Some With Autism Diagnosis Can Recover, Study Finds

Doctors have long believed that disabling autistic disorders last a lifetime, but a new study has found that some children who exhibit signature symptoms of the disorder recover completely.

The study, posted online on Wednesday by the Journal of Child Psychology and Psychiatry, is the largest to date of such extraordinary cases and is likely to alter the way that scientists and parents think and talk about autism, experts said.

Researchers on Wednesday cautioned against false hope. The findings suggest that the so-called autism spectrum contains a small but significant group who make big improvements in behavioral therapy for unknown, perhaps biological reasons, but that most children show much smaller gains. Doctors have no way to predict which children will do well.

Researchers have long known that between 1 and 20 percent of children given an autism diagnosis no longer qualify for one a few years or more later. They have suspected that in most cases the diagnosis was mistaken; the rate of autism diagnosis has ballooned over the past two decades, and some research suggests that it has been loosely applied.

The new study should put some of that skepticism to rest.

“This is the first solid science to address this question of possible recovery, and I think it has big implications,” said Sally Ozonoff of the MIND Institute at the University of California, Davis, who was not involved in the research. “I know many of us as would rather have had our tooth pulled than use the word ‘recover,’ it was so unscientific. Now we can use it, though I think we need to stress that it’s rare.”

She and other experts said the findings strongly supported the value of early diagnosis and treatment.

In the study, a team led by Deborah Fein of the University of Connecticut at Storrs recruited 34 people who had been diagnosed before the age of 5 and no longer had any symptoms. They ranged in age from 8 to 21 years old and early in their development were in the higher-than-average range of the autism spectrum. The team conducted extensive testing of its own, including interviews with parents in some cases, to gauge current social and communication skills.

The debate over whether recovery is possible has simmered for decades and peaked in 1987, when the pioneering autism researcher O. Ivar Lovaas reported that 47 percent of children with the diagnosis showed full recovery after undergoing a therapy he had devised. This therapy, a behavioral approach in which increments of learned skills garner small rewards, is the basis for the most effective approach used today; still, many were skeptical and questioned his definition of recovery.

Dr. Fein and her team used standardized, widely used measures and found no differences between the group of 34 formerly diagnosed people and a group of 34 matched control subjects who had never had a diagnosis.

“They no longer qualified for the diagnosis,” said Dr. Fein, whose co-authors include researchers from Queens University in Kingston, Ontario; Children’s Hospital of Philadelphia; the Institute of Living in Hartford; and the Child Mind Institute in New York. “I want to stress to parents that it’s a minority of kids who are able to do this, and no one should think they somehow missed the boat if they don’t get this outcome.”

On measures of social and communication skills, the recovered group scored significantly better than 44 peers who had a diagnosis of high-functioning autism or Asperger’s syndrome.

Dr. Fein emphasized the importance of behavioral therapy. “These people did not just grow out of their autism,” she said. “I have been treating children for 40 years and never seen improvements like this unless therapists and parents put in years of work.”

The team plans further research to learn more about those who are able to recover. No one knows which ingredients or therapies are most effective, if any, or if there are patterns of behavior or biological markers that predict such success.

“Some children who do well become quite independent as adults but have significant anxiety and depression and are sometimes suicidal,” said Dr. Fred Volkmar, the director of the Child Study Center at the Yale University School of Medicine. There are no studies of this group, he said.

That, because of the new study, is about to change.

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State of the Art: Imagining Ho-Hum C.E.S. as an Action Movie - State of the Art

Hi boss! I’m back from the Consumer Electronics Show in Las Vegas. You assigned me to report on what’s new and exciting, but I have some bad news. The answer is: almost nothing.

I mean, think about it: Apple, Google, Microsoft and Facebook don’t even attend C.E.S.; they’d rather make their product announcements on their own schedules without being locked into this every-January thing. It’s still a big show, bigger than ever this year, with 3,200 exhibits and 150,000 attendees, but I wonder why people bother. Whose product announcement will get any press at all when it’s buried by 3,199 others?

C.E.S.’s organizers publish a daily magazine during the show that profiles new products announced there. Here are some actual examples: “Braven Expands Bluetooth Speaker Line.” “Armpocket Unveils Smartphone Cases.” “Bits Ltd. Expands Line of Surge Protectors.”

So if you want an exciting column from me, the thrills won’t come from the news of new products at C.E.S. I’ll have to spice things up another way. See what you think of this.

As he plummets toward the Nevada desert, two deafening sounds assail Daxton Blackthorne’s eardrums — the wind rushing past his ears at terminal velocity, and a deafening explosion over his head. Fumbling for his parachute cord, he’s blasted by the searing heat from the fireball that, until seconds ago, was his Cessna Citation.

For now, though, his concern isn’t the air-to-air missile that has just dispatched his jet, courtesy of the Bora Boran Mafia on his tail. It isn’t even the fact that Daxton Blackthorne is all that stands between them and the collapse of American democracy.

It’s finding a good place to land.

There! Squinting in the blinding sun, he spots an enormous chain of low-slung buildings, stretching through the bustling downtown like a sleeping cobra: the Las Vegas Convention Center.

He hits the roof of the South Hall hard — too hard. Keeping low, he scuttles across the gravel to a ventilation shaft and emerges, moments later, in a blasting cacophony of color, sound and electronics.

He hears the crash of boots behind him as his pursuers explode from the same shaft. Got to move, Daxton thinks. Detaching his ’chute, he darts among the booths, dodging clumps of buyers, reporters and electronics executives.

He weaves among the exhibits, barely noting their wares. External battery packs for phones. Car chargers for phones. Screen protectors for phones. Cases for phones.

What is this place? he thinks, pulse pounding.

Booth after booth. GPS units. Tablets. Earbuds. Bluetooth speakers. Phone cases. Row after row of Chinese manufacturers he’s never heard of. Like this one, Huwei, selling the world’s largest Android phone — the thin, shiny Ascend Mate, with a 6.1-inch screen. That’d be like talking into a cutting board, he thinks.

He bursts into the Central Hall, and the sensory overload is immediate; he pauses, gasping, to take it in. TV screens. Thousands. Screens bigger than a man. Screens stacked up to the distant ceiling. Screens brighter and louder than explosives in the morning. Sharp, Sony, Samsung, LG, Toshiba, Panasonic. The bombardment is almost as lethal as the one that took down his Cessna.

Here are OLED screens, with incredibly black blacks, vivid colors and razor-thin bodies; this LG model is only 0.16 inches thick. Panasonic and Sony each claim “the world’s largest OLED screen” — 56-inch prototypes.

Footsteps pound behind him. Too late to run. He’ll blend in. He merges into a throng of eager showgoers.

“Three-D may have been a flop,” a rep is saying. “But this year, the industry is back with an irresistible offering: 4K television. Ultra HD, we call it. You thought HDTV was sharp? Now imagine: four times as many pixels. Stunning picture quality, in stunning screen sizes.”

Daxton figures you’d have to sit pretty darned close to see any difference between HDTV and 4KTV. But never mind that — out of the corner of his eye, Daxton spots the black uniforms of his pursuers, fanning through the crowd. Play along, he thinks. “Excuse me,” he shouts in a faux French accent. “What is there to watch in 4K?”

“Unfortunately, 4K video requires too much data for today’s cable, satellite, broadcast, Blu-ray, or Internet streaming,” is the reply. “But at Sony, we’re leading the way! If you buy our 84-inch 4K television for $25,000, we’ll lend you a hard drive with 10 Sony movies on it — in gorgeous 4K.”

Daxton can think of better uses for $25,000; a jetpack would come in handy right about now. He dives into the crowd. Must. Find. Disguise.

A crowd wearing headsets is gathered before a Samsung TV. That’ll do. He grabs one; it covers both his eyes and his ears.

“You’re seeing a prototype of Samsung’s OLED dual-view technology,” the spokesman says. “This TV can display two 3-D video sources simultaneously, or four regular ones. Imagine: Your children can be playing Xbox while you watch the Super Bowl!” Daxton moves the switch on the earpiece; sure enough, the TV’s image changes accordingly, along with the audio from the tiny earpiece speakers.

But angry shouts in Tahitian are closing in. He bolts through an archipelago of audio booths, hawking celebrity headphones bearing the names of the rapper 50 Cent, the heavy-metal band Motorhead, the runner Usain Bolt, the N.F.L. quarterback Tim Tebow and the TV reality star Snooki. When did Snooki become an audiophile? he wonders.

By the time he storms into the North Hall, his lungs are screaming. He stands, panting, in a broader area populated by gleaming, polished automobiles. Here are Ford and General Motors, announcing new developer programs, open platforms for new apps that will run on their cars’ computer screens. Ford’s Sync AppLink bans games and video apps, for safety reasons. Good thinking, Daxton thinks. Wouldn’t want distracted driving.

Here are Audi and Lexus, announcing self-driving cars. Glancing at the video loop, he notes that the Audi prototype can, at this point, drive itself only through specially equipped parking garages, like the one set up at the Mandarin Oriental for a demonstration.

But on the Lexus stage, he spots something much more enticing: a car, festooned with sensors, that can actually drive itself on regular roads, much like Google’s fleet of 12 autonomous cars.

“California and Nevada have both made self-driving cars legal, with certain restrictions,” the executive on stage says. “And this Lexus LS safety-research vehicle is a pioneer. The 360-degree laser on the roof detects objects up to 230 feet away; the front camera knows if the traffic light is red or green. Side cameras, GPS and radar enhance what could someday be a safe, efficient, road-aware vehicle.”

There’s a burst of commotion from Daxton’s near right. It’s them. He vaults onto the stage. “Love the idea of self-driving cars,” Daxton tells the presenter. “But right now, I need a car I can drive myself.”

A saber blade shatters the air next to his ear. With a burst of adrenaline, he dives through the open window of the Lexus. His assailants push through the crowd and clamber after him, but he’s already powered on the car. Huddling low, he guns the engine and shifts into gear.

As a hail of bullets shatters the rear window, the Lexus arcs off the stage, plows through seven rotating shelves of phone cases, and, in a cloud of plaster and twisted beams, erupts through the wall of the convention center.

With a wry smile, Daxton adjusts his rear-view mirror just in time to see the knot of black-suited Bora Borans shaking their fists in the distance.

He brushes some safety glass off his shoulder, slips on sunglasses, and leans back into the leather seat.

“Now that’s what I call an exciting show,” he says, grinning, and he swings onto the open road for home.

This article has been revised to reflect the following correction:

Correction: January 17, 2013

An earlier version of this article misspelled the name of a Chinese technology company. It is Huawei, not Huwei.

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Bomb Strikes Disputed Iraqi City of Kirkuk

BAGHDAD (AP) — A powerful suicide car bomb struck the local headquarters for the party of a key Kurdish leader early Wednesday in the disputed Iraqi city of Kirkuk, killing at least four and wounding dozens, according to officials.

The blast outside the offices of the Kurdistan Democratic Party caused widespread damage, mangling cars and tearing apart storefronts. The KDP is led by Massoud Barzani, the president of Iraq's largely autonomous Kurdish region, who has frequently sparred with Iraq's central governor in Baghdad.

Kirkuk provincial council chairman Hassan Torhan said 90 people have been wounded, suggesting the death toll could rise.

The blast comes amid rising tensions along Iraq's ethnic and sectarian divide.

Kirkuk, 290 kilometers (180 miles) north of Baghdad, is home to a mix of Arabs, Kurds and Turkomen, who all have competing claims to the oil-rich area. The Kurds want to incorporate it into their self-ruled region in Iraq's north, but Arabs and Turkomen are opposed.

The city is at the heart of a snaking swath of territory disputed between the Kurds, who have their own armed fighting force, and Iraq's central government. A shootout in another area along the contested area prompted both sides to rush troops and heavy weapons to the area in November.

Violence has fallen since the peak of insurgency several years ago, but lethal attacks still occur frequently.

There was no immediate claim of responsibility for Tuesday's attacks, but car bombs are the hallmark of Sunni insurgents such as al-Qaida in Iraq.

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Apple scoops PBS on “Downton Abbey” episodes, but PBS is cool with it

NEW YORK (TheWrap.com) – Apple is making the entire third season of “Downton Abbey” available on iTunes before every episode airs on PBS – and that’s just fine with PBS.

Fans who buy a season pass on iTunes beginning January 29 will get to see three episodes before they air on PBS. The Season 3 finale airs February 17.

But PBS CEO Paula Kerger isn’t worried that viewers will watch the show online, then tune out PBS. In fact, she says, Apple isn’t the only place Americans can see “Downton” before they can see it on her network.

“You can also buy the DVD sets. They’re being shipped at the end of January, and the DVD sets and Apple are going up at the same time,” Kerger told TheWrap. “I think that for people who are really passionate and want to have it, it’s a great thing.”

Kerger says she hopes more viewers will discover “Downton” on whatever format they like best – and then watch it on PBS next season.

“At the end of the day, my interest is just in seeing it get to the widest possible audience, and there are people that would pick it up on Apple that may not pick it up anywhere else,” she said.

The first episode of the third season premiered to a record 7.9 million viewers earlier this month. Many of those viewers, no doubt, caught up on the previous seasons online or through DVD viewing.

“Downton” airs in the U.K. in the fall but on PBS in January, which means PBS viewers must shield themselves from spoilers. That has led to some grumbling from American fans.

But Kerger said airing the show in January allows the show to get more attention domestically than it might otherwise receive in the crowded fall season.

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Anti-doping officials want Armstrong under oath

A televised confession by Lance Armstrong isn't enough.

Anti-doping officials want the disgraced cyclist to admit his guilt under oath before considering whether to lift a lifetime ban clouding his future as a competitive athlete. That was seconded by at least one former teammate whom Armstrong pushed aside on his way to the top of the Tour de France podium.

"Lance knows everything that happened," Frankie Andreu told The Associated Press on Tuesday. "He's the one who knows who did what because he was the ringleader. It's up to him how much he wants to expose."

Armstrong has been in conversations with U.S. Anti-Doping Agency officials, touching off speculation that he may be willing to cooperate with authorities there and name names.

Interviewer Oprah Winfrey didn't say if the subject was broached during the taping Monday at a downtown Austin hotel. In an appearance on "CBS This Morning," she declined to give details of what Armstrong told her, but said she was "mesmerized and riveted by some of his answers."

Asked whether the disgraced cyclist appeared genuinely contrite after a decade of fierce denials, Winfrey replied, "I felt that he was thoughtful, I thought that he was serious, I thought that he certainly had prepared for this moment. I would say that he met the moment."

She was promoting what has become a two-part special, Thursday and Friday, on her OWN network.

Around the same time, World Anti-Doping Agency officials issued a statement saying nothing short of "a full confession under oath" would cause them to reconsider Armstrong's lifetime ban from sanctioned events.

The International Cycling Union also urged Armstrong to tell his story to an independent commission it has set up to examine claims that the sport's governing body hid suspicious samples from the cyclist, accepted financial donations from him and helped him avoid detection in doping tests.

The ban was only one of several penalties handed to Armstrong after a scathing, 1,000-page report by USADA last year. The cyclist was also stripped of his seven Tour de France titles, lost nearly all of his endorsements and was forced to cut ties with the Livestrong cancer charity he founded in 1997.

The report portrayed Armstrong as the mastermind of a long-running scheme that employed steroids, blood boosters such as EPO, and a range of other performance-enhancers to dominate the tour. It included revealing testimony from 11 former teammates, including Andreu and his wife, Betsy.

"A lot of it was news and shocking to me," Andreu said. "I am sure it's shocking to the world. There's been signs leading up to this moment for a long time. For my wife and I, we've been attacked and ripped apart by Lance and all of his people, and all his supporters repeatedly for a long time. I just wish they wouldn't have been so blind and opened up their eyes earlier to all the signs that indicated there was deception there, so that we wouldn't have had to suffer as much.

"And it's not only us," he added, "he's ruined a lot of people lives."

Armstrong was believed to have left for Hawaii. The street outside his Spanish-style villa on Austin's west side was quiet the day after international TV crews gathered there hoping to catch a glimpse of him. Nearby, members of his legal team mapped out a strategy on how to handle at least two pending lawsuits against Armstrong, and possibly a third.

The AP reported earlier Tuesday that Justice Department officials were likely to join a whistleblower lawsuit against Armstrong by former teammate Floyd Landis, citing a source who works outside the government and requested anonymity because he was not authorized to speak on the record about the matter.

The lawsuit by Landis, who was stripped of the 2006 Tour de France title after testing positive, alleges that Armstrong defrauded the U.S. government by repeatedly denying he used performance-enhancing drugs. The deadline to join the False Claims Act lawsuit, which could require Armstrong to return substantial sponsorship fees and pay a hefty penalty, is Thursday.

Landis is hardly the only one seeking money back from Armstrong.

During his long reign as cycling champion, Armstrong scolded some critics in public, didn't hesitate to punish outspoken riders during the race, and waged legal battles against still others in court.

The London-based Sunday Times has already filed a lawsuit to recover about $500,000 it paid Armstrong to settle a libel case, and Dallas-based SCA Promotions, which tried to deny him a promised bonus for a Tour de France win, has threatened to bring another lawsuit seeking to recover more than $7.5 million awarded by an arbitration panel.

In Australia, the government of the state of South Australia said it will seek the repayment of several million dollars in appearance fees paid to Armstrong for competing in the Tour Down Under in 2009, 2010 and 2011.

"We'd be more than happy for Mr. Armstrong to make any repayment of monies to us," South Australia Premier Jay Weatherill said.

___

Litke reported from Chicago, Vertuno from Austin, Texas. Pete Yost in Washington and John L. Mone in Dearborn, Mich., also contributed to this report.

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Well: Boosting Your Flu Shot Response

Phys Ed

Gretchen Reynolds on the science of fitness.

As this year’s influenza season continues to take its toll, those procrastinators now hurrying to get a flu shot might wish to know that exercise may amplify the flu vaccine’s effect. And for maximal potency, the exercise should be undertaken at the right time and involve the right dosage of sweat, according to several recent reports.

Flu shots are one of the best ways to lessen the risk of catching the disease. But they are not foolproof. By most estimates, the yearly flu vaccine blocks infection 50 to 70 percent of the time, meaning that some of those being inoculated gain little protection. The more antibodies someone develops, the better their protection against the flu, generally speaking. But for some reason, some people’s immune systems produce fewer antibodies to the influenza virus than others’ do.

Being physically fit has been found in many studies to improve immunity in general and vaccine response in particular. In one notable 2009 experiment, sedentary, elderly adults, a group whose immune systems typically respond weakly to the flu vaccine, began programs of either brisk walking or a balance and stretching routine. After 10 months, the walkers had significantly improved their aerobic fitness and, after receiving flu shots, displayed higher average influenza antibody counts 20 weeks after a flu vaccine than the group who had stretched.

But that experiment involved almost a year of dedicated exercise training, a prospect that is daunting to some people and, in practical terms, not helpful for those who have entered this flu season unfit.

So scientists have begun to wonder whether a single, well-calibrated bout of exercise might similarly strengthen the vaccine’s potency.

To find out, researchers at Iowa State University in Ames recently had young, healthy volunteers, most of them college students, head out for a moderately paced 90-minute jog or bike ride 15 minutes after receiving their flu shot. Other volunteers sat quietly for 90 minutes after their shot. Then the researchers checked for blood levels of influenza antibodies a month later.

Those volunteers who had exercised after being inoculated, it turned out, exhibited “nearly double the antibody response” of the sedentary group, said Marian Kohut, a professor of kinesiology at Iowa State who oversaw the study, which is being prepared for publication. They also had higher blood levels of certain immune system cells that help the body fight off infection.

To test how much exercise really is required, Dr. Kohut and Justus Hallam, a graduate student in her lab, subsequently repeated the study with lab mice. Some of the mice exercised for 90 minutes on a running wheel, while others ran for either half as much time (45 minutes) or twice as much (3 hours) after receiving a flu shot.

Four weeks later, those animals that, like the students, had exercised moderately for 90 minutes displayed the most robust antibody response. The animals that had run for three hours had fewer antibodies; presumably, exercising for too long can dampen the immune response. Interestingly, those that had run for 45 minutes also had a less robust response. “The 90-minute time point appears to be optimal,” Dr. Kohut says.

Unless, that is, you work out before you are inoculated, another set of studies intimates, and use a dumbbell. In those studies, undertaken at the University of Birmingham in England, healthy, adult volunteers lifted weights for 20 minutes several hours before they were scheduled to receive a flu shot, focusing on the arm that would be injected. Specifically, they completed multiple sets of biceps curls and side arm raises, employing a weight that was 85 percent of the maximum they could lift once. Another group did not exercise before their shot.

After four weeks, the researchers checked for influenza antibodies. They found that those who had exercised before the shot generally displayed higher antibody levels, although the effect was muted among the men, who, as a group, had responded to that year’s flu vaccine more robustly than the women had.

Over all, “we think that exercise can help vaccine response by activating parts of the immune system,” said Kate Edwards, now a lecturer at the University of Sydney, and co-author of the weight-training study.

With the biceps curls, she continued, the exercises probably induced inflammation in the arm muscles, which may have primed the immune response there.

As for 90 minutes of jogging or cycling after the shot, it probably sped blood circulation and pumped the vaccine away from the injection site and to other parts of the body, Dr. Kohut said. The exercise probably also goosed the body’s overall immune system, she said, which, in turn, helped exaggerate the vaccine’s effect.

But, she cautions, data about exercise and flu vaccines is incomplete. It is not clear, for instance, whether there is any advantage to exercising before the shot instead of afterward, or vice versa; or whether doing both might provoke the greatest response – or, alternatively, be too much and weaken response.

So for now, she says, the best course of action is to get a flu shot, since any degree of protection is better than none, and, if you can, also schedule a visit to the gym that same day. If nothing else, spending 90 minutes on a stationary bike will make any small twinges in your arm from the shot itself seem pretty insignificant.

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Rights Group Reports on Abuses of Surveillance and Censorship Technology

A Canadian human rights monitoring group has documented the use of American-made Internet surveillance and censorship technology by more than a dozen governments, some with harsh human rights policies like Syria, China and Saudi Arabia.

Jakub Dalek of the Munk School of Global Affairs.

Thor Swift for The New York Times

Morgan Marquis-Boire led the research with Mr. Dalek.

The Citizen Lab Internet research group, based at the Munk School of Global Affairs at the University of Toronto, used computer servers to scan for the distinctive signature of gear made by Blue Coat Systems of Sunnyvale, Calif.

It determined that Egypt, Kuwait, Qatar, Saudi Arabia and the United Arab Republic employed a Blue Coat system that could be used for digital censorship. The group also determined that Bahrain, China, India, Indonesia, Iraq, Kenya, Kuwait, Lebanon, Malaysia, Nigeria, Qatar, Russia, Saudi Arabia, South Korea, Singapore, Thailand, Turkey and Venezuela used equipment that could be used for surveillance and tracking.

The authors said they wanted to alert the public that there was a growing amount of surveillance and content-filtering technology distributed throughout the Internet. The technology is not restricted from export by the State Department, except to countries that are on embargo lists, like Syria, Iran and North Korea.

“Our findings support the need for national and international scrutiny of the country Blue Coat implementations we have identified, and a closer look at the global proliferation of dual-use information and communications technology,” the group noted. “We hope Blue Coat will take this as an opportunity to explain their due diligence process to ensure that their devices are not used in ways that violate human rights.”

A spokesman for Blue Coat Systems said the firm had not seen the final report and was not prepared to comment.

In 2011, several groups, including Telecomix and Citizen Labs, raised concerns that Blue Coat products were being used to find and track opponents of the Syrian government. The company initially denied that its equipment had been sold to Syria, which is subject to United States trade sanctions.

Shortly afterward, Blue Coat reversed itself and acknowledged that the systems were indeed in Syria, but it said that the devices had been shipped to a distributor in Dubai, and said that it thought that they had been destined for the Iraqi Ministry of Communications.

The Citizen Lab research project was led by Morgan Marquis-Boire and Jakub Dalek. Mr. Marquis-Boire, a Google software engineer, has during the last year been involved in a variety of research projects aimed at exposing surveillance tools used by authoritarian regimes. He said that he carefully segregated his work at Google from his human rights research.

Last year, Mr. Marquis-Boire used computer servers to identify the use of an intelligence-oriented surveillance software program, called FinSpy, which was being used by Bahrain to track opposition activists.

On a hunch last month, the researchers used the Shodan search engine, a specialized Internet tool intended to help identify computers and software services that were connected to the Internet. They were able to identify a number of the Blue Coat systems that are used for content filtering and for “deep packet inspection,” a widely used technology for detecting and controlling digital content as it travels through the Internet.

The researchers stressed that they were aware that there were both benign and harmful uses for the Blue Coat products identified as ProxySG, which functions as a Web filter, and a second system, PacketShaper, which can detect about 600 Web applications and can be used to control undesirable Web traffic.

“I’m not trying to completely demonize this technology,” Mr. Marquis-Boire said.

The researchers also noted that the equipment does not directly fall under the dual-use distinction employed by the United States government to control the sale of equipment that has both military and civilian applications, but it can be used for both political and intelligence applications by authoritarian governments.

“Syria is subject to U.S. export sanctions,” said Sarah McKune, a senior researcher at the Citizen Lab. “When it comes to other countries that aren’t subject to U.S. sanctions it’s a more difficult situation. There could still be significant human rights impact.”

The researchers also noted that a large number of American and foreign companies supplied similar gear in what Gartner, the market research firm, described as a $1.02 billion market in a report issued in May 2012.

The researchers said that some American security technology companies, like Websense, had taken strong human rights stands, but had declined to grapple with the issue of the possible misuse of the technology.

This article has been revised to reflect the following correction:

Correction: January 16, 2013

An earlier version of this article misspelled the surname of a senior researcher at the Citizen Lab Internet research group. She is Sarah McKune, not McCune.

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IHT Rendezvous: IHT Quick Read: Jan. 15

NEWS Despite intensive airstrikes by French warplanes, Islamist fighters overran a strategic village and military post in central Mali on Monday, indicating that the war against extremists who have carved out a jihadist state in the nation’s north could be a long and difficult one. Steven Erlanger, Alan Cowell and Adam Nossiter report.

President Barack Obama and Republican Congressional leaders dug in Monday on their conflicting positions over raising the U.S. debt limit, indicating that the president’s second term will open with a potentially perilous budget showdown. Jackie Calmes and Jonathan Weisman report from Washington.

The chief human rights official at the United Nations, Navi Pillay, called on Monday for an international inquiry into human rights offenses committed by the North Korean government over many decades. Nick Cumming-Bruce reports from Geneva.

The Chinese state news media on Monday published aggressive reports on what they described as the dangerous air pollution in Beijing and other parts of northern China, indicating that popular anger over air quality had reached a level where propaganda officials felt they had to let the officially sanctioned press address the issue. Edward Wong reports from Beijing.

Unidentified gunmen on Monday sprayed bullets into the headquarters of Greece’s governing New Democracy party in Athens, adding to a wave of politically motivated violence. Liz Alderman reports from Athens.

ARTS When “Kung Fu Panda 3” kicks its way into China’s theaters in 2016, the country’s vigilant film censors will find no nasty surprises — after all, they have already dropped in to monitor the movie at the DreamWorks Animation campus in Los Angeles. The lure of access to China’s fast-growing film market is entangling studios and moviemakers with the state censors of a country in which American notions of free expression simply do not apply. Michael Cieply and Brooks Barnes report from Los Angeles.

Yannick Nézet-Séguin, the Philadelphia Orchestra’s Quebec-born music director, is what the orchestra world is desperate for: a young, charismatic maestro who can win the respect of grizzled orchestra veterans, the enthusiasm of audiences and the praise of critics. Daniel J. Wakin reports from Montreal.

FASHION Something in the dank winter air or the chily economy is bringing out the tough side of the alpha male. Boots elevated on rubber soles and leather jackets padded with nylon and neoprene make men’s wear for winter 2013 look like it is designed to handle a hurricane. Suzy Menkes writes from Milan.

SPORTS Caroline Wozniacki, long No. 1 in women’s tennis, is now No. 10. Her plan for 2013 is to minimize the pain and the confusion; to restore clarity to her game and stability to her off-court structure. Christopher Clarey reports from Melbourne.

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AP source: Armstrong tells Oprah Winfrey he doped

AUSTIN, Texas (AP) — The disgraced cyclist made the confession to Oprah Winfrey during an interview taped Monday, a person familiar with the situation told The Associated Press. The person spoke on condition of anonymity because the interview is to be broadcast Thursday on Winfrey's network.

The admission Monday came hours after an emotional apology by Armstrong to the Livestrong charity that he founded and took global on the strength of his celebrity as a cancer survivor who came back to win one of sport's most grueling events.

The confession was a stunning reversal, after years of public statements, interviews and court battles in which he denied doping and zealously protected his reputation.

Winfrey tweeted afterward, "Just wrapped with (at)lancearmstrong More than 2 1/2 hours. He came READY!" She was scheduled to appear on "CBS This Morning" on Tuesday to discuss the interview.

Even before the taping session with Winfrey began around 2 p.m., EST, Armstrong's apology suggested he would carry through on promises over the weekend to answer her questions "directly, honestly and candidly."

The cyclist was stripped of his Tour de France titles, lost most of his endorsements and was forced to leave the foundation last year after the U.S. Anti-Doping Agency issued a damning, 1,000-page report that accused him of masterminding a long-running doping scheme.

About 100 staff members of the charity Armstrong founded in 1997 gathered in a conference room as Armstrong arrived with a simple message: "I'm sorry." He choked up during a 20-minute talk, expressing regret for the long-running controversy tied to performance-enhancers had caused, but stopped short of admitting he used them.

Before he was done, several members were in tears when he urged them to continue the charity's mission, helping cancer patients and their families.

"Heartfelt and sincere," is how Livestrong spokesman Katherine McLane described his speech.

Armstrong later huddled with almost a dozen people before stepping into a room set up at a downtown Austin hotel for the interview.

The group included close friends and advisers, two of his lawyers and Bill Stapleton, his agent, manager and business partner. They exchanged handshakes and smiles, but declined comment when approached by a reporter. Most members of that group left the hotel through the front entrance around 5 p.m., although Armstrong was not with them.

No further details about the interview were available immediately because of confidentiality agreements signed by both camps. But Winfrey promoted it as a "no-holds barred" session, and after the voluminous USADA report — which included testimony from 11 former teammates — she had plenty of material for questions. USADA chief executive Travis Tygart, a longtime critic of Armstrong's, called the drug regimen practiced while Armstrong led the U.S. Postal Service team, "The most sophisticated, professionalized and successful doping program that sport has ever seen."

Armstrong also went after his critics ruthlessly during his reign as cycling champion. He scolded some in public and didn't hesitate to punish outspoken riders during the race itself. He waged legal battles against still others in court.

Betsy Andreu, the wife of former Armstrong teammate Frankie Andreu, was one of the first to publicly accuse Armstrong of using performance-enhancing drugs. She called news of Armstrong's confession "very emotional and very sad," and got choked up as well when asked to comment.

"He used to be one of my husband's best friends and because he wouldn't go along with the doping, he got kicked to the side. Lance could have a positive impact if he tells the truth on everything. He's got to be completely honest," she said.

At least one of his opponents, the London-based Sunday Times, has already filed a lawsuit to recover about $500,000 it paid him to settle a libel case, and Dallas-based SCA Promotions, which tried to deny Armstrong a promised bonus for a Tour de France win, has threatened to bring yet another lawsuit seeking to recover more than $7.5 million an arbitration panel awarded the cyclist in that dispute.

In addition, former teammate Floyd Landis, who was stripped of the 2006 Tour de France title for doping, has filed a federal whistle-blower lawsuit that accused Armstrong of defrauding the U.S. Postal Service. An attorney familiar with Armstrong's legal problems told the AP that the Justice Department is highly likely to join the lawsuit. The False Claims Act lawsuit could result in Armstrong paying a substantial amount of money to the U.S. government. The deadline for the department to join the case is Thursday, though the department could seek an extension if necessary.

According to the attorney, who works outside the government, the lawsuit alleges that Armstrong defrauded the U.S. government based on his years of denying use of performance-enhancing drugs. The attorney spoke on condition of anonymity because the source was not authorized to speak on the record about the matter.

The lawsuit most likely to be influenced by a confession might be the Sunday Times case. Potential perjury charges stemming from Armstrong's sworn testimony in the 2005 arbitration fight would not apply because of the statute of limitations. Armstrong was not deposed during the federal investigation that was closed last year.

Armstrong is said to be worth around $100 million. But most sponsors dropped him after USADA's scathing report — at the cost of tens of millions of dollars — and soon after, he left the board of Livestrong.

After the USADA findings, he was also barred from competing in the elite triathlon or running events he participated in after his cycling career. World Anti-Doping Code rules state his lifetime ban cannot be reduced to less than eight years. WADA and U.S. Anti-Doping officials could agree to reduce the ban further depending on what information Armstrong provides and his level of cooperation.

Whether his confession would begin to heal those ruptures and restore that reputation remains to be seen.

Diagnosed with testicular cancer in October 1996, the disease soon spread to his lungs and brains. Armstrong's doctors gave him a 40 percent chance of survival at the time and never expected he'd compete at anything more strenuous than gin rummy. Winning the demanding race less than three years later made Armstrong a hero.

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Jim Litke reported from Chicago. Pete Yost in Washington also contributed to this report.

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Well: Turning to the Web for a Medical Diagnosis

Thirty-five percent of American adults said they have used the Internet to diagnose a medical condition for themselves or someone else, according to a new Pew Research Center study. Women are more likely than men to turn to the Internet for diagnoses. Other groups more likely to do so are younger people, white adults, people with college degrees and those who live in households with income above $75,000.

The study, released by Pew’s Internet and American Life Project on Tuesday, points out that Americans have always tried to answer their health questions at home, but that the Internet has expanded the options for research. Previous surveys have asked questions about online diagnoses, but the Pew study was the first to focus on the topic with a nationally representative sample, said Susannah Fox, an associate director at Pew Internet. Surveyors interviewed 3,014 American adults by telephone, from August to September 2012.

Of the one in three Americans who used the Internet for a diagnosis, about a third said they did not go to a doctor to get a professional medical opinion, while 41 percent said a doctor confirmed their diagnosis. Eighteen percent said a doctor did not agree with their diagnosis. As far as where people start when researching health conditions online, 77 percent said they started at a search engine like Google, Bing or Yahoo, while 13 percent said they began at a site that specializes in health information.

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