DealBook: Allergan to Buy MAP Pharmaceuticals for $958 Million

Allergan has agreed to pay nearly $1 billion to acquire MAP Pharmaceuticals and gain full control of its experimental treatment for migraine headaches, the two companies announced Tuesday night.

The purchase price of $25 a share in cash is a 60 percent premium over MAP’s closing price on Tuesday of $15.58 a share. The deal, valued at $958 million in total, suggests that Allergan has considerable faith that MAP’s new migraine treatment will win regulatory approval from the Food and Drug Administration by the agency’s deadline of April 15.

The two companies said the deal had been unanimously approved by the boards of both companies and was expected to close in the second quarter.

Allergan already had the rights to help market the migraine drug, known as Levadex, in the United States and Canada, but after an acquisition it would have control of all the profits and costs globally.

Allergan is most known for Botox, a form of the botulinum toxin, which is used for cosmetic purposes as well as medical ones, including the treatment of chronic migraines with the goal of reducing the frequency of headaches. By contrast, Levadex is meant to treat migraines after they occur, making it complementary to Botox, Allergan said.

Levadex is actually a new form of an old drug, known as dihydroergotamine, or DHE, which has been used to treat severe migraine attacks for decades. DHE is typically given by intravenous infusion, requiring patients to get to a hospital at a time when many would rather remain in a dark quiet room.

Levadex, by contrast, is breathed into the lungs using an inhaler similar to one used for asthma, allowing people to use it at home.

The F.D.A. declined to approve Levadex last March, though MAP said the rejection was related to manufacturing and questions about use of the inhaler, not the safety and efficacy of the drug. It resubmitted its application, with additional data and answers to questions from the F.D.A., in October.

Levadex would be the first approved product for MAP, which is based in Mountain View, Calif.

Allergan said that if Levadex is approved by April, the transaction would dilute earnings by about 7 cents a share in 2013 and add to earnings in the second half of 2014.

Allergan was advised by Goldman Sachs and the law firm Gibson, Dunn & Crutcher. MAP was advised by Centerview Partners and the law firm Latham & Watkins.

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IHT Rendezvous: IHT Quick Read: Jan. 22

NEWS Barack Hussein Obama ceremonially opened his second term on Monday with an assertive Inaugural Address that offered a robust articulation of modern liberalism in America, arguing that “preserving our individual freedoms ultimately requires collective action.” Peter Baker reports from Washington. The President made addressing climate change the most prominent policy vow of his second Inaugural Address, setting in motion what Democrats say will be a deliberately paced but aggressive campaign built around the use of his executive powers to sidestep Congressional opposition. Richard W. Stevenson and John M. Broder report.

As the death toll from the crisis in the Sahara rose sharply to 37, Algeria’s prime minister said that the hostage takers intended to kill all their captives and that the army saved many by attacking. Adam Nossiter reports from Algiers and Eric Schmitt from Washington.

Malian and French troops appeared to recapture two important central Malian towns on Monday, pushing back an advance by Islamist militants who have overrun the country’s northern half. Lydia Polgreen reports from Segou, Mali, and Peter Tinti reports from Diabaly.

A report from the International Labor Organization predicted jobless levels to rise to 202 million worldwide this year, and said that government budget-balancing was hurting employment. David Jolly reports from Paris.

Europe’s political leaders have taken important steps to improve spending discipline among euro members, but have yet to address some serious flaws in the structure of the euro zone. Liz Alderman reports from Paris and Jack Ewing from Frankfurt.

Chancellor Angela Merkel’s main rivals eked out a one-seat majority that will usher the opposition Social Democrats into power in the state of Lower Saxony. Melissa Eddy and Nicholas Kulish report from Berlin.

ARTS The Neues Museum in Berlin is celebrating a bust of the Egyptian queen Nefertiti that “fell” into its hands 100 years ago. Melissa Eddy reports.

FASHION Raf Simons sent out a Dior summer couture collection rooted in reality — note the model’s wash-’n'-go hair — but full of flowers and the beauty of nature. Suzy Menkes writes from Paris.

SPORTS Sloane Stephens’s reward for reaching her first Grand Slam quarterfinal will be a match against a friend and fellow American, Serena Williams. Christopher Clarey reports from Melbourne.

Golfers will be able to express their opinions during Tuesday’s PGA Tour players’ meeting on the proposed ban of the anchored putting stroke. Karen Crouse reports from San Diego.

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BlackBerry Z10 compared to iPhone 5 on camera [video]






Alongside BGR’s own extensive BlackBerry 10 walkthrough, Austrian website Telekom Presse has uploaded another video comparing Research in Motion’s (RIMM) not-so-secret BlackBerry Z10 smartphone to the iPhone 5. The company’s upcoming BlackBerry 10 operating system seems to be a mix between iOS and Android, while adding some unique features. The video showcases the BlackBerry voice assistant app, multitasking and app switching, the app drawer, and the device’s business and home profiles.


[More from BGR: BlackBerry 10 OS walkthrough, BlackBerry Z10 pricing]






Despite the fact that the handset is still running beta software it appears to be exceptionally fast, even besting the iPhone 5 in some scenarios.


[More from BGR: Rumored Xbox 720 specs: 8-core processor, 8GB of RAM, 800MHz GPU]


The BlackBerry Z10 smartphone is said to be equipped with a 4.2-inch HD display, 16GB of internal storage, an 8-megapixel rear camera, 2GB of RAM, NFC, 4G LTE and an 1,800 mAh battery.


RIM will unveil the device along with a second BlackBerry 10 phone at a press conference on January 30th. The BlackBerry Z10, iPhone 5 comparison video follows below.


This article was originally published on BGR.com


Gadgets News Headlines – Yahoo! News





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Jim, John Harbaugh ready for rematch at Super Bowl


SANTA CLARA, Calif. (AP) — Jim and John Harbaugh have exchanged a handful of text messages, and plan to leave it at that. No phone conversations necessary while the season's still going. No time for pleasantries, even for the friendly siblings.


There is work to be done to prepare for the Super Bowl, prepare for each other, prepare for a history-making day already being widely hyped as "Harbowl" or "Superbaugh" depending which nickname you prefer.


"It doesn't matter who the coach is, what relationship you have with the person on the other side," 49ers coach Jim Harbaugh said so matter-of-factly Monday afternoon.


Their parents sure aren't picking sides for the Feb. 3 matchup in New Orleans.


These days, the Harbaughs' longtime coaching father, Jack, stays away from game-planning chatter or strategy sessions with his Super Bowl-bound coaching sons. Baltimore's John Harbaugh and little brother Jim have been doing this long enough now to no longer need dad's input.


Yet, they still regularly seek it. And, their father does offer one basic mantra: "Get ahead, stay ahead."


"Probably the greatest advice that I've ever been given and the only advice that I've ever found to be true in all of coaching, I think we mentioned it to both John and Jim ... the coaching advice is, 'Get ahead, stay ahead,'" Jack Harbaugh said.


"If I'm called upon, I'll repeat that same message."


His boys still call home regularly to check in with the man who turned both on to the coaching profession years ago, and the mother who has handled everything behind the scenes for decades in a highly competitive, sports-crazed family — with all the routine sports clichés to show for it.


The Harbaugh brothers will become the first siblings to square off from opposite sidelines when their teams play for the NFL championship at the Superdome.


Not that they're too keen on playing up the storyline that has no chance of going away as hard as they try.


"Well, I think it's a blessing and a curse," Jim Harbaugh said Monday. "A blessing because that is my brother's team. And, also, personally I played for the Ravens. Great respect for their organization. ... The curse part would be the talk of two brothers playing in the Super Bowl and what that takes away from the players that are in the game. Every moment that you're talking about myself or John, that's less time that the players are going to be talked about."


Both men love history, just not the kind with them making it.


"I like reading a lot of history ... I guess it's pretty neat," John Harbaugh offered Monday. "But is it really going to be written about? It's not exactly like Churchill and Roosevelt or anything. It's pretty cool, but that's as far as it goes."


Nice try, guys.


John watched the end of Jim's game from the field in Foxborough, Mass., as Baltimore warmed up for the AFC championship game. Jim called his sister's family from the team plane before takeoff after a win at Atlanta and asked how his big brother's team was doing against New England.


The improbable Super Bowl features a set of brothers known around the NFL as fierce competitors unafraid to make a bold move during the season. Unafraid to upset anyone who stands in their way.


In fact, each one made a major change midseason to get this far — John fired his offensive coordinator, while Jim boosted his offense with a quarterback switch from Alex Smith to Colin Kaepernick.


Leading up to Sunday's games, parents Jack and Jackie said they would wait to decide whether to travel to New Orleans if both teams advanced or stick to what has been working so well — watching from the comfort of their couch in Mequon, Wis.


"We enjoy it very much. We get down in our basement, turn on the television and just have a fantastic day watching outstanding football," Jack said last week. "We share our misery with no one but ourselves. Not only the misery, but the ups and downs, the ins and outs of an outstanding professional game."


And, no, the Harbaughs weren't looking ahead to a potential big trip to the Big Easy.


Jack insists his wife is quick to pull out that old sports cliche: "It's one game at a time. I think it's very appropriate," he said.


Jim figures they won't possibly miss this history-making game.


"I think they'll be there," he said with a smile.


The brothers, separated in age by 15 months, have taken different paths to football's biggest stage — years after their intense games of knee football at the family home. They tried to beat each other at cards, or whatever other game it was at the time. Sometimes, they tried to beat each other up. Sister, Joani Crean, often got in on the fun, too.


The 49-year-old Jim never reached a Super Bowl, falling a last-gasp pass short during a 15-year NFL career as a quarterback. The 50-year-old John never played in the NFL.


Still, both will tell you, "Who's got it better than us? No-body!" — one catchphrase they got from their dad.


"We can't put into words what it means to see John and Jim achieve this incredible milestone," their brother-in-law, Indiana basketball coach Tom Crean, said on Twitter. "We talked to Jim (before) his team plane left. All he wanted to know was how was John doing? How were they playing? One incredible family who puts the care, well-being and love for each other at the forefront like most families do. Again, we are very proud of them. Going to be exciting to watch it unfold."


John worked his way up from the bottom of the coaching ranks, while Jim was the star college quarterback at Michigan, a first-round draft pick and eventual Pro Bowler who made coaching his career once he retired.


John already has the one-up, while Jim's team is the early favorite. John's Ravens beat the 49ers 16-6 on Thanksgiving night 2011, in Jim's rookie season as an NFL coach — though both know that means nothing now.


"I just want everybody to know, that was a four-day deal and every story has been told," John said. "We're not that interesting. There's nothing more to learn. The tape across the middle of the room story, OK, you got it? It's OK. It was just like any other family, really. I really hope the focus is not so much on that. We get it, it's really cool and it's exciting and all that."


Said Jim, "Completely new business."


In spite of his efforts to avoid the topic, Jim did take the opportunity to express how proud he is of John.


"He's a great football coach, a real grasp of all phases — offense, defense, special teams. I think he could coordinate at least two of those phases and do it as well as anyone in the league," Jim said. "I've got half the amount of coaching experience he does. Again, it's not about us. I keep coming back to that. I'm really proud of my brother. I love him. That's the blessing part, that this is happening to him."


And, fittingly for the big brother, John feels the exact same way.


___


AP Sports Writer Dave Ginsburg in Baltimore contributed to this story.


___


Online: http://pro32.ap.org/poll and http://twitter.com/AP_NFL


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The Week: A Roundup of This Week’s Science News





“Science,” a colleague once said at a meeting, “is a mighty enterprise, which is really rather quite topical.” He was so right: as we continue to enhance our coverage of the scientific world, we always aim to keep the latest news front and center.




His observation seemed like a nice way to introduce this column, which will highlight the week’s developments in health and science news and glance at what’s ahead. This past week, for instance, the mighty enterprise of science addressed itself to such newsy topics as the flu (there’s still time to get vaccinated!), and mental illness and gun control.


In addition to the big-headline stories that invite wisdom from scientists, each week there is a drumbeat of purely scientific and medical news that emerges from academic journals, fieldwork and elsewhere. These developments, from the quirky to the abstruse, often make their way into the daily news cycle, depending on the strength of the research behind them. (Well, that’s how we judge them, anyway.)


Many discoveries are hard to unravel. “In a way, science is antithetical to everything that has to do with a newspaper,” the same colleague observed. “You couldn’t imagine anything less consumer-friendly.”


Let’s aim to fix that. Below, a selection of the week’s stories.


DEVELOPMENTS


Health


Strange, but Effective


People with a bacterial infection called Clostridium difficile — which kills 14,000 Americans a year — have a startling cure: a transplant of someone else’s feces into their digestive system, which introduces good bacteria that the gut needs to fight off the bad. For some people, antibiotics don’t fix this problem, but an infusion of diluted stool from a healthy person seems to do the trick.


Genetics


Dig We Must



Hillery Metz and Hopi Hoekstra/Harvard University



Evolutionary biologists at Harvard took a tiny species of deer mice, known for building elaborate burrows with long tunnels, and bred it with another species of deer mice, which builds short-tunneled burrows. Comparing the DNA of the original mice with their offspring, the biologists pinpointed four regions of genetic code that help tell the mice what kind of burrow to construct.


Aerospace


Launch, Then Inflate



Uncredited/Bigelow Aerospace, via Associated Press



NASA signed a contract for an inflatable space habitat — roughly pineapple-shaped, with walls of floppy cloth — that will ideally be appended to the International Space Station in 2015. NASA aims to use the pod to test inflatable technology in space, but the company that builds these things, Bigelow Aerospace, has bigger ambitions: think of a 12-person apartment and laboratory in the sky, with two months’ rent at north of $26 million.


Biology


What’s Green and Flies?



Jodi Rowley/Australian Museum



National Geographic reported on an Australian researcher working in Vietnam who discovered a great-looking new species of flying frog. Described as having flappy forearms (the better for gliding), the three-and-a-half-inch-long frog likes to “parachute” from tree to tree, Jodi Rowley, an amphibian biologist at the Australian Museum in Sydney, told the magazine. She named it Helen’s Flying Frog, for her mother.


Privacy


That’s Joe’s DNA!


People who volunteer their genetic information for the betterment of science — and are assured anonymity — may find that their privacy is not a slam dunk. A researcher who set out to crack the identities of a few men whose genomes appeared in a public database was able to do so using genealogical Web sites (where people upload parts of their genomes to try to find relatives) as well as some simple search tools. He was trying to test the database’s security, but even he did not expect it to be so easy.


Genetics


An On/Off Switch for Disease


Geneticists have long puzzled over what it is that activates a disease in one person but not in another — even in identical twins. Now researchers from Johns Hopkins and the Karolinska Institute in Sweden who studied people with rheumatoid arthritis have identified a pattern of chemical tags that tell genes whether to turn on or not. In rheumatoid arthritis, the immune system attacks the body, and it is thought the tags enable the attack.


Planetary Science


That Red Planet


Everybody loves Mars, and we’re all secretly hoping that NASA’s plucky little rover finds evidence of life there. Meanwhile, a separate NASA craft — the Mars Reconnaissance Orbiter, which has been looping the planet since 2006 — took some pictures of a huge crater that looks as if it once held a lake fed by groundwater. It is too soon to say if the lake held living things, but NASA’s news release did include the happy phrase “clues to subsurface habitability.”


COMING UP


Animal Testing


Retiring Chimps



Emily Wabitsch/European Pressphoto Agency



A lot of people have strong feelings about the use of chimpanzees in biomedical and behavioral experiments, and the National Institutes of Health has been listening. On Tuesday, the agency is to release its recommendations for curtailing chimp research in a big way. This will be but a single step in a long process and it will apply only to the chimps the agency owns, but it may well stir big reactions from many constituencies.


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Bank of Japan Moves to Fight Deflation



TOKYO — The Bank of Japan set an ambitious 2 percent inflation target and pledged to ease monetary policy “decisively” by introducing open-ended asset purchases, following intense pressure from the country’s audacious new prime minister, Shinzo Abe, who has made beating deflation a national priority.


In a joint statement with the government, the central bank said it was doubling its inflation target to 2 percent and said it would “pursue monetary easing and aim to achieve this target at the earliest possible time.”


The Bank of Japan also said that it intended to purchase assets indefinitely, promising to stick to a program that has allowed the bank to pump funds into the Japanese economy, even with interest rates at virtually zero. The bank’s board voted to keep its benchmark rate at a range of zero to 0.1 percent.


Since last year, when Mr. Abe was still opposition leader, he has urged the central bank to do more to end deflation, the all-around fall in prices, profit and incomes that has plagued Japan’s economy since the late 1990s. He has stepped up the pressure on the bank after a landslide victory by his Liberal Democratic Party in parliamentary elections in December, which catapulted him to office for the second time since a short-lived stint in 2006-07.


Mr. Abe’s push to increase the monetary supply, among other things, has weakened the yen, a boon to the competitiveness of exporters, which make up much of Japan’s growth. Earlier this month, Mr. Abe also announced a 12 trillion yen emergency stimulus, providing even more tailwind for the Japanese economy. That bright outlook has pushed the Nikkei stock index 20 percent higher since mid-November, when Mr. Abe first campaigned on his expansionary platform.


Mr. Abe’s critics, however, warn that the central bank, which will buy up more government bonds as part of its asset purchase program, will become a printing press for profligate government spending — spending that carries great risks for a country whose public debt is already twice the size of its economy. Critics also say that before flooding a broken system with money, Japan must first tackle structural problems that hurt economic efficiency.


Mr. Abe maintains that deflation will undermine any efforts to grow, and that the government and central bank must act together to get prices rising again. But in a nod to critics, the joint statement said the government would also promote “all possible decisive policy actions for reforming the economic structure” and establish “a sustainable fiscal structure.”


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Center-Left Defeats Merkel’s Party in State Vote





BERLIN — Chancellor Angela Merkel’s main rivals pulled off an upset in a regional election, eking out a one-seat majority that will usher the opposition Social Democrats into power in the state of Lower Saxony, months ahead of balloting for the national Parliament.




Preliminary results released on Monday showed the center-left bloc of the Social Democrats and the Greens securing a one-seat majority in the regional legislature in Hanover.


The shift signaled an end to a decade of center-right government in the state and will have a direct impact at the national level by tipping the balance of power in the upper house of Parliament, the Bundesrat.


The victory in Lower Saxony gives the center-left a majority in the Bundesrat that could allow it to block legislation from the lower house, dominated by Ms. Merkel’s center-right bloc.


“I expect that it will hardly be possible to push through proposals that the S.P.D. opposes,” Volker Kauder, the parliamentary leader for Ms. Merkel’s party told ZDF public television on Monday. “We will have to see if they use it.”


The Social Democrats took 32.6 percent of the vote, while the Greens won 13.7 percent, the preliminary results showed, giving them 69 seats in the regional legislature. Although the Christian Democrats emerged as the strongest party with 36 percent of the vote, combined with their Free Democrat partners, they were able to secure only 68 seats.


The Free Democrats, the junior partner in Ms. Merkel’s governing coalition in Berlin, won 9.9 percent of the vote.


Neither the Pirate Party nor the Left Party cleared the 5 percent hurdle need to secure representation in the Lower Saxony legislature.


It was unclear how much the loss will hurt Ms. Merkel, who enjoys overwhelming popularity in Germany, thanks to a relatively robust economy, low unemployment and her hard-nosed handling of Europe’s debt crisis.


Ms. Merkel made seven appearances in Lower Saxony this month, alongside the state’s governor, David McAllister.


Although he was the incumbent, the campaign was the first for Mr. McAllister, 42, who took over the position in 2010 when his predecessor, Christian Wulff, was called to Berlin to become president. The son of a soldier from Scotland and a German mother, Mr. McAllister insisted throughout the campaign that his tenure had brought prosperity to the region, and he urged voters to support continuity.


He was expected in Berlin for talks at the Christian Democratic headquarters later Monday.


His main challenger, the mayor of Hanover, Stephan Weil, who ran for the Social Democrats, struggled to make himself better known among voters, resorting at one point in the campaign to handing out red roses to prospective voters, which stretches across largely rural countryside from the North Sea to the former inner-German border.


“I am excited about five years of red-green,” Mr. Weil told reporters after realizing his bloc’s success, using the traditional color codes for his party and their partners. “That was a real roller-coaster ride tonight.”


Although local issues tend to dominate regional elections — as was the case in Lower Saxony, where the education system and completion of several infrastructure projects dominated the debate — the outcome could help the Free Democrats improve their image at the national level of a party dogged by a leadership crisis.


Many had blamed the party’s chairman, Philipp Rösler, who also serves as economy minister and consistently ranks among the country’s least popular politicians, for failing to focus on concrete issues.


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RIM mulls licensing out software: CEO in paper






FRANKFURT (Reuters) – Research in Motion will look into strategic alliances with other technology companies once it has launched its new BlackBerry 10 models, its chief executive told a German newspaper.


German-born CEO Thorsten Heins told daily Die Welt in an interview published on Monday that the group’s strategic review could lead to the sale of RIM’s hardware production or the sale of licenses to its software, among other options.






“The main thing for now is to successfully introduce Blackberry 10. Then we’ll see,” Heins was quoted as saying.


RIM hopes its re-engineered line of Blackberry 10 touch-screen and keyboard devices will win back market share lost to rivals such as Apple’s iPhone and devices powered by Google’s market-leading Android operating system.


(Reporting by Ludwig Burger; Editing by Mark Potter)


Wireless News Headlines – Yahoo! News





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Harbaugh brothers take 49ers, Ravens to Super Bowl


Preparing to coach the Baltimore Ravens in the AFC championship game Sunday night, John Harbaugh watched on the stadium's big video screen as Jim Harbaugh's San Francisco 49ers wrapped up their victory in the NFC championship game.


John looked into a nearby TV camera, smiled broadly and said: "Hey, Jim, congratulations. You did it. You're a great coach. Love you."


Less than four hours later, the Ravens won, too. Some siblings try to beat each other in backyard games. These guys will do it in the biggest game of all. Yes, get ready for the Brother Bowl.


It'll be Harbaugh vs. Harbaugh when Big Bro John's Ravens play Little Bro Jim's 49ers in the Super Bowl at New Orleans in two weeks.


As much chatter as there will be about the players involved — from Ravens linebacker Ray Lewis and his impending retirement to 49ers quarterback Colin Kaepernick's sudden emergence — the Harbaugh family angle will make this coaching matchup the most scrutinized in the nearly half-century of Super Sundays.


The Harbaughs' sister, Joani Crean, wrote in a text to The Associated Press: "Overwhelmed with pride for John, Jim and their families! They deserve all that has come their way! Team Harbaugh!"


Who's a parent to cheer for?


During the 2011 regular season, the Harbaughs became the only brothers to coach against each other in any NFL game (the Ravens beat the 49ers 16-6 on Thanksgiving Day that year).


Now they'll be squaring off with a championship at stake in a Super Bowl filled with firsts — and one truly significant last.


It will be the first one between coaching brothers, of course. First one for Joe Flacco, the oft-doubted Ravens quarterback with the superb touch on deep balls and a QB-record six postseason road wins. First one for Kaepernick, the second-year player with the tattooed arms, the sprinter's speed, and a shoulder that zips throws like the high school baseball pitcher he used to be.


And it will be the last game for 17-year veteran Lewis, Baltimore's emotional leader and this postseason's top tackler with 44 so far.


"This is our time," Lewis pronounced.


He appeared to be on the verge of tears before and after helping Baltimore become the only team in 68 tries to overcome a halftime deficit against Patriots quarterback Tom Brady in Foxborough, Mass.


The NFC West champion 49ers (13-4-1) open as 5-point favorites, seeking a record-tying sixth Super Bowl title but first since 1995. The franchise of Hall of Fame quarterbacks Joe Montana and Steve Young is 5-0 in Super Bowls.


The AFC South champion Ravens (13-6) are headed to their second Super Bowl; Lewis was the MVP when Baltimore beat the New York Giants in 2001.


With Kaepernick's terrific passing — he was 16 of 21 for 233 yards and a touchdown in only his ninth career NFL start — and two TD runs by Frank Gore, San Francisco erased a 17-point deficit to beat the Atlanta Falcons 28-24 Sunday.


Baltimore then fashioned a comeback of its own by scoring the last 21 points to defeat the New England Patriots 28-13, thanks in large part to Flacco's three second-half touchdown tosses, two to Anquan Boldin.


In the often risk-averse NFL, each Harbaugh made a critical change late in the regular season in a bid to boost his team's postseason chances. Clearly, both moves worked.


After 49ers quarterback Alex Smith, the starter in last season's overtime NFC title game loss to the New York Giants, got a concussion, Jim switched to Kaepernick for Week 11 — and never switched back. Now San Francisco has its first three-game winning streak of the season, at precisely the right time.


Baltimore, meanwhile, was in the midst of a three-game losing streak when John fired offensive coordinator Cam Cameron and promoted quarterbacks coach Jim Caldwell to replace him.


The 50-year-old John is 15 months older than Jim and generally the less demonstrative of the pair, although John certainly did not lack intensity while making his case with officials a couple of times Sunday.


The ever-excitable Jim — who was treated for an irregular heartbeat in November — was up to his usual sideline antics in Atlanta.


He spun around and sent his headset flying when the original call stood after he threw his red challenge flag on a catch by the Falcons. He hopped and yelled at his defense to get off the field after their key fourth-down stop with less than 1½ minutes left. He made an emphatic-as-can-be timeout signal with 13 seconds remaining.


Expect CBS to fill plenty of time during its Super Bowl broadcast with shots of Jim, that trademark red pen dangling in front of his chest, and John, who usually wears a black Ravens hat. Yes, that is sure to be a focal point, until they meet for a postgame handshake.


___


Follow Howard Fendrich on Twitter at http://twitter.com/HowardFendrich


___


AP sports writer Janie McCauley contributed to this report from San Francisco.


___


Online: http://pro32.ap.org/poll and http://twitter.com/AP_NFL


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Well: A Check on Physicals

“Go Beyond Your Father’s Annual Physical. Live Longer, Feel Better”

This sales pitch for the Princeton Longevity Center’s “comprehensive exam” promises, for $5,300, to take “your health beyond the annual physical.” But it is far from certain whether this all-day checkup, and others less inclusive, make a meaningful difference to health or merely provide reassurance to the worried well.

Among physicians, researchers and insurers, there is an ongoing debate as to whether regular checkups really reduce the chances of becoming seriously ill or dying of an illness that would have been treatable had it been detected sooner.

No one questions the importance of regular exams for well babies, children and pregnant women, and the protective value of specific exams, like a Pap smear for sexually active women and a colonoscopy for people over 50. But arguments against the annual physical for all adults have been fueled by a growing number of studies that failed to find a medical benefit.

Some experts note that when something seemingly abnormal is picked up during a routine exam, the result is psychological distress for the patient, further testing that may do more harm than good, and increased medical expenses.

“Part of the problem of looking for abnormalities in perfectly well people is that rather a lot of us have them,” Dr. Margaret McCartney, a Scottish physician, wrote in The Daily Mail, a British newspaper. “Most of them won’t do us any harm.”

She cited the medical saga of Brian Mulroney, former prime minister of Canada. A CT scan performed as part of a checkup in 2005 revealed two small lumps in Mr. Mulroney’s lungs. Following surgery, he developed an inflamed pancreas, which landed him in intensive care. He spent six weeks in the hospital, then was readmitted a month later for removal of a cyst on his pancreas caused by the inflammation.

The lumps on his lungs, by the way, were benign. But what if, you may ask, Mr. Mulroney’s lumps had been cancer? Might not the discovery during a routine exam have saved his life?

Logic notwithstanding, the question of benefits versus risks from routine exams can be answered only by well-designed scientific research.

Defining the value of a routine checkup — determining who should get one and how often — is especially important now, because next year the Affordable Care Act will add some 30 million people to the roster of the medically insured, many of whom will be eligible for government-mandated preventive care through an annual exam.

Dr. Ateev Mehrotra of the University of Pittsburgh School of Medicine, who directed a study of annual physicals in 2007, reported that an estimated 44.4 million adults in the United States undergo preventive exams each year. He concluded that if every adult were to receive such an exam, the health care system would be saddled with 145 million more visits every year, consuming 41 percent of all the time primary care doctors spend with patients.

There is already a shortage of such doctors and not nearly enough other health professionals — physician assistants and nurse practitioners — to meet future needs. If you think the wait to see your doctor is too long now, you may want to stock up on some epic novels to keep you occupied in the waiting room in the future.

Few would challenge the axiom that an ounce of prevention is worth a pound of cure. Lacking incontrovertible evidence for the annual physical, this logic has long been used to justify it:

¶ If a thorough exam and conversation about your well-being alerts your doctor to a health problem that is best addressed sooner rather than later, isn’t that better than waiting until the problem becomes too troublesome to ignore?

¶ What if you have a potentially fatal ailment, like heart disease or cancer, that may otherwise be undetected until it is well advanced or incurable?

¶ And wouldn’t it help to uncover risk factors like elevated blood sugar or high cholesterol that could prevent an incipient ailment if they are reversed before causing irreparable damage?

Even if there is no direct medical benefit, many doctors say that having their patients visit once a year helps to maintain a meaningful relationship and alert doctors to changes in patients’ lives that could affect health. It is also an opportunity to give patients needed immunizations and to remind them to get their eyes, teeth and skin checked.

But the long-sacrosanct recommendation that everyone should have an annual physical was challenged yet again recently by researchers at the Nordic Cochrane Center in Copenhagen.

The research team, led by Dr. Lasse T. Krogsboll, analyzed the findings of 14 scientifically designed clinical trials of routine checkups that followed participants for up to 22 years. The team found no benefit to the risk of death or serious illness among seemingly healthy people who had general checkups, compared with people who did not. Their findings were published in November in BMJ (formerly The British Medical Journal).

In introducing their analysis, the Danish team noted that routine exams consist of “combinations of screening tests, few of which have been adequately studied in randomized trials.” Among possible harms from health checks, they listed “overdiagnosis, overtreatment, distress or injury from invasive follow-up tests, distress due to false positive test results, false reassurance due to false negative test results, adverse psychosocial effects due to labeling, and difficulties with getting insurance.”

Furthermore, they wrote, “general health checks are likely to be expensive and may result in lost opportunities to improve other areas of health care.”

In summarizing their results, the team said, “We did not find an effect on total or cause-specific mortality from general health checks in adult populations unselected for risk factors or disease. For the causes of death most likely to be influenced by health checks, cardiovascular mortality and cancer mortality, there were no reductions either.”

What, then, should people do to monitor their health?

Whenever you see your doctor, for any reason, make sure your blood pressure is checked. If a year or more has elapsed since your last blood test, get a new one.

Keep immunizations up to date, and get the screening tests specifically recommended based on your age, gender and known risk factors, including your family and personal medical history.

And if you develop a symptom, like unexplained pain, shortness of breath, digestive problems, a lump, a skin lesion that doesn’t heal, or unusual fatigue or depression, consult your doctor without delay. Seek further help if the initial diagnosis and treatment fails to bring relief.

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