's "Lincoln" (opening in limited release this weekend), the dramedy "Silver Linings Playbook" with Bradley Cooper, a star-studded version of Broadway's hit musical "Les Misérables" and "Zero Dark Thirty," about the mission to kill Osama bin Laden.

"Unlike last year, which had a very slow December, the final six weeks of this year are going to make up for that ... because of the mix of summer-style blockbusters and Oscar-bait films," said Paul Dergarabedian, president of Hollywood.com.

Still, there could be some costly misses. Director Ang Lee's 3-D spectacle "Life of Pi" has earned favorable reviews in early screenings, but with a production cost of $120 million and an unknown 19-year-old lead, the holiday release is considered a big gamble for 20th Century Fox and its financial partners.

"We all have a lot riding on these films, and you want people to be buying tickets," said Elizabeth Gabler, whose Fox 2000 Pictures produced "Life of Pi." "But I think ... the more exciting movies you can offer people will get them to the theater. When there's a lot of energy there, that fosters excitement about the moviegoing experience."

Only two films released during the fourth quarter in 2011 had U.S. ticket sales top $200 million, and the season also brought some unexpectedly expensive misses in Martin Scorsese's "Hugo" and the animated comedy "Arthur Christmas."

"Admissions going up is always good news. Would you like them to go up more? Of course," said Warner Bros. Motion Picture Group President Jeff Robinov. "But the business is in flux — there's a diversity of choices for consumers, home video is shrinking and there's a debate over release windows."

Ticket sales have been trending down since hitting the 1.57 billion mark in 2002, falling to 1.28 billion last year, the lowest in 16 years.

Box office revenue, by comparison, has shown modest gains — largely because of higher ticket prices and new premiums for Imax and 3-D showings.

To end the year strong, Hollywood has to score a robust holiday season, which accounts for about 20% of annual box-office receipts.

"We look forward to these last six weeks of the year to really ramp up business," said Gary Dupuis, the general manager of Montana-based Polson Theatres. "It's one of the better holiday seasons coming up. I think that's positive, because we are certainly still in the economy crunch where people know it's not cheap to go to the movies."

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