Phys Ed: Getting the Right Dose of Exercise

Phys Ed

Gretchen Reynolds on the science of fitness.

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A common concern about exercise is that if you don’t do it almost every day, you won’t achieve much health benefit. But a commendable new study suggests otherwise, showing that a fairly leisurely approach to scheduling workouts may actually be more beneficial than working out almost daily.

For the new study, published this month in Exercise & Science in Sports & Medicine, researchers at the University of Alabama at Birmingham gathered 72 older, sedentary women and randomly assigned them to one of three exercise groups.

One group began lifting weights once a week and performing an endurance-style workout, like jogging or bike riding, on another day.

Another group lifted weights twice a week and jogged or rode an exercise bike twice a week.

The final group, as you may have guessed, completed three weight-lifting and three endurance sessions, or six weekly workouts.

The exercise, which was supervised by researchers, was easy at first and meant to elicit changes in both muscles and endurance. Over the course of four months, the intensity and duration gradually increased, until the women were jogging moderately for 40 minutes and lifting weights for about the same amount of time.

The researchers were hoping to find out which number of weekly workouts would be, Goldilocks-like, just right for increasing the women’s fitness and overall weekly energy expenditure.

Some previous studies had suggested that working out only once or twice a week produced few gains in fitness, while exercising vigorously almost every day sometimes led people to become less physically active, over all, than those formally exercising less. Researchers theorized that the more grueling workout schedule caused the central nervous system to respond as if people were overdoing things, sending out physiological signals that, in an unconscious internal reaction, prompted them to feel tired or lethargic and stop moving so much.

To determine if either of these possibilities held true among their volunteers, the researchers in the current study tracked the women’s blood levels of cytokines, a substance related to stress that is thought to be one of the signals the nervous system uses to determine if someone is overdoing things physically. They also measured the women’s changing aerobic capacities, muscle strength, body fat, moods and, using sophisticated calorimetry techniques, energy expenditure over the course of each week.

By the end of the four-month experiment, all of the women had gained endurance and strength and shed body fat, although weight loss was not the point of the study. The scientists had not asked the women to change their eating habits.

There were, remarkably, almost no differences in fitness gains among the groups. The women working out twice a week had become as powerful and aerobically fit as those who had worked out six times a week. There were no discernible differences in cytokine levels among the groups, either.

However, the women exercising four times per week were now expending far more energy, over all, than the women in either of the other two groups. They were burning about 225 additional calories each day, beyond what they expended while exercising, compared to their calorie burning at the start of the experiment.

The twice-a-week exercisers also were using more energy each day than they had been at first, burning almost 100 calories more daily, in addition to the calories used during workouts.

But the women who had been assigned to exercise six times per week were now expending considerably less daily energy than they had been at the experiment’s start, the equivalent of almost 200 fewer calories each day, even though they were exercising so assiduously.

“We think that the women in the twice-a-week and four-times-a-week groups felt more energized and physically capable” after several months of training than they had at the start of the study, says Gary Hunter, a U.A.B. professor who led the experiment. Based on conversations with the women, he says he thinks they began opting for stairs over escalators and walking for pleasure.

The women working out six times a week, though, reacted very differently. “They complained to us that working out six times a week took too much time,” Dr. Hunter says. They did not report feeling fatigued or physically droopy. Their bodies were not producing excessive levels of cytokines, sending invisible messages to the body to slow down.

Rather, they felt pressed for time and reacted, it seems, by making choices like driving instead of walking and impatiently avoiding the stairs.

Despite the cautionary note, those who insist on working out six times per week need not feel discouraged. As long as you consciously monitor your activity level, the findings suggest, you won’t necessarily and unconsciously wind up moving less over all.

But the more fundamental finding of this study, Dr. Hunter says, is that “less may be more,” a message that most likely resonates with far more of us. The women exercising four times a week “had the greatest overall increase in energy expenditure,” he says. But those working out only twice a week “weren’t far behind.”

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Sources: American, US Airways boards approve merger

The boards of AMR Corp and US Airways Group Inc each met on Wednesday to approve a merger that would create the world's largest airline with an expected market value of around $11 billion, people familiar with the matter said.

The all-stock merger, which is set to be announced early on Thursday, would finalize the consolidation of legacy U.S. air carriers that helped put the industry on a more solid financial footing.

AMR's bankruptcy creditors will own 72 percent of the combined airline, which will do business under the American Airlines brand and be based in Fort Worth, Texas, the people said. US Airways shareholders will own the rest.

The board approval came after AMR's unsecured creditors committee, which includes all three of AMR's major unions, met earlier on Wednesday to approve a proposed merger agreement, the people said.

The merged company will have a board of 12 members: four from US Airways including its chief executive Doug Parker, three from AMR including chief executive Tom Horton and five to be designated by the AMR creditors, two of the people said.

That will shrink to 11 members in 2014 after Horton steps down following the combined company's first annual meeting, the person added. Parker becomes chief executive of the new airline.

AMR's unsecured creditors are expected to be made whole on their claims in the form of stock in the merged company and also get accrued interest, the people said. AMR's shareholders will get a small equity stake as well, they added.

All the sources asked not to be named because the matter was not public. US Airways declined to comment while AMR representatives could not be immediately reached for comment.

The deal comes more than 14 months after the bankrupt parent of American Airlines filed for bankruptcy in November 2011, and would mark the last combination of legacy U.S. carriers, following the Delta-Northwest and United-Continental mergers.

A tie-up with US Airways would create the world's top airline by passenger traffic and help American and US Air better compete with United Continental Holdings and Delta Air Lines.

Some $11 billion valuation of the combined American-US Airways compares to the roughly $12.4 billion market capitalization for Delta, and $8.7 billion for United Continental.

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Ex-cop shootout: Cabin on fire, search for suspect

Raw footage of Christopher Dorner's cabin engulfed in flames. It is unclear who set it. There are also reports of ammo exploding inside.

A single gunshot was heard as authorities moved into the cabin where Christopher Dorner was believed holed up.

According to a law enforcement source, police had broken down windows, pumped in tear gas and blasted a loud speaker urging Dorner to give up. When they got no response, police deployed a vehicle to rip down the walls of cabin "one by one, like peeling an onion," one law enforcement official said.

By the time they got to the last wall, authorities heard a single gunshot, the source said. Then flames began to spread through the structure. Then, they heard gunshots likely set off by the fire.

Dorner's body has not been found. Police will search will be focused in the basement area, the source said.

A tall plume of smoke was rising from the area where the standoff occurred. Hundreds of law enforcement personnel swooped down on the site near Big Bear after the gun battles between Dorner and officers that broke out in the snow-covered mountains where the fugitive had been eluding a massive manhunt since his truck was found burning in the area late last week.

Law enforcement personnel in military-style gear and armed with high-powered weapons were involved in a tense standoff after Dorner took refuge in the cabin Tuesday afternoon. 

One San Bernardino County sheriff's deputy died of his wounds after he and another deputy were wounded in an exchange of gunfire outside the cabin in which hundreds of rounds were fired, sources told The Times. The deputy was airlifted to Loma Linda University Medical Center, where he died of his wounds.

The afternoon gun battle was part of a quickly changing situation that began after Dorner allegedly broke into a home, tied up a couple and held them hostage before fleeing with their white pickup truck, authorities said. 

Then Dorner was allegedly spotted by a state Fish and Wildlife officer in the pickup truck, sources said. A vehicle-to-vehicle shootout ensued. The officer's vehicle was peppered with multiple rounds, according to authorities.

Dorner crashed his vehicle and took refuge in a nearby cabin, sources said. One deputy was hit as Dorner fired out of the cabin and a second deputy was injured when Dorner exited the back of the cabin, deployed a smoke bomb and opened fire again in an apparent attempt to flee. Dorner was driven back inside the cabin, the sources said.

During the unprecedented manhunt, officers had crisscrossed California for days pursuing the more than 1,000 tips that poured in about Dorner's possible whereabouts -- including efforts in Tijuana, San Diego County and Big Bear -- and serving warrants at homes in Las Vegas and the Point Loma area of San Diego.

Statewide alerts were issued in California and Nevada, and border authorities were alerted. The Transportation Security Administration also had issued an alert urging pilots and other aircraft operators to keep an eye out for Dorner.

The search turned to Big Bear last week after Dorner's burning truck was found on a local forest road.

At the search's height, more than 200 officers scoured the mountain, conducting cabin-by-cabin checks. It was scaled back Sunday -- about 30 officers were out in the field Tuesday, the San Bernardino County Sheriff's Department said.

Dorner allegedly threatened "unconventional and asymmetrical warfare" against police in a lengthy manifesto that authorities say he posted on Facebook. The posting named dozens of potential targets, including police officers, whom Dorner allegedly threatened to attack, according to authorities.

Records state that the manifesto was discovered by authorities last Wednesday, three days after the slaying of an Irvine couple: Monica Quan, a Cal State Fullerton assistant basketball coach, and her fiance, Keith Lawrence, a USC public safety officer.

Quan was the daughter of a retired LAPD captain whom Dorner allegedly blamed in part for his firing from the force in 2009.

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Well: Straining to Hear and Fend Off Dementia

At a party the other night, a fund-raiser for a literary magazine, I found myself in conversation with a well-known author whose work I greatly admire. I use the term “conversation” loosely. I couldn’t hear a word he said. But worse, the effort I was making to hear was using up so much brain power that I completely forgot the titles of his books.

A senior moment? Maybe. (I’m 65.) But for me, it’s complicated by the fact that I have severe hearing loss, only somewhat eased by a hearing aid and cochlear implant.

Dr. Frank Lin, an otolaryngologist and epidemiologist at Johns Hopkins School of Medicine, describes this phenomenon as “cognitive load.” Cognitive overload is the way it feels. Essentially, the brain is so preoccupied with translating the sounds into words that it seems to have no processing power left to search through the storerooms of memory for a response.

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Katherine Bouton speaks about her own experience with hearing loss.

A transcript of this interview can be found here.

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Over the past few years, Dr. Lin has delivered unwelcome news to those of us with hearing loss. His work looks “at the interface of hearing loss, gerontology and public health,” as he writes on his Web site. The most significant issue is the relation between hearing loss and dementia.

In a 2011 paper in The Archives of Neurology, Dr. Lin and colleagues found a strong association between the two. The researchers looked at 639 subjects, ranging in age at the beginning of the study from 36 to 90 (with the majority between 60 and 80). The subjects were part of the Baltimore Longitudinal Study of Aging. None had cognitive impairment at the beginning of the study, which followed subjects for 18 years; some had hearing loss.

“Compared to individuals with normal hearing, those individuals with a mild, moderate, and severe hearing loss, respectively, had a 2-, 3- and 5-fold increased risk of developing dementia over the course of the study,” Dr. Lin wrote in an e-mail summarizing the results. The worse the hearing loss, the greater the risk of developing dementia. The correlation remained true even when age, diabetes and hypertension — other conditions associated with dementia — were ruled out.

In an interview, Dr. Lin discussed some possible explanations for the association. The first is social isolation, which may come with hearing loss, a known risk factor for dementia. Another possibility is cognitive load, and a third is some pathological process that causes both hearing loss and dementia.

In a study last month, Dr. Lin and colleagues looked at 1,984 older adults beginning in 1997-8, again using a well-established database. Their findings reinforced those of the 2011 study, but also found that those with hearing loss had a “30 to 40 percent faster rate of loss of thinking and memory abilities” over a six-year period compared with people with normal hearing. Again, the worse the hearing loss, the worse the rate of cognitive decline.

Both studies also found, somewhat surprisingly, that hearing aids were “not significantly associated with lower risk” for cognitive impairment. But self-reporting of hearing-aid use is unreliable, and Dr. Lin’s next study will focus specifically on the way hearing aids are used: for how long, how frequently, how well they have been fitted, what kind of counseling the user received, what other technologies they used to supplement hearing-aid use.

What about the notion of a common pathological process? In a recent paper in the journal Neurology, John Gallacher and colleagues at Cardiff University suggested the possibility of a genetic or environmental factor that could be causing both hearing loss and dementia — and perhaps not in that order. In a phenomenon called reverse causation, a degenerative pathology that leads to early dementia might prove to be a cause of hearing loss.

The work of John T. Cacioppo, director of the Social Neuroscience Laboratory at the University of Chicago, also offers a clue to a pathological link. His multidisciplinary studies on isolation have shown that perceived isolation, or loneliness, is “a more important predictor of a variety of adverse health outcomes than is objective social isolation.” Those with hearing loss, who may sit through a dinner party and not hear a word, frequently experience perceived isolation.

Other research, including the Framingham Heart Study, has found an association between hearing loss and another unexpected condition: cardiovascular disease. Again, the evidence suggests a common pathological cause. Dr. David R. Friedland, a professor of otolaryngology at the Medical College of Wisconsin in Milwaukee, hypothesized in a 2009 paper delivered at a conference that low-frequency loss could be an early indication that a patient has vascular problems: the inner ear is “so sensitive to blood flow” that any vascular abnormalities “could be noted earlier here than in other parts of the body.”

A common pathological cause might help explain why hearing aids do not seem to reduce the risk of dementia. But those of us with hearing loss hope that is not the case; common sense suggests that if you don’t have to work so hard to hear, you have greater cognitive power to listen and understand — and remember. And the sense of perceived isolation, another risk for dementia, is reduced.

A critical factor may be the way hearing aids are used. A user must practice to maximize their effectiveness and they may need reprogramming by an audiologist. Additional assistive technologies like looping and FM systems may also be required. And people with progressive hearing loss may need new aids every few years.

Increasingly, people buy hearing aids online or from big-box stores like Costco, making it hard for the user to follow up. In the first year I had hearing aids, I saw my audiologist initially every two weeks for reprocessing and then every three months.

In one study, Dr. Lin and his colleague Wade Chien found that only one in seven adults who could benefit from hearing aids used them. One deterrent is cost ($2,000 to $6,000 per ear), seldom covered by insurance. Another is the stigma of old age.

Hearing loss is a natural part of aging. But for most people with hearing loss, according to the National Institute on Deafness and Other Communication Disorders, the condition begins long before they get old. Almost two-thirds of men with hearing loss began to lose their hearing before age 44. My hearing loss began when I was 30.

Forty-eight million Americans suffer from some degree of hearing loss. If it can be proved in a clinical trial that hearing aids help delay or offset dementia, the benefits would be immeasurable.

“Could we do something to reduce cognitive decline and delay the onset of dementia?” he asked. “It’s hugely important, because by 2050, 1 in 30 Americans will have dementia.

“If we could delay the onset by even one year, the prevalence of dementia drops by 15 percent down the road. You’re talking about billions of dollars in health care savings.”

Should studies establish definitively that correcting hearing loss decreases the potential for early-onset dementia, we might finally overcome the stigma of hearing loss. Get your hearing tested, get it corrected, and enjoy a longer cognitively active life. Establishing the dangers of uncorrected hearing might even convince private insurers and Medicare that covering the cost of hearing aids is a small price to pay to offset the cost of dementia.

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Katherine Bouton is the author of the new book, “Shouting Won’t Help: Why I — and 50 Million Other Americans — Can’t Hear You,” from which this essay is adapted.

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This post has been revised to reflect the following correction:

Correction: February 12, 2013

An earlier version of this article misstated the location of the Medical College of Wisconsin. It is in Milwaukee, not Madison.

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Chicago leads nation in gas-price spikes

Drivers in Chicago are seeing a painful rise in gas prices get even worse this month.

The average price of regular unleaded in the Chicago metro area on Tuesday is $3.93, according to AAA. That's up 12 cents from a week ago. A month ago, the average was $3.42. Statewide, the average is about $3.79, up 8 cents from last week and 46 cents last month.

Prices are rising at pumps across the country, too, but not as dramatically. The national average is $3.60, up about 7 cents from a week ago and 30 cents higher than this time last month.

It's not typical to see gas price spikes at this time of year. Demand is typically low and picks up in the spring before driving season. And in general, gas is cheaper to produce in the winter because refineries can use less expensive blends.

The main reason for the spike is the higher price of crude oil. The price of oil has gone from around $85 a barrel in December to around $97 now because of improving economic certainty as the country moved past the election and the fiscal cliff deadline, according to energy analyst Phil Flynn. It's also being driven by better-than-expected growth in China, the world's second largest economy.

Prices in the Chicago area are typically some the highest in the nation, but the cost of a local fill-up is accelerating at almost double the national rate.

Flynn attributes this to a number of refinery issues in the region. Some scheduled maintenance at refineries -- where gasoline and other products are produced from oil -- occurred earlier than usual, which cut off some supply, affecting prices. Many close at this time of year to start the switchover to lower-emission summer blends of gasoline.

Besides a major overhaul of BP's Whiting refinery, the largest supplier of gasoline to Midwest markets, that's believed to be driving prices higher, a fire temporarily shut down a refinery in northwest Ohio.

AAA, which tracks daily gasoline prices around the country, predicts they will continue their rapid climb as local refinery issues continue into the beginning of peak driving season.

Flynn is more optimistic.

He believes that once the major Whiting refinery overhaul is complete later this year, gas prices will stabilize.

"I'm probably in the minority but I think we are starting to see some light at the end of the tunnel," he said.

sbomkamp@tribune.com | Twitter: @SamWillTravel

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Slain teen's dad: 'The healing can start' after 2 charged with murder

Two men have  been charged in the shooting death of 15-year-old Hadiya Pendleton in a case of mistaken identity in which one of those charged was trying to retaliate for his being shot last year, authorities said.

Charged were Michael Ward, 18, and Kenneth Williams, 20. The two face charges of first-degree murder, attempted murder, and aggravated battery with a firearm in the attack that also left two other teens wounded. Ward, of the 3900 block of South Lake Park Avenue, confessed in the shooting, police said.

Ward and Williams told police that they were en route to a strip club in Harvey when they were arrested Saturday night--just hours after Hadiya's funeral, said Police Superintendent Garry McCarthy in a news conference at Area Central police headquarters this evening.

Williams, of the 300 block of West 59th Street, had been shot in July, but refused to sign a complaint against those police suspected in that attack. Williams and Ward targeted the group Hadiya was with because they believed, mistakenly, they were members of the gang responsible for that shooting, .

With news of the charges, Hadiya's father Nathaniel Pendleton said this is the first time since the shooting that he's had a "legitimate" smile on his face.

"I'm ecstatic that they found the two guys," he told the Tribune during a brief telephone interview Monday night from a Washington, D.C. restaurant, where he was with his wife, Cleopatra Cowley-Pendleton, and other relatives. "(I'm) thanking God that these two guys are off the streets, so that this doesn't happen to another innocent person."

Pendleton and his family were in the nation's capital to be guests of President Barack Obama while he delivers the State Of The Union address Tuesday night.

Still, Pendleton acknowledged that true closure will come if the men are convicted of the crimes. But the charges, he said, are a good start.

"Right now, I can say to you that the healing can start," he said.

Chicago police picked up the two men, 18 and 20, over the weekend, hours after first lady Michelle Obama attended the funeral for the teenager whose death has become a symbol of escalating violence in Chicago.

The men were pulled over near 67th Street and South Chicago Avenue late Saturday night or early Sunday morning after detectives canvassed the area of the park where she was fatally shot Jan. 29 and tracked down witnesses, the sources said.

Hadiya was shot in Vivian Gordon Harsh Park, about a mile north of President Barack Obama's Kenwood neighborhood home on the South Side. Her slaying took place a little more than a week after the honor student performed with the King College Prep band in Washington during inauguration festivities. Two other teens were wounded.

The shooting in the 4400 block of South Oakenwald Avenue happened after classes were dismissed for the day during finals week at King. Hadiya, a sophomore at King, was at the park with a group of teens, primarily other students from the school, when a male gunman climbed over a fence, ran to the group and started firing, police have said. The shooter escaped in what has been described as a white Nissan vehicle, possibly driven by a getaway driver.

One of the sources said at least one of the men brought into custody was riding in a Nissan Sentra, one of the two vehicles police pulled over when bringing the pair into custody. The source didn't know that Nissan's color.

After police News Affairs initially--and mistakenly--said that her companions included gang members, Police have said the teens in Hadiya's group who had gathered in the park were not involved in gangs. But police have been looking into whether the gunman may have mistaken them for rival gang members.

While police and neighbors have generally described Harsh Park and its immediate surroundings as safe, there has been an internal gang conflict brewing in the area between factions of the Gangster Disciples, police said. The two men who are charged are alleged members of the Gangster Disciples, sources said.

Ward pleaded guilty early last year in a 2011 aggravated unlawful use of a weapon case, and was given two years probation, according to court records. After an arrest on criminal trespass to a vehicle last summer, he was held without bond for a few weeks, but was released after a Sept. 9, 2012, hearing.

Williams was arrested on a misdemeanor retail theft charge in October 2011, but the charge was dismissed.

In addition to Hadiya's homicide, there have been at least three other shootings within blocks of Harsh Park so far this year, according to police records.

Mayor Rahm Emanuel personally called Hadiya's parents, Cleopatra Cowley-Pendleton and Nathaniel Pendleton, to inform them of the development, according to a source. Nathaniel Pendleton told the Tribune on Sunday night that he didn't want to say too much about the men being questioned because charges have not been filed.
“Right now, we're just happy that Chicago police have some leads and things are moving,” he said.

Shatira Wilks, a cousin of Hadiya's and a family spokesperson, said the development is a “good response” and better news than the family had Saturday.

Arrests and charges “will bring a small level of closure to the family, although (the shooter) still will be allowed to eat, drink, mingle,” Wilks said. “The thing about that is, Hadiya is no longer (able) to do so.”

On how Hadiya's family is doing, Wilks said, “Everyone keeps asking that. I don't know if you'll ever get an answer that we're feeling good or we're feeling fine.”

Hadiya's godmother, LaKeisha Stewart, said questioning the men is a good start, but she's more eager to find out when or if charges are filed.

“Until this person is off the streets for good, that an example is made to … other people like him -- that's when I'll breathe a sigh of relief,” Stewart said. “For me, when the person is in court and a judge says they are responsible for her murder … to me, that's when this will make a difference.”

Hadiya's death occurred during the deadliest January for Chicago since 2002. It also came on the heels of a homicide total last year that was the highest since 2008, and the second highest since 2003.

The playground where Hadiya was shot was the setting for an amateur rap video posted to YouTube. The video, which also highlights the intersection at South Oakenwald and East 44th Place, uses the moniker of a local gang in an opening credit and features a rapper shown leaving the Cook County Jail, then threatening to shoot down his foes.

The video ends at a house party with a smiling teenage girl flashing gang signs at the camera.

The first lady's attendance at Hadiya's funeral placed Chicago even further into the spotlight of a national debate over gun violence that has polarized Congress and led the president to take his gun-control initiatives on the road to garner more public support.

Neither the first lady nor elected officials gave remarks during the funeral. Only the friends and relatives who knew Hadiya best were allowed to speak.

In the days following Hadiya's death, clergy and community leaders raised $40,000 in reward money for information leading to the arrest and conviction of the teen's killer or killers. McCarthy has said that detectives have received numerous tips to follow up on for the homicide investigation.

Tribune reporter Carlos Sadovi contributed to this story.

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Health Testing on Mice Is Found Misleading in Some Cases

Evan McGlinn for The New York Times

Dr. H. Shaw Warren is one of the authors of a new study that questions the use of laboratory mice as models for all human diseases.

For decades, mice have been the species of choice in the study of human diseases. But now, researchers report evidence that the mouse model has been totally misleading for at least three major killers — sepsis, burns and trauma. As a result, years and billions of dollars have been wasted following false leads, they say.

The study’s findings do not mean that mice are useless models for all human diseases. But, its authors said, they do raise troubling questions about diseases like the ones in the study that involve the immune system, including cancer and heart disease.

“Our article raises at least the possibility that a parallel situation may be present,” said Dr. H. Shaw Warren, a sepsis researcher at Massachusetts General Hospital and a lead author of the new study.

The paper, published Monday in Proceedings of the National Academy of Sciences, helps explain why every one of nearly 150 drugs tested at a huge expense in patients with sepsis has failed. The drug tests all were based on studies in mice. And mice, it turns out, can have something that looks like sepsis in humans, but is very different from the condition in humans.

Medical experts not associated with the study said that the findings should change the course of research worldwide for a deadly and frustrating condition. Sepsis, a potentially deadly reaction that occurs as the body tries to fight an infection, afflicts 750,000 patients a year in the United States, kills one-fourth to one-half of them, and costs the nation $17 billion a year. It is the leading cause of death in intensive-care units.

“This is a game changer,” said Dr. Mitchell Fink, a sepsis expert at the University of California, Los Angeles, of the new study.

“It’s amazing,” said Dr. Richard Wenzel, a former chairman at the department of internal medicine at Virginia Commonwealth University and a former editor of The New England Journal of Medicine. “They are absolutely right on.”

Potentially deadly immune responses occur when a person’s immune system overreacts to what it perceives as danger signals, including toxic molecules from bacteria, viruses, fungi, or proteins released from cells damaged by trauma or burns, said Dr. Clifford S. Deutschman, who directs sepsis research at the University of Pennsylvania and was not part of the study.

The ramped-up immune system releases its own proteins in such overwhelming amounts that capillaries begin to leak. The leak becomes excessive, and serum seeps out of the tiny blood vessels. Blood pressure falls, and vital organs do not get enough blood. Despite efforts, doctors and nurses in an intensive-care unit or an emergency room may be unable to keep up with the leaks, stop the infection or halt the tissue damage. Vital organs eventually fail.

The new study, which took 10 years and involved 39 researchers from across the country, began by studying white blood cells from hundreds of patients with severe burns, trauma or sepsis to see what genes were being used by white blood cells when responding to these danger signals.

The researchers found some interesting patterns and accumulated a large, rigorously collected data set that should help move the field forward, said Ronald W. Davis, a genomics expert at Stanford University and a lead author of the new paper. Some patterns seemed to predict who would survive and who would end up in intensive care, clinging to life and, often, dying.

The group had tried to publish its findings in several papers. One objection, Dr. Davis said, was that the researchers had not shown the same gene response had happened in mice.

“They were so used to doing mouse studies that they thought that was how you validate things,” he said. “They are so ingrained in trying to cure mice that they forget we are trying to cure humans.”

“That started us thinking,” he continued. “Is it the same in the mouse or not?”

The group decided to look, expecting to find some similarities. But when the data were analyzed, there were none at all.

“We were kind of blown away,” Dr. Davis said.

The drug failures became clear. For example, often in mice, a gene would be used, while in humans, the comparable gene would be suppressed. A drug that worked in mice by disabling that gene could make the response even more deadly in humans.

Even more surprising, Dr. Warren said, was that different conditions in mice — burns, trauma, sepsis — did not fit the same pattern. Each condition used different groups of genes. In humans, though, similar genes were used in all three conditions. That means, Dr. Warren said, that if researchers can find a drug that works for one of those conditions in people, it might work for all three.

This article has been revised to reflect the following correction:

Correction: February 11, 2013

An earlier version of this article misstated the position of Dr. Richard Wenzel. He is a former chairman of the department of internal medicine at Virginia Commonwealth University. He is not currently the chairman.

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Maker's Mark lowering proof to meet demand

Maker's Mark announced it is reducing the amount of alcohol in the spirit to keep pace with rapidly increasing consumer demand.

In an email to its fans, representatives of the brand said the entire bourbon category is "exploding" and demand for Maker's Mark is growing even faster. Some customers have even reported empty shelves in their local stores, it said.

After looking at "all possible solutions," the total alcohol by volume of Maker's Mark is being reduced by 3 percent. Representatives said the change will allow it to maintain the same taste while making sure there's "enough Maker's Mark to go around." It's working to expand its distillery and production capacity, too.

Maker's Mark, made by Deerfield-based Beam Inc., said it's done extensive testing to ensure the same taste. It says bourbon drinkers couldn't tell the difference. It also underscored the fact that nothing else in the production process has changed.

"In other words, we've made sure we didn't screw up your whisky," the note said.

Rob Samuels, chief operating officer and grandson of Maker's Mark Founder Bill Samuels, Sr., said this is a permanent decision that won’t be reversed when demand for bourbon slows down. Samuels said that bourbon has gone from the slowest growing spirits category to the fastest over the last 18 months, driven by growth overseas and demand from younger drinkers. An average bottle of Maker’s Mark takes six and half years to produce from start to finish, and since the company doesn’t buy or trade whiskey, it’s been impossible to keep up. 

The first bottle of Maker's Mark, with its signature red wax closure, was produced in 1958.

Beam is the country's second-largest spirits company by volume. It also makes Jim Beam, Sauza tequila and Pinnacle vodka. It's still dwarfed by industry-leading Diageo, the London-based maker of Smirnoff, Tanqueray, Captain Morgan and Johnnie Walker.

It's a tough time to take a risk with one of its oldest and most popular brands. Beam has promised that 25 percent of sales will come from new products, a difficult goal to attain but a critical one for investor confidence.The move met some backlash on social media sites, where some said they would boycott the bourbon if the company went ahead with its plans.

Many also complained that they'd rather see an increase in its price than a decrease in the alcohol. But observers say that by raising the price, Beam would have hurt itself by positioning Maker's Mark to compete against its own higher end brands like Basil Hayden's.

sbomkamp@tribune.com | Twitter: @SamWillTravel

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Grammy Awards: Fun. wins song of the year

Live Grammy Awards updates from the LA Times:

7:51: Song of the year goes to Fun.'s "We Are Young" featuring Janelle Monae.

7:47 p.m.: When the Grammys get things right, they still manage to get things wrong. Miguel is an R&B voice worth paying attention to. He’s old-fashioned without being tied to a time period and knows how to swing and soon with deftness. He’s the exact sort of newer voice the Grammys should be championing, but here they paired him with rapper Wiz Khalifa for his "Adorn," as if producers were unsure whether Miguel was a big-enough name to appear solo. Yes, Khalifa is on the song’s remix, but let Miguel have the spotlight for his song of the year-nominated tune.

 Moments later, Carrie Underwood received the award for country solo performance for her “Blown Away.”

7:43 p.m.: Miranda Lambert and Dierks Bentley, who just happen to be touring together (golly, what a coincidence) gave the Grammys their first medley of the night. Underneath what looked like a giant dead Christmas tree, Lambert sang her ballad “Over You.” Lambert’s better when she’s pretending she’s crazy, but her voice isn’t anything to trifle with. Yet by the time Bentley appeared onstage, Lambert’s melody was starting to sound too close to Tom Petty’s “Free Falling” to not be daydreaming of better songs. Bentley’s “Home,” however, was a real mismatch here. With its images of blood-scarred landscapes, this is a song written to be played at military tributes, not awards shows.

7:32 p.m.(Central time): Wait…. who changed the channel to “Glee”? Oh, never mind, that’s just Fun., stomping and hollering over any sense of melody or subtlety. Fun. is upbeat, but upbeat at its most aggressive. Give Fun. a verse, and it’ll send you back a choir and a song filled with shout-outs built for sporting events. As evidence, the band offered its “Carry On” at the Grammys, and just to make sure that everyone knew the band was taking the Grammys  really seriously, its members allowed themselves to get doused in water. They suffer for their good-time party songs. 

7:30 p.m.: Twenty minutes in and the Grammys have their first head-scratcher. The Grammy for pop solo performance went to Adele’s “Set Fire to the Rain,” from her “Live at the Royal Albert Hall” disc. Adele, of course, was the big winner last year, and sneaking in an older track via a live disc simply seemed the way to get her back onstage. In winning, she bested Kelly Clarkson’s “Stronger” and Carly Rae Jepsen’s “Call Me Maybe,” among others.

 “Thank you so much,” said Adele. “This is amazing. I just wanted to come and be part of the night. I loved it last year, obviously.”

7:22 p.m.: After a lengthy (whew) opening speech from LL Cool J, in which he referenced the passing last year of Whitney Houston but had no fun or made no jokes otherwise, the show continued down its offend-no-one path. Ed Sheeran, a little Cocker Spaniel of a singer-songwriter, sang his nominated number “The A Team.” It aims for grand statements, but it largely just kind of strums along. With all its references to angels -- flying angels, freezing cold angels, dying angels -- this was a sudden momentum killer after Swift’s Halloween show.  But if you’re going to write a song with important-sounding lyrics with angels, may as well have Elton John to play along. 

7:05 p.m. (Central time): The Grammys are definitely opting for frivolous from the get-go in 2013. After using Bruce Springsteen last year to open the show with a somber, uplifting rock number, “We Take Care of Our Own,” producers this year decided to play dress-up with Taylor Swift. The country-turned-pop star went all “Alice in Wonderland” for her take on “We Are Never Ever Getting Back Together,” full of surrealist art swirls and a Mad Hatter. What all of this had to do with a featherweight breakup album, I’m all ears, but when it comes to spectacle, Swift definitely seems to be taking a page from Lady Gaga. So perhaps this is one of the weirdest Grammy openings in recent memory. Rarely have the Grammys presented someone so normal in such an odd setting. 

6:59 p.m.: Welcome to the 2013 Pop & Hiss live blog of the Grammy Awards. The Black Keys are off to a fast start in the race for album of the year, as the band earlier today won rock album for "El Camino" and rock song for "Lonely Boy." 

In winning rock song, the Black Keys bested tracks from fellow album of the year nominees Jack White and Mumford & Sons, which, for those looking for a Grammy story line, would seem to set the stage for a Frank Ocean/Black Keys showdown for the top Grammy prize. 

In some ways, Ocean is the biggest story of the year -- he stands at the heart of a new R&B movement that emphasizes thoughtfulness and sexual tolerance over booty shaking -- but he's also an unlikely album-of-the-year candidate. His songs emphasize introspection and experimentation, where beats are muffled and thoughts are complex. And he's not a million-plus seller. -- LA Times

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Black Keys, Skrillez win big early awards

Skrillex and the Black Keys' Dan Auerbach were the big early winners at the 55th annual Grammy Awards in Los Angeles with three awards.

The vast majority of the 81 awards were handed out before the television broadcast, and included some memorable moments:

Skrillex in accepting an award for his electronic-dance-music single and album, both titled “Bangarang”: “Thanks for letting us do it the weird way.”

Bonnie Raitt on her upset in the Americana category over Mumford & Sons and the Lumineers, among others: “I was not expecting this. I have enough!”

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For Families Struggling with Mental Illness, Carolyn Wolf Is a Guide in the Darkness

When a life starts to unravel, where do you turn for help?

Melissa Klump began to slip in the eighth grade. She couldn’t focus in class, and in a moment of despair she swallowed 60 ibuprofen tablets. She was smart, pretty and ill: depression, attention deficit disorder, obsessive-compulsive disorder, either bipolar disorder or borderline personality disorder.

In her 20s, after a more serious suicide attempt, her parents sent her to a residential psychiatric treatment center, and from there to another. It was the treatment of last resort. When she was discharged from the second center last August after slapping another resident, her mother, Elisa Klump, was beside herself.

“I was banging my head against the wall,” the mother said. “What do I do next?” She frantically called support groups, therapy programs, suicide prevention lines, anybody, running down a list of names in a directory of mental health resources. “Finally,” she said, “somebody told me, ‘The person you need to talk to is Carolyn Wolf.’ ”

That call, she said, changed her life and her daughter’s. “Carolyn has given me hope,” she said. “I didn’t know there were people like her out there.”

Carolyn Reinach Wolf is not a psychiatrist or a mental health professional, but a lawyer who has carved out what she says is a unique niche, working with families like the Klumps.

One in 17 American adults suffers from a severe mental illness, and the systems into which they are plunged — hospitals, insurance companies, courts, social services — can be fragmented and overwhelming for families to manage. The recent shootings in Newtown, Conn., and Aurora, Colo., have brought attention to the need for intervention to prevent such extreme acts of violence, which are rare. But for the great majority of families watching their loved ones suffer, and often suffering themselves, the struggle can be boundless, with little guidance along the way.

“If you Google ‘mental health lawyer,’ ” said Ms. Wolf, a partner with Abrams & Fensterman, “I’m kinda the only game in town.”

On a recent afternoon, she described in her Midtown office the range of her practice.

“We have been known to pull people out of crack dens,” she said. “I have chased people around hotels all over the city with the N.Y.P.D. and my team to get them to a hospital. I had a case years ago where the person was on his way back from Europe, and the family was very concerned that he was symptomatic. I had security people meet him at J.F.K.”

Many lawyers work with mentally ill people or their families, but Ron Honberg, the national director of policy and legal affairs for the National Alliance on Mental Illness, said he did not know of another lawyer who did what Ms. Wolf does: providing families with a team of psychiatrists, social workers, case managers, life coaches, security guards and others, and then coordinating their services. It can be a lifeline — for people who can afford it, Mr. Honberg said. “Otherwise, families have to do this on their own,” he said. “It’s a 24-hour, 7-day-a-week job, and for some families it never ends.”

Many of Ms. Wolf’s clients declined to be interviewed for this article, but the few who spoke offered an unusual window on the arcane twists and turns of the mental health care system, even for families with money. Their stories illustrate how fraught and sometimes blind such a journey can be.

One rainy morning last month, Lance Sheena, 29, sat with his mother in the spacious family room of her Long Island home. Mr. Sheena was puffy-eyed and sporadically inattentive; the previous night, at the group home where he has been living since late last summer, another resident had been screaming incoherently and was taken away by the police. His mother, Susan Sheena, eased delicately into the family story.

“I don’t talk to a lot of people because they don’t get it,” Ms. Sheena said. “They mean well, but they don’t get it unless they’ve been through a similar experience. And anytime something comes up, like the shooting in Newtown, right away it goes to the mentally ill. And you think, maybe we shouldn’t be so public about this, because people are going to be afraid of us and Lance. It’s a big concern.”

Her son cut her off. “Are you comparing me to the guy that shot those people?”

“No, I’m saying that anytime there’s a shooting, like in Aurora, that’s when these things come out in the news.”

“Did you really just compare me to that guy?”

“No, I didn’t compare you.”

“Then what did you say?”

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