Cost of Brand-Name Prescription Medicines Soaring





The price of brand-name prescription medicines is rising far faster than the inflation rate, while the price of generic drugs has plummeted, creating the largest gap so far between the two, according to a report published Wednesday by the pharmacy benefits manager Express Scripts.




The report tracked an index of commonly used drugs and found that the price of brand-name medicines increased more than 13 percent from September 2011 to this September, which it said was more than six times the overall price inflation of consumer goods. Generic drug prices dipped by nearly 22 percent.


The drop in the price of generics “represents low-hanging fruit for the country to save money on health care,” said Dr. Steve Miller, the chief medical officer of Express Scripts, which manages the drug benefits for employers and insurers and also runs a mail-order pharmacy.


The report was based on a random sample of six million Express Scripts members with prescription drug coverage.


The Pharmaceutical Research and Manufacturers of America, the trade group representing brand-name manufacturers, criticized the report, saying it was skewed by a handful of high-priced specialty drugs that are used by a small number of patients and overlooked the crucial role of major drug makers.


“Without the development of new medicines by innovator companies, there would be neither the new treatments essential to progress against diseases nor generic copies,” Josephine Martin, executive vice president of the group, said in a statement.


The report cited the growth of specialty drugs, which treat diseases like cancer and multiple sclerosis, as a major reason for the increase in spending on branded drugs. Spending on specialty medicines increased nearly 23 percent during the first three quarters of 2012, compared with the same period in 2011. All but one of the new medicines approved in the third quarter of this year were specialty drugs, the report found, and many of them were approved to treat advanced cancers only when other drugs had failed.


Stephen W. Schondelmeyer, a professor of pharmaceutical economics at the University of Minnesota, said the potential benefits of many new drugs did not always match the lofty price tags. “Increasingly it’s going to be difficult for drug-benefit programs to make decisions about coverage and payment and which drugs to include,” said Mr. Schondelmeyer, who conducts a similar price report for AARP. He also helps manage the drug benefit program for the University of Minnesota.


“We’re going to be faced with the issue that any drug at any price will not be sustainable.”


Spending on traditional medicines — which treat common ailments like high cholesterol and blood pressure — actually declined by 0.6 percent during the period, the report found. That decline was mainly because of the patent expiration of several blockbuster drugs, like Lipitor and Plavix, which opened the market for generic competitors. But even as the entry of generic alternatives pushed down spending, drug companies continued to raise prices on their branded products, in part to squeeze as much revenue as possible out of an ever-shrinking portfolio, Dr. Miller said.


Drug makers are also being pushed by from companies like Express Scripts and health insurers, which are increasingly looking for ways to cut costs, said C. Anthony Butler, a pharmaceuticals analyst at Barclays. “I think they’re pricing where they can but what they keep telling me is they’re under significant pressure” to keep prices low, he said.


Express Scripts earns higher profits from greater use of generic medicines than brand name drugs sold through their mail-order pharmacy, Mr. Butler said. “There’s no question that they would love for everybody to be on a generic,” he said.


Dr. Miller acknowledged that was true but said that ultimately, everyone wins. “When we save people money, that’s when we make money,” he said. “We don’t shy away from that.”


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App Smart: Apps for Home Repairs for the Handy and the Less So





With the holiday season approaching, the last thing you need is to worry about home repairs. And as rain and cold try to penetrate your house, it’s inevitable that something will go awry — a pipe will burst or that warped window frame will let in too much of the cold. That’s my problem right now — a window frame in my bathroom just won’t seal against the breeze (a minor problem, certainly, considering the damage from Hurricane Sandy, but a problem that is crying to be fixed). I could try to repair it myself, but I’m not too confident in working with aluminum windows, so I may end up calling a professional.







Multi Measures HD for iPad can become a spirit level, a surface level, a ruler, a protractor, a plumb bob and more.








The Finding Home & Hardware app locates suppliers.






Tips for fixing frozen pipes on wikiHow.






For issues like this, or even just to while away hours doing some D.I.Y. research, there are many apps to help.


If you find yourself struggling to repair something and really need a handyman, a simple way to find a suitable one nearby is Yelp’s app, free on iOS and Android. Yelp, often a go-to for restaurant advice, works for home repair experts, too. Type “handyman” or “plumber” into the app’s “Filter” boxes, along with location, and it will show a list of people and businesses. The advantage of Yelp is the ability to see how previous clients rated the quality of work. Read several reviews, as people’s experiences and expectations can vary.


For a more controlled experience, try RedBeacon (free on iOS and Android), a popular app with many positive reviews. RedBeacon covers only certain metropolitan areas across the United States, however, and may not help everyone. Unlike Yelp’s more open platform, RedBeacon has a list of approved businesses and tries to match the task at hand with the right worker. The app operates through a “request” system: users enter job details, and can provide photos and video. The system also has reviews, and can help schedule a time for the work.


More confident do-it-yourselfers may tackle a problem on their own. If it’s urgent, like a broken water heater or even water damage after a leak, the WikiHow How To and DIY Survival guide (free on Android and iOS) might be useful. Type in a few key words about the problem into the app’s Search page and the guide will return some advice. Its information pages are clear and well laid-out. They begin with an introductory description, then offer a list of steps to follow. The app displays the necessary tools and items, and includes tips and warnings (like shutting off the electricity before trying to fix a water heater). When you’re done with the home repair tasks, this app can teach self-defense tricks or help you fix your car. But it’s not an exhaustive reference on home upkeep or emergency repairs.


Some apps can turn a smartphone into an actual work tool. One app for iOS devices is Multi Measures ($1, or $2 for an “HD” iPad version). The app’s interfaces are attractive and easy to read, and it offers a long list of measurement options that use the device’s sensors. It can become a spirit level, a surface level, a ruler, a protractor, a plumb bob and more. It even has a decibel meter to measure volume, and a teslameter, which measures magnetic fields. This last option turns the device into a metal detector, which could be useful if you’re trying to find buried treasure, or just nailheads that show where the studs are in your walls.


The Smart Tools app is roughly equivalent to Multi Measures, on Android, for $2.50. And some free apps for iOS and Android promise similar features (sometimes separately — for example, Smart Protractor for angles, free on Android, or Dual Level, free on iOS). The apps’ quality can vary significantly, but they cost nothing to download and test-drive.


Finally, when it comes to buying supplies, an app like Finding HOME & Hardware ($1 on iOS and Android) is invaluable. It shows nearby hardware stores that meet your needs.


Happy D.I.Y.-ing. (Or, at least, I hope your apps find you an efficient and cheap plumber!)


Quick Calls


For smartphone or tablet users who dislike the map services from Apple and Google, Nokia’s Here app is a new, free alternative. It is available on iOS now and will be on Android devices later. You may prefer its clean, elegant design to the alternatives. ... In time for holiday shopping, Amazon now has an Android tablet-optimized version of its free Amazon Mobile shopping app ready, with one-click purchase options.


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News Analysis: Sunni Leaders Gaining Clout in Mideast


Mohammed Saber/European Pressphoto Agency


A Palestinian woman in Gaza City on Tuesday walked amid the rubble left from eight days of fighting that ended in a cease-fire.







RAMALLAH, West Bank — For years, the United States and its Middle East allies were challenged by the rising might of the so-called Shiite crescent, a political and ideological alliance backed by Iran that linked regional actors deeply hostile to Israel and the West.




But uprising, wars and economics have altered the landscape of the region, paving the way for a new axis to emerge, one led by a Sunni Muslim alliance of Egypt, Qatar and Turkey. That triumvirate played a leading role in helping end the eight-day conflict between Israel and Gaza, in large part by embracing Hamas and luring it further away from the Iran-Syria-Hezbollah fold, offering diplomatic clout and promises of hefty aid.


For the United States and Israel, the shifting dynamics offer a chance to isolate a resurgent Iran, limit its access to the Arab world and make it harder for Tehran to arm its agents on Israel’s border. But the gains are also tempered, because while these Sunni leaders are willing to work with Washington, unlike the mullahs in Tehran, they also promote a radical religious-based ideology that has fueled anti-Western sentiment around the region.


Hamas — which received missiles from Iran that reached Israel’s northern cities — broke with the Iranian axis last winter, openly backing the rebellion against the Syrian president, Bashar al-Assad. But its affinity with the Egypt-Qatar-Turkey axis came to fruition this fall.


“That camp has more assets that it can share than Iran — politically, diplomatically, materially,” said Robert Malley, the Middle East program director for the International Crisis Group. “The Muslim Brotherhood is their world much more so than Iran.”


The Gaza conflict helps illustrate how Middle Eastern alliances have evolved since the Islamist wave that toppled one government after another beginning in January 2011. Iran had no interest in a cease-fire, while Egypt, Qatar and Turkey did.


But it is the fight for Syria that is the defining struggle in this revived Sunni-Shiite duel. The winner gains a prized strategic crossroads.


For now, it appears that that tide is shifting against Iran, there too, and that it might well lose its main Arab partner, Syria. The Sunni-led opposition appears in recent days to have made significant inroads against the government, threatening the Assad family’s dynastic rule of 40 years and its long alliance with Iran. If Mr. Assad falls, that would render Iran and Hezbollah, which is based in Lebanon, isolated as a Shiite Muslim alliance in an ever more sectarian Middle East, no longer enjoying a special street credibility as what Damascus always tried to sell as “the beating heart of Arab resistance.”


If the shifts seem to leave the United States somewhat dazed, it is because what will emerge from all the ferment remains obscure.


Clearly the old leaders Washington relied on to enforce its will, like President Hosni Mubarak of Egypt, are gone or at least eclipsed. But otherwise confusion reigns in terms of knowing how to deal with this new paradigm, one that could well create societies infused with religious ideology that Americans find difficult to accept. The new reality could be a weaker Iran, but a far more religiously conservative Middle East that is less beholden to the United States.


Already, Islamists have been empowered in Egypt, Libya and Tunisia, while Syria’s opposition is being led by Sunni insurgents, including a growing number identified as jihadists, some identified as sympathizing with Al Qaeda. Qatar, which hosts a major United States military base, also helps finance Islamists all around the region.


In Egypt, President Mohamed Morsi resigned as a member of the Muslim Brotherhood only when he became head of state, but he still remains closely linked with the movement. Turkey, the model for many of them, has kept strong relations with Washington while diminishing the authority of generals who were longstanding American allies.


“The United States is part of a landscape that has shifted so dramatically,” said Mr. Malley of the International Crisis Group. “It is caught between the displacement of the old moderate-radical divide by one that is defined by confessional and sectarian loyalty.”


The emerging Sunni axis has put not only Shiites at a disadvantage, but also the old school leaders who once allied themselves with Washington.


The old guard members in the Palestinian Authority are struggling to remain relevant at a time when their failed 20-year quest to end the Israeli occupation of Palestinian lands makes them seem both anachronistic and obsolete.


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General Allen Investigation Narrows Focus





WASHINGTON — Two and a half weeks after Defense Secretary Leon E. Panetta announced an inquiry into e-mail exchanges between Gen. John R. Allen of the Marines and a socialite in Tampa, Fla., some 15 investigators working seven days a week in the Pentagon inspector general’s office have narrowed their focus to 60 to 70 e-mails that “bear a fair amount of scrutiny,” a defense official said.







Alex Wong/Getty Images

Gen. John R. Allen testifying before the House Armed Services Committee in March. He is being investigated over e-mails he sent to Jill Kelley, who was also an acquaintance of David H. Petraeus.








Tampa Bay Magazine, via Associated Press

Jill Kelley with her husband, Scott.






The official did not disclose the content of the e-mails, but senior Pentagon officials have described the voluminous correspondence between General Allen, the top NATO commander in Afghanistan, and the socialite, Jill Kelley, as potentially “inappropriate communication.” Law enforcement officials say the e-mails number in the hundreds and cover a period of two and a half years starting in 2010, when General Allen was the deputy commander of Central Command, based in Tampa.


The investigation, which is delaying and could derail General Allen’s appointment to be the NATO supreme allied commander in Europe, is on a fast track but is unlikely to be completed before the end of the year. Investigations of senior officers in the inspector general’s office usually take about seven months on average, although normally there are only two or three investigators assigned to a case.


The defense official, who asked not to be named because of the nature of the inquiry, said investigators were trying to determine whether the e-mails violated Defense Department policy, government regulations or military law. They were discovered in the course of an F.B.I. investigation into anonymous e-mails to Ms. Kelley warning her to stay away from David H. Petraeus, then the C.I.A. director. The F.B.I. found that the e-mails had been sent by Paula Broadwell, Mr. Petraeus’s biographer; he admitted to having had an affair with Ms. Broadwell and resigned on Nov. 9.


Like General Allen, Mr. Petraeus, a retired four-star general, was a social acquaintance of Ms. Kelley when he was stationed at MacDill Air Force Base in Tampa, headquarters of the Central Command.


The e-mails between General Allen and Ms. Kelley were sent to the Pentagon by the F.B.I. on Nov. 11. “They just forwarded the evidence,” the official said, referring to the F.B.I. “People have to go through and decide if they fit one of three potential violations.” Those violations include misconduct, which could range from inappropriate language on a government computer to adultery, prohibited under military law; more than an incidental use of government property for personal matters; and security breaches.


The defense official said there was no evidence so far that there had been security violations. General Allen, who is in Kabul planning the drawdown of American forces from Afghanistan, is cooperating with the investigation and has said through associates that he did not commit adultery. The inquiry does not appear to have progressed to interviews with General Allen, 58, who is married and the father of two, or Ms. Kelley, 37, the wife of a cancer surgeon and the mother of three.


Gen. Joseph F. Dunford Jr., who has been nominated to succeed General Allen as part of a regular military rotation, is expected to be confirmed by the Senate before the end of the year and to be in Kabul by February. General Allen is expected to return to the United States at that time, but it is unclear what he will do.


There have been conflicting accounts of the nature of the e-mails between him and Ms. Kelley. A law enforcement official has described some of them as sexually explicit. Pentagon officials briefed on the matter say they have been told that half a dozen are embarrassing. But General Allen’s associates say they are innocuous and contain little beyond language like “you’re a sweetheart.”


Although Ms. Kelley’s e-mail correspondence with General Allen has not been made public, dozens of her e-mails to Mayor Bob Buckhorn of Tampa have been released under Florida’s public record laws and refer to her friendship with both General Allen and Mr. Petraeus.


A year ago, after inviting the mayor to a birthday party for one of her children, she added a casual P.S.: “I’ll be in DC this weekend with Petraeus, but let’s set up a double date when I return!” Last January, she wrote to a mayoral aide, “I’m up in DC having dinner tonight with Gen. Petraeus and Gen. John Allen.”


Thom Shanker and Eric Schmitt contributed reporting.



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Recipes for Health: Spinach and Turkey Salad — Recipes for Health


Andrew Scrivani for The New York Times







Turkey or chicken transforms this classic spinach salad (minus the bacon) into a light main dish, welcome after Thanksgiving and before the rest of the holiday season feasting begins.




2 cups (12 ounces) shredded cooked turkey, chicken breast or chicken breast tenders


1 6-ounce bag baby spinach


6 white or cremini mushrooms, thinly sliced


1 cup cooked wild rice


2 tablespoons chopped walnuts


1 to 2 hard boiled eggs (to taste), finely chopped (optional)


2 tablespoons chopped chives


1 to 2 tablespoons chopped fresh herbs such as parsley, tarragon or marjoram


For the dressing:


2 tablespoons fresh lemon juice


1 tablespoon red wine vinegar, tarragon vinegar or sherry vinegar


1 teaspoon Dijon mustard


Salt and freshly ground pepper


1 small garlic clove, pureed


1/3 cup extra virgin olive oil


2 tablespoons plain low-fat yogurt


1. Combine all of the salad ingredients in a large salad bowl. Whisk together the lemon juice, vinegar, Dijon mustard, salt, pepper, garlic, olive oil and yogurt. Toss with the salad just before serving.


Yield: Serves 4 as a main dish


Advance preparation: The salad can be assembled and the dressing mixed several hours before serving. Refrigerate and toss together when ready to serve.


Variation: Add 1 ripe but firm persimmon, peeled, cored and sliced, to the mixture.


Nutritional information per serving: 375 calories; 25 grams fat; 4 grams saturated fat; 5 grams polyunsaturated fat; 15 grams monounsaturated fat; 53 milligrams cholesterol; 14 grams carbohydrates; 2 grams dietary fiber; 119 milligrams sodium (does not include salt to taste); 26 grams protein


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


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Recipes for Health: Spinach and Turkey Salad — Recipes for Health


Andrew Scrivani for The New York Times







Turkey or chicken transforms this classic spinach salad (minus the bacon) into a light main dish, welcome after Thanksgiving and before the rest of the holiday season feasting begins.




2 cups (12 ounces) shredded cooked turkey, chicken breast or chicken breast tenders


1 6-ounce bag baby spinach


6 white or cremini mushrooms, thinly sliced


1 cup cooked wild rice


2 tablespoons chopped walnuts


1 to 2 hard boiled eggs (to taste), finely chopped (optional)


2 tablespoons chopped chives


1 to 2 tablespoons chopped fresh herbs such as parsley, tarragon or marjoram


For the dressing:


2 tablespoons fresh lemon juice


1 tablespoon red wine vinegar, tarragon vinegar or sherry vinegar


1 teaspoon Dijon mustard


Salt and freshly ground pepper


1 small garlic clove, pureed


1/3 cup extra virgin olive oil


2 tablespoons plain low-fat yogurt


1. Combine all of the salad ingredients in a large salad bowl. Whisk together the lemon juice, vinegar, Dijon mustard, salt, pepper, garlic, olive oil and yogurt. Toss with the salad just before serving.


Yield: Serves 4 as a main dish


Advance preparation: The salad can be assembled and the dressing mixed several hours before serving. Refrigerate and toss together when ready to serve.


Variation: Add 1 ripe but firm persimmon, peeled, cored and sliced, to the mixture.


Nutritional information per serving: 375 calories; 25 grams fat; 4 grams saturated fat; 5 grams polyunsaturated fat; 15 grams monounsaturated fat; 53 milligrams cholesterol; 14 grams carbohydrates; 2 grams dietary fiber; 119 milligrams sodium (does not include salt to taste); 26 grams protein


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


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Facebook Gift Store Urges Users to Shop While They Share





SAN FRANCISCO — Facebook is already privy to its users’ e-mail addresses, wedding pictures and political beliefs. Now the company is nudging them to share a bit more: credit card numbers and offline addresses.







James Best Jr./The New York Times

Facebook Gifts is a service that prompts users to buy things for friends on the social network.






Sharing Even More




What do you think about Facebook’s plan to have users buy gifts for their friends through the site using their credit cards?







A screenshot of Facebook Gifts.






The nudge comes from a new Facebook service called Gifts. It allows Facebook users — only in the United States for now — to buy presents for their friends on the social network. On offer are items as varied as spices from Dean & DeLuca, pajamas from BabyGap and subscriptions to Hulu Plus, the video service. This week Facebook added iTunes gift cards.


The gift service is part of an aggressive moneymaking push aimed at pleasing Facebook’s investors after the company’s dismal stock market debut. Facebook has stepped up mobile advertising and is starting to customize the marketing messages it shows to users based on their Web browsing outside Facebook.


Those efforts seem to have brought some relief to Wall Street. Analysts issued more bullish projections for the company in recent days, and the stock was up 49 percent from its lowest point, closing Tuesday at $26.15, although that is still well below the initial offering price of $38. The share price has been buoyed in part by the fact that a wave of insider lockup periods expired without a flood of shares hitting the market.


To power the Gifts service, Facebook rented a warehouse in South Dakota and created its own software to track inventory and shipping. It will not say how much it earns from each purchase made through Gifts, though merchants that have a similar arrangement with Amazon.com give it a roughly 15 percent cut of sales.


If it catches on, the service would give Facebook a toehold in the more than $200 billion e-commerce market. Much more important, it would let the company accumulate a new stream of valuable personal data and use it to refine targeted advertisements, its bread and butter. The company said it did not now use data collected through Gifts for advertising purposes, but could not rule it out in the future.


“The hard part for Facebook was aggregating a billion users. Now it’s more about how to monetize those users without scaring them away,” said Colin Sebastian, an analyst with Robert W. Baird.


He added: “Gifts should also contribute more to Facebook’s treasure trove of user data, which has the benefit of a virtuous cycle, driving more personalization of the site, leading to better and more targeted ads, which improves overall monetization.”


Facebook already collects credit card information from users who play social games on its site. But they are a limited constituency, and a wider audience may be persuaded to buy a gift when Facebook reminds them that a friend is expecting a baby or a cousin is approaching her 40th birthday.


The Gifts service, which grew out of Facebook’s acquisition of a mobile application called Karma, was introduced in September and expanded earlier this month on the eve of the holiday shopping season.


Magnolia Bakery, based in New York, was among Facebook’s early partners for Gifts. Its vice president for public relations, Sara Gramling, said the company had sold roughly 200 packages of treats since then. She counted it as a marketing success. The bakery, which gained fame thanks to “Sex and the City,” had only recently begun shipping its goods. “It was a great opportunity to expand our network,” she said.


Magnolia Bakery isn’t exactly catering to the masses. A half-dozen cupcakes cost $35, plus about $12 for shipping. Facebook, Ms. Gramling said, takes care of the billing. The bakery is eyeing Facebook’s global reach, too, as it opens outlets internationally, especially in the Middle East.


One of the appeals of Facebook Gifts is the ease of making a purchase. Facebook users are nudged to buy a gift (a gift-box icon pops up) for Facebook friends on their birthdays. They are offered a vast menu to choose from: beer glasses, cake pops, quilts, marshmallows, magazine subscriptions and donations to charity. They are asked to choose a greeting card. Then they are asked for credit card details. Facebook says it stores that credit card information, unless users remove it after making a purchase.


Facebook has declined to say how many users have bought gifts, only that among those who have, the average purchase is $25.


David Streitfeld contributed reporting.



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Egypt’s President Said to Limit Scope of Judicial Decree


Tara Todras-Whitehill for The New York Times


Egyptians at a burned-out school in Cairo on Monday before the funeral of an activist who was injured in a clash and died Sunday.







CAIRO — With public pressure mounting, President Mohamed Morsi appeared to pull back Monday from his attempt to assert an authority beyond the reach of any court. His allies in the Muslim Brotherhood canceled plans for a large demonstration in his support, signaling a chance to calm an escalating battle that has paralyzed a divided nation.




After Mr. Morsi met for hours with the judges of Egypt’s Supreme Judicial Council, his spokesman read an “explanation” on television that appeared to backtrack from a presidential decree placing Mr. Morsi’s official edicts above judicial scrutiny — even while saying the president had not actually changed a word of the statement.


Though details of the talks remained hazy, and it was not clear whether the opposition or the court would accept his position, Mr. Morsi’s gesture was another demonstration that Egyptians would no longer allow their rulers to operate above the law. But there appeared little chance that the gesture alone would be enough to quell the crisis set off by his perceived power grab.


Protesters remained camped in Tahrir Square, and the opposition was moving ahead with plans for a major demonstration on Tuesday.


The presidential spokesman, Yasser Ali, said for the first time that Mr. Morsi had sought only to assert pre-existing powers already approved by the courts under previous precedents, not to free himself from judicial oversight.


He said that the president meant all along to follow an established Egyptian legal doctrine suspending judicial scrutiny of presidential “acts of sovereignty” that work “to protect the main institutions of the state.” The judicial council had said Sunday that it could bless aspects of the decree deemed to qualify under the doctrine.


Mr. Morsi had maintained from the start that his purpose was to empower himself to prevent judges appointed by former President Hosni Mubarak from dissolving the constituent assembly, which is led by his fellow Islamists of the Muslim Brotherhood’s Freedom and Justice Party. The courts have already dissolved the Islamist-led Parliament and an earlier constituent assembly, and the Supreme Constitutional Court was widely expected to rule against this one next week.


But the text of the original decree had exempted all presidential edicts from judicial review until the ratification of a constitution, not just those edicts related to the assembly or justified as “acts of sovereignty.”


Legal experts said that the spokesman’s explanations of the president’s intentions, if put into effect, would amount to a revision of the decree Mr. Morsi issued last Thursday. But lawyers said that the verbal statements alone carried little legal weight.


How the courts would apply the doctrine remained hard to predict. And Mr. Morsi’s opposition indicated it was holding out for far greater concessions, including the breakup of the whole constituent assembly.


Speaking at a news conference while Mr. Morsi was meeting with the judges, the opposition activist and intellectual Abdel Haleem Qandeil called for “a long-term battle,” declaring that withdrawal of Mr. Morsi’s new powers was only the first step toward the opposition’s goal of “the withdrawal of the legitimacy of Morsi’s presence in the presidential palace.” Completely withdrawing the edict would be “a minimum,” he said.


Khaled Ali, a human rights lawyer and former presidential candidate, pointed to the growing crowd of protesters camped out in Tahrir Square for a fourth night. “The one who did the action has to take it back,” Mr. Ali said.


Moataz Abdel Fattah, a political scientist at Cairo University, said Mr. Morsi was saving face during a strategic retreat. “He is trying to simply say, ‘I am not a new pharaoh; I am just trying to stabilize the institutions that we already have,’ ” he said. “But for the liberals, this is now their moment, and for sure they are not going to waste it, because he has given them an excellent opportunity to score.”


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Business Cards Give Way to Cellphone Apps for Networking





The business card has long since left the realm of the office Rolodex and entered the world of the Web.







Chris Young for The New York Times

Sandy Avvari, who works near Toronto, using her iPhone to scan a business card via the CardMunch app.







Business acquaintances and meeting attendees now transmit contact information between cellphones, and Web sites and mobile apps can connect that information to social and business networks.


Sandy Avvari, a digital and social media analyst at a Canadian automotive manufacturer, said she met about 15 people a week in her job but exchanged paper business cards only about 20 percent of the time. “We’re much more likely to exchange Twitter handles or connect to each other on LinkedIn,” she said.


Ms. Avvari said she used CardMunch, a free app, to take a photograph of a business card and send it to a service that transcribes the information and adds it to her phone’s address book. CardMunch is owned by LinkedIn, and so if the person is a member, a photo and basic profile of the business card’s owner appear on Ms. Avvari’s phone, allowing her to connect with the person on that service.


Attaching a LinkedIn profile to the business card “makes the contact dynamic, showing job changes or new phone numbers when they happen,” Ms. Avvari said. “It becomes more than a static piece of paper or address book entry.”


With the free app Bump, users can bump or tap their phones together to share contact information. The phones vibrate when they, or the hands holding them, make contact, and information is exchanged between the users’ address books.


If both users are signed into Facebook or LinkedIn, a list of acquaintances they have in common on those sites and in their address books will be displayed. Users can also transmit a photo, for example, of a product they sell if they are meeting at a trade show. Once two people have exchanged data, they can stay in touch using a messaging feature in the app. Bump works across platforms on Android and Apple devices.


With so many contacts flooding into business travelers’ address books, the details of how they met, what they talked about or why someone may be a good contact in the future can fade. Apps like Contacts Journal ($7.99 for iOS, or a free trial version) help users keep track of interactions. Documents like contracts or brochures can be attached to contact information, and users can see a map with pushpins denoting their contacts’ locations.


Many networking apps go beyond electronic business card exchanges and mobile contact databases. LinkedIn is the largest player in the business networking market, with more than 187 million members around the world. In addition to displaying their résumés online, LinkedIn members “connect” to people they know on the service, creating a virtual who-knows-whom map. Job seekers can look for a specific hiring manager and see if they have any connections in common. An employer evaluating a job candidate can get a trusted reference from someone they both know.


The basic functions of LinkedIn are free for individual users. For a monthly fee ranging from $16 to $500, users can gain access to additional search features and contact other members directly without waiting for an electronic introduction.


To network while on a business trip, travelers can use the free Planely Web site to type in their flight itineraries and see who else is traveling at the same time, with overlapping flight plans. Conference- or conventiongoers might find other attendees to share a taxi to the hotel, for instance. Nervous fliers might find someone to take their mind off a long or bumpy flight. The app lists all the Planely travelers on the user’s flight and those who are passing through the airport at the same time, to create a “social flying experience.”


Some networking apps use the phone owner’s location. The Friendthem app works with Facebook, displaying all members who are nearby and have signed up to be visible. This allows two people who meet at a conference, or perhaps at a hotel bar, to become Facebook friends easily, without having to search through a list of similar names to find the right person.


Friend requests can be sent to people who appear nearby, but no instant messaging is available because “our users don’t want creepy people sending them messages like, ‘I see you across the room,’ ” said Charles Sankowich, chief executive and founder of Friendthem. “We want our users to have total control of who communicates with them.” Friendthem also allows users to specify “hiding places,” like home or work, where they want to be invisible.


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Books: Woe Is Syphilis, and Other Afflictions of Famous Writers





The old Irishman was a swollen, wheezing mess, blood pressure wildly out of control, kidneys failing, heart fibrillating. “What we have here,” said his new Spanish doctor, “is an antique cardiorenal sclerotic of advanced years.”




In fact, what the doctor had there was William Butler Yeats: the poet had a long list of chronic medical problems and experienced one of his regular cardiac crises while wintering in Spain. He still had three poetically productive years ahead of him before he died of heart failure in 1939, at age 73.


What makes antique case histories like Yeats’s so compelling to research, so interesting to read? Admittedly, they have educational value — medicine moves forward by looking back — but their major attraction is undoubtedly the operatic vigor of their emotional punch. As we contemplate the poor health of historic notables, we can sigh gustily at the immense suffering our ancestors considered routine, wince at the lunatic treatments they so innocently underwent, and marvel over and over again that the body, the brain and the mind can take such divergent paths.


These pleasures are present in abundance in the newest addition to the genre of medical biography, “Shakespeare’s Tremor and Orwell’s Cough.” Dr. John J. Ross, a Harvard physician, writes that he stumbled into the field by accident while trying to enliven a lecture on syphilis with a few literary references. The discovery that Shakespeare was apparently obsessed with syphilis (and suspiciously familiar with its symptoms) hooked Dr. Ross.


The resulting collection of 10 medico-literary biographical sketches ranges from the tubercular Brontës, whose every moist cough is familiar to their fans, to figures like Nathaniel Hawthorne, whose medical stories are considerably less familiar.


Dr. Ross’s discussion of Shakespeare is unique in the collection for its paucity of relevant data: so few details are known of the playwright’s life, let alone his health, that all commentary is necessarily supposition. Dr. Ross is not the first to note that references to syphilis are “more abundant, intrusive and clinically exact” in Shakespeare’s works than those of his contemporaries. This observation, along with the apparent deterioration of Shakespeare’s handwriting in his last years, leads to the hypothesis that Shakespeare had syphilis repeatedly as a young man, and wound up suffering more from treatment than disease.


The Elizabethans dosed syphilis with a combination of hot baths (treating the disease by raising body temperature endured into the 20th century), cathartics and lavish quantities of mercury. The drooling that accompanies mercury poisoning was considered a sign of excellent therapeutic progress, Dr. Ross writes: “Savvy physicians adjusted the mercury dose to produce three pints of saliva a day for two weeks.”


And so, when Shakespeare signed his will a month before he died with a shaky hand, was his tremor not possibly a sign of residual nerve damage from the mercury doses of his sybaritic youth? No amount of scholarship is likely to confirm this theory, but details of the argument are gripping and instructive nonetheless.


The story of the blind poet John Milton runs for a while along similar lines. Much is known about the long deterioration of Milton’s vision and other particulars of his delicate health, but Dr. Ross observes that many of his problems seem to have cleared up once he actually became blind. Was he vigorously medicating himself with lead-based nostrums in hopes of forestalling what Dr. Ross argues was probably progressive retinal detachment, then recovering from lead poisoning once his vision was irretrievably gone? Another intriguing if unanswerable question.


Just as the competing injuries of disease and treatment battered the luminaries of English and American literature, so did pervasive mental illness.


Jonathan Swift was a classic obsessive-compulsive long before he succumbed to frontotemporal dementia (Pick’s disease). Poor Hawthorne, so forceful on the page, was in person a tortured shrinking violet, the embodiment of social phobia and depression. Emily Brontë’s behavior was strongly suggestive of Asperger syndrome; Herman Melville was clearly bipolar; Ezra Pound was just nuts.


Yet they all wrote on, despite continual psychic and physical torments. Perhaps the thickest medical chart of all belongs to Jack London, who survived several dramatic episodes of scurvy while prospecting in the Klondike (he was treated with raw potatoes, a can of tomatoes and a single lemon), then accumulated a long list of other medical problems before killing himself (inadvertently, Dr. Ross argues) with an overdose of morphine from his personal and very capacious medicine chest.


Dr. Ross has not written a perfect book. The fictionalized scenes he creates between some of his subjects and their medical providers should all have been excised by a kindly editorial hand, which might also have addressed more than a few grammatical errors. Frequent leaps from descriptive to didactic mode as Dr. Ross updates the reader on various medical conditions can be jarring, like PowerPoint slides suddenly deployed in a poetry reading. True literary scholars might dismiss the book as lit crit lite, a hodgepodge of known facts culled from the usual secondary sources.


But all these caveats fade into the background when Dr. Ross hits his narrative stride, as he does in chapter after chapter. Then the stories of the wounded storytellers unfold smoothly on the page, as mesmerizing as any they themselves might have told, those squinting, wheezing, arthritic, infected, demented, defective yet superlative examples of the human condition.


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