F.D.A. Approves Sirturo, a New Tuberculosis Drug

The Food and Drug Administration announced on Monday that it had approved a new treatment for multidrug-resistant tuberculosis that can be used as an alternative when other drugs fail.

The drug, to be called Sirturo, was discovered by scientists at Janssen, the pharmaceuticals unit of Johnson & Johnson, and is the first in a new class of drugs that aims to treat the drug-resistant strain of the disease.

Tuberculosis is a highly infectious disease that is transmitted through the air and usually affects the lungs but can also affect other parts of the body, including the brain and kidneys. It is considered one of the world’s most serious public health threats. Although rare in the United States, multidrug-resistant tuberculosis is a growing problem elsewhere in the world, especially in poorer countries. About 12 million people worldwide had tuberculosis in 2011, according to Johnson & Johnson, and about 630,000 had multidrug-resistant TB.

A study in September in The Lancet found that almost 44 percent of patients with tuberculosis in countries like Russia, Peru and Thailand showed resistance to at least one second-line drug, or a medicine used after another drug had already failed.

Treating drug-resistant tuberculosis can take years and can cost 200 times as much as treating the ordinary form of the disease

“This is quite a milestone in the story of therapy for TB,” Dr. Paul Stoffels, the chief scientific officer at Johnson & Johnson, said in an interview. He said the approval was the first time in 40 years that the agency had approved a drug that attacked tuberculosis in a different way from the current treatments on the market. Sirturo works by inhibiting an enzyme needed by the tuberculosis bacteria to replicate and spread throughout the body.

Sirturo, also known as bedaquiline, would be used on top of the standard treatment, which is a combination of several drugs. Patients with drug-resistant tuberculosis often must be treated for 18 to 24 months.

Even as it announced the approval, however, the F.D.A. also issued some words of caution.

“Multidrug-resistant tuberculosis poses a serious health threat throughout the world, and Sirturo provides much-needed treatment for patients who have don’t have other therapeutic options available,” Edward Cox, director of the office of antimicrobial products in the F.D.A.’s center for drug evaluation and research, said in a statement. “However, because the drug also carries some significant risks, doctors should make sure they use it appropriately and only in patients who don’t have other treatment options.”

The consumer advocacy group Public Citizen opposed approval in a letter to the F.D.A. in mid-December, saying that the results of a limited clinical trial showed that patients using bedaquiline were five times as likely to die than those on the standard drug regimen to treat the disease.

“Given that bedaquiline belongs to an entirely new class of drugs, it is entirely feasible that death in some cases was due to some unmeasured toxicity of the drug,” the letter said.

Sirturo carries a so-called black box warning for patients and health care professionals that the drug can affect the heart’s electrical activity, which could lead to an abnormal and potentially fatal heart rhythm. The warning also notes deaths in patients treated with Sirturo. Nine patients who received Sirturo died compared with two patients who received a placebo. Five of the deaths in the Sirturo group and all of the deaths in the placebo arm seemed to be related to tuberculosis, but no consistent reason for the deaths in the remaining Sirturo-treated patients could be identified.

Doctors Without Borders and the Bill and Melinda Gates Foundation, both active in the fight against tuberculosis and other global diseases, applauded the F.D.A.’s decision.

Jan Gheuens, interim director of the TB Program for the Gates Foundation, called it a “long-awaited event” and said the fight against TB had not benefited from new drugs in the way H.I.V. had. Beyond the benefits of the drug itself, he said the quick approval process could be a model for other drugs sorely needed in the developing world.

He also suggested, however, that more trials should be conducted to get a better understanding of the side effects that led to the black box warning.

The F.D.A. approved bedaquiline under an accelerated program that allows the agency to conditionally approve drugs that are viewed as filling unmet medical needs with less than the usual evidence that they work. The drug’s approval was based on studies that showed it killed bacteria more quickly than a control group taking the standard regimen, but it did not measure whether in the end patients actually fared better on bedaquiline. Johnson & Johnson will conduct larger clinical trials to investigate whether the drug performs as predicted.

In a statement responding to Public Citizen’s letter, a spokeswoman for Johnson & Johnson said the company was committed to supporting appropriate use of Sirturo and would “work to ensure Sirturo is used only where treatment alternatives are not available.”

Dr. Stoffels said the hope was that other new tuberculosis drugs would also be approved that, when used in combination with bedaquiline, could shorten and simplify the current standard of treatment. “That is still a long time away,” he acknowledged, but “this is a first step in a new regimen for TB.”

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Tribune Co. emerges from bankruptcy

The last day of 2012 is the first of a new era for Tribune Co.

After spending more than four years embroiled in a contentious Chapter 11 bankruptcy case, the reorganized Chicago-based media company emerged Monday under new owners and a newly appointed board, freed from its massive debt and facing an uncertain future.

Senior creditors Oaktree Capital Management, Angelo, Gordon & Co. and JPMorgan Chase & Co. are set to take control of Tribune Co.’s storied portfolio of publishing and broadcasting assets, including the Chicago Tribune, officials said.

It was an almost anticlimactic end to a long and painful chapter in Tribune Co.'s 165-year history. Late Sunday, the new Tribune Co. named its board of directors, filed notification with the Delaware bankruptcy court where the bulk of legal wrangling took place and declared its existence.

"It took a long time to get here," said Ken Liang, a managing director at Oaktree and a new member of the board. "It was a tough restructuring. We're pretty excited about the exit."

The new board also will include Tribune Co. CEO Eddy Hartenstein; Ross Levinsohn, who recently left as interim chief executive of Yahoo Inc.; Craig Jacobson, a well-known entertainment lawyer; Peter Murphy, a former strategy executive at Walt Disney Co. and Ceasars Entertainment; Bruce Karsh, Oaktree president; and Peter Liguori, a former top television executive at Fox and Discovery.

Liguori is expected to be named chief executive of Tribune Co. going forward.

Hartenstein, who is publisher of the Los Angeles Times, has been CEO of Tribune Co. since May 2011. He will remain in the role until the board convenes its first meeting in the next several weeks, where it will name the company’s executive officers, according to a company statement.

“Tribune will emerge from the bankruptcy process as a multi-media company with a great mix of profitable assets, strong brands in major markets and a much-improved capital structure,” Hartenstein said in the statement.

Tribune Co. owns 23 television stations, including WGN-Ch. 9, WGN America, eight daily newspapers and other media assets, all of which the reorganization plan valued at $4.5 billion after cash distributions and new financing. Eventually, all the assets are expected to be sold, according to the new owners.

They take the reins of a company that saw its worth essentially cut in half since 2007, when Chicago billionaire Sam Zell took it private in an $8.2 billion leveraged buyout. The rapid decline was mostly due to falling newspaper valuations in the face of digital competition. The anticipated hiring of Liguori suggests that broadcasting will be the operational focus going forward, according to several media analysts.

Los Angeles-based Oaktree, the largest shareholder, with about 23 percent of the equity, appointed two of seven board members. Both Angelo Gordon and JPMorgan have roughly a 9 percent stake and appointed one seat each. The three jointly appointed two more board members, with the final seat occupied by the chief executive.

Among the outgoing board members is Zell, whose deal was seen at the time as an alternative to the squabbles within Tribune Co. that threatened to break apart the then-publicly traded company. But the Great Recession and plummeting advertising revenues across all media, especially the struggling newspaper industry, made the company’s resulting $13 billion debt load untenable.

Tribune Co. filed for Chapter 11 bankruptcy protection in December 2008. Zell blamed a “perfect storm” of industry and economic forces. But the bankruptcy case turned on charges leveled by junior creditors that saddling the company with such a debt burden left it insolvent from the outset.

Led by an aggressive distressed debt fund called Aurelius Capital Management, the junior creditors pressed litigation that stretched out the case for three and a half years in a Delaware court before U.S. Bankruptcy Judge Kevin Carey confirmed the reorganization plan in July. An emergency appeal to stay that decision was dismissed by the 3rd U.S. Circuit Court of Appeals in September. In November, the Federal Communications Commission signed off on waivers needed to transfer Tribune Co.’s broadcast properties to the new ownership, clearing the last hurdle to its emergence from Chapter 11.

“Usually, bankruptcy cases like this take much less time and cost less money,” said Douglas Baird, a bankruptcy expert and law professor at the University of Chicago.

Baird said legal fees for most large corporate bankruptcies run 3 to 4 percent of the company’s total worth. The Tribune Co. case, which will likely cost the company more than $500 million in legal and other professional fees, was more than twice that percentage, due to both the extended litigation and the company’s declining valuation.

Before cash distributions and new financing, a 2012 analysis by financial adviser Lazard valued the broadcasting assets, including the TV stations, WGN-AM 720, CLTV and national cable channel WGN America, at $2.85 billion. Other strategic assets, such as online job site CareerBuilder and cable channel Food Network, are worth $2.26 billion.

Tribune Co.’s newspaper holdings, including the Tribune, Los Angeles Times and six other daily publications, have withered to $623 million in total value, according to Lazard. In 2006, entertainment mogul David Geffen made a $2 billion cash offer for the Los Angeles Times.

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Senate adjourns for day with no deal on 'fiscal cliff'

WASHINGTON (Reuters) - Lawmakers pushed the country to the edge of the "fiscal cliff" on Sunday as they struggled to reach a last-minute deal that could protect the world's largest economy from a politically induced recession.

Democratic and Republican leaders in the Senate had hoped to clear the way for swift action that would avert sweeping tax increases and spending cuts due to kick in on Tuesday.

But with the two sides still at loggerheads in talks, Senate Democratic leader Harry Reid postponed any possible votes and the Senate adjourned until Monday, leaving mere hours to pass any deal that may emerge through both chambers of a bitterly divided Congress.

"There are still significant differences between the two sides," Reid said on the Senate floor.

Behind closed doors, the parties kept seeking a way to bridge deep divides over taxes and spending. But even if a deal emerges in the coming hours, under Senate rules any one of the 100 senators could prevent the chamber from acting quickly.

Prospects are also uncertain in the House of Representatives, where dozens of conservative Republicans could oppose any deal that includes a tax increase on the nation's wealthiest households.

As the hours ticked away, it appeared increasingly likely that Washington's failure to act would deliver a $600 billion hammer blow to the fragile U.S. economic recovery.

"Something has gone terribly wrong when the biggest threat to the American economy is the American Congress," said Democratic Senator Joe Manchin of West Virginia.

Americans could see a bigger bite taken out of their paychecks starting on Tuesday as payroll and income tax cuts expire, while 2 million unemployed Americans could see their jobless benefits run out. Government contractors might be forced to lay off employees as $109 billion in automatic spending cuts kick in, and businesses could lose tax breaks for everything from wind power to research and development.

The uncertainty has weighed on financial markets and forced businesses to slow hiring and investment. Market participants braced for more turbulence on Monday.

"I believe investors will show their displeasure tomorrow by selling stocks if there is no deal," said Mohannad Aama, managing director at Beam Capital Management in New York.

Though corporate chieftains have lobbied lawmakers to show flexibility, Congress also faces pressure from an array of interest groups urging them not to compromise core principles.

Conservative groups have warned Republicans that a vote to increase any taxes could be held against them, while liberal and labor groups have pressed Democrats to resist any benefit cuts to popular retirement and health programs.

Lawmakers may find it easier to act once the country goes over the "fiscal cliff" on January 1, as any new legislation can then be portrayed as a tax cut rather than a tax increase.

POINTS OF DISAGREEMENT

Republicans floated a proposal on Sunday to slow the growth of Social Security retirement benefits by changing the way they are measured against inflation, but they backed away after Democrats said they would not consider it.

Still, there were disagreements over all the major aspects of the negotiation.

Buoyed by his re-election in November, Obama has insisted that any deal must include a tax increase on the wealthiest Americans, who have seen their earnings rise steadily over the past decade at a time when income for the less affluent has stalled.

Many conservative Republicans in the House of Representatives oppose a tax hike on anyone, no matter how wealthy.

Obama has proposed raising income taxes on households that earn more than $250,000, but Republicans pushed to set the threshold between $400,000 and $500,000. Republicans also were resisting a Democratic proposal to raise inheritance taxes on the wealthiest estates.

Republicans were looking for new reductions to replace the looming spending cuts, which would fall equally on military and domestic social programs. Democrats say the increased taxes on the wealthy would generate enough revenue to offset those cuts.

Senate Republican leader Mitch McConnell talked several times to Vice President Joe Biden by phone in the hope of breaking the stalemate.

"I'm willing to get this done, but I need a dance partner," McConnell said.

In a rare appearance on NBC's "Meet the Press," Obama accused Republicans of rejecting significant compromises several times already. He said he would try to reverse the tax hikes for most Americans if Congress fails to act.

"If people start seeing that on January 1st this problem still hasn't been solved ... then obviously that's going to have an adverse reaction in the markets," he said.

House Speaker John Boehner rejected Obama's accusations that his fellow Republicans were not being amenable to compromise.

"The president's comments today are ironic, as a recurring theme of our negotiations was his unwillingness to agree to anything that would require him to stand up to his own party," he said in a statement.

(Additional reporting by David Gaffen, Thomas Ferraro, Rachelle Younglai, Jeff Mason and Emily Stephenson; Writing by Andy Sullivan; Editing by Alistair Bell and Christopher Wilson)

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Comedian Katt Williams arrested in LA

LOS ANGELES (AP) — Katt Williams, the comedian who has repeatedly found himself on the wrong side of the law, is out on bail after being arrested in Los Angeles on suspicion of child endangerment and possession of a stolen gun.

Police Officer Norma Eisenman says Williams was taken into custody Friday after the LA County Department of Children and Family Services did a welfare check at his home. Authorities found more than one firearm, one of which had been reported stolen.

Eisenman says the DCFS did not specify how many children lived at the home or whether they were removed.

The 41-year-old was arrested this month on a felony warrant related to a police chase. In November, he was accused of hitting a man on the head with a bottle during a fight.

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Dr. Rita Levi-Montalcini, a Revolutionary in the Study of the Brain, Dies at 103

Fabio Campana/European Pressphoto Agency

Rita Levi-Montalcini, the Italian Nobel laureate, in 2007.

Dr. Rita Levi-Montalcini, a Nobel Prize-winning neurologist who discovered critical chemical tools that the body uses to direct cell growth and build nerve networks, opening the way for the study of how those processes can go wrong in diseases like dementia and cancer, died on Sunday at her home in Rome. She was 103.

Her death was announced by Mayor Gianni Alemanno of Rome.

“I don’t use these words easily, but her work revolutionized the study of neural development, from how we think about it to how we intervene,” said Dr. Gerald D. Fishbach, a neuroscientist and professor emeritus at Columbia.

Scientists had virtually no idea how embryo cells built a latticework of intricate connections to other cells when Dr. Levi-Montalcini began studying chicken embryos in the bedroom of her house in Turin, Italy, during World War II. After years of obsessive study, much of it at Washington University in St. Louis with Dr. Viktor Hamburger, she found a protein that, when released by cells, attracted nerve growth from nearby developing cells.

In the early 1950s, she and Dr. Stanley Cohen, a biochemist also at Washington University, isolated and described the chemical, known as nerve growth factor — and in the process altered the study of cell growth and development. Scientists soon realized that the protein gave them a new way to study and understand disorders of neural growth, like cancer, or of degeneration, like Alzheimer’s disease, and to potentially develop therapies.

In the years after the discovery, Dr. Levi-Montalcini, Dr. Cohen and others described a large family of such growth-promoting agents, each of which worked to regulate the growth of specific cells. One, called epidermal growth factor and discovered by Dr. Cohen, plays a central role in breast cancer; in part by studying its behavior, scientists developed drugs to combat the abnormal growth.

In 1986, Dr. Levi-Montalcini and Dr. Cohen shared the Nobel Prize in Physiology or Medicine for their work.

Dr. Cohen, now an emeritus professor at Vanderbilt University, said Dr. Levi-Montalcini possessed a rare combination of intuition and passion, as well as biological knowledge. “She had this feeling for what was happening biologically,” he said. “She was an intuitive observer, and she saw that something was making these nerve connections grow and was determined to find out what it was.”

One of four children, Rita Levi-Montalcini was born in Turin on April 22, 1909, to Adamo Levi, an engineer, and Adele Montalcini, a painter, both Italian Jews who traced their roots to the Roman Empire. In keeping with the Victorian customs of the time, Mr. Levi discouraged his three daughters from entering college, fearing that it would interfere with their lives as wives and mothers.

It was not a future that Rita wanted. She had decided to become a doctor and told her father so. “He listened, looking at me with that serious and penetrating gaze of his that caused me such trepidation,” she wrote in her autobiography, “In Praise of Imperfection” (1988). He also agreed to support her.

She graduated summa cum laude from the University of Turin medical school in 1936. Two years later, Mussolini issued a manifesto barring non-Aryan Italians from having professional careers. She began her research anyway, setting up a small laboratory in her home to study chick embryos, inspired by the work of Dr. Hamburger, a prominent researcher in St. Louis who also worked with the embryos.

During World War II, the family fled Turin for the countryside, and in 1943 the invasion by Germany forced them to Florence. The family returned at the close of the war, in 1945, and Dr. Hamburger soon invited Dr. Levi-Montalcini to work for a year in his lab at Washington University.

She stayed on, becoming an associate professor in 1956 and a full professor in 1958. In 1962, she helped establish the Institute of Cell Biology in Rome and became its first director. She retired from Washington University in 1977, becoming a guest professor and splitting her time between Rome and St. Louis.

Italy honored her in 2001 by making her a senator for life.

An elegant presence, confident and passionate, she was a sought-after speaker until late in life. “At 100, I have a mind that is superior — thanks to experience — than when I was 20,” she said in 2009.

She never married and had no children. In addition to her autobiography, she was the author or co-author of dozens of research studies and received numerous professional awards, including the National Medal of Science.

“It is imperfection — not perfection — that is the end result of the program written into that formidably complex engine that is the human brain,” Dr. Levi-Montalcini wrote in her autobiography, “and of the influences exerted upon us by the environment and whoever takes care of us during the long years of our physical, psychological and intellectual development.”

This article has been revised to reflect the following correction:

Correction: December 30, 2012

An earlier version of this obituary misstated the year Mussolini issued a manifesto barring non-Aryan Italians from having professional careers. It was 1938, not 1936.

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Airlines' plans for 2013 up in the air

Airfares will be on the rise in 2013, and those niggling airline fees will metamorphose into optional bundles of services.

Meanwhile, onboard amenities, such as Internet access, entertainment options and refreshed interiors, will abound among U.S. carriers, but tight seating in coach probably won't improve.

And 2013 might be the year you'll finally be able to keep your smartphone, iPad or Kindle turned on during takeoffs and landings.

Those are some of the predictions airline industry experts foresee in the new year. Here's the lowdown on fares, fees and flight experience for 2013.

Higher fares forecast

Airlines pushed through six fare increases in 2012. Expect a similar number in the new year, said Rick Seaney, co-founder of FareCompare.com.

"I wouldn't be surprised to see airfares rise like they did this year, between 3 and 6 percent domestically," Seaney said. That's because airlines will succeed in properly balancing supply and demand by trimming the number of seats they offer to match "decent, but bordering on tepid, demand."

Fares are typically driven by four main factors: competition, most of all, then supply, demand and oil prices. "If you look at those drivers, they are, for the most part, on the airlines' side, which gives them pricing power," Seaney said.

That doesn't mean there won't be good airfare deals on some flights on some routes. And consumers will still see lower prices during off-peak days, such as Tuesday, Wednesday and Saturday departures and off-peak seasons, such as late January and early February. Like this year, summertime fares probably will stay relatively high, he said.

Airline mergers can also affect fares, and a huge one could take place early in 2013. American Airlines and US Airways are in talks about combining.

The general consensus among consumer advocates is that airline mergers aren't good for passengers.

"Any time you have two big airlines merging, that means consumers have less choice and competition is reduced, which only translates to higher prices," said Charlie Leocha, director of the Consumer Travel Alliance.

However, a bit of new evidence bucks that conventional wisdom. Despite four mega-mergers in the U.S. airline industry during the past seven years, fares have not increased significantly, just 1.8 percent per year, according to a December report from professional services firm PwC. In fact, average domestic fares decreased 1 percent from 2004 to 2011 when inflation is factored in, the report found.

Fliers know full well, however, that the fare isn't all that counts nowadays. There are those fees.

Fees get a makeover

The most noticeable trend in recent years with airline fees is that there are more of them: fees for checked bags, aisle seats, onboard meals, among many others. 

"What we hear is that people pay their fare and get to the airport and feel they're constantly being nickeled-and-dimed to death for things that used to be included," said Kate Hanni, founder of FlyersRights.org. 

The top five U.S. carriers alone generated more than $12 billion in fees in 2011, with even more expected through 2012, according to the PwC report.

What consumers call fees, airlines call "unbundling" — making a la carte choices from services that used to be included in the fare.

A likely trend for 2013 might be called "rebundling," airlines packaging a few now-optional services and charging for a tier of service.

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Microsoft Surface trampled at the bottom of the tablet pile this Christmas

While it does have drawbacks just like anything else, Microsoft’s (MSFT) Surface is a great slate for those looking for a fresh new take on the modern tablet. Unfortunately, it doesn’t look like very many people were looking for a fresh new take on the modern tablet this holiday season. In a recent note to investors, R.W. Baird analyst William Power recounted recent conversations had at retailers including Best Buy (BBY) and Staples (SPLS). While speaking with sales reps at the stores, Apple’s (AAPL) iPad was the most highly recommended tablet while Amazon’s (AMZN) Kindle Fire line and Samsung’s (005930) Galaxy Tab line were both recommended as alternatives. Microsoft’s Surface tablet, on the other hand, was not pushed by reps at either chain.

[More from BGR: Purported photo of new BlackBerry phone with QWERTY keyboard leaks]

From Power’s note, as picked up by Barron’s:

[More from BGR: Sprint salesman refuses to sell iPhone to customer, says his ‘fingers are too fat’ to use it]

Microsoft’s Surface, which Best Buy just recently started carrying, was not recommended to us by reps without us asking about it specifically. When asked about sales to date, reps noted that the device was new and indicated that early demand has been modest relative to the iPad and Kindle Fire. We would also note that the device was in stock at every store we contacted […] We contacted Staples stores in an effort to further gauge Microsoft Surface sales, though our impression from speaking with reps was tablets are not a major seller at Staples. Tellingly, Staples doesn’t currently carry the iPad. When pressed for details, Staples reps indicated that Surface volumes have been modest to date. Most reps told us that the primary appeal to Surface buyers is the ability to run Microsoft Office. Consistent with our Best Buy checks, the Surface was also in stock at all Staples stores we contacted. Outside of the Surface, the Google Nexus 10 was cited as another strong tablet option.

Further supporting the idea that Microsoft’s debut tablet wasn’t a big seller this holiday season, Twitter user A.X. Ian did a quick analysis of tweets discussing new tablets during a 24-hour period around Christmas Eve.

Based on his data, 1,795 people tweeted about getting a new iPad during that time span while 250 tweeted about their new Kindle Fires, 100 mentioned their new Nexus 10 tablets and just 36 tweets were posted by users who had received a new Surface.

This article was originally published by BGR

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Senate leaders to make last-ditch 'fiscal cliff' effort

WASHINGTON (Reuters) - President Barack Obama and U.S. congressional leaders agreed on Friday to make a final effort to prevent the United States from going over the "fiscal cliff," setting off intense bargaining over Americans' tax rates as a New Year's Eve deadline looms.

With only days left to avoid steep tax hikes and spending cuts that could cause a recession, two Senate veterans will try to forge a deal that has eluded the White House and Congress for months.

Obama said he was "modestly optimistic" an agreement could be found. But neither side appeared to give much ground at a White House meeting of congressional leaders on Friday.

What they did agree on was to task Harry Reid, the Democratic Senate majority leader, and Mitch McConnell, who heads the chamber's Republican minority, with reaching a budget agreement by Sunday at the latest.

"The hour for immediate action is here. It is now. We're now at the point where in just four days, every American's tax rates are scheduled to go up by law. Every American's paycheck will get considerably smaller. And that would be the wrong thing to do," Obama told reporters.

A total of $600 billion in tax hikes and automatic cuts to government spending will start kicking in on Tuesday - New Year's Day - if politicians cannot reach a deal. Economists fear the measures will push the U.S. economy into a recession.

Pessimism about the fiscal cliff helped push U.S. stocks down on Friday for a fifth straight day. The Dow Jones industrial average dropped 158.20 points, or 1.21 percent. Retailers are blaming worries about the "fiscal cliff" for lackluster Christmas season shopping.

Under the plan hashed out on Friday, any agreement between McConnell and Reid would be backed by the Senate and then approved in the Republican-controlled House of Representatives before the end of the year.

But the House could well be the graveyard of any accord.

A core of fiscal conservatives there strongly opposes Obama's efforts to raise taxes for the wealthiest as part of a plan to close America's budget deficit. House Republicans also want to see Obama commit to major spending cuts.

Talks between Obama and Republican House Speaker John Boehner collapsed last week when several dozen Republicans defied their leader and rejected a plan to raise rates for those earning $1 million and above.

A Democratic aide said Boehner stuck mainly to "talking points" in Friday's White House meeting, with the message that the House had acted on the budget and it was now time for the Senate to move.

TALKS ON 'BIG NUMBERS'

The two Senate leaders and their aides will plunge into talks on Saturday that will focus mainly on the threshold for raising income taxes on households with upper-level earnings, a Democratic aide said. Analysts say both sides could agree on raising taxes for households earning more than $400,000 or $500,000 a year.

The pair will also discuss whether the estate tax should be kept at current low levels or allowed to rise, the aide said.

Democrat Reid warned of tough talks.

"It's not easy, we're dealing with big numbers, and some of that stuff we do is somewhat complicated," he said.

McConnell described Friday's White House summit, also attended by Democratic House Minority Leader Nancy Pelosi, as "a good meeting."

"So we'll be working hard to try to see if we can get there in the next 24 hours. So I'm hopeful and optimistic," he said.

If things cannot be worked out between the Senate leaders, Obama said he wanted both chambers in Congress to vote on a backup plan that would increase taxes only for households with more than $250,000 of annual income.

The plan would also extend unemployment insurance for about 2 million Americans and set up a framework for a larger deficit reduction deal next year.

There are signs in the options market that investor fear is taking hold. The CBOE Volatility Index, or the VIX, the market's favored anxiety indicator, has remained at relatively low levels throughout this process, but it moved on Friday above 22, the highest level since June.

But some in the market were resigned to Washington going beyond the New Year's Day deadline, as long as a serious agreement on deficit reduction comes out of the talks in early January.

"Regardless of whether the government resolves the issues now, any deal can easily be retroactive. We're not as concerned with January 1 as the market seems to be," said Richard Weiss, a senior money manager at American Century Investments.

Another component of the "fiscal cliff" - $109 billion in automatic spending cuts to military and domestic programs - is set to kick in on Wednesday.

S&P rating agency said on Friday the fiscal cliff impasse did not affect the U.S. sovereign rating.

That lifted the immediate threat of a downgrade from the agency, which cut the United States' triple-A rating in August, 2011 in an unprecedented move after a similar partisan budget fight.

(Additional reporting by David Lawder, Thomas Ferraro, Rachelle Younglai and Mark Felsenthal; Writing by Alistair Bell; Editing by Peter Cooney)

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Fans to join Beyonce onstage at Super Bowl

NEW YORK (AP) — All the single ladies — and fellas — will have a chance to join Beyonce onstage at the upcoming Super Bowl.

Pepsi announced Friday that 100 fans will hit the stage when the Grammy-winning diva performs on Feb. 3 at the Mercedes-Benz Superdome in New Orleans. A contest that kicks off Saturday will allow fans to submit photos of themselves in various poses, including head bopping, feet tapping and hip shaking. Those pictures will be used in a TV ad introducing Beyonce’s halftime performance, and 50 people — along with a friend — will be selected to join the singer onstage.

The photo contest — at www.pepsi.com/halftime — ends Jan. 19, but Jan. 11 is the cut-off date for those interested in appearing onstage with Beyonce.

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Surgery Returns to NYU Langone Medical Center

Chang W. Lee/The New York Times

Senator Charles E. Schumer spoke at a news conference Thursday about the reopening of NYU Langone Medical Center.

NYU Langone Medical Center opened its doors to surgical patients on Thursday, almost two months after Hurricane Sandy overflowed the banks of the East River and forced the evacuation of hundreds of patients.

While the medical center had been treating many outpatients, it had farmed out surgery to other hospitals, which created scheduling problems that forced many patients to have their operations on nights and weekends, when staffing is traditionally low. Some patients and doctors had to postpone not just elective but also necessary operations for lack of space at other hospitals.

The medical center’s Tisch Hospital, its major hospital for inpatient services, between 30th and 34th Streets on First Avenue, had been closed since the hurricane knocked out power and forced the evacuation of more than 300 patients, some on sleds brought down darkened flights of stairs.

“I think it’s a little bit of a miracle on 34th Street that this happened so quickly,” Senator Charles E. Schumer of New York said Thursday.

Mr. Schumer credited the medical center’s leadership and esprit de corps, and also a tour of the damaged hospital on Nov. 9 by the administrator of the Federal Emergency Management Agency, W. Craig Fugate, whom he and others escorted through watery basement hallways.

“Every time I talk to Fugate there are a lot of questions, but one is, ‘How are you doing at NYU?’ ” the senator said.

The reopening of Tisch to surgery patients and associated services, like intensive care, some types of radiology and recovery room anesthesia, was part of a phased restoration that will continue. Besides providing an essential service, surgery is among the more lucrative of hospital services.

The hospital’s emergency department is expected to delay its reopening for about 11 months, in part to accommodate an expansion in capacity to 65,000 patient visits a year, from 43,000, said Dr. Andrew W. Brotman, its senior vice president and vice dean for clinical affairs and strategy.

In the meantime, NYU Langone is setting up an urgent care center with 31 bays and an observation unit, which will be able to treat some emergency patients. It will initially not accept ambulances, but might be able to later, Dr. Brotman said. Nearby Bellevue Hospital Center, which was also evacuated, opened its emergency department to noncritical injuries on Monday.

Labor and delivery, the cancer floor, epilepsy treatment and pediatrics and neurology beyond surgery are expected to open in mid-January, Langone officials said. While some radiology equipment, which was in the basement, has been restored, other equipment — including a Gamma Knife, a device using radiation to treat brain tumors — is not back.

The flooded basement is still being worked on, and electrical gear has temporarily been moved upstairs. Mr. Schumer, a Democrat, said that a $60 billion bill to pay for hurricane losses and recovery in New York and New Jersey was nearing a vote, and that he was optimistic it would pass in the Senate with bipartisan support. But the measure’s fate in the Republican-controlled House is far less certain.

The bill includes $1.2 billion for damage and lost revenue at NYU Langone, including some money from the National Institutes of Health to restore research projects. It would also cover Long Beach Medical Center in Nassau County, Bellevue, Coney Island Hospital and the Veterans Affairs hospital in Manhattan.

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