Well: Effects of Bullying Last Into Adulthood, Study Finds

Victims of bullying at school, and bullies themselves, are more likely to experience psychiatric problems in childhood, studies have shown. Now researchers have found that elevated risk of psychiatric trouble extends into adulthood, sometimes even a decade after the intimidation has ended.

The new study, published in the journal JAMA Psychiatry on Wednesday, is the most comprehensive effort to date to establish the long-term consequences of childhood bullying, experts said.

“It documents the elevated risk across a wide range of mental health outcomes and over a long period of time,” said Catherine Bradshaw, an expert on bullying and a deputy director of the Center for the Prevention of Youth Violence at Johns Hopkins University, which was not involved in the study.

“The experience of bullying in childhood can have profound effects on mental health in adulthood, particularly among youths involved in bullying as both a perpetuator and a victim,” she added.

The study followed 1,420 subjects from Western North Carolina who were assessed four to six times between the ages of 9 and 16. Researchers asked both the children and their primary caregivers if they had been bullied or had bullied others in the three months before each assessment. Participants were divided into four groups: bullies, victims, bullies who also were victims, and children who were not exposed to bullying at all.

Participants were assessed again in young adulthood — at 19, 21 and between 24 and 26 — using structured diagnostic interviews.

Researchers found that victims of bullying in childhood were 4.3 times more likely to have an anxiety disorder as adults, compared to those with no history of bullying or being bullied.

Bullies who were also victims were particularly troubled: they were 14.5 times more likely to develop panic disorder as adults, compared to those who did not experience bullying, and 4.8 times more likely to experience depression. Men who were both bullies and victims were 18.5 times more likely to have had suicidal thoughts in adulthood, compared to the participants who had not been bullied or perpetuators. Their female counterparts were 26.7 times more likely to have developed agoraphobia, compared to children not exposed to bullying.

Bullies who were not victims of bullying were 4.1 times more likely to have antisocial personality disorder as adults than those never exposed to bullying in their youth.

The effects persisted even after the researchers accounted for pre-existing psychiatric problems or other factors that might have contributed to psychiatric disorders, like physical or sexual abuse, poverty and family instability.

“We were actually able to say being a victim of bullying is having an effect a decade later, above and beyond other psychiatric problems in childhood and other adversities,” said William E. Copeland, lead author of the study and an associate professor of psychiatry and behavioral sciences at Duke University Medical Center.

Bullying is not a harmless rite of passage, but inflicts lasting psychiatric damage on a par with certain family dysfunctions, Dr. Copeland said. “The pattern we are seeing is similar to patterns we see when a child is abused or maltreated or treated very harshly within the family setting,” he said.

One limitation of the study is that bullying was not analyzed for frequency, and the researchers’ assessment did not distinguish between interpersonal and overt bullying. It only addressed bullying at school, not in other settings.

Most of what experts know about the effects of bullying comes from observational studies, not studies of children followed over time.

Previous research from Finland, based on questionnaires completed on a single occasion or on military registries, used a sample of 2,540 boys to see if being a bully or a victim at 8 predicted a psychiatric disorder 10 to 15 years later. The researchers found frequent bully-victims were at particular risk of adverse long-term outcomes, specifically anxiety and antisocial personality disorders. Victims were at greater risk for anxiety disorders, while bullies were at increased risk for antisocial personality disorder.

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DealBook: Anheuser- Busch InBev and Justice Dept. Ask for Halt in Antitrust Case

Anheuser-Busch InBev and the Justice Department said Wednesday that they were in talks to resolve antitrust concerns over the beer maker’s planned deal with Grupo Modelo, the maker of Corona beer and other brands.

The parties said they had jointly requested a temporary stay of an antitrust suit filed by the Justice Department while they work through the options.

Last year, Anheuser-Busch InBev had offered $20.1 billion to buy the rest of with Grupo Modelo that it did not already own, but the Justice Department filed suit on Jan. 31 seeking to block the deal on antitrust grounds. United States authorities had said the original Grupo Modelo merger proposal would increase Anheuser-Busch InBev’s control of the American beer market, enabling it to raise prices while reducing choice for local consumers.

Grupo Modelo is the third-largest beer company in the United States. Anheuser-Busch InBev is the largest, ahead of MillerCoors.

In response, Anheuser-Busch InBev last week offered broad concessions, saying it would sell the rights to Corona and other Grupo Modelo brands in the United States to Constellation Brands, one of the world’s largest wine companies, for $2.9 billion. The new agreement would also include the sale of a brewery close to the United States-Mexico border that is owned by Grupo Modelo, as well as the perpetual licensing rights to Grupo Modelo’s brands in the United States.

The Grupo Modelo deal is a vital merger for Anheuser-Busch InBev, which has been seeking greater access to emerging markets.

Despite robust competition from microbrewers and other brands, analysts say that the craft beer market makes up just 6 percent of beer sales.

The biggest in the market, Anheuser — brewer of Budweiser and Stella Artois — has raised its prices with regularity every year, with MillerCoors following suit, the Justice Department said.

In a statement on Wednesday, the companies involved in the talks and the Justice Department jointly requested a delay until March 19. Anheuser-Busch InBev and Modelo reiterated that the “revised transaction resolves the concerns raised” by the Justice Department’s antitrust suit.

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Brazen Jewel Robbery at Brussels Airport Nets $50 Million in Diamonds

BRUSSELS — They arrived at Brussels Airport armed with automatic weapons and dressed in police uniforms aboard two vehicles equipped with blue police lights. But their most important weapon was information: the eight hooded gangsters who on Monday evening seized diamonds worth tens of millions of dollars from a passenger plane preparing to depart for Switzerland knew exactly when to strike — just 20 minutes before takeoff.

Forcing their way through the airport’s perimeter fence, the thieves raced, police lights flashing, to flight LX789, which had just been loaded with diamonds from a Brinks armored van from Antwerp, Belgium, and was getting ready for an 8:05 p.m. departure for Zurich.

“There is a gap of only a few minutes” between the loading of valuable cargo and the moment the plane starts to move, said Caroline De Wolf, a spokeswoman for the Antwerp World Diamond Centre, an industry body that promotes the diamond business in Belgium. “The people who did this knew there was going to be this gap and when.”

They also knew they had to move swiftly in a secure airport zone swarming with police officers and security guards. Waving guns that the Brussels prosecutors office described as “like Kalashnikovs,” they calmly ordered ground staff and the pilot, who was outside the plane making a final inspection, to back off and began unloading scores of gem-filled packets from the cargo hold. Without firing a shot, they then sped away into the night with a booty that the Antwerp Diamond Centre said was worth around $50 million but which some Belgian news media reported as worth much more.

The thieves’ only mishap: they got away with 120 packets of diamonds but left some gems behind in their rush.

“They were very, very professional,” said the Brussels prosecutor Ine Van Wymersch, who said the whole operation lasted barely five minutes. The police, she added, are now examining whether the thieves had inside information. “This is an obvious possibility,” she said.

Passengers, already on board the plane awaiting takeoff, had no idea anything was amiss until they were told to disembark as their Zurich-bound flight, operated by Helvetic Airways, had been canceled.

“I am certain this was an inside job,” said Doron Levy, an expert in airport security at a French risk management company, Ofek. The theft, he added, was “incredibly audacious and well organized,” and beyond the means of all but the most experienced and strong-nerved criminals. “In big jobs like this we are often surprised by the level of preparation and information: they know so much they probably know the employees by name.”

He said the audacity of the crime recalled in some ways the so-called Pink Panther robberies, a long series of brazen raids on high-end jewelers in Geneva, London and elsewhere blamed on criminal gangs from the Balkans. But he said the military precision of Monday’s diamond robbery and the targeting of an airport suggested a far higher level of organization than the cruder Pink Panther operations.

The police have yet to make any arrests related to the airport robbery, said the prosecutor, but have found a burned-out white van that they believe may have been used by the robbers. It was found near the airport late on Monday.

Scrambling to crack a crime that has delivered an embarrassing blow to the reputation of Brussels Airport and Antwerp’s diamond industry, the Belgian police are now looking into possible links with earlier robberies at the same airport. The airport, which handles nearly daily deliveries of diamonds to and from Antwerp, the world’s leading diamond trading center, has been targeted on three previous occasions since the mid-1990s by thieves using similar methods to seize gems and other valuables. Most of the culprits in those robberies have been caught.

Jan Van Der Cruysse, a spokesman for the airport, insisted that security was entirely up to international standards, but “what we face is organized crime with methods and means not addressed in aviation security measures as we know them today.” Precautions designed to combat would-be bombers and other threats, he added, could not prevent commando-style raids by heavily armed criminals. “This involves much more than an aviation security problem.”

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Pistorius: Lover caught in tragedy or killer?

PRETORIA, South Africa (AP) — Oscar Pistorius portrayed himself as a lover caught in tragedy, wielding a pistol and frightened as he stood only on his stumps, then killed his girlfriend after mistaking her for an intruder on Valentine's Day.

Prosecutors, however, said the double-amputee Olympian committed premeditated murder, planning the slaying, then firing at Reeva Steenkamp as she cowered behind his locked bathroom door with no hope of escape.

"She couldn't go anywhere," Prosecutor Gerrie Nel told a packed courtroom Tuesday. "It must have been horrific."

Weeping uncontrollably, Pistorius listened as his words were read out in court by his attorney during the opening of a two-day bail hearing, his first public account of the events surrounding the shooting death of Steenkamp, a 29-year-old model and reality TV star who had spoken out against violence against women.

"I fail to understand how I could be charged with murder, let alone premeditated murder, as I had no intention to kill my girlfriend, Reeva Steenkamp," Pistorius said in the sworn affidavit. "I deny the aforesaid allegation in the strongest terms."

It was the first time that the prosecution and Pistorius provided details of their radically divergent accounts of the killing, which has shocked South Africans and fans worldwide, who idolized the 26-year-old track star known as the Blade Runner for overcoming his disability to compete in last summer's London Olympics.

Nel said Pistorius committed premeditated murder when he rose from his bed after a fight with Steenkamp, pulled on his prosthetic legs and walked about 20 feet from his bedroom to the locked toilet door and pumped it with four bullets, three of which hit the model.

That contradicted the runner's statement, read aloud by defense attorney Barry Roux, who described how the couple spent a quiet night together in the athlete's upscale home in a gated community in the capital of Pretoria, then went to sleep around 10 p.m.

Sometime before dawn, Pistorius said he awoke, and walking only on his stumps, pulled a fan in from an open balcony and closed it. That's when he said he heard a noise and became alarmed because the bathroom window, which had no security bars, was open and workers had left ladders nearby.

"It filled me with horror and fear," Pistorius said in the statement.

"I am acutely aware of violent crime being committed by intruders entering homes," he said. "I have received death threats before. I have also been a victim of violence and of burglaries before. For that reason I kept my firearm, a 9 mm Parabellum, underneath my bed when I went to bed at night."

Too frightened to turn on a light, Pistorius said, he pulled out his pistol and headed for the bathroom, believing Steenkamp was still asleep "in the pitch dark" of the bedroom.

"As I did not have my prosthetic legs on and felt extremely vulnerable, I knew I had to protect Reeva and myself," he said, adding that he shouted to Steenkamp to call the police as he fired at the closed toilet door.

It was then, Pistorius said, that he realized Steenkamp was not in bed.

He said he pulled on his prosthetic legs and tried to kick down the toilet door before finally giving up and bashing it in with a cricket bat. Inside, he said he found Steenkamp, slumped over but still alive. He said he lifted her bloodied body and carried her downstairs to seek medical help.

But it was too late. "She died in my arms," Pistorius said.

"We were deeply in love and I could not be happier," the athlete said. "I know she felt the same way. She had given me a present for Valentine's Day but asked me only to open it the next day."

Pistorius broke down in sobs repeatedly as his account was read, prompting Chief Magistrate Desmond Nair to call a recess at one point.

"Maintain your composure," the magistrate said. "You need to apply your mind here."

"Yes, my lordship," Pistorius replied, his voice quivering.

Nair adjourned the case until Wednesday without ruling on whether Pistorius would be granted bail. However, he said the gravity of the charge — which carries a mandatory life sentence — meant the athlete's lawyers must offer "exceptional" reasons for bail to be granted, making his release unlikely.

Roux, the defense attorney, said there was no evidence to substantiate a murder charge. "We submit it is not even murder. There is no concession this is a murder," he said.

The prosecutor disagreed.

"It is our respectful argument that 'pre-planning' or premeditation do not require months of planning," Nel said. "If ... I ready myself and walk a distance with the intention to kill someone, it is premeditated."

Hundreds of miles from the Magistrate's Court, a memorial service was held for Steenkamp in the south coast city of Port Elizabeth. Six pallbearers carried her coffin, draped with a white cloth and covered in white flowers, into the church for the private service and cremation.

Relatives recalled how the model with a law degree had campaigned against domestic violence and had planned to don black for a "Black Friday" protest in honor of a 17-year-old girl who was recently gang-raped and mutilated.

What "she stood for, and the abuse against women, unfortunately it's gone right around, and I think the Lord knows that statement is more powerful now," said her uncle, Mike Steenkamp.

South Africa has some of the world's worst rates of violence against women and the highest rate in the world of women killed by an intimate partner, according to a study by the Medical Research Council, which said at least three women are killed by a partner every day in the country of 50 million.

Since the shooting, several of Pistorius' sponsors have dropped him. On Tuesday, Clarins Group, which owns Thierry Mugler Perfumes, said it would withdraw all advertising featuring the Olympian. A cologne line with the company, called A(asterisk)Men, bears his image.

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Associated Press writer Michelle Faul in Johannesburg and AP photographer Schalk van Zuydam in Port Elizabeth, South Africa, contributed to this report.

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Jon Gambrell can be reached at www.twitter.com/jongambrellAP. Gerald Imray can be reached at www.twitter.com/geraldimrayAP.

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DNA Analysis, More Accessible Than Ever, Opens New Doors

Matt Roth for The New York Times

Sam Bosley of Frederick, Md., going shopping with his daughter, Lillian, 13, who has a malformed brain and severe developmental delays, seizures and vision problems. More Photos »

Debra Sukin and her husband were determined to take no chances with her second pregnancy. Their first child, Jacob, who had a serious genetic disorder, did not babble when he was a year old and had severe developmental delays. So the second time around, Ms. Sukin had what was then the most advanced prenatal testing.

The test found no sign of Angelman syndrome, the rare genetic disorder that had struck Jacob. But as months passed, Eli was not crawling or walking or babbling at ages when other babies were.

“Whatever the milestones were, my son was not meeting them,” Ms. Sukin said.

Desperate to find out what is wrong with Eli, now 8, the Sukins, of The Woodlands, Tex., have become pioneers in a new kind of testing that is proving particularly helpful in diagnosing mysterious neurological illnesses in children. Scientists sequence all of a patient’s genes, systematically searching for disease-causing mutations.

A few years ago, this sort of test was so difficult and expensive that it was generally only available to participants in research projects like those sponsored by the National Institutes of Health. But the price has plunged in just a few years from tens of thousands of dollars to around $7,000 to $9,000 for a family. Baylor College of Medicine and a handful of companies are now offering it. Insurers usually pay.

Demand has soared — at Baylor, for example, scientists analyzed 5 to 10 DNA sequences a month when the program started in November 2011. Now they are doing more than 130 analyses a month. At the National Institutes of Health, which handles about 300 cases a year as part of its research program, demand is so great that the program is expected to ultimately take on 800 to 900 a year.

The test is beginning to transform life for patients and families who have often spent years searching for answers. They can now start the grueling process with DNA sequencing, says Dr. Wendy K. Chung, professor of pediatrics and medicine at Columbia University.

“Most people originally thought of using it as a court of last resort,” Dr. Chung said. “Now we can think of it as a first-line test.”

Even if there is no treatment, there is almost always some benefit to diagnosis, geneticists say. It can give patients and their families the certainty of knowing what is wrong and even a prognosis. It can also ease the processing of medical claims, qualifying for special education services, and learning whether subsequent children might be at risk.

“Imagine the people who drive across the whole country looking for that one neurologist who can help, or scrubbing the whole house with Lysol because they think it might be an allergy,” said Richard A. Gibbs, the director of Baylor College of Medicine’s gene sequencing program. “Those kinds of stories are the rule, not the exception.”

Experts caution that gene sequencing is no panacea. It finds a genetic aberration in only about 25 to 30 percent of cases. About 3 percent of patients end up with better management of their disorder. About 1 percent get a treatment and a major benefit.

“People come to us with huge expectations,” said Dr. William A. Gahl, who directs the N.I.H. program. “They think, ‘You will take my DNA and find the causes and give me a treatment.' ”

“We give the impression that we can do these things because we only publish our successes,” Dr. Gahl said, adding that when patients come to him, “we try to make expectations realistic.”

DNA sequencing was not available when Debra and Steven Sukin began trying to find out what was wrong with Eli. When he was 3, they tried microarray analysis, a genetic test that is nowhere near as sensitive as sequencing. It detected no problems.

“My husband and I looked at each other and said, ‘The good news is that everything is fine; the bad news is that everything is not fine,' ” Ms. Sukin said.

In November 2011, when Eli was 6, Ms. Sukin consulted Dr. Arthur L. Beaudet, a medical geneticist at Baylor.

“Is there a protein missing?” she recalled asking him. “Is there something biochemical we could be missing?”

By now, DNA sequencing had come of age. Dr. Beaudet said that Eli was a great candidate, and it turned out that the new procedure held an answer.

A single DNA base was altered in a gene called CASK, resulting in a disorder so rare that there are fewer than 10 cases in all the world’s medical literature.

“It really became definitive for my husband and me,” Ms. Sukin said. “We would need to do lifelong planning for dependent care for the rest of his life.”

This article has been revised to reflect the following correction:

Correction: February 19, 2013

An earlier version of this article misstated the name of a medicine taken by two teenagers who have a rare gene mutation. The drug is 5-hydroxytryptophan, not 5-hydroxytryptamine.

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Nanotubes Seen as an Alternative to Silicon Circuits

SAN FRANCISCO — In the next decade or so, the circuits etched on silicon-based computer chips are expected to shrink as small as they can physically become, prompting a search for alternative materials to take their place.

Some researchers are putting high hopes on carbon nanotubes, and on Monday a group of researchers at Stanford successfully demonstrated a simple microelectronic circuit composed of 44 transistors fabricated entirely from the threadlike fibers.

The development, which was presented both as a paper and a working demonstration at a technical conference here, is the most striking evidence yet that carbon nanotubes may prove to be the material of the future when today’s silicon-based chips reach their fundamental physical limits.

I.B.M., which is one of the biggest proponents of nanotubes for microelectronic applications, has made clear its hope that carbon nanotube technology will be ready a decade from now, when semiconductors are expected to shrink to minimum dimensions of just 5 nanometers. But until now, researchers at universities and chip makers have succeeded in making only individual devices, like transistors, from carbon nanotubes.

The Stanford development is the first time a complete working circuit has been created and publicly demonstrated, suggesting that the material may indeed live up to its promise.

Silicon, a plentiful natural element which functions both as a conductor and an insulator, has already lasted decades longer than computer engineers originally expected, as generations of increasingly smaller transistors have been perfected. It is used by the computer chip industry to etch circuits much finer than the wave length of light, and engineers and scientists say they believe that the material will continue to scale down, at least until the end of the decade.

But sooner or later the shrinking of circuits made from the material will stop, ending the microelectronic era that has been defined by Moore’s Law, the 1965 observation by the Intel co-founder, Gordon Moore, that the number of transistors that could be placed on a silicon chip doubled at regular intervals.

The Stanford advance seems to hold promise for the belief that whenever the silicon era stalls, the scaling-down process will continue, and permit designers to increase power and capacity of computers far into the future.

The Stanford demonstration came during a session at the International Solid State Circuits Conference, held here annually. A graduate student, Max Shulaker, chose a wooden, human-size hand, connected to a simple motor and gear arrangement on a makeshift stand. Onstage, he threw a switch and the hand shook vigorously.

It was a simple demonstration, but the research group said its goal was to build an entire microprocessor from carbon nanotubes to confirm the potential of the material.

Besides their small size, carbon nanotubes use much less power and switch faster than today’s silicon transistors.

“The bottom line is you can expect an order of magnitude in power saving at the system level,” said Subhasish Mitra, an associate professor of electrical engineering at Stanford and director of the Robust Systems Group. That offers tremendous promise for effectively increasing the battery life in mobile consumer devices in the future, he said.

Other new materials and variations of silicon-based transistors are also being studied to see if they will shrink to smaller sizes. Intel, for example, last year began using a three-dimensional transistor called a FinFET. By turning the device on its side, the chip maker was able to pack transistors more densely on the surface of a chip.

“I’m not saying there is nothing else around,” said H.-S. Philip Wong, a Stanford electrical engineering professor. “It’s just a matter of who wins when you scale down to really, really small dimensions.”

The challenge of carbon nanotubes in their type state is that they form a giant “hairball” of interwoven molecules. However, by chemically growing them on a quartz surface, the researchers are able to align them closely and in regularly spaced rows. They then transfer them to a silicon wafer, where they used conventional photolithographic techniques to make working circuits.

The technological hurdle has been to make reliable circuits even when a small percentage of the wires are misaligned. The Stanford group stated it had perfected a circuit technique that made use of redundancy to work around the imperfectly formed wires.

Dr. Mitra said that “99.5 percent looks very nice on a PowerPoint slide. But when you’re talking about 10 billion things, .5 percent of 10 billion is a really large number, and that completely messes things up.”

Beyond microelectronics, carbon nanotubes are showing promise in commercial applications like rechargeable batteries, bicycle frames, ship hulls, solar cells and water filters, according to an article in the Feb. 1 issue of the journal Science.

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As Assad Holds Firm, Obama Could Revisit Arms Policy

Reuters

A member of the Free Syrian Army inside a weapons factory in Aleppo on Monday. President Obama has decided against providing arms to rebels in the past.

WASHINGTON — When President Obama rebuffed four of his top national security officials who wanted to arm the rebels in Syria last fall, it put an end to a months-long debate over how aggressively Washington should respond to the strife there that has now left nearly 70,000 dead.

But the decision also left the White House with no clear strategy to resolve a crisis that has bedeviled it since a popular uprising erupted against President Bashar al-Assad almost two years ago. Despite an American program of nonlethal assistance to opponents of the Syrian government and $365 million in humanitarian aid, Mr. Obama appears to be running out of options to speed Mr. Assad’s exit.

With conditions continuing to deteriorate, officials said, the president could reopen the question of whether to provide weapons to select members of the resistance in an effort to break the impasse in Syria. The question is whether a wary Mr. Obama, surrounded by a new national security team, would come to a different conclusion.

“This is not a closed decision,” a senior administration official insisted. “As the situation evolves, as our confidence increases, we might revisit it.”

Mr. Obama’s refusal to provide arms when the proposal was broached before the November election, officials said, was driven by his reluctance to get drawn into a proxy war and his fear that the weapons would end up in unreliable hands, where they could be used against civilians or Israeli and American interests.

As the United States struggles to formulate a policy, however, Mr. Assad has given no sign that he is ready to yield power, and the Syrian resistance is adamant that it will not negotiate a transition in which he has a role. Mr. Obama, in his State of the Union address, did not repeat his oft-stated confidence that Mr. Assad’s days are numbered.

Even if Mr. Assad was overthrown, the convulsion could fragment Syria along sectarian and ethnic lines, each supported by competing outside powers, said Paul Salem, who runs the Beirut-based Middle East office for the Carnegie Endowment for International Peace. “Syria,” he said, “is in the process, not of transitioning, but disintegrating.”

The State Department has funneled $50 million of nonlethal assistance to the Syrian opposition, including satellite telephones, radios, broadcasting equipment, computers, survival equipment and the training in how to use them. This support, officials say, has helped Syrians opposed to the Assad regime communicate with one another and the outside world, despite efforts by Syrian forces to target rebel communications using Iranian-supplied equipment. A Syria-wide FM radio network is to connect broadcasting operations in several cities in the next several days. The State Department has also helped train local councils in areas that have freed from the Syrian government’s control.

But the State Department does not provide non-lethal assistance to armed rebel factions. This has greatly limited the influence the United States has with armed groups that are likely to control much of Syria if Mr. Assad is ousted.

“The odds are very high that, for better or worse, armed men will determine Syria’s course for the foreseeable future,” said Frederic C. Hof, a former senior State Department official and a senior fellow at the Atlantic Council. “For the U.S. not to have close, supportive relationships with armed elements, carefully vetted, is very risky.”

Because units of the anti-Assad Free Syria Army have captured prisoners and detained criminals in the areas they control, Mr. Hof said, it is essential that either the United States or an ally train rebel staff officers in judicial procedures and make them sensitive to human rights concerns.

While the White House has focused on the risks of providing weapons, other nations have had no such reservations. Russia has continued to provide arms and financial support to the Assad government. Iran has supplied the regime with weapons and Quds Force advisers. Hezbollah has sent militants to Syria to help Mr. Assad’s forces. On the other side of the struggle, anti-government Qaeda-affiliated fighters have been receiving financial and other support from their backers in the Middle East.

The arming plan that was considered last year originated with David H. Petreaus, then the director of the Central Intelligence Agency, and was supported by former Secretary of State Hillary Rodham Clinton. The goal was to create allies in Syria with whom the United States could work during the conflict and if Mr. Assad was removed from power. Each had their reasons for supporting it.

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Jerry Buss, Lakers' flamboyant owner, dies at 80

Jerry Buss built a glittering life at the intersection of sports and Hollywood.

After growing up in poverty in Wyoming, he earned success in academia, aerospace and real estate before discovering his favorite vocation when he bought the Los Angeles Lakers in 1979. While Buss wrote the checks and fostered partnerships with two generations of basketball greats, the Lakers won 10 NBA titles and became a glamorous worldwide brand.

With a scientist's analytical skills, a playboy's flair, a businessman's money-making savvy and a die-hard hoops fan's heart, Buss fashioned the Lakers into a remarkable sports entity. They became a nightly happening, often defined by just one word coined by Buss: Showtime.

"His impact is felt worldwide," said Kobe Bryant, who has spent nearly half his life working for Buss.

Buss, who shepherded his NBA team from the Showtime dynasty of the 1980s to the current Bryant era while becoming one of the most important and successful owners in pro sports, died Monday. He was 80.

"Think about the impact that he's had on the game and the decisions he's made, and the brand of basketball he brought here with Showtime and the impact that had on the sport as a whole," Bryant said a few days ago. "Those vibrations were felt to a kid all the way in Italy who was 6 years old, before basketball was even global."

Under Buss' leadership, the Lakers became Southern California's most beloved sports franchise and a worldwide extension of Los Angeles glamour. Buss acquired, nurtured and befriended a staggering array of talented players and basketball minds during his Hall of Fame tenure, from Magic Johnson and Kareem Abdul-Jabbar to Bryant, Shaquille O'Neal and Dwight Howard.

Few owners in sports history can approach Buss' accomplishments with the Lakers, who made the NBA finals 16 times during his nearly 34 years in charge, winning 10 titles between 1980 and 2010. Whatever the Lakers did under Buss' watch, they did it big — with marquee players, eye-popping style and a relentless pursuit of success.

"His incredible commitment and desire to build a championship-caliber team that could sustain success over a long period of time has been unmatched," said Jerry West, Buss' longtime general manager and now a consultant with the Golden State Warriors. "With all of his achievements, Jerry was without a doubt one of the most humble men I've ever been around. His vision was second to none; he wanted an NBA franchise brand that represented the very best and went to every extreme to accomplish his goals."

Buss died at Cedars-Sinai Medical Center in Los Angeles, said Bob Steiner, his assistant and longtime friend. Buss had been hospitalized for most of the past 18 months while undergoing cancer treatment, but the immediate cause of death was kidney failure, Steiner said.

"Anybody associated with the NBA since 1980 benefited greatly from Jerry Buss' impact on the game," Steiner said. "He had a different way of looking at things than I did, and people who had been raised in basketball."

With his condition worsening in recent months, several prominent former Lakers visited Buss to say goodbye. Buss' list of basketball friends is long and stellar, with Johnson citing him as a role model and nearly all former Lakers considering him a friend.

"He was a great man and an incredible friend," Johnson tweeted.

Buss always referred to the Lakers as his extended family, and his players rewarded his fanlike excitement with devotion, friendship and two hands full of championship rings. Working with front-office executives West, Bill Sharman and Mitch Kupchak, Buss spent lavishly to win his titles despite lacking a huge personal fortune, often running the NBA's highest payroll while also paying high-profile coaches Pat Riley and Phil Jackson.

With 1,786 victories, the Lakers easily are the NBA's winningest franchise since he bought the club, which is now run largely by Jim Buss and Jeanie Buss, two of his six children.

"We not only have lost our cherished father, but a beloved man of our community and a person respected by the world basketball community," the Buss family said in a statement issued by the Lakers.

"It was our father's often-stated desire and expectation that the Lakers remain in the Buss family. The Lakers have been our lives as well, and we will honor his wish and do everything in our power to continue his unparalleled legacy."

Johnson and fellow Hall of Famers Abdul-Jabbar and Worthy formed lifelong bonds with Buss during the Lakers' run to five titles in nine years in the 1980s, when the Lakers earned a reputation as basketball's most exciting team with their flamboyant Showtime repartee.

The buzz extended throughout the Forum, where Buss used the Laker Girls, a brass band and promotions to keep Lakers fans interested in all four quarters of their games. Courtside seats, priced at $15 when he bought the Lakers, became the hottest tickets in Hollywood — and they still are, with fixture Jack Nicholson and many other celebrities attending every home game.

Worthy tweeted that Buss was "not only the greatest sports owner, but a true friend & just a really cool guy. Loved him dearly."

After a rough stretch of the 1990s for the Lakers, Jackson led O'Neal and Bryant to a three-peat from 2000-02, rekindling the Lakers' mystique, before Bryant and Pau Gasol won two more titles under Jackson in 2009 and 2010. The Lakers have struggled mightily during their current season despite adding Howard and Steve Nash, and could miss the playoffs for just the third time since Buss bought the franchise.

"Today is a very sad day for all the Lakers and basketball," Gasol tweeted. "All my support and condolences to the Buss family. Rest in peace Dr. Buss."

Always an innovative businessman, Buss paid for the Lakers through both their wild success and his groundbreaking moves to raise revenue. He co-founded a basic-cable sports television network and sold the naming rights to the Forum at times when both now-standard strategies were unusual, further justifying his induction to the Naismith Memorial Basketball Hall of Fame in 2010.

"The NBA has lost a visionary owner whose influence on our league is incalculable and will be felt for decades to come," NBA Commissioner David Stern said. "More importantly, we have lost a dear and valued friend."

Although Buss gained fame and another fortune with the Lakers, he also was a scholar, Renaissance man and bon vivant who epitomized California cool his entire public life.

Buss rarely appeared in public without at least one attractive, much younger woman on his arm — at USC football games, high-stakes poker tournaments, hundreds of boxing matches promoted by Buss at the Forum — and, of course, Lakers games from his private box at Staples Center, which was built under his watch. In failing health recently, Buss hadn't attended a Lakers game in the past two seasons.

After a rough-and-tumble childhood that included stints as a ditch-digger and a bellhop in the frigid Wyoming winters, Buss earned a Ph.D. in chemistry at age 24 and had careers in aerospace and real estate development before getting into sports. With money from his real-estate ventures and a good bit of creative accounting, Buss bought the then-struggling Lakers, the NHL's Los Angeles Kings and both clubs' arena — the Forum — from Jack Kent Cooke in a $67.5 million deal that was the largest sports transaction in history at the time.

Last month, Forbes estimated the Lakers were worth $1 billion, second most in the NBA.

Buss also helped change televised sports by co-founding the Prime Ticket network in 1985, receiving a star on the Hollywood Walk of Fame in 2006 for his work in television. Breaking the contemporary model of subscription services for televised sports, Buss' Prime Ticket put beloved broadcaster Chick Hearn and the Lakers' home games on basic cable.

Buss also sold the naming rights to the Forum in 1988 to Great Western Savings & Loan — another deal that was ahead of its time.

Born in Salt Lake City, Gerald Hatten Buss was raised in poverty in Wyoming before improving his life through education. He also grew to love basketball, describing himself as an "overly competitive but underly endowed player."

After graduating from the University of Wyoming, Buss attended USC for graduate school. He became a chemistry professor and worked as a chemist for the Bureau of Mines before carving out a path to wealth and sports prominence.

The former mathematician's fortune grew out of a $1,000 real-estate investment in a West Los Angeles apartment building with partner Frank Mariani, an aerospace engineer and co-worker.

Heavily leveraging his fortune and various real-estate holdings during two years of negotiations, Buss purchased Cooke's entire Los Angeles sports empire in 1979, including a 13,000-acre ranch in Kern County. Buss cited his love of basketball as the motivation for his purchase, and he immediately worked to transform the Lakers — who had won just one NBA title since moving west from Minneapolis in 1960 — into a star-powered endeavor befitting Hollywood.

"One of the first things I tried to do when I bought the team was to make it an identification for this city, like Motown in Detroit," he told the Los Angeles Times in 2008. "I try to keep that identification alive. I'm a real Angeleno. I want us to be part of the community."

Buss' plans immediately worked: Johnson, Abdul-Jabbar and coach Paul Westhead led the Lakers to the 1980 title. Johnson's ball-handling wizardry and Abdul-Jabbar's smooth inside game made for an attractive style of play, and the Lakers came to define West Coast sophistication.

Riley, the former broadcaster who fit the L.A. image perfectly with his slick-backed hair and good looks, was surprisingly promoted by Buss early in the 1981-82 season after West declined to co-coach the team. Riley became one of the best coaches in NBA history, leading the Lakers to four straight NBA finals and four titles, with Worthy, Michael Cooper, Byron Scott and A.C. Green playing major roles.

Overall, the Lakers made the finals nine times in Buss' first 12 seasons while rekindling the NBA's best rivalry with the Boston Celtics, and Buss basked in the worldwide celebrity he received from his team's achievements. His partying became Hollywood legend, with even his players struggling to keep up with Buss' lifestyle.

Johnson's HIV diagnosis and retirement in 1991 staggered Buss and the Lakers, the owner recalled in 2011. The Lakers struggled through much of the 1990s, going through seven coaches and making just one conference finals appearance in an eight-year stretch despite the 1996 arrivals of O'Neal, who signed with Los Angeles as a free agent, and Bryant, the 17-year-old high schooler acquired in a draft-week trade.

Shaq and Kobe didn't reach their potential until Buss persuaded Jackson, the Chicago Bulls' six-time NBA champion coach, to take over the Lakers in 1999. Los Angeles immediately won the next three NBA titles in brand-new Staples Center, AEG's state-of-the-art downtown arena built with the Lakers as the primary tenant.

After the Lakers traded O'Neal in 2004, they hovered in mediocrity again until acquiring Gasol in a heist of a trade with Memphis in early 2008. Los Angeles made the next three NBA finals, winning two more titles.

Through the Lakers' frequent successes and occasional struggles, Buss never stopped living his Hollywood dream. He was an avid poker player and a fixture on the Los Angeles club scene well into his 70s, when a late-night drunk-driving arrest in 2007 — with a 23-year-old woman in the passenger seat of his Mercedes-Benz — prompted him to cut down on his partying.

Buss owned the NHL's Kings from 1979-87, and the WNBA's Los Angeles Sparks won two league titles under Buss' ownership. He also owned Los Angeles franchises in World Team Tennis and the Major Indoor Soccer League.

Ownership of the Lakers is now in a trust controlled by Buss' six children, who all have worked for the Lakers organization in various capacities for several years. Jim Buss, the Lakers' executive vice president of player personnel and the second-oldest child, has taken over much of the club's primary decision-making responsibilities in the last few years, while daughter Jeanie runs the franchise's business side.

"I am blessed with a wonderful family who have helped me and guided me every step of the way," Buss said in 2010 at his Hall of Fame induction ceremony. "This support is the best anybody could ever have."

Jerry Buss still served two terms as president of the NBA's Board of Governors and was actively involved in the 2011 lockout negotiations, developing blood clots in his legs attributed to his extensive travel during that time.

Buss is survived by his six children: sons Johnny, Jim, Joey and Jesse, and daughters Jeanie Buss and Janie Drexel. He had eight grandchildren.

Arrangements are pending for a funeral and memorial service, likely at Staples Center or a nearby theatre in downtown Los Angeles.

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Associated Press writers Beth Harris and Andrew Dalton contributed to this report.

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Personal Health: Health Effects of Smoking for Women

The title of a recent report on smoking and health might well have paraphrased the popular ad campaign for Virginia Slims, introduced in 1968 by Philip Morris and aimed at young professional women: “You’ve come a long way, baby.”

Today that slogan should include: “. . . toward a shorter life.” Ten years shorter, in fact.

The new report is one of two rather shocking analyses of the hazards of smoking and the benefits of quitting published last month in The New England Journal of Medicine. The data show that “women who smoke like men die like men who smoke,” Dr. Steven A. Schroeder, a professor of health and health care at the University of California, San Francisco, wrote in an accompanying editorial.

That was not always the case. Half a century ago, the risk of death from lung cancer among men who smoked was five times higher than that among women smokers. But by the first decade of this century, that risk had equalized: for both men and women who smoked, the risk of death from lung cancer was 25 times greater than for nonsmokers, Dr. Michael J. Thun of the American Cancer Society and his colleagues reported.

Today, women who smoke are even more likely than men who smoke to die of lung cancer. According to a second study in the same journal, women smokers face a 17.8 times greater risk of dying of lung cancer, than women who do not smoke; men who smoke are at 14.6 times greater risk to die of lung cancer than men who don’t. Women who smoke now face a risk of death from lung cancer that is 50 percent higher than the estimates reported in the 1980s, according to Dr. Prabhat Jha of the Center for Global Health Research in Toronto and his colleagues.

After controlling for age, body weight, education level and alcohol use, the new analysis found something else: men and women who continue to smoke die on average more than 10 years sooner than those who never smoked.

Dramatic progress has been made in reducing the prevalence of smoking, which has fallen in the United States from 42 percent of adults in 1965 (the year after the first surgeon general’s report on smoking and health) to 19 percent in 2010. Yet smoking still results in nearly 200,000 deaths a year among people 35 to 69 years old in this country. A quarter of all deaths in this age group would not occur if smokers had the same risk of death as nonsmokers.

The risks are even greater among men 55 to 74 and women 60 to 74. More than two-thirds of all deaths among current smokers in these age groups are related to smoking. Over all, the death rate from all causes combined in these age groups “is now at least three times as high among current smokers as among those who have never smoked,” Dr. Thun’s team found.

While lung cancer is the most infamous hazard linked to smoking, the habit also raises the risk of death from heart disease, stroke, pulmonary disease and other cancers, including breast cancer.

Furthermore, changes in how cigarettes are manufactured may have increased the dangers of smoking. The use of perforated filters, tobacco blends that are less irritating, and paper that is more porous made it easier to inhale smoke and encouraged deeper inhalation to achieve satisfying blood levels of nicotine.

The result of deeper inhalation, Dr. Thun’s report suggests, has been an increased risk of chronic obstructive pulmonary disease, or C.O.P.D., and a shift in the kind of lung cancer linked to smoking. Among nonsmokers, the risk of death from C.O.P.D. has declined by 45 percent in men and has remained stable in women, but the death rate has more than doubled among smokers.

But there is good news, too: it’s never too late to reap the benefits of quitting. The younger you are when you stop smoking, the greater your chances of living a long and healthy life, according to the findings of Dr. Jha’s international team.

The team analyzed smoking and smoking-cessation histories of 113,752 women and 88,496 men 25 and older and linked them to causes of deaths in these groups through 2006.

Those who quit smoking by age 34 lived 10 years longer on average than those who continued to smoke, giving them a life expectancy comparable to people who never smoked. Smokers who quit between ages 35 and 44 lived nine years longer, and those who quit between 45 and 54 lived six years longer. Even quitting smoking between ages 55 and 64 resulted in a four-year gain in life expectancy.

The researchers emphasized, however, that the numbers do not mean it is safe to smoke until age 40 and then stop. Former smokers who quit by 40 still experienced a 20 percent greater risk of death than nonsmokers. About one in six former smokers who died before the age of 80 would not have died so young if he or she had never smoked, they reported.

Dr. Schroeder believes we can do a lot better to reduce the prevalence of smoking with the tools currently in hand if government agencies, medical insurers and the public cooperate.

Unlike the races, ribbons and fund-raisers for breast cancer, “there’s no public face for lung cancer, even though it kills more women than breast cancer does,” Dr. Schroeder said in an interview. Lung cancer is stigmatized as a disease people bring on themselves, even though many older victims were hooked on nicotine in the 1940s and 1950s, when little was known about the hazards of smoking and doctors appeared in ads assuring the public it was safe to smoke.

Raising taxes on cigarettes can help. The states with the highest prevalence of smoking have the lowest tax rates on cigarettes, Dr. Schroeder said. Also helpful would be prohibiting smoking in more public places like parks and beaches. Some states have criminalized smoking in cars when children are present.

More “countermarketing” of cigarettes is needed, he said, including antismoking public service ads on television and dramatic health warnings on cigarette packs, as is now done in Australia. But two American courts have ruled that the proposed label warnings infringed on the tobacco industry’s right to free speech.

Health insurers, both private and government, could broaden their coverage of stop-smoking aids and better publicize telephone quit lines, and doctors “should do more to stimulate quit attempts,” Dr. Schroeder said.

As Nicola Roxon, a former Australian health minister, put it, “We are killing people by not acting.”

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DealBook: Reader's Digest Files for Bankruptcy, Again

Executives at Reader’s Digest must be hoping that the magazine’s second trip to bankruptcy court in under four years will be its last.

The magazine’s parent, RDA Holding, filed for Chapter 11 protection late on Sunday in another effort to cut down the debt that has plagued the pocket-size publication for years. The company is hoping to convert about $465 million of its debt into equity held by its creditors.

In a court filing, Reader’s Digest said it held about $1.1 billion in assets and just under $1.2 billion in debt. It has provisionally lined up about $105 million in financing to keep it afloat during the Chapter 11 case.

This week’s filing is the latest effort by the 91-year-old publisher, whose magazine once resided on many American coffee tables, to fix itself in a difficult economic environment.

“After considering a wide range of alternatives, we believe this course of action will most effectively enable us to maintain our momentum in transforming the business and allow us to capitalize on the growing strength and presence of our outstanding brands and products,” Robert E. Guth, the company’s chief executive, said in a statement.

Reader’s Digest last filed for bankruptcy in 2009, emerging a year later under the control of lenders like JPMorgan Chase.

That reorganization substantially cut the publisher’s debt, and afterward the company worked to further shrink its footprint. It jettisoned nonessential publications in a series of deals, including the $180 million sale of Allrecipes.com and the $4.3 million sale of Every Day With Rachael Ray, both to the Meredith Corporation.

Most of the money from those transactions went to pay down a still significant debt burden. But the company remained pressured by what it described in a court filing as steep declines that still bedevil the media industry. Last year, the publisher began negotiating with its lenders, including Wells Fargo, about amending some of its debt obligations. That process eventually led to a “pre-negotiated agreement” with creditors, which will be put into effect by the bankruptcy filing.

This time, Reader’s Digest is hoping to spend even less time in court. Mr. Guth said in a court filing that the publisher aims to emerge from bankruptcy protection in about four months.

The company’s biggest unsecured creditors include firms represented by Luxor Capital. The Federal Trade Commission also contends that it is owed $8.8 million in a settlement claim.

Reader’s Digest is being advised by Evercore Partners and the law firm Weil, Gotshal & Manges.

Reader's Digest bankruptcy petition (2013) by

Declaration by Reader's Digest Chief Executive by

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