Protests Erupt After Egypt’s Leader Seizes New Power

Tara Todras-Whitehill for The New York Times

Egyptians in central Cairo ran from tear gas during clashes with the police on Friday. Protesters took to the streets in several cities. More Photos »

CAIRO — Protests erupted across Egypt on Friday, as opponents of President Mohamed Morsi clashed with his supporters over a presidential edict that gave him unchecked authority and polarized an already divided nation while raising a specter, the president’s critics charged, of a return to autocracy.  

In an echo of the uprising 22 months ago, thousands of protesters chanted for the downfall of Mr. Morsi’s government in Cairo, while others ransacked the offices of the president’s former party in Suez, Alexandria and other cities.

Mr. Morsi spoke to his supporters in front of the presidential palace here, imploring the public to trust his intentions as he cast himself as a protector of the revolution and a fledgling democracy.

In a speech that was by turns defensive and conciliatory, he ultimately gave no ground to the critics who now were describing him as a pharaoh, in another echo of the insult once reserved for the deposed president, Hosni Mubarak.

“God’s will and elections made me the captain of this ship,” Mr. Morsi said.

The battles that raged on Friday — over power, legitimacy and the mantle of the revolution — posed a sharp challenge not only to Mr. Morsi but also to his opponents, members of secular, leftist and liberal groups whose crippling divisions have stifled their agenda and left them unable to confront the more popular Islamist movement led by the Muslim Brotherhood.

The crisis over his power grab came just days after the Islamist leader won international praise for his pragmatism, including from the United States, for brokering a cease-fire between Hamas and Israel.

On Friday, the State Department expressed muted concern over Mr. Morsi’s decision. “One of the aspirations of the revolution was to ensure that power would not be overly concentrated in the hands of any one person or institution,” said the State Department spokeswoman, Victoria Nuland.

She said, “The current constitutional vacuum in Egypt can only be resolved by the adoption of a constitution that includes checks and balances, and respects fundamental freedoms, individual rights and the rule of law consistent with Egypt’s international commitments.”

But the White House was notably silent after it had earlier this week extolled the emerging relationship between President Obama and Mr. Morsi and credited a series of telephone calls between the two men with helping to mediate the cease-fire in Gaza.

For Mr. Morsi, who seemed to be saying to the nation that it needed to surrender the last checks on his power in order to save democracy from Mubarak-era judges, the challenge was to convince Egyptians that the ends justified his means.

But even as he tried, thousands of protesters marched to condemn his decision. Clashes broke out between the president’s supporters and his critics, and near Tahrir Square, the riot police fired tear gas and bird shot as protesters hurled stones and set fires.

Since Thursday, when Mr. Morsi issued the decree, the president and his supporters have argued that he acted precisely to gain the power to address the complaints of his critics, including the families of protesters killed during the uprising and its aftermath.

By placing his decisions above judicial review, the decree enabled him to replace a public prosecutor who had failed to win convictions against senior officers implicated in the killings of protesters.

The president and his supporters also argued that the decree insulated the Constituent Assembly, which is drafting the constitution, from meddling by Mubarak-era judges.

Since Mr. Mubarak’s ouster, courts have dissolved Parliament, kept a Mubarak loyalist as top prosecutor and disbanded the first Assembly.

But by ending legal appeals, the decree also removed a safety valve for critics who say the Islamist majority is dominating the drafting of the constitution.

Mayy El Sheikh contributed reporting from Cairo, and Helene Cooper from Washington.

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G.E. Looks to Industry for the Next Digital Disruption

SAN RAMON, Calif. — When Sharoda Paul finished a postdoctoral fellowship last year at the Palo Alto Research Center, she did what most of her peers do — considered a job at a big Silicon Valley company, in her case, Google. But instead, Ms. Paul, a 31-year-old expert in social computing, went to work for General Electric.

Ms. Paul is one of more than 250 engineers recruited in the last year and a half to G.E.’s new software center here, in the East Bay of San Francisco. The company plans to increase that work force of computer scientists and software developers to 400, and to invest $1 billion in the center by 2015. The buildup is part of G.E’s big bet on what it calls the “industrial Internet,” bringing digital intelligence to the physical world of industry as never before.

The concept of Internet-connected machines that collect data and communicate, often called the “Internet of Things,” has been around for years. Information technology companies, too, are pursuing this emerging field. I.B.M. has its “Smarter Planet” projects, while Cisco champions the “Internet of Everything.”

But G.E.’s effort, analysts say, shows that Internet-era technology is ready to sweep through the industrial economy much as the consumer Internet has transformed media, communications and advertising over the last decade.

In recent months, Ms. Paul has donned a hard hat and safety boots to study power plants. She has ridden on a rail locomotive and toured hospital wards. “Here, you get to work with things that touch people in so many ways,” she said. “That was a big draw.”

G.E. is the nation’s largest industrial company, a producer of aircraft engines, power plant turbines, rail locomotives and medical imaging equipment. It makes the heavy-duty machinery that transports people, heats homes and powers factories, and lets doctors diagnose life-threatening diseases.

G.E. resides in a different world from the consumer Internet. But the major technologies that animate Google and Facebook are also vital ingredients in the industrial Internet — tools from artificial intelligence, like machine-learning software, and vast streams of new data. In industry, the data flood comes mainly from smaller, more powerful and cheaper sensors on the equipment.

Smarter machines, for example, can alert their human handlers when they will need maintenance, before a breakdown. It is the equivalent of preventive and personalized care for equipment, with less downtime and more output.

“These technologies are really there now, in a way that is practical and economic,” said Mark M. Little, G.E.’s senior vice president for global research.

G.E.’s embrace of the industrial Internet is a long-term strategy. But if its optimism proves justified, the impact could be felt across the economy.

The outlook for technology-led economic growth is a subject of considerable debate. In a recent research paper, Robert J. Gordon, a prominent economist at Northwestern University, argues that the gains from computing and the Internet have petered out in the last eight years.

Since 2000, Mr. Gordon asserts, invention has focused mainly on consumer and communications technologies, including smartphones and tablet computers. Such devices, he writes, are “smaller, smarter and more capable, but do not fundamentally change labor productivity or the standard of living” in the way that electric lighting or the automobile did.

But others say such pessimism misses the next wave of technology. “The reason I think Bob Gordon is wrong is precisely because of the kind of thing G.E. is doing,” said Andrew McAfee, principal research scientist at M.I.T.’s Center for Digital Business.

Today, G.E. is putting sensors on everything, be it a gas turbine or a hospital bed. The mission of the engineers in San Ramon is to design the software for gathering data, and the clever algorithms for sifting through it for cost savings and productivity gains. Across the industries it covers, G.E. estimates such efficiency opportunities at as much as $150 billion.

Some industrial Internet projects are already under way. First Wind, an owner and operator of 16 wind farms in America, is a G.E. customer for wind turbines. It has been experimenting with upgrades that add more sensors, controls and optimization software.

The new sensors measure temperature, wind speeds, location and pitch of the blades. They collect three to five times as much data as the sensors on turbines of a few years ago, said Paul Gaynor, chief executive of First Wind. The data is collected and analyzed by G.E. software, and the operation of each turbine can be tweaked for efficiency. For example, in very high winds, turbines across an entire farm are routinely shut down to prevent damage from rotating too fast. But more refined measurement of wind speeds might mean only a portion of the turbines need to be shut down. In wintry conditions, turbines can detect when they are icing up, and speed up or change pitch to knock off the ice.

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Wealth Matters: Dealing With Doctors Who Accept Only Cash

A FEW weeks ago, my wife and I were at our wits’ end: our 4-month-old daughter wouldn’t sleep for more than an hour at a time at night. We had consulted books and seen our pediatrician, but nothing was working. So my wife called a pediatrician who specializes in babies who struggle with sleep problems.

The next day, he drove an hour from Brooklyn to our house. He then spent an hour and a half talking to us and examining our daughter in her nursery. He prescribed some medicine for her and suggested some changes to my wife’s diet. Within two days, our baby was sleeping through the night and we were all feeling better.

The only catch was this pediatrician did not accept insurance. He had taken our credit card information before his visit and given us a form to submit to our insurance company as he left, saying insurance usually paid a portion of his fee, which was $650.

A couple of weeks later, our insurance company said it wouldn’t pay anything. Here’s how the company figured it: First, it said a fair price for our doctor’s fee was $285, about 60 percent less, because that was the going rate for our town. Then, it said the lower fee was not enough to meet our out-of-network deductible.

While we were none too happy with the insurance company, we remained impressed by the doctor: he had made our baby better and was compensated for it, all the while avoiding the hassle of dealing with insurance.

Last year, I wrote about doctors who catered only to the richest of the rich and charged accordingly. But after my experience, I became interested in doctors for the average person who take only cash. What pushes a doctor to go this route, often called concierge medicine? And how hard is it to make a living?

As to why doctors decide to switch to a concierge practice, the answer is almost always frustration.

“About four years ago, one insurance company was driving me crazy saying I had to fax documents to show I had done a visit,” said Stanford Owen, an internal medical doctor in Gulfport, Miss. “At 2 a.m., I woke up and said, ‘This is it.’ ”

Dr. Owen stopped accepting all insurance and now charges his 1,000 patients $38 a month.

“When I decided to abandon insurance, I didn’t want to lose my patient base and make it unaffordable,” he said. “I have everything from waitresses and shrimpers to international businessmen. It’s a concierge model, but it’s also the personal doctor model.”

Dr. Owen, who once had three nurses and 10 examining rooms, said it was now just him and a receptionist. He has become obsessed with keeping overhead low, but he said that, for the first time since the 1990s, his income was going up.

At the other end of the spectrum is David Edelson, who runs a practice called HealthBridge in Great Neck, N.Y. In addition to five doctors, the practice has a full fitness center and provides the services of a personal trainer, nutritionist, acupuncturist, sleep expert and stress-management consultant.

“The current model for primary care is broken,” Dr. Edelson told me. “Either I can go down with the ship, sell my practice to a hospital or take my practice in the wrong direction. Or I can develop a better mousetrap, which is more time dealing with patients and their care.”

Dr. Edelson has reduced his own practice to 300 patients, from more than 3,000. Of those, 250 pay $1,800 a year for concierge services and 50 others receive scholarships. He estimated that from the combination of the membership fee for the extra services and what gets billed to insurance for typical care, he will make $600,000, and more of that will end up in his pocket.

“We’re bringing in the same fees but we’re reducing our overhead,” he said. Fewer patients means fewer medical assistants, receptionists and staff members to deal with insurance.

But of the five doctors in the practice, he is the only one to go fully concierge. Another, William Klein, is testing the model, with 15 percent of his patients in the concierge program. Dr. Klein said he was hedging his bets because he was not sure what the new federal health care law would mean for primary care physicians.

Weren’t some patients getting shortchanged by this hybrid model? He said he saw no difference in care.

“It’s like paying for first class and not coach,” Dr. Klein said. “Everyone is getting to the same destination, but some people have a better seat.”

This approach to medicine is not without risks for the doctors and downsides for patients.

This article has been revised to reflect the following correction:

Correction: November 23, 2012

An earlier version of this column gave an incorrect middle initial for Mr. Harris. It is M., not V.

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Wealth Matters: Dealing With Doctors Who Accept Only Cash

A FEW weeks ago, my wife and I were at our wits’ end: our 4-month-old daughter wouldn’t sleep for more than an hour at a time at night. We had consulted books and seen our pediatrician, but nothing was working. So my wife called a pediatrician who specializes in babies who struggle with sleep problems.

The next day, he drove an hour from Brooklyn to our house. He then spent an hour and a half talking to us and examining our daughter in her nursery. He prescribed some medicine for her and suggested some changes to my wife’s diet. Within two days, our baby was sleeping through the night and we were all feeling better.

The only catch was this pediatrician did not accept insurance. He had taken our credit card information before his visit and given us a form to submit to our insurance company as he left, saying insurance usually paid a portion of his fee, which was $650.

A couple of weeks later, our insurance company said it wouldn’t pay anything. Here’s how the company figured it: First, it said a fair price for our doctor’s fee was $285, about 60 percent less, because that was the going rate for our town. Then, it said the lower fee was not enough to meet our out-of-network deductible.

While we were none too happy with the insurance company, we remained impressed by the doctor: he had made our baby better and was compensated for it, all the while avoiding the hassle of dealing with insurance.

Last year, I wrote about doctors who catered only to the richest of the rich and charged accordingly. But after my experience, I became interested in doctors for the average person who take only cash. What pushes a doctor to go this route, often called concierge medicine? And how hard is it to make a living?

As to why doctors decide to switch to a concierge practice, the answer is almost always frustration.

“About four years ago, one insurance company was driving me crazy saying I had to fax documents to show I had done a visit,” said Stanford Owen, an internal medical doctor in Gulfport, Miss. “At 2 a.m., I woke up and said, ‘This is it.’ ”

Dr. Owen stopped accepting all insurance and now charges his 1,000 patients $38 a month.

“When I decided to abandon insurance, I didn’t want to lose my patient base and make it unaffordable,” he said. “I have everything from waitresses and shrimpers to international businessmen. It’s a concierge model, but it’s also the personal doctor model.”

Dr. Owen, who once had three nurses and 10 examining rooms, said it was now just him and a receptionist. He has become obsessed with keeping overhead low, but he said that, for the first time since the 1990s, his income was going up.

At the other end of the spectrum is David Edelson, who runs a practice called HealthBridge in Great Neck, N.Y. In addition to five doctors, the practice has a full fitness center and provides the services of a personal trainer, nutritionist, acupuncturist, sleep expert and stress-management consultant.

“The current model for primary care is broken,” Dr. Edelson told me. “Either I can go down with the ship, sell my practice to a hospital or take my practice in the wrong direction. Or I can develop a better mousetrap, which is more time dealing with patients and their care.”

Dr. Edelson has reduced his own practice to 300 patients, from more than 3,000. Of those, 250 pay $1,800 a year for concierge services and 50 others receive scholarships. He estimated that from the combination of the membership fee for the extra services and what gets billed to insurance for typical care, he will make $600,000, and more of that will end up in his pocket.

“We’re bringing in the same fees but we’re reducing our overhead,” he said. Fewer patients means fewer medical assistants, receptionists and staff members to deal with insurance.

But of the five doctors in the practice, he is the only one to go fully concierge. Another, William Klein, is testing the model, with 15 percent of his patients in the concierge program. Dr. Klein said he was hedging his bets because he was not sure what the new federal health care law would mean for primary care physicians.

Weren’t some patients getting shortchanged by this hybrid model? He said he saw no difference in care.

“It’s like paying for first class and not coach,” Dr. Klein said. “Everyone is getting to the same destination, but some people have a better seat.”

This approach to medicine is not without risks for the doctors and downsides for patients.

This article has been revised to reflect the following correction:

Correction: November 23, 2012

An earlier version of this column gave an incorrect middle initial for Mr. Harris. It is M., not V.

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Military Analysis: For Israel, Gaza Conflict Is Test for an Iran Confrontation

Menahem Kahana/Agence France-Presse — Getty Images

An Israeli missile is launched from a battery. Officials said their antimissile system shot down 88 percent of all assigned targets.

WASHINGTON — The conflict that ended, for now, in a cease-fire between Hamas and Israel seemed like the latest episode in a periodic showdown. But there was a second, strategic agenda unfolding, according to American and Israeli officials: The exchange was something of a practice run for any future armed confrontation with Iran, featuring improved rockets that can reach Jerusalem and new antimissile systems to counter them.

It is Iran, of course, that most preoccupies Prime Minister Benjamin Netanyahu and President Obama. While disagreeing on tactics, both have made it clear that time is short, probably measured in months, to resolve the standoff over Iran’s nuclear program.

And one key to their war-gaming has been cutting off Iran’s ability to slip next-generation missiles into the Gaza Strip or Lebanon, where they could be launched by Iran’s surrogates, Hamas, Hezbollah and Islamic Jihad, during any crisis over sanctions or an Israeli strike on Iran’s nuclear facilities.

Michael B. Oren, the Israeli ambassador to the United States and a military historian, likened the insertion of Iranian missiles into Gaza to the Cuban missile crisis.

“In the Cuban missile crisis, the U.S. was not confronting Cuba, but rather the Soviet Union,” Mr. Oren said Wednesday, as the cease-fire was declared. “In Operation Pillar of Defense,” the name the Israel Defense Force gave the Gaza operation, “Israel was not confronting Gaza, but Iran.”

It is an imprecise analogy. What the Soviet Union was slipping into Cuba 50 years ago was a nuclear arsenal. In Gaza, the rockets and parts that came from Iran were conventional, and, as the Israelis learned, still have significant accuracy problems. But from one point of view, Israel was using the Gaza battle to learn the capabilities of Hamas and Islamic Jihad — the group that has the closest ties to Iran — as well as to disrupt those links.

Indeed, the first strike in the eight-day conflict between Hamas and Israel arguably took place nearly a month before the fighting began — in Khartoum, the capital of Sudan, as another mysterious explosion in the shadow war with Iran.

A factory said to be producing light arms blew up in spectacular fashion on Oct. 22, and within two days the Sudanese charged that it had been hit by four Israeli warplanes that easily penetrated the country’s airspace. Israelis will not talk about it. But Israeli and American officials maintain that Sudan has long been a prime transit point for smuggling Iranian Fajr rockets, the kind that Hamas launched against Tel Aviv and Jerusalem over recent days.

The missile defense campaign that ensued over Israeli territory is being described as the most intense yet in real combat anywhere — and as having the potential to change warfare in the same way that novel applications of air power in the Spanish Civil War shaped combat in the skies ever since.

Of course, a conflict with Iran, if a last-ditch effort to restart negotiations fails, would look different than what has just occurred. Just weeks before the outbreak in Gaza, the United States and European and Persian Gulf Arab allies were practicing at sea, working on clearing mines that might be dropped in shipping lanes in the Strait of Hormuz.

But in the Israeli and American contingency planning, Israel would face three tiers of threat in a conflict with Iran: the short-range missiles that have been lobbed in this campaign, medium-range rockets fielded by Hezbollah in Lebanon and long-range missiles from Iran.

The last of those three could include the Shahab-3, the missile Israeli and American intelligence believe could someday be fitted with a nuclear weapon if Iran ever succeeded in developing one and — the harder task — shrinking it to fit a warhead.

A United States Army air defense officer said that the American and Israeli militaries were “absolutely learning a lot” from this campaign that may contribute to a more effective “integration of all those tiered systems into a layered approach.”

The goal, and the challenge, is to link short-, medium- and long-range missile defense radar systems and interceptors against the different types of threats that may emerge in the next conflict.

Even so, a historic battle of missile versus missile defense has played out in the skies over Israel, with Israeli officials saying their Iron Dome system shot down 350 incoming rockets — 88 percent of all targets assigned to the missile defense interceptors. Israeli officials declined to specify the number of interceptors on hand to reload their missile-defense batteries.

Before the conflict began, Hamas was estimated to have amassed an arsenal of 10,000 to 12,000 rockets. Israeli officials say their pre-emptive strikes on Hamas rocket depots severely reduced the arsenal of missiles, both those provided by Iran and some built in Gaza on a Syrian design.

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The Shrewd Shopper Carries a Smartphone

Tim Gruber for The New York Times

From left, Tara Niebeling, Sarah Schmidt, Bridget Jewell and Erin Vande Steeg are members of the social media team at the Mall of America in Bloomington, Minn.

Retailers are trying to lure shoppers away from the Internet, where they have increasingly been shopping to avoid Black Friday madness, and back to the stores. The bait is technological tools that will make shopping on the busiest day of the year a little more sane — and give shoppers an edge over their competition.

Those with smartphones in hand will get better planning tools, prices and parking spots. Walmart has a map that shows shoppers exactly where the top Black Friday specials can be found. A Mall of America Twitter feed gives advice on traffic and gifts, and the Macy’s app sends special deals for every five minutes a shopper stays in a store.

“The crazy mad rush to camp out and the crazy mad rush to hit the doorbusters have really made people think, ‘I’m just going to stay home on Black Friday,’ ” said Carey Rossi, editor in chief of ConsumerSearch.com, a review site. “This is going to invite some people back and say, ‘You know what? It doesn’t have to be that crazy.’ ”

Part of the retailers’ strategy is to slap back at online stores like Amazon.com, which last year used apps to pick off shoppers as they browsed in physical stores. But the stores are also recognizing that shopping on the Friday after Thanksgiving need not require an overnight wait in line, a helmet and elbow pads. A smartphone gives shoppers enough of an edge.

“This takes away that frantic Black Friday anxiety,” said Lawrence Fong, co-founder of BuyVia, an app that sends people price alerts and promotions. “While there’s a sport to it, life’s a little too short.”

Denise Fouts, 45, who works repairing fire and water damage in Chandler, Ariz., was already using apps, including Shopkick, Target’s app and one called Black Friday, before Thanksgiving to prepare for Black Friday. “There still are going to be the crowds, but at least I already know ahead of time what I’m going specifically for,” Ms. Fouts said.

Last week, Macy’s released an update to its app with about 300 Black Friday specials and their location. In the Herald Square store, for instance, the $49.99 cashmere sweater specials will be in the Broadway side of the fifth-floor women’s department.

“With the speed that people are shopping with on Black Friday, they need to be really efficient about how they’re spending their time,” said Jennifer Kasper, group vice president for digital media at Macy’s.

When shoppers keep the app open, Macy’s will start sending special deals to the phone every five minutes. The deals are not advertised elsewhere.

Walmart has had an app for several years, but recently introduced an in-store mode, which shows things like the current circular or food tastings when a shopper is near a certain location. Twelve percent of Walmart’s mobile revenue now comes from when a person is inside a store.

For Black Friday, the app will have a map of each store, with the precise location of the top sale items — so planners can determine the best way to run. “The blitz items are not where you think they would be, because for traffic reasons, maybe the hot game console is in the lawn and garden center,” said Gibu Thomas, senior vice president for mobile and digital for Walmart Global eCommerce.

Target is also testing a way-finding feature on its app at stores that include some in Seattle, Chicago and Los Angeles. If a shopper types in an item, the app will give its location.

Other app makers are betting that shoppers want apps that pull in information from many stores.

RedLaser, an eBay app, lets shoppers use their phones to compare prices and recently started using location data to give shoppers personalized promotions when they walk into stores, including items not on store shelves at Best Buy, for instance. RetailMeNot, which offers e-commerce coupons, now has offline coupons that will pop up on users’ cellphones when they step near 500 malls on Black Friday.

“Consumers are not going to download 40 different apps for 40 different stores,” said Cyriac Roeding, co-founder of Shopkick, a location-based app that gives shoppers points, redeemable for perks, when they walk into stores or scan certain items.

For Black Friday, Shopkick is publishing what it calls a little black book with the top doorbusters. Shoppers will earn extra points and rewards for shopping on Black Friday.

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Recipes for Health: Pear Clafoutis — Recipes for Health

Andrew Scrivani for The New York Times NYTCREDIT:

If you don’t want to make a crust but want something tartlike for your Thanksgiving dessert, a clafoutis, which is something like a cross between a flan and a pancake, is a great choice. It’s a very easy dessert, yet it’s always impressive.

2 tablespoons pear eau-de-vie or liqueur (optional)

2 tablespoons mild-flavored honey, like clover

2 pounds ripe but firm pears, like Bartlett or Comice

3 large eggs

1 vanilla bean, scraped

1/3 cup sugar

2/3 cup sifted unbleached white flour

1/2 cup plain yogurt

1/2 cup milk

pinch of salt

1. Combine the pear eau-de-vie and the honey in a bowl. Peel, core and slice the pears and toss with the mixture. Let sit for 30 minutes.

2. Preheat the oven to 375 degrees. Butter a 10-inch ceramic tart pan or baking dish.

3. In the bowl of an electric mixer or with a whisk, beat together the eggs, the seeds from the vanilla bean and the sugar. Pour off the marinade from the pears and add to the egg mixture. Gradually beat in the flour, then beat in the yogurt, milk and salt.

4. Arrange the pears in the baking dish. Pour on the batter. Place in the oven and bake 40 to 50 minutes, until the top is beginning to brown. Serve hot or warm.

Yield: 8 servings.

Advance preparation: Although this is best served warm, you can allow it to cool completely and serve it at room temperature. It will hold for several hours out of the refrigerator. Leftovers make a nice breakfast treat.

Nutritional information per serving: 195 calories; 2 grams fat; 1 gram saturated fat; 0 grams polyunsaturated fat; 1 gram monounsaturated fat; 71 milligrams cholesterol; 40 grams carbohydrates; 4 grams dietary fiber; 47 milligrams sodium; 5 grams protein

Martha Rose Shulman is the author of “The Very Best of Recipes for Health.”

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Recipes for Health: Pear Clafoutis — Recipes for Health

Andrew Scrivani for The New York Times NYTCREDIT:

If you don’t want to make a crust but want something tartlike for your Thanksgiving dessert, a clafoutis, which is something like a cross between a flan and a pancake, is a great choice. It’s a very easy dessert, yet it’s always impressive.

2 tablespoons pear eau-de-vie or liqueur (optional)

2 tablespoons mild-flavored honey, like clover

2 pounds ripe but firm pears, like Bartlett or Comice

3 large eggs

1 vanilla bean, scraped

1/3 cup sugar

2/3 cup sifted unbleached white flour

1/2 cup plain yogurt

1/2 cup milk

pinch of salt

1. Combine the pear eau-de-vie and the honey in a bowl. Peel, core and slice the pears and toss with the mixture. Let sit for 30 minutes.

2. Preheat the oven to 375 degrees. Butter a 10-inch ceramic tart pan or baking dish.

3. In the bowl of an electric mixer or with a whisk, beat together the eggs, the seeds from the vanilla bean and the sugar. Pour off the marinade from the pears and add to the egg mixture. Gradually beat in the flour, then beat in the yogurt, milk and salt.

4. Arrange the pears in the baking dish. Pour on the batter. Place in the oven and bake 40 to 50 minutes, until the top is beginning to brown. Serve hot or warm.

Yield: 8 servings.

Advance preparation: Although this is best served warm, you can allow it to cool completely and serve it at room temperature. It will hold for several hours out of the refrigerator. Leftovers make a nice breakfast treat.

Nutritional information per serving: 195 calories; 2 grams fat; 1 gram saturated fat; 0 grams polyunsaturated fat; 1 gram monounsaturated fat; 71 milligrams cholesterol; 40 grams carbohydrates; 4 grams dietary fiber; 47 milligrams sodium; 5 grams protein

Martha Rose Shulman is the author of “The Very Best of Recipes for Health.”

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News Analysis: Case Casts a Shadow on a Hedge Fund Mogul

In 2010, the billionaire hedge fund manager Steven A. Cohen gave a rare interview to Vanity Fair. He said that he wanted to combat persistent rumors that his firm, SAC Capital Advisors, routinely violated securities laws by trading on confidential information.

“In some respects I feel like Don Quixote fighting windmills,” Mr. Cohen said at the time. “There’s a perception, and I’m trying to fight that perception.”

Federal prosecutors only heightened that perception on Tuesday, bringing a criminal case against a former SAC employee in what Preet Bharara, the United States attorney in Manhattan, who brought the charges in Federal District Court in Manhattan, called the most lucrative insider trading scheme ever charged.

And for the first time, the evidence suggests that Mr. Cohen participated in trades that the government says illegally used insider information — though prosecutors have not said that Mr. Cohen himself knew the information was confidential, and he has not been charged.

Any prosecution of Mr. Cohen would most likely hinge on the cooperation of Mathew Martoma, the former SAC employee charged in the case. Mr. Bharara said in the charges that Mr. Martoma obtained secret data from a doctor about clinical trials for an Alzheimer’s drug being developed by the companies Elan and Wyeth. The information enabled SAC to avoid losses of almost $194 million on the stocks, which it sold and then bet against, reaping $83 million in profit — a total benefit to the firm of more than $276 million. SAC executed the trades shortly after Mr. Martoma e-mailed Mr. Cohen and said he needed to discuss something important.

As to Mr. Cohen’s potential culpability in the case, the crucial issue is what Mr. Martoma told Mr. Cohen that led SAC to quickly dump $700 million worth of stock. Did he provide his boss details on why he had turned sour on Wyeth and Elan? Specifically, did he share the leak about the drug trial’s negative results and identify the source of the secret information? Through a spokesman, he said he was confident he had acted appropriately.

It appears, for now, that Mr. Martoma will fight the charges. But the crucial question, as it relates to Mr. Cohen, is whether at some point Mr. Martoma will reverse course, admit to insider trading and agree to help the government build a case against his former boss. Without Mr. Martoma’s cooperation, it is unlikely that the prosecutors have enough evidence to charge Mr. Cohen.

“This has all the markings of a case where the government goes after the smaller fish and then pressures them to flip so they can get the whale,” said Bradley D. Simon, a criminal defense lawyer and former federal prosecutor in New York.

The government has several weapons for its effort to persuade Mr. Martoma to agree to a plea, including the stiff sentences for insider trading. Under the federal sentencing guidelines, Mr. Martoma could receive more than 15 years in prison, a term that could be reduced — or avoided altogether — if he agreed to testify against Mr. Cohen.

F.B.I. agents arrested Mr. Martoma, 38, early Tuesday morning at his home in Boca Raton, Fla., a nearly 8,000-square-foot Mediterranean-style mansion on the grounds of the elite Royal Palm Yacht and Country Club. He lives there with his wife, a pediatrician, and three children. A graduate of Duke University and Stanford University’s business school, Mr. Martoma is expected to make an appearance in Federal District Court in Manhattan Monday morning.

Described by a former colleague as low-key and cerebral, Mr. Martoma is one of scores of traders who have earned millions of dollars working under Mr. Cohen and feeding him their best investment ideas. He joined SAC in 2006. In 2008, the year he participated in the alleged illegal trade, the firm paid Mr. Martoma a $9.3 million bonus. But SAC fired him in 2010 after two years of subpar performance.

Charles A. Stillman, a lawyer for Mr. Martoma, said on the day of his arrest, “What happened today is only the beginning of a process that we are confident will lead to Mr. Martoma’s full exoneration.”

It is no secret that the government has been circling Mr. Cohen since the middle of last decade, when it began its crackdown on insider trading, an investigation that has resulted in more than 70 criminal charges. Prosecutors have already linked five former SAC employees to insider trading while at the fund — securing three convictions — though none of those cases connected Mr. Cohen to any illicit activity. But the complaint filed on Tuesday puts Mr. Cohen at the center of the supposed improper conduct.

Mr. Cohen, 56, is a legend on Wall Street, having amassed a multibillion-dollar fortune by posting phenomenal investment returns averaging about 30 percent over the last two decades. Starting with a $25 million grubstake, SAC now manages about $13 billion and has 900 employees across the globe. Mr. Cohen has also emerged as a major force in the art world, owning an eclectic collection that includes works by Picasso, Warhol and Cézanne.

Prosecutors have constructed their case against Mr. Martoma, and increased the pressure on him, by securing the cooperation of Dr. Sidney Gilman, the doctor who supposedly leaked to him the Alzheimer’s drug’s trial data. The case against Mr. Martoma will depend largely on Dr. Gilman’s credibility as a witness.

Dr. Gilman, 80, a neurologist at the University of Michigan medical school, was hired by Elan and Wyeth to monitor the trial’s safety, which gave him access to secret information about the results. SAC retained Dr. Gilman as a consultant and paid him about $108,000.

At first, Dr. Gilman’s reports on the trial’s progress were positive, and SAC built a position in the two drug makers worth approximately $700 million, according to prosecutors. But then, on July 17, 2008, Dr. Gilman told Mr. Martoma that there were problems with the drug, the government said.

A few days later, Mr. Martoma e-mailed Mr. Cohen that he needed to discuss something “important,” and the two then spoke for 20 minutes, according to court filings. Over the next four days, at Mr. Cohen’s direction, SAC Capital jettisoned its entire position in the two stocks and then placed a big negative bet on the drug makers, the government said.

On July 30, after disclosure of the poor trial results, shares of Elan and Wyeth sank. According to the prosecutors’ calculations, SAC would have lost about $194 million had it kept the stock; taking a short position instead generated profits of about $83 million.

Dr. Gilman and the Justice Department have entered into a nonprosecution agreement under which he will cooperate in exchange for not being criminally charged.

Thus far, any potential evidence against Mr. Cohen is entirely circumstantial. The government’s complaint includes e-mails about secretly selling the Elan and Wyeth shares through esoteric methods like algorithms and dark pools. But that is common practice among large, sophisticated funds that do not want to alert competitors or move the stock too much. Moreover, while SAC dumped its large positions in the two stocks quickly — raising the question of what prompted it to do so — Mr. Cohen is known for a rapid-fire trading style. He frequently moves aggressively in and out of stocks while processing gobs of information fed to him by his underlings.

It would be difficult for a jury to infer anything incriminating just from the way these trades were executed.

The government in this case also lacks the powerful wiretap evidence that it has used to convict dozens others, including Raj Rajaratnam, the head of the Galleon Group. Federal agents did wiretap Mr. Cohen’s home telephone for a short period in 2008, according to a person with direct knowledge of the investigation who spoke only on the condition of anonymity. But it is unclear whether the eavesdropping, which was first reported by The Wall Street Journal, yielded any fruit.

Even without incriminating wiretap evidence, the government has brought cases that rely almost entirely on witnesses testifying against their bosses.

One of those cases is now under way in federal court in Manhattan. Prosecutors are currently trying the former hedge fund portfolio managers Anthony Chiasson of Level Global Investors and Todd Newman of Diamondback Capital Management. Prosecutors say that the two were part of a conspiracy that made about $68 million illegally trading technology stocks.

The outcome of that trial is expected to depend largely on whether the jury believes the testimony of two cooperating witnesses who admitted to the conspiracy — Spyridon Adondakis and Jesse Tortora, former junior analysts at Level Global and Diamondback. The two say they shared secret information with the defendants. Defense lawyers have attacked the witnesses’ credibility, accusing them of lying to avoid prison.

That case, too, has strong ties to SAC. Mr. Chiasson and his co-founder were star traders under Mr. Cohen before starting the now-defunct Level Global. And the owners of Diamondback are both former SAC employees; one is Mr. Cohen’s brother-in-law, Richard Schimel. Diamondback, which continues to operate, has not been accused of wrongdoing.

“SAC’s extraordinary profits have always been something of a market mystery,” said Sebastian Mallaby, the author of “More Money Than God,” a book on the history of hedge funds. “As more and more lawsuits implicate former SAC traders, we may at last understand where SAC’s profits came from.”

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Egypt Leader and Obama Forge Link in Gaza Deal

Lefteris Pitarakis/Associated Press

Israelis in the town of Sderot watched a Palestinian missile on Wednesday, before a cease-fire.

WASHINGTON — President Obama skipped dessert at a long summit meeting dinner in Cambodia on Monday to rush back to his hotel suite. It was after 11:30 p.m., and his mind was on rockets in Gaza rather than Asian diplomacy. He picked up the telephone to call the Egyptian leader who is the new wild card in his Middle East calculations.

Over the course of the next 25 minutes, he and President Mohamed Morsi of Egypt hashed through ways to end the latest eruption of violence, a conversation that would lead Mr. Obama to send Secretary of State Hillary Rodham Clinton to the region. As he and Mr. Morsi talked, Mr. Obama felt they were making a connection. Three hours later, at 2:30 in the morning, they talked again.

The cease-fire brokered between Israel and Hamas on Wednesday was the official unveiling of this unlikely new geopolitical partnership, one with bracing potential if not a fair measure of risk for both men. After a rocky start to their relationship, Mr. Obama has decided to invest heavily in the leader whose election caused concern because of his ties to the Muslim Brotherhood, seeing in him an intermediary who might help make progress in the Middle East beyond the current crisis in Gaza.

The White House phone log tells part of the tale. Mr. Obama talked with Mr. Morsi three times within 24 hours and six times over the course of several days, an unusual amount of one-on-one time for a president. Mr. Obama told aides he was impressed with the Egyptian leader’s pragmatic confidence. He sensed an engineer’s precision with surprisingly little ideology. Most important, Mr. Obama told aides that he considered Mr. Morsi a straight shooter who delivered on what he promised and did not promise what he could not deliver.

“The thing that appealed to the president was how practical the conversations were — here’s the state of play, here are the issues we’re concerned about,” said a senior administration official who spoke on the condition of anonymity to discuss private conversations. “This was somebody focused on solving problems.”

The Egyptian side was also positive about the collaboration. Essam el-Haddad, the foreign policy adviser to the Egyptian president, described a singular partnership developing between Mr. Morsi, who is the most important international ally for Hamas, and Mr. Obama, who plays essentially the same role for Israel.

“Yes, they were carrying the point of view of the Israeli side but they were understanding also the other side, the Palestinian side,” Mr. Haddad said in Cairo as the cease-fire was being finalized on Wednesday. “We felt there was a high level of sincerity in trying to find a solution. The sincerity and understanding was very helpful.”

The fledgling partnership forged in the fires of the past week may be ephemeral, a unique moment of cooperation born out of necessity and driven by national interests that happened to coincide rather than any deeper meeting of the minds. Some longtime students of the Middle East cautioned against overestimating its meaning, recalling that Mr. Morsi’s Muslim Brotherhood constitutes a philosophical brother of Hamas even if it has renounced violence itself and become the governing party in Cairo.

“I would caution the president from believing that President Morsi has in any way distanced himself from his ideological roots,” said Robert Satloff, executive director of the Washington Institute for Near East Policy. “But if the president takes away the lesson that we can affect Egypt’s behavior through the artful use of leverage, that’s a good lesson. You can shape his behavior. You can’t change his ideology.”

Other veterans of Middle East policy agreed with the skepticism yet saw the seeds of what might eventually lead to broader agreement.

“It really is something with the potential to establish a new basis for diplomacy in the region,” said Tamara Cofman Wittes, who was Mr. Obama’s deputy assistant secretary of state for the Middle East until earlier this year and now runs the Saban Center for Middle East Policy at the Brookings Institution. “It’s just potential, but it’s particularly impressive potential.”

The relationship between the two leaders has come a long way in just 10 weeks. Mr. Morsi’s election in June as the first Islamist president of Egypt set nerves in Washington on edge and raised questions about the future of Egypt’s three-decade-old peace treaty with Israel. Matters worsened in September when Egyptian radicals protesting an anti-Islam video stormed the United States Embassy in Cairo.

Peter Baker reported from Washington, and David D. Kirkpatrick from Cairo.

This article has been revised to reflect the following correction:

Correction: November 21, 2012

An earlier version of this article misstated the given name of the director of the Saban Center for Middle East Policy at the Brookings Institution. She is Tamara Cofman Wittes, not Teresa.

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When Phones Come Out Long Before the Turkey

ATLANTA — Caleb J. Spivak will be busier with his phone than his fork this Thanksgiving.

Mr. Spivak, 23, is spending the holiday with his boyfriend’s family in Kennesaw, Ga. His mother will be in Virginia with his grandmother. His sister will be in Ohio, his father and brother in Florida. And his friends will be all over the country.

So he’ll post photographs of dinner to show his tight inner circle on Facebook, send out more general Thanksgiving cheer to his 11,000 Twitter followers and post images of the prettiest dishes to Instagram.

To stay close to his mother, he will use the videoconferencing feature on his phone to talk to her as he sits down to eat.

Multiply Mr. Spivak’s social media activity by that of the millions of others who will be using the platforms to record their Thanksgivings, and this year’s holiday could be the most documented in history.

“This year, more than ever before, we will see how we get along as a national family,” said Lee Rainie, director of the Pew Research Center’s Internet and American Life Project in Washington. All of the strengths and weaknesses of the American family will be on full display, he said.

Not long ago, pulling out a phone to send a photograph of Thanksgiving dinner or a text about the proceedings was considered rude, a violation of the “eat it, don’t tweet it” rule.

But almost 40 percent of the 234 million Americans over the age of 13 with a mobile phone now use a social network, according to the analyst group comScore, and the numbers are growing fast. Instagram, the darling of people who love to share pictures of what they’re eating, has more than doubled its members to more than 100 million in less than a year, according to Facebook, the company that bought Instagram this spring. Facebook says Thanksgiving is one of its busiest days of the year.

At Twitter, as the holiday approached, the words “turkey,” “Thanksgiving” and “thankful” have been appearing in those 140-word posts more and more each year. In 2011, use of “thankful” alone was up 263 percent on the network from 2010, and more than a thousandfold from a non-holiday, the company said.

“People are sharing on such a scale for common experiences like Thanksgiving,” said Mor Naaman, a professor at Rutgers University and the founder of Mahaya, a social media start-up. “The potential is just mind-blowing.”

Mr. Naaman, along with others who research humanities, social sciences and media trends, says the development of such a vast pool of documentation has staggering possibilities for understanding American culture — at least once they figure out how to harness and make sense of it.

“There is a lot of information that will be available and ready to mine like never before,” he said. “When do the family arguments start? How many people watch the football games? How much do people drink?”

The desire to share a common experience will bring out Sarah Han’s phone with regularity as she and her boyfriend prepare dinner for her extended family in their new house in Oakland, Calif.

Her mother used to take pictures constantly, many of which ended up in a photo album. Sending images of her meal to her followers through Instagram isn’t any different, she says, except that no one has to paste photographs into a book.

And instant photo-sharing creates something a traditional collection of snapshots cannot.

“It is kind of cool when you are on Instagram, and you see a common thread throughout an event,” said Ms. Han, 34, who works as a producer for The Bold Italic, an online magazine in San Francisco.

She cited a double rainbow that recently arced across the city’s skyline.

“Literally within five minutes, everyone’s photos were of a double rainbow,” she said. “The same thing will happen this Thanksgiving. You’ll see everyone’s table setting and turkey and see how everyone does it differently.”

Of course, not everyone is thrilled that Thanksgiving is becoming something to document constantly and share obsessively. The argument is as old as the mobile phone: by trying to stay connected, we end up being less connected.

“The problem is when the cellphones come out, people will take a picture, but then they’ll check Facebook and check e-mail, and it becomes an obsession that distracts everyone,” said Dr. Gwenn Schurgin O’Keeffe, a pediatrician who writes often about the effects of technology on family life.

Once, people took a photograph and had the patience to get it developed, reliving the moment well after it was over.

“So document the moment, and then worry about passing it around later,” she said. “You don’t need these instant updates of, ‘Oh, look, Grandma’s eating cranberries.’ ”

Sharing that shot of your partner trying to carve the turkey means an instant connection for families celebrating apart.

Most of Rebecca Palsha’s family doesn’t live in Anchorage, where she is a television reporter. She will use social media to keep them close as she and her husband, another journalist, prepare dinner for 10 this year.

Still, she realizes there comes a point where the moment might be better simply experienced.

“At some point, you have to put your phone away,” she said. “You have to realize when it’s time to talk to people here instead of people who aren’t with you.”

Mr. Spivak, a social media manager for Atlantic Station, a planned urban community in Atlanta, disagrees.

“It’s not that you’re missing out on real life,” he said. “Maybe now this is what’s becoming real life.”

Robbie Brown contributed reporting.

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Documents Show F.D.A.’s Failures in Meningitis Outbreak

Newly released documents add vivid detail to the emerging portrait of the Food and Drug Administration’s ineffective and halting efforts to regulate a Massachusetts company implicated in a national meningitis outbreak that has sickened nearly 500 people and killed 34.

In the documents, released on Tuesday in response to a Freedom of Information Act request, the agency would threaten to bring the full force of its authority down on the company, only to back away, citing lack of jurisdiction.

The company, the New England Compounding Center, at times cooperated with F.D.A. inspectors and promised to improve its procedures, and at other times challenged the agency’s legal authority to regulate it, refused to provide records and continued to ship a drug in defiance of the agency’s concerns.

Some of the documents were summarized last week by Congressional committees that held hearings on the meningitis outbreak. Republicans and Democrats criticized the F.D.A. for failing to act on information about unsafe practices at the company as far back as March 2002.

By law, compounding pharmacies are regulated primarily by the states, but the pharmacies have grown over the years into major suppliers of some of the country’s biggest hospitals. The F.D.A. is asking Congress for stronger, clearer authority to police them, but Republicans have said the agency already has enough power.

Records show that the agency was sometimes slow in pursuing its own inspection findings. In one case involving the labeling and marketing of drugs, the agency issued a warning letter to New England Compounding 684 days after an inspection, a delay that the company’s chief pharmacist complained was so long that some of the letter’s assertions no longer applied to its operations.

The agency said in a statement Wednesday that it “was not the timeline we strive for,” but that much of the delay was because of “our limited, unclear and contested authority in this area.” Because of litigation, it said, there was “significant internal discussion about how to regulate compounders.”

The agency first inspected the company in April 2002 after reports that two patients had become dizzy and short of breath after being injected with a steroid made by the company.

 On the first day of the inspection, Barry Cadden, the chief pharmacist, was cooperative, but the next day, the agency inspectors wrote, Mr. Cadden “had a complete change in attitude & basically would not provide any additional information either by responding to questions or providing records,” adding that he challenged their legal authority to be at his pharmacy at all.

The F.D.A. was back at New England Compounding in October 2002 because of possible contamination of another of its products, methylprednisolone acetate, the same drug involved in the current meningitis outbreak.

 While the F.D.A. had the right to seize an adulterated steroid, officials at the time said that action alone would not resolve the company’s poor compounding practices. In a meeting with Massachusetts regulators, F.D.A. officials left authority in the hands of the state, which “would be in a better position to gain compliance or take regulatory action,” according to a memo by an F.D.A. official summarizing the meeting.

 David Elder, compliance branch director for the F.D.A.’s New England District, warned at the meeting that there was the “potential for serious public health consequences if N.E.C.C.’s compounding practices, in particular those relating to sterile products, are not improved.”

 The company fought back hard, repeatedly questioning the F.D.A.’s jurisdiction. In a September 2004 inspection over concerns that the company was dispensing trypan blue, a dye used for some eye surgeries that had not been approved by the F.D.A., Mr. Cadden told the agency inspector that he had none in stock.

But in the clean room, the inspector noticed a drawer labeled “Trypan Blue,” which contained 189 vials of the medicine.

A few days later, Mr. Cadden was defiant. He told the agency that he was continuing to dispense trypan blue and that there was nothing in the law saying a compounder could not dispense unapproved products.

 The conversation turned testy. “Don’t answer any more questions!” Mr. Cadden told another pharmacy executive, according to the F.D.A.’s report.

Mr. Cadden rejected many of the assertions in the warning letter that finally came in December 2006. The next correspondence from the agency did not come until almost two years later, in October 2008, saying that the agency still had “serious concerns” about the company’s practices, and that failing to correct them could result in seizure of products and an injunction against the company and its principals.

It is not known whether any corrective actions were taken. The agency did not conduct another inspection until the recent meningitis outbreak.

Denise Grady contributed reporting.

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Documents Show F.D.A.’s Failures in Meningitis Outbreak

Newly released documents add vivid detail to the emerging portrait of the Food and Drug Administration’s ineffective and halting efforts to regulate a Massachusetts company implicated in a national meningitis outbreak that has sickened nearly 500 people and killed 34.

In the documents, released on Tuesday in response to a Freedom of Information Act request, the agency would threaten to bring the full force of its authority down on the company, only to back away, citing lack of jurisdiction.

The company, the New England Compounding Center, at times cooperated with F.D.A. inspectors and promised to improve its procedures, and at other times challenged the agency’s legal authority to regulate it, refused to provide records and continued to ship a drug in defiance of the agency’s concerns.

Some of the documents were summarized last week by Congressional committees that held hearings on the meningitis outbreak. Republicans and Democrats criticized the F.D.A. for failing to act on information about unsafe practices at the company as far back as March 2002.

By law, compounding pharmacies are regulated primarily by the states, but the pharmacies have grown over the years into major suppliers of some of the country’s biggest hospitals. The F.D.A. is asking Congress for stronger, clearer authority to police them, but Republicans have said the agency already has enough power.

Records show that the agency was sometimes slow in pursuing its own inspection findings. In one case involving the labeling and marketing of drugs, the agency issued a warning letter to New England Compounding 684 days after an inspection, a delay that the company’s chief pharmacist complained was so long that some of the letter’s assertions no longer applied to its operations.

The agency said in a statement Wednesday that it “was not the timeline we strive for,” but that much of the delay was because of “our limited, unclear and contested authority in this area.” Because of litigation, it said, there was “significant internal discussion about how to regulate compounders.”

The agency first inspected the company in April 2002 after reports that two patients had become dizzy and short of breath after being injected with a steroid made by the company.

 On the first day of the inspection, Barry Cadden, the chief pharmacist, was cooperative, but the next day, the agency inspectors wrote, Mr. Cadden “had a complete change in attitude & basically would not provide any additional information either by responding to questions or providing records,” adding that he challenged their legal authority to be at his pharmacy at all.

The F.D.A. was back at New England Compounding in October 2002 because of possible contamination of another of its products, methylprednisolone acetate, the same drug involved in the current meningitis outbreak.

 While the F.D.A. had the right to seize an adulterated steroid, officials at the time said that action alone would not resolve the company’s poor compounding practices. In a meeting with Massachusetts regulators, F.D.A. officials left authority in the hands of the state, which “would be in a better position to gain compliance or take regulatory action,” according to a memo by an F.D.A. official summarizing the meeting.

 David Elder, compliance branch director for the F.D.A.’s New England District, warned at the meeting that there was the “potential for serious public health consequences if N.E.C.C.’s compounding practices, in particular those relating to sterile products, are not improved.”

 The company fought back hard, repeatedly questioning the F.D.A.’s jurisdiction. In a September 2004 inspection over concerns that the company was dispensing trypan blue, a dye used for some eye surgeries that had not been approved by the F.D.A., Mr. Cadden told the agency inspector that he had none in stock.

But in the clean room, the inspector noticed a drawer labeled “Trypan Blue,” which contained 189 vials of the medicine.

A few days later, Mr. Cadden was defiant. He told the agency that he was continuing to dispense trypan blue and that there was nothing in the law saying a compounder could not dispense unapproved products.

 The conversation turned testy. “Don’t answer any more questions!” Mr. Cadden told another pharmacy executive, according to the F.D.A.’s report.

Mr. Cadden rejected many of the assertions in the warning letter that finally came in December 2006. The next correspondence from the agency did not come until almost two years later, in October 2008, saying that the agency still had “serious concerns” about the company’s practices, and that failing to correct them could result in seizure of products and an injunction against the company and its principals.

It is not known whether any corrective actions were taken. The agency did not conduct another inspection until the recent meningitis outbreak.

Denise Grady contributed reporting.

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Tool Kit: Online Shopping Tips for the Holidays

Some people may be looking forward to leaving Thanksgiving dinner before the pie is served to join the Black Friday rush, which will begin during dinnertime Thursday, earlier than ever, at stores like Sears, Walmart and Lord & Taylor.

But for those who prefer to stay for the pie course, avoid the lines and freezing temperatures and shop from the comfort of their homes, there are just as many deals to be found online this year, especially for smart shoppers.

Last year, online shoppers spent $816 million on Black Friday, an increase of 26 percent from the year before, and an additional $2.3 billion over Thanksgiving weekend and Cyber Monday, according to comScore. It expects online spending to rise this year.

Online, there is no commute, no parking and no crowds — and shopping can be done in bed or at the Thanksgiving dinner table. Still, you cannot try clothes on, you have to wait for your purchase to arrive and there is always the nagging feeling that a better price is just one more click away.

To find your way around those problems, here are some tips from online shopping pros, retailers and shopping bloggers.

BARGAINS START EARLY “Cyber Monday is passé,” said Fiona Dias, chief strategy officer for ShopRunner.com, a network of e-commerce sites. “With online sales beginning as early as the Wednesday night before Thanksgiving, consumers who hold out for the best deal may find that what they are looking for has already sold out.”

Amazon.com, for example, started its Black Friday deals on Monday, but they end Saturday. SHOP ON TUESDAYS One of the secrets of online shopping is that prices change by the second. To maximize your chances of getting the best price year-round, shop on Tuesday, a variety of e-commerce experts say. For whatever reason, Tuesday is when most e-commerce sites, including Shopbop, Etsy and RetailMeNot, post discounts and new items.

No matter the day, online retailers often start sales in the wee hours, so shop early.

As for the time of year, women’s clothes, shoes and accessories are discounted most in January, February, August and September, according to Shop It To Me, an online shopping search site. For consumer electronics like laptops, shop in midsummer and late September, before and after the back-to-school rush, according to Decide.com, a price comparison site.

NEVER PAY FULL PRICE Online holiday shoppers should use 40 percent off as a benchmark for a good deal, said Marjorie Cader, a Shop It To Me spokeswoman, based on discount data the site has collected. Expect discounts that are about 5 percent better from online-only retailers than from those that also operate brick and mortar stores, she said.

Comparison shopping sites like TheFind or ShopStyle can locate the best prices; Google or coupon sites like RetailMeNot can also help find a discount.

Google, Amazon and even flash sale sites like Gilt.com do not always have the lowest prices. You might check small shopping blogs dedicated to your favorite brands, like Grechen’s Closet for contemporary women’s clothes or J. Crew Aficionada.

“Spend 20 minutes and ensure you are getting the best deal out there,” said John Faith, senior vice president of mobile at WhaleShark Media, which operates coupon sites, including RetailMeNot.

BE A HAGGLER This is the year haggling at the cash register could become acceptable, as offline retailers try to keep shoppers offline. If you find a better price online — by using an application like RedLaser or searching Amazon — ask whether the cashier will match it. Big retailers like Target have already said they will.

WAIT TILL THE LAST MINUTE Procrastinators might benefit during the holidays. Electronics sold online are least expensive in the week before Christmas, according to Decide, especially TVs, laptops and cameras.

And while Dec. 17 is the last day that most online retailers will offer free shipping in time for Christmas, Walmart, the luxury clothing seller Net-a-Porter and others will deliver the same day. In San Francisco and New York, eBay now offers same-day delivery from hundreds of stores, including Macy’s, Target and Toys “R” Us.

NEVER PAY FOR SHIPPING... Nine of ten retailers will offer free shipping on certain purchases this holiday season, and a third will offer free shipping on all purchases, according to the National Retail Federation.

Some, though, require that you enter a promotional code, so it’s wise to take a minute to look around the Web site or search a coupon site to find it.

Stores including Walmart, Toys “R” Us and Nordstrom allow you to shop online and pick up your order locally.

...OR FOR RETURNS Sites like Zappos.com and Piperlime send prepaid shipping labels, but beware.

“When it comes to returns, read the fine print,” said Brian Hoyt, a spokesman for WhaleShark Media. Some merchants include a prepaid return label but subtract the price from your refund, and others charge a restocking fee as high as 30 percent for consumer electronics.

Many companies, including Gap and J. Crew, also let you return an online purchase to a local store. And until Dec. 31, PayPal will cover the return shipping cost if the merchant does not, as long as you pay with PayPal and make the return within 30 days.

SEARCH WISELY Try searching synonyms, like “coat” instead of “jacket.” On sites like eBay, try leaving out words — if you are looking for an Yves Saint Laurent handbag on eBay, search for “Saint Laurent” or “Laurent bag.”

“If you search for ‘Yves Saint Laurent,’ you’ll be fighting over pieces with a bigger group of people,” said Sophia Amoruso, founder and chief executive of the e-commerce retailer Nasty Gal, who suggested purposefully misspelling brand names as well. “Think of what an uninformed person might list a really great designer piece as, and you can get an amazing gem for an incredible price.”

EBay Fashion also lets shoppers search by taking a cellphone picture of a fabric to find similar designs.

GET INSPIRED Search for “black sequin dress,” and you’ll get 128 results on Zappos.com, 2,618 on Amazon.com and a truly overwhelming 18 million on Google.

One solution: Trust online curators to suggest items. Etsy creates lists of recommended items. On Pinterest, you can peruse items culled by others. Other sites to search for inspiration: Polvyore, Fancy, Svpply, Lookbook.nu and We Heart It.

TRY IT ON, VIRTUALLY You can visit sites that show real people wearing the clothes you’re interested in buying, like Go Try It On, Fashism and Rent the Runway and sites that show video, including Asos, MyHabit and Joyus. Or, as long as a site offers free shipping and returns, order two sizes and return one.

SHOP INTERNATIONALLY “Don’t let international shopping scare you off,” said Caroline Nolan, the writer of Pregnant Fashionista, a maternity shopping blog.

Many international e-commerce sites, like Asos, ship free to the United States. And because the seasons are different, winter clothes in Australia, for instance, go on sale just as Americans are starting to shop for winter, she said. FarFetch has items from small boutiques worldwide and 1stDibs is good at finding rare items like an antique from Paris. On eBay, you might have luck finding items made by a European designer by switching to eBay’s site for a particular country.

MAKE SITES WORK FOR YOU On Shop It To Me, you can enter your favorite designers and sizes and the site will send you personalized e-mails with promotions and sales. Many sites allow shoppers to place a symbol like a heart on best-liked items or save them to a wish list. On a site like Pinterest, shoppers can build a list.

“You always think you’ll remember where you saw something or what brand it was, but really you never do,” said Noria Morales, style director at SugarInc, a network of fashion and lifestyle blogs.

Even better, sites like Shopbop and Polyvore send alerts when items you have saved go on sale or are running low. EBay sends alerts when new items are listed for a search you have saved.

BE DILIGENT No one has time to read 50 e-mails a day from retailers. But for your favorite e-commerce sites, it is worth signing up for e-mails, as well as tracking them on Facebook and Twitter, where they often post exclusive deals. Many online shoppers have more luck hunting for items than trusting services to send alerts, said Grechen Reiter, owner of Grechen Media, a network of shopping blogs.

“It is the thrill of the hunt that gets us going, after all,” she said.

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Toll Rises as U.S. Pushes for Israel-Hamas Truce

JERUSALEM — Efforts to agree on a cease-fire between Israel and Hamas intensified Tuesday, but the struggle to achieve even a brief pause in the fighting emphasized the obstacles to finding any lasting solution.

On the deadliest day of fighting in the week-old conflict, Secretary of State Hillary Rodham Clinton arrived hurriedly in Jerusalem and met with Prime Minister Benjamin Netanyahu of Israel to push for a truce. She was due in Cairo on Wednesday to consult with Egyptian officials in contact with Hamas, placing her and the Obama administration at the center of a fraught process with multiple parties, interests and demands.

Officials on all sides had raised expectations that a cease-fire would begin around midnight, followed by negotiations for a longer-term agreement. But by the end of Tuesday, officials with Hamas, the militant Islamist group that governs Gaza, said any announcement would not come at least until Wednesday.

The Israelis, who have amassed tens of thousands of troops on the Gaza border and have threatened to invade for a second time in four years to end the rocket fire from Gaza, never publicly backed the idea of a short break in fighting. They said they were open to a diplomatic accord but were looking for something more enduring.

“If there is a possibility of achieving a long-term solution to this problem through diplomatic means, we prefer that,” Mr. Netanyahu said before meeting with Mrs. Clinton at his office. “But if not, I’m sure you understand that Israel will have to take whatever actions necessary to defend its people.”

Mrs. Clinton spoke of the need for “a durable outcome that promotes regional stability and advances the security and legitimate aspirations of Israelis and Palestinians alike.” It was unclear whether she was starting a complex task of shuttle diplomacy or whether she expected to achieve a pause in the hostilities and then head home.

The diplomatic moves came as the antagonists on both sides stepped up their attacks. Israeli aerial and naval forces assaulted several Gaza targets in multiple strikes, including a suspected rocket-launching site near Al Shifa Hospital. More than 30 people were killed on Tuesday, bringing the total number of fatalities in Gaza to more than 130 — roughly half of them civilians, the Gaza Health Ministry said.

A delegation visiting from the Arab League canceled a news conference at the hospital because of the Israeli aerial assaults as wailing ambulances brought victims in, some of them decapitated.

The Israeli assaults carried into early Wednesday, with multiple blasts punctuating the otherwise darkened Gaza skies.

Militants in Gaza fired a barrage of at least 200 rockets into Israel, killing an Israeli soldier — the first military casualty on the Israeli side since the hostilities broke out. The Israeli military said the soldier, identified as Yosef Fartuk, 18, had died from a rocket strike that hit an area near Gaza. Israeli officials said a civilian military contractor working near the Gaza border had also been killed, bringing the number of fatalities in Israel from the week of rocket mayhem to five.

Other Palestinian rockets hit the southern Israeli cities of Beersheba and Ashdod, and longer-range rockets were fired at Tel Aviv and Jerusalem. Neither main city was struck, and no casualties were reported. One Gaza rocket hit a building in Rishon LeZion, just south of Tel Aviv, wounding one person and wrecking the top three floors.

Senior Egyptian officials in Cairo said Israel and Hamas were “very close” to a cease-fire agreement. “We have not received final approval, but I hope to receive it any moment,” said Essam el-Haddad, President Mohamed Morsi’s top foreign affairs adviser.

Foreign diplomats who were briefed on the outlines of a tentative agreement said it had been structured in stages — first, an announcement of a cease-fire, followed by its implementation for 48 hours. That would allow time for Mrs. Clinton to involve herself in the process here and create a window for negotiators to agree on conditions for a longer-term cessation of hostilities.

But it seemed that each side had steep demands of a longer-term deal that the other side would reject.

Khaled Meshal, the Hamas leader, said in Cairo that Israel needed to end its blockade of Gaza. Israel says the blockade keeps arms from entering the coastal strip.

Ethan Bronner reported from Jerusalem, and David D. Kirkpatrick from Cairo. Reporting was contributed by Jodi Rudoren and Fares Akram from Gaza; Isabel Kershner from Jerusalem; Peter Baker from Phnom Penh, Cambodia; David E. Sanger and Mark Landler from Washington; and Rick Gladstone from New York.

This article has been revised to reflect the following correction:

Correction: November 20, 2012

Because of an editing error, an earlier version of this article misspelled the family name of the Israeli soldier who was killed in a Palestinian rocket attack on Tuesday. He is Yosef Fartuk, not Yosef Faruk. An earlier version also referred imprecisely to the cause of deaths near Al Shifa Hospital. A series of attacks, not a single attack, killed more than a dozen people there.

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