A Breakthrough Against Leukemia Using Altered T-Cells

PHILIPSBURG, Pa. — Emma Whitehead has been bounding around the house lately, practicing somersaults and rugby-style tumbles that make her parents wince.

It is hard to believe, but last spring Emma, then 6, was near death from leukemia. She had relapsed twice after chemotherapy, and doctors had run out of options.

Desperate to save her, her parents sought an experimental treatment at the Children’s Hospital of Philadelphia, one that had never before been tried in a child, or in anyone with the type of leukemia Emma had. The experiment, in April, used a disabled form of the AIDS virus to reprogram Emma’s immune system genetically to kill cancer cells.

The treatment very nearly killed her. But she emerged from it cancer-free, and seven months later is still in complete remission. She is the first child and one of the first humans ever in whom new techniques have achieved a long-sought goal — giving a patient’s own immune system the lasting ability to fight cancer.

Emma had been ill with acute lymphoblastic leukemia since 2010, when she was 5, her parents, Kari and Tom, said. She is their only child.

She is among just a dozen patients with advanced leukemia to have received the experimental treatment, which was developed at the University of Pennsylvania. Similar approaches are also being tried at other centers, including the National Cancer Institute and Memorial Sloan-Kettering Cancer Center in New York.

“Our goal is to have a cure, but we can’t say that word,” said Dr. Carl June, who leads the research team at the University of Pennsylvania. He hopes the new treatment will eventually replace bone-marrow transplantation, an even more arduous, risky and expensive procedure that is now the last hope when other treatments fail in leukemia and related diseases.

Three adults with chronic leukemia treated at the University of Pennsylvania have also had complete remissions, with no signs of disease; two of them have been well for more than two years, said Dr. David Porter. Four adults improved but did not have full remissions, and one was treated too recently to evaluate. A child improved and then relapsed. In two adults, the treatment did not work at all. The Pennsylvania researchers are presenting their results on Sunday and Monday in Atlanta at a meeting of the American Society of Hematology.

Despite the mixed results, cancer experts not involved with the research say it has tremendous promise, because even in this early phase of testing it has worked in seemingly hopeless cases.

“I think this is a major breakthrough,” said Dr. Ivan Borrello, a cancer expert and associate professor of medicine at the Johns Hopkins University School of Medicine.

Dr. John Wagner, director of pediatric blood and marrow transplantation at the University of Minnesota, called the Pennsylvania results “phenomenal,” and said they were “what we’ve all been working and hoping for but not seeing to this extent.”

A major drug company, Novartis, is betting on the Penn team, and has committed $20 million to building a research center on the Penn campus to bring the treatment to market.

Hervé Hoppenot, president of Novartis Oncology, called the research “fantastic” and said it had the potential — if the early results hold up — to revolutionize the treatment of leukemia and related blood cancers. Researchers say the same approach, reprogramming the patient’s immune system, may also be used eventually against tumors like breast and prostate cancer.

To perform the treatment, doctors remove millions of the patient’s T-cells — a type of white blood cell — and insert new genes that enable the T-cells to kill cancer cells. The new genes program the T-cells to attack B-cells, a normal part of the immune system that turns malignant in leukemia.

The altered T-cells — called chimeric antigen receptor cells — are then dripped back into the patient’s veins, and if all goes well they multiply like crazy and start destroying the cancer.

The T-cells home in on a protein called CD-19 that is found on the surface of most B-cells, whether they are healthy or malignant.

A sign that the treatment is working is that the patient becomes terribly ill, with raging fevers and chills — a reaction that oncologists call “shake and bake,” Dr. June said. Its medical name is cytokine-release syndrome, or cytokine storm, referring to the natural chemicals that pour out of cells in the immune system as they are being activated, causing fevers and other symptoms. The storm can also flood the lungs and cause perilous drops in blood pressure — effects that nearly killed Emma.

Steroids sometimes ease the reaction, but did not help Emma. Her temperature hit 105. She wound up on a ventilator, unconscious and swollen almost beyond recognition, surrounded by friends and family who had come to say goodbye.

But at the eleventh hour, a battery of blood tests gave the researchers a clue as to what might help save Emma: Her level of one of the cytokines, interleukin-6 or IL-6, had shot up a thousandfold. Doctors had never seen such a spike before and thought it might be what was making her so sick. Dr. June knew that a drug could lower IL-6 — his daughter takes it, for rheumatoid arthritis. It had never been used for a crisis like Emma’s, but there was little to lose. Her oncologist, Dr. Stephan A. Grupp, ordered the drug. The response, he said, was “amazing.”

Within hours, Emma began to stabilize. She woke up a week later, on May 2, the day she turned 7; the intensive-care staff sang “Happy Birthday.”

Since then, the research team has used the same drug, tocilizumab, in several other patients.

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Fed Likely to Sustain Bond-Buying Program to Stimulate Growth

WASHINGTON — The Federal Reserve is widely expected to announce on Wednesday that it will continue buying Treasury securities to stimulate growth in the new year.

The Fed’s public declaration in September that it would buy bonds until the outlook for the labor market “improved substantially” has cleared away much of the uncertainty and controversy that usually precedes such announcements.

The economic recovery remains lackluster and millions are looking for work. But while some analysts question the central bank’s ability to improve the situation, few doubt that the Fed, under its chairman, Ben S. Bernanke, is determined to keep trying.

Indeed, while Fed officials continue to warn that a failure to avert scheduled tax increases and spending cuts next year would overwhelm their efforts and plunge the economy back into recession, they have also said that even if Congress and the White House negotiate a compromise, the Fed’s efforts would continue.

“I am not prepared to say we are remotely close to substantial improvement on the employment front,” Dennis P. Lockhart, president of the Federal Reserve Bank of Atlanta, said in a recent speech. “I expect that continued aggressive use of balance sheet monetary tools will be appropriate and justified by economic conditions for some time, even if fiscal cliff issues are properly addressed.”

The remarks were particularly significant because Mr. Lockhart is among the moderate members of the Federal Open Market Committee whose support Mr. Bernanke invested months in winning before starting the new policy.

With the direction of policy clearly set, debate has turned to the details. The Fed, whose policy-making committee is meeting on Tuesday and Wednesday, still must determine what to buy and how much to spend, and officials continue to debate the best way to describe when the agency is likely to stop buying.

In making those decisions, the Fed must balance its conviction that buying bonds reduces borrowing costs for businesses and consumers against concerns the purchases might disrupt financial markets or inhibit its control of inflation.

Analysts say the immediate answer is likely to be more of the same. The Fed currently buys $40 billion of mortgage-backed securities and $45 billion of Treasury securities a month. Officials highlighted that $85 billion figure in September, and have indicated since that it remained their rough target.

“It would be odd for them to disappoint the expectations that they have created themselves,” Kris Dawsey of Goldman Sachs wrote in a note to clients predicting that the Fed would maintain both the dollar amount and the division. Other analysts have suggested the Fed might slightly decrease the total amount of purchases, to $80 billion, or increase the share of mortgage securities.

The Fed is unlikely to announce a new timetable this week, analysts said. The committee has said that it does not plan to raise interest rates before the middle of 2015, and that it will stop buying bonds before it starts raising rates.

Many officials on the 12-member committee — perhaps even the majority — would prefer to substitute economic objectives for guidance set by the calendar. The Fed’s ability to reduce borrowing costs derives in part from persuading investors that interest rates will remain low. Telling investors how the economic situation must change in order to warrant a change in policy could be more convincing, and therefore more potent, than simply publishing an estimated endpoint, these officials say.

But an account of the committee’s previous meeting, in late October, showed that officials remained divided about which economic objectives to use.

The most vocal proponent of focusing on economic goals, Charles L. Evans, president of the Federal Reserve Bank of Chicago, said last month that the Fed should declare its intent to keep short-term interest rates near zero until the unemployment rate fell below 6.5 percent, provided that the rate of inflation did not exceed 2.5 percent.

“I believe we have the ability to go even further in reassuring financial markets and the general public that policy will stay appropriately accommodative,” Mr. Evans said in advocating the change during a speech in Toronto.

Other officials have misgivings about placing such emphasis on any single economic indicator, or on the unemployment rate in particular.

The discussions are moving slowly, in part because it is not clear the changes being contemplated would have significant benefits. The targets the Fed is considering closely resemble its own past practice, meaning the new thresholds would tend to reinforce rather than shift expectations.

Lou Crandall, chief economist at the research firm Wrightson ICAP, noted in a recent analysis that the unemployment rate exceeded 7 percent in the mid-1980s and again in the early 1990s, and in both cases the Fed waited until the rate fell well into the 6 percent range before it began to raise interest rates.

The relative complacency of Fed officials also reflects their judgment that the mortgage-bond purchases announced in September are working. Average interest rates on 30-year mortgages are at the lowest levels on record, averaging 3.35 percent in November, according to Freddie Mac’s regular survey.

“This is solid evidence that our policy has been and continues to be effective — though it is certainly not all-powerful in current circumstances,” William C. Dudley, president of the Federal Reserve Bank of New York, said last week.

To continue the companion purchases of Treasury securities, the Fed will need to change its approach. It is now buying long-term securities with proceeds from the sale of short-term securities, but it is running out of inventory to sell.

The most likely alternative is to create money by crediting the accounts of banks that sell bonds to the Fed, the same method now being used to buy mortgage bonds and also to finance earlier rounds of the Fed’s so-called quantitative easing.

The Fed has repeatedly overestimated the health of the economy and the impact of its efforts. This time, officials have promised to maintain their efforts even as the economy shows signs of improvement. But they are once again sounding notes of cautious optimism about the coming year — if Washington does not interfere.

A budget deal reducing deficits in the long term, Mr. Bernanke said in November, “could help make the new year a very good one for the American economy.”

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For Afghan Officials, Prospect of Death Comes With Territory

Bryan Denton for The New York Times

Abdul Majid Khogyani, center, the governor of Wardak Province, touring government buildings damaged by a suicide truck bombing two days earlier.

KABUL, Afghanistan — There are so many ways for an Afghan official to die: car bombs, suicide attacks, a volley of bullets or, in the case of one particularly enterprising assassin, a handgun hidden in the sole of a shoe.

On Thursday, a Taliban suicide bomber with a bomb hidden in his groin area tried to assassinate the new chief of Afghanistan’s intelligence service in Kabul, seriously wounding him. Two weeks before, insurgents welcomed two of the country’s newest governors with an armed assault in Helmand Province and a car bomb that leveled an entire city block in Wardak Province. Both governors survived and came away with an attribute essential for politicians here: a sharpened sense of fatalism.

“Assassination attempts are a part of the job,” said Abdul Majid Khogyani, the new Wardak governor, seated in a makeshift office in his compound’s frigid courtyard, the only place untouched by the bombing. “It comes with the package.” He actually grinned.

Government officials here do not worry so much about the wrath of constituents; a more immediate fear is coldblooded assassination at the hands of the Taliban. Public service jobs are among the most dangerous in Afghanistan, with hundreds of officials killed every year. The more important the official, the greater the risk — some particularly fortunate, and well defended, governors have survived more than a dozen assassination attempts.

In the last few years, the Taliban have stepped up their campaign against politicians, targeting dozens of provincial and district governors, police chiefs and even marginal officials. It has been an effective tool, demonstrating the insurgents’ power to inflict chaos and sow fear among government supporters. Last year, assassinations claimed 304 lives, the most since 2001, according to a United Nations report.

Barring the remote possibility of a peace agreement with the Taliban, the killings are only likely to rise as the American-led military coalition withdraws its combat forces over the next two years.

Perhaps the most favored targets are the 34 provincial governors, most of whom are far from the relatively secure enclave of Kabul. Appointed by the president, governors are often the highest-ranking officials most Afghans will ever see.

If the persistence of attacks suggests a high-priority target, Gulab Mangal, the former governor of Helmand Province, is a Taliban trophy. Mr. Mangal survived 17 deadly attacks in his five years in office, including a rocket attack on a helicopter, before he was replaced this year by President Hamid Karzai.

“Even my friends asked me to quit,” he said, emitting a burst of laughter. “But I loved my job and slowly, as time went on, I grew fearless.”

Not all politicians are so fortunate. Last year, a suicide bomber with explosives in his turban killed the mayor of Kandahar. This spring, the former governor of Uruzgan was fatally gunned down. A man wearing a police uniform with a suicide bomb vest underneath killed Gen. Daoud Daoud, the police commander who oversaw security in nine northern provinces, last year. The year before, insurgents killed the governor of Kunduz Province by bombing the mosque where he prayed.

Though some assassinations are carried out for personal reasons, most are political. Despite the risks, governorships have retained their allure. While the position pays an average of only $23,000 a year, the job affords great power, and abundant opportunities for patronage and corruption.

And after three decades of war — with the Soviets, among themselves or against the Taliban — some Afghans say they have become inured to the threat of death.

“The mind-set we have in Afghanistan is different,” said Farid Mamundzay, a deputy minister at the Independent Directorate of Local Governance. “We see people dying on a weekly if not daily basis. We’ve gotten used to it.”

“If you die, you die,” he added.

Still, politicians take security seriously, spending vast amounts, sometimes from their own pockets, and often taking a direct role in their self-preservation.

Sangar Rahimi contributed reporting from Kabul, Jawad Sukhanyar from Parwan, and Habib Zohori from Wardak

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James Cameron Relives Voyage to Ocean’s Deepest Spot

SAN FRANCISCO — The first thing James Cameron saw 7 miles below the sea was man-made: tracks from a remotely operated vehicle.

“When I got to the bottom, I saw skid marks from the ROV,” Cameron said yesterday (Dec. 4) here at the annual meeting of the American Geophysical Union, referring to a 2009 survey by the Monterey Bay Aquarium Research Institute. Scientific results of the film director’s expedition to the Mariana Trench were presented at the meeting this week, and Cameron and the researchers described the highlights to a packed crowd.

Cameron reported a new, corrected depth for his landing — 35,803 feet (10,912 meters) — which beats by five feet (1.5 m) the record set by U.S. Navy Lt. Don Walsh and Jacques Piccard in 1960 at the same spot. However, “because the error [calculating the depth] on Don’s dive is much greater, we’re just going to have to call it a tie,” Cameron said.

Deepsea Challenger

Cameron’s Deepsea Challenger expedition made dives to the New Britain Trench and the Mariana Trench in the southwestern Pacific Ocean between Jan. 31 and April 3, with one manned dive by Cameron to the Mariana’s Challenger Deep, the deepest spot in any ocean.

Unusual, never-before-seen species were snared and brought back to the surface. A bizarre microbial mat community was discovered living on altered rocks in the Sirena Deep, another deep pool 6.77 miles (10.9 kilometers) below the surface.

Changes in temperature and salinity starting at 26,200 feet (8 km) deep hint at an unknown current coming into the Challenger Deep, said Doug Bartlett, a microbiology professor at the Scripps Institution of Oceanography at UC San Diego.

The filmmaker journeyed inside a high-tech lime-green machine — a steel sphere encased in foam — dubbed the Deepsea Challenger. The expedition traveled with two unmanned seafloor “landers” — large contraptions hoisted over the side of a ship and dropped to the seafloor. Once on the bottom, bait attached to the lander lured seafloor creatures to the craft, and a suite of instruments took samples, photographs and data. [Images: James Cameron's Historic Deep-Sea Dive]

The two contraptions working together proved to be a very good system, Cameron said. “We could rendezvous on the bottom and see the results of that bait running for six to eight hours, and that’s how Doug could find a new species of giant arthropod,” Cameron said.

Challenging journey

The March 26 dive proved to be a physical and mental challenge for Cameron. “I did yoga for six months so I could contort myself into the sphere,” he said.

As he sank through the water, Cameron said he “burned though my whole checklist,” designed to distract him during the long hours of the dive. “I still had 3,000 meters left to go with pretty much nothing left to do but sit quietly and think about the pressure building up around the hull,” he said.

The sub touched down gently, and Cameron immediately took a sample of the seafloor, as planned. This was a good contingency, because the sub’s hydraulic fluid line then burst, leaving him unable to collect more samples.

To his surprise, the sub’s voice communications worked perfectly. “We actually expected they wouldn’t, and I would have to default to texting,” he said. “Texting while driving is not a good thing, especially if you’re using two hands to operate seven joysticks and you’re 7 miles down.”

Cameron first drove the sub about 200 meters, finding the seafloor elevation stayed the same. In fact, Challenger Deep turned out to be remarkably flat, and the sub was easy to drive. “The vehicle was quite nimble, the sub’s yaw rate was very good,” he said. (Yaw describes the left-to-right rotation of a craft.)

A quick return

After about three hours, some of the submersible’s batteries had low charge readings, the steering was problematic, and it was time to return to the surface. The mission should have lasted five to six hours. “I hate this. I hated having to go back,” Cameron recalled thinking.

The trip to the top was mercifully short at 73 minutes. The submersible covered nearly 7 miles in a little over an hour — slow in a car, but like riding a missile for a human in a metal ball. Cameron said the surface trip is when he noticed the aches and pains from the cramped sub. “That’s when your butt is really sore, and when you notice how much it hurts.” [Infographic: James Cameron's Mariana Trench Dive]

The sub now sits in a barn in Santa Barbara, waiting for Cameron or another group with enough money to send it back to the deep ocean. He declined to say how much it cost to build and mount the expedition.

“I would love for the sub to dive again,” he said. “I personally feel that we just barely got started before we had to turn back and there’s just so much out there.”

“And if not, at the very least, the technical innovations can be incorporated into other vehicle platforms,” Cameron added. “As far as I’m concerned, it’s an open source situation.”

Reach Becky Oskin at [email protected]. Follow her on Twitter @beckyoskin. Follow OurAmazingPlanet on Twitter @OAPlanet. We’re also on Facebook and Google+.

Copyright 2012 OurAmazingPlanet, a TechMediaNetwork company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
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Cowboy charged after player dies in auto accident

IRVING, Texas (AP) — Police charged Dallas Cowboys defensive lineman Josh Brent with intoxication manslaughter Saturday after he flipped his car in a pre-dawn accident that killed teammate Jerry Brown.

Irving police spokesman John Argumaniz said the accident happened about 2:20 a.m. Saturday in the Dallas suburb, hours before Brent was to be on a team flight to Cincinnati for the Cowboys' game Sunday against the Bengals.

Argumaniz said the 25-year-old Brown — a practice-squad linebacker who also was Brent's teammate at the University of Illinois for three seasons — was found unresponsive at the scene and pronounced dead at a hospital.

Brown's death was the second tragedy to hit the NFL in a week. Last Saturday, Kansas City Chiefs linebacker Jovan Belcher fatally shot his girlfriend before killing himself in front of his coach and general manager.

"We are deeply saddened by the news of this accident and the passing of Jerry Brown," Cowboys owner Jerry Jones said in a statement. "At this time, our hearts and prayers and deepest sympathies are with the members of Jerry's family and all of those who knew him and loved him."

Officers conducted a field sobriety test on Brent and arrested him on suspicion of driving while intoxicated, Argumaniz said. The charge, a second-degree felony punishable by two to 20 years in prison, was upgraded after Brown was pronounced dead.

Argumaniz said Brent, who pleaded guilty to a drunken driving charge three years ago at Illinois, was being held without bond. Brent is named as Joshua Price-Brent in the police news release. Argumaniz also said Brent missed a 10 a.m. Saturday booking session with a judge because he was intoxicated. He did not know if Brent had an attorney.

Brent was speeding when the vehicle hit a curb and flipped at least once, Argumaniz said. Police received 911 calls from motorists who saw the upside-down vehicle but they did not immediately have any eyewitnesses to the wreck, the police spokesman said.

Argumaniz said when officers arrived at the scene on a state highway service road, Brent was dragging Brown from the vehicle, a Mercedes, which was on fire. Officers quickly put out the small blaze, he said.

Argumaniz wasn't sure if the vehicle was a car or SUV and said it wasn't known how fast the vehicle was traveling. The road has a 45 mph limit.

"I can say investigators are certain they were traveling well above the posted speed limit," Argumaniz said.

Before he was taken to the jail, Brent went to a hospital for a blood draw for alcohol testing and also received treatment for some minor scrapes.

Argumaniz said Brent identified himself to officers as a Cowboys player.

Brent was arrested in February 2009 near the Illinois campus for driving under the influence, driving on a suspended license and speeding, according to Champaign County, Ill., court records.

In June 2009, Brent pleaded guilty to DUI and was sentenced to 60 days in jail, two years of probation, 200 hours of community service and a fine of about $2,000. As part of his plea deal, prosecutors dropped one count of aggravated DUI/no valid driver's license. Brent successfully completed his probation in July 2011, court records show.

Brent, a nose guard, has played in all 12 games this season and has been a bigger presence on defense with starter Jay Ratliff battling injuries. Brent made his first career start in the season opener against the New York Giants and has 35 tackles and 1 1/2 sacks.

The Cowboys signed Brown to their practice squad Oct. 24, but he hasn't been on the active roster. He was released from the Indianapolis Colts' practice squad Oct. 20. Brown played in one game for the Colts, a loss to the New York Jets on Oct. 14.

"On behalf of the entire Colts family, our sincerest condolences go out to Jerry's family and friends," Colts general manager Ryan Grigson said in a statement. "He was a good teammate that was well liked by all. Today's tragic news is just another reminder of how fragile life is and how everyday given is a gift."

Brown played for San Antonio in the Arena Football League this year. In 2011, he played for Jacksonville in the AFL and the Hamilton Tiger-Cats in the Canadian Football League.

He was born and grew up in St. Louis, attending Vashon High School.

___

Associated Press Writers Michael Graczyk in Houston and Sara Burnett in Chicago contributed to this report.

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New Taxes to Take Effect to Fund Health Care Law

WASHINGTON — For more than a year, politicians have been fighting over whether to raise taxes on high-income people. They rarely mention that affluent Americans will soon be hit with new taxes adopted as part of the 2010 health care law.

The new levies, which take effect in January, include an increase in the payroll tax on wages and a tax on investment income, including interest, dividends and capital gains. The Obama administration proposed rules to enforce both last week.

Affluent people are much more likely than low-income people to have health insurance, and now they will, in effect, help pay for coverage for many lower-income families. Among the most affluent fifth of households, those affected will see tax increases averaging $6,000 next year, economists estimate.

To help finance Medicare, employees and employers each now pay a hospital insurance tax equal to 1.45 percent on all wages. Starting in January, the health care law will require workers to pay an additional tax equal to 0.9 percent of any wages over $200,000 for single taxpayers and $250,000 for married couples filing jointly.

The new taxes on wages and investment income are expected to raise $318 billion over 10 years, or about half of all the new revenue collected under the health care law.

Ruth M. Wimer, a tax lawyer at McDermott Will & Emery, said the taxes came with “a shockingly inequitable marriage penalty.” If a single man and a single woman each earn $200,000, she said, neither would owe any additional Medicare payroll tax. But, she said, if they are married, they would owe $1,350. The extra tax is 0.9 percent of their earnings over the $250,000 threshold.

Since the creation of Social Security in the 1930s, payroll taxes have been levied on the wages of each worker as an individual. The new Medicare payroll is different. It will be imposed on the combined earnings of a married couple.

Employers are required to withhold Social Security and Medicare payroll taxes from wages paid to employees. But employers do not necessarily know how much a worker’s spouse earns and may not withhold enough to cover a couple’s Medicare tax liability. Indeed, the new rules say employers may disregard a spouse’s earnings in calculating how much to withhold.

Workers may thus owe more than the amounts withheld by their employers and may have to make up the difference when they file tax returns in April 2014. If they expect to owe additional tax, the government says, they should make estimated tax payments, starting in April 2013, or ask their employers to increase the amount withheld from each paycheck.

In the Affordable Care Act, the new tax on investment income is called an “unearned income Medicare contribution.” However, the law does not provide for the money to be deposited in a specific trust fund. It is added to the government’s general tax revenues and can be used for education, law enforcement, farm subsidies or other purposes.

Donald B. Marron Jr., the director of the Tax Policy Center, a joint venture of the Urban Institute and the Brookings Institution, said the burden of this tax would be borne by the most affluent taxpayers, with about 85 percent of the revenue coming from 1 percent of taxpayers. By contrast, the biggest potential beneficiaries of the law include people with modest incomes who will receive Medicaid coverage or federal subsidies to buy private insurance.

Wealthy people and their tax advisers are already looking for ways to minimize the impact of the investment tax — for example, by selling stocks and bonds this year to avoid the higher tax rates in 2013.

The new 3.8 percent tax applies to the net investment income of certain high-income taxpayers, those with modified adjusted gross incomes above $200,000 for single taxpayers and $250,000 for couples filing jointly.

David J. Kautter, the director of the Kogod Tax Center at American University, offered this example. In 2013, John earns $160,000, and his wife, Jane, earns $200,000. They have some investments, earn $5,000 in dividends and sell some long-held stock for a gain of $40,000, so their investment income is $45,000. They owe 3.8 percent of that amount, or $1,710, in the new investment tax. And they owe $990 in additional payroll tax.

The new tax on unearned income would come on top of other tax increases that might occur automatically next year if President Obama and Congress cannot reach an agreement in talks on the federal deficit and debt. If Congress does nothing, the tax rate on long-term capital gains, now 15 percent, will rise to 20 percent in January. Dividends will be treated as ordinary income and taxed at a maximum rate of 39.6 percent, up from the current 15 percent rate for most dividends.

Under another provision of the health care law, consumers may find it more difficult to obtain a tax break for medical expenses.

Taxpayers now can take an itemized deduction for unreimbursed medical expenses, to the extent that they exceed 7.5 percent of adjusted gross income. The health care law will increase the threshold for most taxpayers to 10 percent next year. The increase is delayed to 2017 for people 65 and older.

In addition, workers face a new $2,500 limit on the amount they can contribute to flexible spending accounts used to pay medical expenses. Such accounts can benefit workers by allowing them to pay out-of-pocket expenses with pretax money.

Taken together, this provision and the change in the medical expense deduction are expected to raise more than $40 billion of revenue over 10 years.

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Tax Arithmetic Shows Top Rate Is Just a Starter in Talks

WASHINGTON — Despite hints in recent days that President Obama and House Speaker John A. Boehner might compromise on the tax rate to be paid by top earners, a host of other knotty tax questions could still derail a deal to avert a fiscal crisis in January.

The math shows why. Even if Republicans were to agree to Mr. Obama’s core demand — that the top marginal income rates return to the Clinton-era levels of 36 percent and 39.6 percent after Dec. 31, rather than stay at the Bush-era rates of 33 percent and 35 percent — the additional revenue would be only about a quarter of the $1.6 trillion that Mr. Obama wants to collect over 10 years. That would be about half of the $800 billion that Republicans have said they would be willing to raise.

That calculation alone suggests the scope of the other major tax issues to be negotiated beyond tax rates. And that is why many people in both parties remain unsure that a deal will come together before Jan. 1. Without agreement, more than $500 billion in automatic tax increases on all Americans and cuts in domestic and military programs will take hold, which could cause a recession if left in place for months, economists say.

“The question is making sure that we hit a revenue target that’s required for a truly balanced deficit-reduction plan,” said Representative Chris Van Hollen of Maryland, the senior Democrat on the House Budget Committee. “And when the president and all of us say this is a question of math, we mean it. It’s very hard to make the numbers work without the top rates going back to the full Clinton-era levels.”

The top tax rates are taking center stage right now because Mr. Obama believes he won a mandate after campaigning relentlessly on the idea of extending Mr. Bush’s tax cuts only for households with annual income below $250,000. But the two parties also have ideological differences on taxes affecting savings, investment and inheritance, which have flared in battles going back to the Reagan years. To get a deal in the coming weeks, those differences must be addressed at least in broad terms, even if the details are left to a battle over revamping the tax code next year.

The argument over rates is far from settled. Although the two sides seem close enough on the percentages for easy compromise, principle and politics loom large: Republicans oppose raising rates as a matter of ideology, saying that it kills jobs, and the president insists that he will not keep the Bush-era rates on income above roughly $250,000 after two campaigns in which he vowed to return them to the levels of the Clinton years.

“Just to be clear, I’m not going to sign any package that somehow prevents the top rate from going up for folks at the top 2 percent,” he said Thursday.

In recent days, comments from some Republicans, including Mr. Boehner, their chief negotiator, have hinted that the party — recognizing its weak hand — might be moving toward a concession on tax rates. Seldom mentioned is that Mr. Obama’s revenue total also reflects four other changes from Bush-era tax cuts: higher tax rates on investment income from capital gains and dividends, and the restoration of two other Clinton-era provisions limiting deductions and tax exemptions for affluent individuals.

Together those changes would raise $407.4 billion over a decade — nearly as much as the president’s proposal on higher rates, which would raise $441.6 billion by 2023, for a total of $849 billion. Another $119 billion would come from higher estate taxes, opposed by Republicans and some Democrats.

And both the president and Republicans are committed to raising hundreds of billions of dollars by overhauling the tax code to further limit or end the tax breaks that high-income taxpayers can claim, though they differ in how to do that.

Republicans want to raise all $800 billion from overhauling the tax code, erasing tax breaks for high-income households and using the new revenues both to reduce deficits and to lower everyone’s tax rates. But they have not proposed how to do that, and the president insists it cannot be done without hitting middle-income taxpayers.

Mr. Obama has proposed to keep existing tax breaks but to limit the rate of those breaks for people in higher tax brackets to 28 percent, which would raise $584 billion in a decade. He has proposed variations of that proposal for four years, only to be ignored by both parties because of opposition from charitable groups, the housing industry, insurers and others to curbing deductions for charitable giving, mortgage insurance and other purposes.

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Afghan Spy Chief’s Attacker Hid Bomb by His Groin

KABUL, Afghanistan — The man who tried to kill Afghanistan’s intelligence chief this week by smuggling a bomb into a guesthouse in Kabul concealed the device “around his groin,” according to a statement released Friday by the government. The statement suggested one reason the bomb might not have been detected during a search.

It called the bombing, which seriously wounded the intelligence director, Asadullah Khalid, “unethical and contrary to principles of Shariah law.”

Shafiqullah Taheri, a spokesman for the National Directorate of Security, the agency headed by Mr. Khalid, said, “It is degrading and insulting to search anyone’s genital area, according to Shariah law.”

The spy agency has not said whether the bomber was searched when he entered the guesthouse on Thursday, where Mr. Khalid was meeting with the head of another government agency.

But if he were searched, the bomber would have forced any security guard who wanted to do his job thoroughly to behave in an un-Islamic fashion and intrude on an area of the body that is usually off limits to anyone other than a very close relative.

The only other information released Friday by the government was that Mr. Khalid, who is in his early 40s, was recovering. Western officials with some knowledge of the case said that while he would survive, he had serious abdominal injuries that would require multiple operations and that it was not yet clear if or when he would be able to return to work. The Taliban have claimed responsibility for the attack.

President Hamid Karzai visited Mr. Khalid on Thursday at a hospital run by the security directorate where he was initially taken, and Gen. John R. Allen, the commander of the international coalition forces in Afghanistan, visited him on Friday at the Bagram Air Base hospital where he was transferred late Thursday.

Other than the location of the bomb, the intelligence agency said little about the attack and released no information about the attacker, including whether he had died in the explosion or had been shot by a guard.

The directorate’s statement about the location of the bomb seemed in part to be a response to questions from the public about how a suicide bomber was able to get so close to Mr. Khalid without being detected.

Afghans have found the notion of security searches, which are routine in the West, extremely difficult to embrace from a religious and a cultural perspective. Muslim cultures generally place great emphasis on modesty, and men and women are reluctant to show any parts of their bodies to strangers. While different schools of Islamic law have somewhat different teachings, revealing any part of the body and touching anyone else’s body is restricted.

In Afghanistan’s extremely conservative culture, a sense of discretion runs even deeper. Even at the height of summer, most Afghan men do not wear shorts; if they were to, the shorts would be knee-length. Outside major cities, a vast majority of women would not leave their homes without wearing a burqa, a veil that completely hides the face and body.

Gradually, searches in Afghanistan have become more thorough as suicide bombers wearing explosive vests have become more prevalent. Afghan security forces have tried to inculcate a more Western approach to searches among their guards, but it has not been easy.

A number of Afghans regard a body search as an insult signifying a lack of trust. So if the bomber who tried to assassinate Mr. Khalid was being brought to meet him by a trusted person, guards might well have been reluctant to offend him with a thorough body search.

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The Era of Twitter Without Instagram Has Now Begun

We know everyone is a little bummed about all those filtered photos disappearing from your Twitter streams this weekend, but let’s not get all worked up about it: They are disappearing, and there is no scandal.

RELATED: Why You Can’t See Instagram Photos on Twitter Anymore

TechCrunch’s  Drew Olanoff got a little too excited on Friday and thought a single in-stream photo meant that Instagram was allowing its Twitter cards back on Twitter and thought the two services were planning a sudden reunion. You may have seen some, too, but a Facebook spokesperson assured users these Instagram photos on Twitter were the last holdouts in the switchover. ”What you are seeing now may be some sort of regression depending on the mobile client, but we’re checking in with the engineers,” read Facebook’s statement, via Talking Points Memo’s Carl Franzen.

RELATED: How to Get Over the Twitter-Instagram War on Photos

Which means the end of this particular social-media marriage is upon us. Despite the immediate user backlash, Instagram CEO Kevin Systrom has made it pretty clear that the photo-sharing app doesn’t plan on making nice with Twitter. In case you hadn’t accepted the reality of Silicon Valley competition the first time around, this photo-friendly weekend might be the time to check out our handy three-step guide to getting over it. 

Social Media News Headlines – Yahoo! News

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Te'o and Manziel hit Manhattan with Heisman hopes

NEW YORK (AP) — Notre Dame linebacker Manti Te'o was looking forward to a break. It's been a long week for most decorated football player in the country.

Texas A&M quarterback Johnny Manziel seemed to have more energy when he arrived at a midtown Manhattan hotel with his fellow Heisman Trophy finalist.

The two players spent about 30 minutes getting grilled by dozens of reporters before being whisked away to more interviews.

Manziel, Te'o or Collin Klein, the other finalist — who could not make it to town Friday — each has a chance to be a Heisman first Saturday night.

Manziel is trying to be the first freshman to win the award. Te'o would be the first winner to play only defense. Klein would be Kansas State's first Heisman winner.

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