Obama resolute in showdown with GOP over 'fiscal cliff'

WASHINGTON — President Obama brushed off the latest Republican gambit to gain leverage in averting the so-called fiscal cliff, bluntly telling business chief executives in a speech Wednesday, "I'm not going to play that game."

That flash of swagger reflects growing White House confidence about its position in the year-end showdown over scheduled spending cuts and tax increases. With less than a month to act and the wind of an electoral victory at their back, White House officials think they are boxing in Republicans.

The White House credits its strategy crafted from painful lessons of past go-rounds with the Republican-led House. Rather than engaging intensely with the GOP leadership in high-profile meetings, Obama has sought to isolate Republicans and pump up the pressure from all sides. He has picked a red line and is sticking to it. And now he's waiting.

"The only time these guys have ever moved on something is when they have felt the outside pressure," said an Obama advisor who requested anonymity to discuss strategy.

Both sides say they are working to defuse the scheme of tax increases and budget cuts they enacted to force themselves to reach a larger deficit reduction deal. Experts say that if nothing is done, the double blow could send the economy back into recession.

For now, though, the president has reason to be resolute, even as Republicans call on him to counter their latest offer.

Treasury Secretary Timothy F. Geithner underscored that position Wednesday in an interview on CNBC. The administration is "absolutely" ready to go over the "fiscal cliff" if Republicans refuse to raise tax rates on the wealthy, he said.

"There's no prospect in an agreement that doesn't involve those rates going up on the top 2% of the wealthiest Americans," he said.

Public polling shows a majority of Americans not only support the president's push to allow tax rates to rise on top earners but are prepared to hold the GOP responsible if negotiations fail. A new poll from the Washington Post and Pew Research Center found that 53% of Americans said Republicans should be blamed if there is no deal, compared with 27% who would blame the president.

Obama's stance has bred discord and frustration among Republicans on Capitol Hill who find themselves in the politically awkward position of threatening a tax increase for all to preserve lower taxes for the wealthy. Tension bubbled up this week as Republicans floated a new strategy that would involve reviving a threat to let the U.S. default on its debt payments.

Under that scenario, Republicans would agree to raise taxes on the wealthiest 2% of taxpayers, as the president has demanded, but would defer talks about a larger deficit reduction package until the new year, when Obama would need their votes to avoid a federal default on the debt. Republicans could then demand concessions on the federal budget in return for voting to raise the nation's debt limit.

"The debt ceiling is hanging out there, and the debt ceiling is the next point of leverage," said Rep. Steve King, a conservative Republican from Iowa. "The president does not fear the fiscal cliff. He's concerned about who's going to get the blame. But he doesn't fear the cliff."

A spokesman for House Speaker John A. Boehner (R-Ohio) also suggested that Republicans would try to extract spending cuts in return for a debt limit increase. "We agree there is no reason for drama surrounding a debt limit increase. All that is required is the president getting serious about spending cuts," said Boehner spokesman Brendan Buck.

In his CNBC interview, Geithner said the administration would insist that any agreement include an increase in the debt ceiling.

Obama and Boehner spoke on the phone Wednesday. Neither side disclosed details of the call.

Obama's strategy involves risks. His repeated attempts to bludgeon Republicans on taxes while offering no new concessions has engendered little goodwill, and he will need some Republican votes soon.

And his declaration that he won't play chicken with the vote to raise the debt ceiling? Though that is the tough talk that some Democrats have craved, it has little practical meaning. Unless Republicans agree to his request to largely cede authority to raise the limit, he will need Congress to do it.

For Obama, the lesson on how to gain and use leverage began with the summer of 2011, when a marathon of high-level bargaining sessions with Republicans failed to produce a grand bargain on the federal budget.

After that, Obama set out to negotiate on the campaign trail, announcing his terms publicly as he rallied people behind them.

The Obama team added social media campaigns and testimonials from middle-class Americans, and managed to pass an extension of the payroll tax break in February. That's when aides came to believe the president could shift the dynamic in talks with Capitol Hill.

Early signs are that the formula may be working again. The latest Twitter campaign has elicited more than 100,000 emails from people explaining how the middle-class tax increase would affect them.

And Obama's outreach to interested parties is showing progress. Business leaders are worrying openly about the uncertainty around the fiscal cliff and debt ceiling.

At the Business Roundtable on Wednesday, Boeing's chief executive introduced Obama by suggesting that business leaders could "serve a useful purpose in the dialogue."

To be sure, there's grousing about Obama's negotiating posture. Sen. Mitch McConnell (R-Ky.), the chamber's Republican leader, has complained that Obama is campaigning rather than working out the issues with his negotiating partners.

But the strategy is worth the aggravation, administration officials think. The president isn't avoiding private negotiations, but doesn't plan to start them until there is some movement.

"Once Republicans acknowledge that rates are going up for top earners," White House Press Secretary Jay Carney said, "we believe that an agreement is very achievable."

christi.parsons@latimes.com

kathleen.hennessey@latimes.com

Melanie Mason, Michael A. Memoli and Lisa Mascaro in the Washington bureau contributed to this report.

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Google Now Delivers Travel Forecasts, Boarding Passes Before You Search

Google’s Search App has received a travel-focused update just in time for the holidays. Wednesday’s update adds new capabilities to Google Now, the app’s feature set designed to deliver frequently searched-for information before you even think to search for it.

Previously, opening the Google Search App on any Android phone running Jelly Bean (versions 4.1 and newer), would pull up a Google Now card detailing the weather where you’re standing along with traffic routes to your home and office, sports scores, and package tracking info, among other things. The update adds into the mix new information centered around weather, plane flights and finding things to do in the new locale you’re visiting.

In the updated app, Google Now will still bubble up a card with local weather, but it will now also provide a card detailing the forecast for your upcoming destination about a day before you travel so you can pack and plan correctly. This can serve as a raincoat reminder for those headed to Seattle, or an alert for shorts if you’re vacationing in Melbourne, Australia.

If you’re flying for the holidays, the Search app will pull up a Google Now card with your boarding pass — if you’re flying United Airlines. Additional airlines will be added in coming weeks and months, said in Baris Gultekin, a Google Now product director. This feature, like all Google Now cards, requires a user’s permission to pull flight details from your Gmail account. If permission is granted, the app will serve up cards with restaurant and hotel reservations, translation help, and currency conversions too.

“Our goal is to figure out what the one thing you need right now is, and deliver that to you,” Gultekin told Wired. “A lot of our users need assistance the most when they’re traveling.”

With that in mind, Google Now also will provide suggestions on places to check out once you’ve reached your destination. The Search app already regularly offers recommendations on nearby restaurants and photo-worthy spots, but now it will list events taking place nearby and local websites that may be useful in figuring out what to do.

But not all the updates have to do with travel. The refresh also adds birthday reminders for those you’re connected to on Google+. And Google’s stellar voice assistant, also built into the Search app, received some new tricks today as well. Now, by speaking to the Google Search app, a user can post a text update to Google+, ask what song is playing in the background and launch a barcode scanner to retrieve product info while out shopping.

The updates hit the Google Search app today for Android owners — sorry iOS users.

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Brazilian architect Oscar Niemeyer dies, aged 104

RIO DE JANEIRO (Reuters) – Oscar Niemeyer, a towering patriarch of modern architecture who shaped the look of modern Brazil and whose inventive, curved designs left their mark on cities worldwide, died late on Wednesday. He was 104.

Niemeyer had been battling kidney ailments and pneumonia for nearly a month in a Rio de Janeiro hospital. His death was confirmed by a hospital spokesperson.

Starting in the 1930s, Niemeyer’s career spanned nine decades. His distinctive glass and white-concrete buildings include such landmarks as the United Nations Secretariat in New York, the Communist Party headquarters in Paris and the Roman Catholic Cathedral in Brasilia.

He won the 1988 Pritzker Architecture Prize, considered the “Nobel Prize of Architecture” for the Brasilia cathedral. Its “Crown of Thorns” cupola fills the church with light and a sense of soaring grandeur despite the fact that most of the building is underground.

It was one of dozens of public structures he designed for Brazil’s made-to-order capital, a city that helped define “space-age” style.

After flying over Niemeyer’s pod-like Congress, futuristic presidential palace and modular ministries in 1961, Yuri Gagarin, the Russian cosmonaut and first man in space, said “the impression was like arriving on another planet.”

In his home city of Rio de Janeiro, Niemeyer’s many projects include the “Sambadrome” stadium for Carnival parades. Perched across the bay from Rio is the “flying saucer” he designed for the Niteroi Museum of Contemporary Art.

The collection of government buildings in Brasilia, though, remain his most monumental and enduring achievement. Built from scratch in a wild and nearly uninhabited part of Brazil’s remote central plateau in just four years, it opened in 1960.

While the airplane-shaped city was planned and laid out by Niemeyer’s friend Lucio Costa, Niemeyer designed nearly every important government building in the city.

BECAME NATIONAL ICON

An ardent communist who continued working from his Copacabana beach penthouse apartment in Rio until days before his death, Niemeyer became a national icon ranking alongside Bossa Nova pioneer Tom Jobim and soccer legend Pelé.

His architecture, though, regularly trumped his politics.

Georges Pompidou, a right-wing Gaullist former French president, said Niemeyer’s design for the Communist Party of France headquarters in Paris “was the only good thing those commies ever did,” according to Niemeyer’s memoirs.

Prada, the fashion company known for providing expensive bags and wallets, thought the Communist Party building in Paris so cool it rented it for a fashion show.

Even the 1964-1985 Brazilian military government that forced Niemeyer into exile in the 1960s eventually found his buildings congenial to their dreams of making Brazil “the country of the future.”

His work is celebrated for innovative use of light and space, experimentation with reinforced concrete for aesthetic value and his self-described “architectural invention” style that produced buildings resembling abstract sculpture.

Initially influenced by the angular modernism of French-Swiss architect Le Cobusier, who worked with Niemeyer and Costa on a visit to Brazil in the 1930s, his style evolved toward rounded buildings that he said were inspired by the curves of Rio’s sunbathing women as well as beaches and verdant hills.

“That is the architecture I do, looking for new, different forms. Surprise is key in all art,” Niemeyer told Reuters in an interview in 2006. “The artistic capability of reinforced concrete is so fantastic – that is the way to go.”

Responding to criticism that his work was impractical and overly artistic, Niemeyer dismissed the idea that buildings’ design should reflect their function as a “ridiculous and irritating” architectural dogma.

“Whatever you think of his buildings, Niemeyer has stamped on the world a Brazilian style of architecture,” Dennis Sharp, a British architect and author of The Illustrated Encyclopedia of Architects and Architecture, once said of Niemeyer.

LIFELONG COMMUNIST

Niemeyer’s legacy is heavily associated with his communist views. He was a close friend of Cuba’s revolutionary leader Fidel Castro and an enemy of Brazil’s 21-year military dictatorship.

“There are only two communists left in the world, Niemeyer and myself,” Castro once joked.

Niemeyer remained politically active after returning to Brazil, taking up the cause of a militant and sometimes violent movement of landless peasants. He said in 2010 that he was a great admirer of Luiz Inacio Lula da Silva, the former labor leader who was Brazil’s president from 2003 to 2010.

Niemeyer once built a house in a Rio slum for his former driver and gave apartments and offices as presents to others.

Despite his egalitarian views, Niemeyer had no illusions that his buildings were helping to improve social justice.

Far from the model city Niemeyer had envisioned, Brasilia today is in many ways the epitome of inequality. Planned for 500,000 people, the city is now home to more than 2.5 million and VIPs keep to themselves in fenced-in villas while the poor live in distant satellite towns.

“It seemed like a new era was coming, but Brazil is the same crap – a country of the very poor and the very rich,” he said in another Reuters interview in 2001.

In a 2010 interview in his office, he was quick to blame Costa for things many dislike about Brasilia, such as its rigid ordering into homogenous “hotel,” “government,” “residential” and even “mansion” and “media” districts that can make finding a newspaper or groceries a chore.

“I just did the buildings,” he said. “All that other stuff was Costa.”

Despite Niemeyer’s atheism, one of his first significant early works was a church built in homage to St. Francis, part of a complex of modern buildings in Belo Horizonte, Brazil.

That work won the confidence of the city’s mayor Juscelino Kubitschek. When he became president, he tapped Niemeyer to help realize the dream of opening up Brazil’s interior by moving the capital from coastal Rio to the empty plains of central Brazil.

Despite years of bohemian living, Niemeyer remained married for 76 years to Annita Baldo, his first wife. He married his second wife, long-time aide Vera Lucia Cabreira, in 2006 at the age of 99. She survives him, as do four grandchildren.

Niemeyer’s only daughter, an architect, designer and gallery owner, Anna Maria, died on June 6 at the age of 82.

(Additional reporting by Brian Ellsworth; Editing by Todd Benson and Kieran Murray)

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Extended Use of Breast Cancer Drug Suggested

The widely prescribed drug tamoxifen already plays a major role in reducing the risk of death from breast cancer. But a new study suggests that women should be taking the drug for twice as long as is now customary, a finding that could upend the standard that has been in place for about 15 years.

In the study, patients who continued taking tamoxifen for 10 years were less likely to have the cancer come back or to die from the disease than women who took the drug for only five years, the current standard of care.

“Certainly, the advice to stop in five years should not stand,” said Prof. Richard Peto, a medical statistician at Oxford University and senior author of the study, which was published in The Lancet on Wednesday and presented at the San Antonio Breast Cancer Symposium.

Breast cancer specialists not involved in the study said the results could have the biggest impact on premenopausal women, who account for a fifth to a quarter of new breast cancer cases. Postmenopausal women tend to take different drugs, but some experts said the results suggest that those drugs might be taken for a longer duration as well.

“We’ve been waiting for this result,” said Dr. Robert W. Carlson, a professor of medicine at Stanford University. “I think it is especially practice-changing in premenopausal women because the results do favor a 10-year regimen.”

Dr. Eric P. Winer, chief of women’s cancers at the Dana-Farber Cancer Institute in Boston, said that even women who completed their five years of tamoxifen months or years ago might consider starting on the drug again.

Tamoxifen blocks the effect of the hormone estrogen, which fuels tumor growth in estrogen receptor-positive cancers that account for about 65 percent of cases in premenopausal women. Some small studies in the 1990s suggested that there was no benefit to using tamoxifen longer than five years, so that has been the standard.

About 227,000 cases of breast cancer are diagnosed each year in the United States, and an estimated 30,000 of them are in premenopausal women with estrogen receptor-positive cancer and prime candidates for tamoxifen. But postmenopausal women also take tamoxifen if they cannot tolerate the alternative drugs, known as aromatase inhibitors.

The new study, known as Atlas, included nearly 7,000 women with ER-positive disease who had completed five years of tamoxifen. They came from about three dozen countries. Half were chosen at random to take the drug another five years, while the others were told to stop.

In the group assigned to take tamoxifen for 10 years, 21.4 percent had a recurrence of breast cancer in the ensuing 10 years, meaning the period 5 to 14 years after their diagnoses. The recurrence rate for those who took only five years of tamoxifen was 25.1 percent.

About 12.2 percent of those in the 10-year treatment group died from breast cancer, compared with 15 percent for those in the control group.

There was virtually no difference in death and recurrence between the two groups during the five years of extra tamoxifen. The difference came in later years, suggesting that tamoxifen has a carry-over effect that lasts long after women stop taking it.

Whether these differences are big enough to cause women to take the drug for twice as long remains to be seen.

“The treatment effect is real, but it’s modest,” said Dr. Paul E. Goss, director of breast cancer research at the Massachusetts General Hospital.

Tamoxifen has side effects, including endometrial cancer, blood clots and hot flashes, which cause many women to stop taking the drug. In the Atlas trial, it appears that roughly 40 percent of the patients assigned to take tamoxifen for the additional five years stopped prematurely.

Some 3.1 percent of those taking the extra five years of tamoxifen got endometrial cancer versus 1.6 percent in the control group. However, only 0.6 percent of those in the longer treatment group died from endometrial cancer or pulmonary blood clots, compared with 0.4 percent in the control group.

“Over all, the benefits of extended tamoxifen seemed to outweigh the risks substantially,” Trevor J. Powles of the Cancer Center London, said in a commentary published by The Lancet.

Dr. Judy E. Garber, director of the Center for Cancer Genetics and Prevention at Dana-Farber, said many women have a love-hate relationship with hormone therapies.

“They don’t feel well on them, but it’s their safety net,” said Dr. Garber, who added that the news would be welcomed by many patients who would like to stay on the drug. “I have patients who agonize about this, people who are coming to the end of their tamoxifen.”

Emily Behrend, who is a few months from finishing her five years on tamoxifen, said she would definitely consider another five years. “If it can keep the cancer away, I’m all for it,” said Ms. Behrend, 39, a single mother in Tomball, Tex. She is taking the antidepressant Effexor to help control the night sweats and hot flashes caused by tamoxifen.

Cost is not considered a huge barrier to taking tamoxifen longer because the drug can be obtained for less than $200 a year.

The results, while answering one question, raise many new ones, including whether even more than 10 years of treatment would be better still.

Perhaps the most important question is what the results mean for postmenopausal women. Even many women who are premenopausal at the time of diagnosis will pass through menopause by the time they finish their first five years of tamoxifen, or will have been pushed into menopause by chemotherapy.

Postmenopausal patients tend to take aromatase inhibitors like anastrozole or letrozole, which are more effective than tamoxifen at preventing breast cancer recurrence, though they do not work for premenopausal women.

Mr. Peto said he thought the results of the Atlas study would “apply to endocrine therapy in general,” meaning that 10 years of an aromatase inhibitor would be better than five years. Other doctors were not so sure.

The Atlas study was paid for by various organizations including the United States Army, the British government and AstraZeneca, which makes the brand-name version of tamoxifen.

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In Inquiry, Drilling Company Chief Quits

LONDON — The chief executive of Saipem, the largest European drilling and engineering contractor for the oil industry, resigned Wednesday evening after an Italian prosecutor’s office said it was investigating possible corruption.

The executive, Pietro Franco Tali, also served as deputy chairman of the company, in which the big Italian oil company Eni has a controlling stake.

A Saipem spokesman, Andrea Pagano Mariano, said the investigation related to contracts on oil and gas projects in Algeria involving the state oil company Sonatrach. He declined to elaborate.

Although Mr. Tali “is in no manner a subject of the prosecutor’s investigation, he felt that his resignation would better enable the company to respond to the prosector’s inquiry,” Saipem said in a statement. The activities were said to have occurred through 2009.

Eni, which has about 43 percent of Saipem’s shares, held an emergency board meeting Wednesday night, according to a news release. In recent days, it said, the board had urged the drilling company’s chairman, Alberto Meomartini, “to take immediate remedial actions in managing the situation.”

Eni’s chief financial officer, Alessandro Bernini, who held the same position at Saipem until 2008, also resigned Wednesday, although he “considers that his actions were right and proper,” according to an Eni release.

An Eni spokeswoman, Erika Mandraffino, said the accusations about Saipem came to Eni’s attention a few days ago. She declined to indicate what the inquiry involves in Algeria, where Saipem has billions of dollars’ worth of oil and gas operations and drilling contracts, and about 2,600 employees.

Saipem’s board named the chief operating officer of Eni’s gas and power division, Umberto Vergine, to replace Mr. Tali as Saipem’s chief.

The company also suspended Pietro Varone, chief operating officer of Saipem’s engineering and construction unit, following a notice of inquiry from the prosecutor related to the same investigation. Saipem’s board also ordered an internal audit using external consultants.

“Saipem believes that its business activities have been conducted in compliance with applicable, internal procedures” and its code of ethics, the company said, and has offered its full cooperation to the prosecutor’s office.

The investigation is a blow to ENI, which under its chief executive, Paolo Scaroni, is working to establish itself as a premier exploration and production company. Earlier on Wednesday, Eni announced a new natural gas discovery off the coast of Mozambique, where the company has become an early leader in staking a position in that country’s promising gas reserves.

Although Eni stresses that Saipem is independently managed, the two companies are closely intertwined.

In an interview on Nov. 19, Mr. Scaroni said that while the company was divesting other noncore assets, he considered Saipem “a major asset.”

He said that Saipem was “managed at arm’s length” because Eni was only “one of the customers” of the engineering company. He said Saipem was the top candidate to build the portion of the proposed South Stream natural gas pipeline from Russia to Eastern and Western Europe, under the Black Sea.

Eni, along with Gazprom, is a crucial backer of the project.

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Debut of repainted sign is Hollywood event

If there's anything Tinseltown excels at, it's turning a ho-hum event into a made-for-TV spectacle. Witness the fanfare that unfolds each time the Hollywood sign gets a fresh coat of paint.

It's not written off as routine maintenance. No, it's a civic event.

A media scrum gathers. Elected officials gush. Someone cracks jokes about face-lifts. (In 1995, nipped-and-tucked actress Phyllis Diller did the honors.)

PHOTOS: Hollywood sign history

So it was on Tuesday, when reporters were whisked to just below the nearly 90-year-old sign, one of the few landmarks in the crazy quilt of neighborhoods that is Los Angeles.

In a clearing, VIPs fidgeted on white folding chairs. At least a dozen cameras were trained on Chris Baumgart, chairman of the nonprofit Hollywood Sign Trust, who wore a dark suit and sneakers. Behind him loomed the nine 45-foot-tall letters that together, he said, cost about $175,000 to gussy up.

Beginning in October, workers stripped the letters of weathered paint, smeared them with 105 gallons of primer and coated them with 255 gallons of new paint (color: No. 7757, high-reflective white). It's made by Sherwin-Williams, which picked up most of the sign restoration bill.

Baumgart, a veritable encyclopedia of sign knowledge, joked with reporters that its face had been pancaked with two tons of makeup. "A lot was done to her backside, but we're leaving that secret," he said, tongue firmly in cheek.

When it was erected in 1923 with the aid of mule teams, the sign touted a high-end real estate development named Hollywoodland. Its creators expected to take it down after a year, according to the Hollywood Sign Trust, but tourists flocked to the hillside and its stunning view of Los Angeles. In the 1940s, the city folded the sign into Griffith Park and truncated it to hype, simply, "Hollywood."

Over the years, the sign has needed numerous touch-ups. In the 1970s, the termite-weakened O cartwheeled away from the rest of its kin and an L was set ablaze. A who's-who of Hollywood helped raise money to rebuild the sign completely, including Alice Cooper, Gene Autry and Hugh Hefner, who threw a fundraiser at the Playboy Mansion.

When the retooled landmark was unveiled in 1978 on live TV, the trust said, 60 million people watched. After that, it seemed, Los Angeles celebrated its every milestone with a dose of stagecraft.

In 1995, during the media event with Diller, black tarps fell to reveal gleaming letters. In 2005, Los Angeles Mayor Antonio Villaraigosa, in the words of the trust, "rappelled down the hillside and applied the final strokes of coating himself."

Tuesday's event was comparatively sedate. But as Baumgart fielded questions, a handful of people crept along the sign's base — cameramen shooting video of painters.

"They're supposed to be painting the last brush strokes on the sign," Baumgart said, "but it's for show."

He shrugged.

"Hey, it's Hollywood."

ashley.powers@latimes.com

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YouTube Releases iPad App, Filling Last Device Gap in Split from Apple

Google has updated its YouTube app to support the iPad’s larger screen, creating a new experience for the iPad and iPhone 5 while filling in yet another gap created when iOS 6 took away YouTube’s coveted spot on iDevice home screens.

Tuesday’s updated YouTube app follows the earlier release of an iPhone-specific app, and using the app is a familiar and seamless experience. A right-hand menu highlights the video service’s channels, ranging from “Film and Animation” to “Pets and Animals.” You get the same sharing features — through Facebook, Twitter, Google+, e-mail, messaging and via your clipboard — as you do on the iPhone app. It just looks so much better on the larger screen. You can scroll through comments, related videos, and channels while watching any given clip. Overall, it’s a very iPad-friendly design that gives you the best (and, too often, worst) of internet video.

The updated YouTube app also supports AirPlay, allowing you to beam videos to an Apple TV. You can now also add and remove videos from your playlist, click links in video descriptions and tap a logo to open your specific guide of channels. The company has also enhanced its VoiceOver accessibility. These are all small updates that amount to a better mobile YouTube experience.

Now Google just needs to release its iOS Google Maps app and the company will be good to go.

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Huston’s “Infrared” wins Bad Sex fiction prize

LONDON (AP) — It’s the prize no author wants to win.

Award-winning novelist Nancy Huston won Britain’s Bad Sex in Fiction award Tuesday for her novel “Infrared,” whose tale of a photographer who takes pictures of her lovers during sex proved too revealing for the judges.

The choice was announced by “Downton Abbey” actress Samantha Bond during a ceremony at the Naval & Military Club in London.

Judges of the tongue-in-cheek prize — which is run by the Literary Review magazine — said they were struck by a description of “flesh, that archaic kingdom that brings forth tears and terrors, nightmares, babies and bedazzlements,” and by a long passage that builds to a climax of “undulating space.”

Huston, who lives in Paris, was not on hand to collect her prize. In a statement read by her publicist, the 59-year-old author said she hoped her victory would “incite thousands of British women to take close-up photos of their lovers’ bodies in all states of array and disarray.”

The Canada-born Huston, who writes in both French and English, is the author of more than a dozen novels, including “Plainsong” and “Fault Lines.” She has previously won France’s Prix Goncourt prize and was a finalist for Britain’s Orange Prize for fiction by women.

She is only the third woman to win the annual Bad Sex prize, founded in 1993 to name and shame authors of “crude, tasteless and … redundant passages of sexual description in contemporary novels.”

Some critics, however, have praised the sexual passages in “Infrared.” Shirley Whiteside in the Independent on Sunday newspaper said there were “none of the lazy cliches of pornography or the purple prose of modern romantic fiction” — though she conceded the book’s sex scenes were “more perfunctory than erotic.”

Huston beat finalists including previous winner Tom Wolfe — for his passage in “Back to Blood” describing “his big generative jockey” — and Booker Prize-nominated Nicola Barker, whose novel “The Yips” compares a woman to “a plump Bakewell pudding.”

Previous recipients of the dubious honor, usually accepted with good grace, include Sebastian Faulks, the late Norman Mailer and the late John Updike, who was awarded a Bad Sex lifetime achievement award in 2008.

___

Online: http://www.literaryreview.co.uk

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Software Programs Help Doctors Diagnose, but Can’t Replace Them

SAN FRANCISCO — The man on stage had his audience of 600 mesmerized. Over the course of 45 minutes, the tension grew. Finally, the moment of truth arrived, and the room was silent with anticipation.

At last he spoke. “Lymphoma with secondary hemophagocytic syndrome,” he said. The crowd erupted in applause.

Professionals in every field revere their superstars, and in medicine the best diagnosticians are held in particularly high esteem. Dr. Gurpreet Dhaliwal, 39, a self-effacing associate professor of clinical medicine at the University of California, San Francisco, is considered one of the most skillful clinical diagnosticians in practice today.

The case Dr. Dhaliwal was presented, at a medical  conference last year, began with information that could have described hundreds of diseases: the patient had intermittent fevers, joint pain, and weight and appetite loss.

To observe him at work is like watching Steven Spielberg tackle a script or Rory McIlroy a golf course. He was given new information bit by bit — lab, imaging and biopsy results. Over the course of the session, he drew on an encyclopedic familiarity with thousands of syndromes. He deftly dismissed red herrings while picking up on clues that others might ignore, gradually homing in on the accurate diagnosis.

Just how special is Dr. Dhaliwal’s talent? More to the point, what can he do that a computer cannot? Will a computer ever successfully stand in for a skill that is based not simply on a vast fund of knowledge but also on more intangible factors like intuition?

The history of computer-assisted diagnostics is long and rich. In the 1970s, researchers at the University of Pittsburgh developed software to diagnose complex problems in general internal medicine; the project eventually resulted in a commercial program called Quick Medical Reference. Since the 1980s, Massachusetts General Hospital has been developing and refining DXplain, a program that provides a ranked list of clinical diagnoses from a set of symptoms and laboratory data.

And I.B.M., on the heels of its triumph last year with Watson, the Jeopardy-playing computer, is working on Watson for Healthcare.

In some ways, Dr. Dhaliwal’s diagnostic method is similar to that of another I.B.M. project: the Deep Blue chess program, which in 1996 trounced Garry Kasparov, the world’s best player at the time, to claim an unambiguous victory in the computer’s relentless march into the human domain.

Although lacking consciousness and a human’s intuition, Deep Blue had millions of moves memorized and could analyze as many each second. Dr. Dhaliwal does the diagnostic equivalent, though at human speed.

Since medical school, he has been an insatiable reader of case reports in medical journals, and case conferences from other hospitals. At work he occasionally uses a diagnostic checklist program called Isabel, just to make certain he hasn’t forgotten something. But the program has yet to offer a diagnosis that Dr. Dhaliwal missed.

Dr. Dhaliwal regularly receives cases from physicians who are stumped by a set of symptoms. At medical conferences, he is presented with one vexingly difficult case and is given 45 minutes to solve it. It is a medical high-wire act; doctors in the audience squirm as the set of facts gets more obscure and all the diagnoses they were considering are ruled out. After absorbing and processing scores of details, Dr. Dhaliwal must commit to a diagnosis. More often than not, he is right.

When working on a difficult case in front of an audience, Dr. Dhaliwal puts his entire thought process on display, with the goal of “elevating the stature of thinking,” he said. He believes this is becoming more important because physicians are being assessed on whether they gave the right medicine to a patient, or remembered to order a certain test.

Without such emphasis, physicians and training programs might forget the importance of having smart, thoughtful doctors. “Because in medicine,” Dr. Dhaliwal said, “thinking is our most important procedure.”

He added: “Getting better at diagnosis isn’t about figuring out if someone has one rare disease versus another. Getting better at diagnosis is as important to patient quality and safety as reducing medication errors, or eliminating wrong site surgery.”

Clinical Precision

Dr. Dhaliwal does half his clinical work on the wards of the San Francisco V. A. Medical Center, and the other half in its emergency department, where he often puzzles through multiple mysteries at a time.

One recent afternoon in the E.R., he was treating a 66-year-old man who was mentally unstable and uncooperative. He complained of hip pain, but routine lab work revealed that his kidneys weren’t working and his potassium was rising to a dangerous level, putting him in danger of an arrhythmia that could kill him — perhaps within hours. An ultrasound showed that his bladder was blocked.

There was work to be done: drain the bladder, correct the potassium level. It would have been easy to dismiss the hip pain as a distraction; it didn’t easily fit the picture. But Dr. Dhaliwal’s instinct is to hew to the ancient rule that physicians should try to come to a unifying diagnosis. In the end, everything — including the hip pain — was traced to metastatic prostate cancer.

“Things can shift very quickly in the emergency room,” Dr. Dhaliwal said. “One challenge of this, whether you use a computer or your brain, is deciding what’s signal and what’s noise.” Much of the time, it is his intuition that helps figure out which is which.

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DealBook: Former Goldman Director Gupta to Stay Free Pending His Appeal

A former Goldman Sachs director, Rajat K. Gupta, may remain free on bail while he challenges his insider-trading conviction, a federal appeals court ruled on Tuesday.

In a surprise decision, the United States Court of Appeals for the Second Circuit in Manhattan ruled that Mr. Gupta would not have to report to prison until his appeal is heard, which could take a year. He had been set to start serving his two-year sentence on Jan. 8.

Mr. Gupta, 64, was found guilty in June of leaking Goldman’s boardroom secrets to his friend, the former hedge fund managerRaj Rajaratnam.

Tuesday’s ruling suggested that Mr. Gupta had convinced the judges that he had legitimate issues to argue on appeal. The same federal appeals court had denied a request by Mr. Rajaratnam to remain free on bail pending his appeal. Mr. Rajaratnam is serving an 11-year prison term.

Mr. Gupta’s lawyers are expected to make several arguments. The most significant issue on appeal could be the government’s use of the wiretaps in the trial.

Judge Jed S. Rakoff, the trial court judge, allowed the jury to hear incriminating taped conversations involving Mr. Rajaratnam and his traders. Those conversations suggested Mr. Rajaratnam had a source at Goldman.

“I heard yesterday from somebody who’s on the board of Goldman Sachs that they are going to lose $2 per share,” Mr. Rajaratnam told a colleague on a wiretapped call in October 2008.

Multimedia: Insider Trading

Without the wiretaps, prosecutors would have had to rely on circumstantial evidence — telephone bills and trading records — to prove their case.

Mr. Gupta’s lawyers had argued that because the conversations were between Mr. Rajaratnam and his employees, Judge Rakoff should declare them inadmissible hearsay evidence, meaning that they were too unreliable to be used against Mr. Gupta.

Another issue that Mr. Gupta’s lawyers are expected to raise is that Judge Rakoff erred in limiting testimony by Mr. Gupta’s daughter about her father’s deteriorating relationship with Mr. Rajaratnam.

Mr. Gupta, who lives in Westport, Conn., has been free on $10 million bail since his arrest in October 2011. In addition to a team of lawyers from Kramer Levin Naftalis & Frankel that had represented him, Mr. Gupta hired Seth P. Waxman, an experienced appellate lawyer, to help with his appeal.
Mr. Waxman, a partner at WilmerHale, is a former United States solicitor general who has argued more than 50 cases before the United States Supreme Court.

The court is expected to hear Mr. Gupta’s appeal in the spring.

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