DealBook: Michael Dell’s Empire in a Buyout Spotlight

The computer empire of Michael S. Dell spreads across a campus of low-slung buildings in Round Rock, Tex.

But his financial empire — estimated at $16 billion — occupies the 21st floor of a dark glass skyscraper on Fifth Avenue in Manhattan.

It is there that MSD Capital, started by Mr. Dell 15 years ago to manage his fortune, has quietly built a reputation as one of the smartest investors on Wall Street. By amassing a prodigious portfolio of stocks, companies, real estate and timberland, Mr. Dell has reduced his exposure to the volatile technology sector and branched out into businesses as diverse as dentistry and landscaping.

Now, Mr. Dell is on the verge of making one of the biggest investments of his life. The 47-year-old billionaire and his private equity backers are locked in talks to acquire Dell, the company he started with $1,000 as a teenager three decades ago, in a leveraged buyout worth more than $20 billion. MSD could play a role in the Dell takeover, according to people briefed on the deal.

The private equity firm Silver Lake has been in negotiations to join with Mr. Dell on a transaction, along with other potential partners like wealthy Asian investors or foreign funds. Mr. Dell would be expected to roll his nearly 16 percent ownership of the company into the buyout, a stake valued at about $3.5 billion. He could also contribute additional personal money as part of the buyout.

That money is managed by MSD, among the more prominent so-called family offices that are set up to handle the personal investments of the wealthy. Others with large family offices include Bill Gates, whose Microsoft wealth financed the firm Cascade Investment, and New York’s mayor, Michael R. Bloomberg, who set up his firm, Willett Advisors, in 2010 to manage his personal and philanthropic assets.

“Some of these family offices are among the world’s most sophisticated investors and have the capital and talent to compete with the largest private equity firms and hedge funds,” said John P. Rompon, managing partner of McNally Capital, which helps structure private equity deals for family offices.

A spokesman for MSD declined to comment for this article. The buyout talks could still fall apart.

In 1998, Mr. Dell, then just 33 years old — and his company’s stock worth three times what it is today — decided to diversify his wealth and set up MSD. He staked the firm with $400 million of his own money, effectively starting his own personal money-management business.

To head the operation, Mr. Dell hired Glenn R. Fuhrman, a managing director at Goldman Sachs, and John C. Phelan, a principal at ESL Investments, the hedge fund run by Edward S. Lampert. He knew both men from his previous dealings with Wall Street. Mr. Fuhrman led a group at Goldman that marketed specialized investments like private equity and real estate to wealthy families like the Dells. And Mr. Dell was an early investor in Mr. Lampert’s fund.

Mr. Fuhrman and Mr. Phelan still run MSD and preside over a staff of more than 100 overseeing Mr. Dell’s billions and the assets in his family foundation. MSD investments include a stock portfolio, with positions in the apparel company PVH, owner of the Calvin Klein and Tommy Hilfiger brands, and DineEquity, the parent of IHOP and Applebee’s.

Among its real estate holdings are the Four Seasons Resort Maui in Hawaii and a stake in the New York-based developer Related Companies.

MSD also has investments in several private businesses, including ValleyCrest, which bills itself as the country’s largest landscape design company, and DentalOne Partners, a collection of dental practices.

Perhaps MSD’s most prominent deal came in 2008, in the middle of the financial crisis, when it joined a consortium that acquired the assets of the collapsed mortgage lender IndyMac Bank from the federal government for about $13.9 billion and renamed it OneWest Bank.

The OneWest purchase has been wildly successful. Steven Mnuchin, a former Goldman executive who led the OneWest deal, has said that the bank is expected to consider an initial public offering this year. An I.P.O. would generate big profits for Mr. Dell and his co-investors, according to people briefed on the deal.

Another arm of MSD makes select investments in outside hedge funds. Mr. Dell invested in the first fund raised by Silver Lake, the technology-focused private equity firm that might now become his partner in taking Dell private.
MSD’s principals have already made tidy fortunes. In 2009, Mr. Fuhrman, 47, paid $26 million for the Park Avenue apartment of the former Lehman Brothers chief executive Richard S. Fuld. Mr. Phelan, 48, and his wife, Amy, a former Dallas Cowboys cheerleader, also live in a Park Avenue co-op and built a home in Aspen, Colo.

Both are influential players on the contemporary art scene, with ARTNews magazine last year naming each of them among the world’s top 200 collectors. MSD, too, has dabbled in the visual arts. In 2010, MSD bought an archive of vintage photos from Magnum, including portraits of Marilyn Monroe and Mahatma Gandhi, and has put the collection on display at the University of Texas, Mr. Dell’s alma mater.

Just as the investment firms Rockefeller & Company (the Rockefellers, diversifying their oil fortune) and Bessemer Trust (the Phippses, using the name of the steelmaking process that formed the basis of their wealth) started out as investment vehicles for a single family, MSD has recently shown signs of morphing into a traditional money management business with clients beside Mr. Dell.

Last year, for the fourth time, an MSD affiliate raised money from outside investors when it collected about $1 billion for a stock-focused hedge fund, MSD Torchlight Partners. A 2010 fund investing in distressed European assets also manages about $1 billion. The Dell family is the anchor investor in each of the funds, according to people briefed on the investments.

MSD has largely remained below the radar, though its name emerged a decade ago in the criminal trial of the technology banker Frank Quattrone on obstruction of justice charges. Prosecutors introduced an e-mail that Mr. Fuhrman sent to Mr. Quattrone during the peak of the dot-com boom in which he pleaded for a large allotment of a popular Internet initial public offering.

“We know this is a tough one, but we wanted to ask for a little help with our Corvis allocation,” Mr. Fuhrman wrote. “We are looking forward to making you our ‘go to’ banker.”

The e-mail, which was not illegal, was meant to show the quid pro quo deals that were believed to have been struck between Mr. Quattrone and corporate chieftains like Mr. Dell — the bankers would give executives hot I.P.O.’s and the executives, in exchange, would hold out the possibility of giving business to the bankers. (Mr. Quattrone’s conviction was reversed on appeal.)

The MSD team has also shown itself to be loyal to its patron in other ways.

On the MSD Web site, in the frequently asked questions section, the firm asks and answers queries like “how many employees do you have” and “what kind of investments do you make.”

In the last question on the list, MSD asks itself, “Do you use Dell computer equipment?” The answer: “Exclusively!”

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This post has been revised to reflect the following correction:

Correction: January 18, 2013

An earlier version of this article misstated when an MSD affiliate raised money from outside investors for a hedge fund. It was last year, not earlier this year. The article also misstated which hedge fund and its focus. It was MSD Torchlight Partners, a stock-focused hedge fund, not MSD Energy Partners, an energy-focused hedge fund.

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India Ink: A Hospital Network With a Vision

Fixes looks at solutions to social problems and why they work.

As the United States struggles to find new business models for health care, some innovators are looking to other industries, ones that provide high-quality services for low prices. In a recent article in The New Yorker, for example, Atul Gawande suggests that the Cheesecake Factory restaurant chain — with its size, central control and accountability for the customer experience — could be a model of sorts for health care. That’s not as outlandish as it seems. The world’s largest provider of eye care has found success by directly adapting the management practices of another big-box food brand, one that is not often associated with good health: McDonald’s.

Aravind can practice compassion successfully because it is run like a McDonald’s.

In 1976, Dr. Govindappa Venkataswamy — known as Dr. V — retired from performing eye surgery at the Government Medical College in Madurai, Tamil Nadu, a state in India’s south. He decided to devote his remaining years to eliminating needless blindness among India’s poor. Twelve million people are blind in India, the vast majority of them from cataracts, which tend to strike people in India before 60 — earlier than in the West. Blindness robs a poor person of his livelihood and with it, his sense of self-worth; it is often a fatal disease. A blind person, the Indian saying goes, is “a mouth with no hands.”

Dr. V started by establishing an 11-bed hospital with six beds reserved for patients who could not pay and five for those who would pay modest rates. He persuaded his siblings to join him in mortgaging their houses, pooling their savings and pawning their jewels to build it. Today, the Aravind Eye Care System is a network of hospitals, clinics, community outreach efforts, factories, and research and training institutes in south India that has treated more than 32 million patients and has performed 4 million surgeries. And it is still largely run by Dr V’s siblings and their spouses and children — he has at least 21 relatives who are eye surgeons. (Aravind’s story is well-told in depth in a new book, “Infinite Vision.”)

Aravind is not just a health success, it is a financial success. Many health nonprofits in developing countries rely on government help or donations, but Aravind’s core services are sustainable: patient care and the construction of new hospitals are funded by fees from paying patients. And at Aravind, patients pay only if they want to. The majority of Aravind’s patients pay only a symbolic amount, or nothing at all.

Dr V was guided by the teachings of the radical Indian nationalist and mystic Sri Aurobindo (Aravind is a southern Indian variation of Aurobindo), who located man’s search for his divine nature not in turning away from the world, but by engaging with it.

This philosophy, however, has produced a sustainable business model because of the other major influence on Dr. V: McDonald’s. Sri Aurobindo and McDonald’s are an unlikely pair. But Aravind can practice compassion successfully because it is run like a McDonald’s, with assembly-line efficiency, strict quality norms, brand recognition, standardization, consistency, ruthless cost control and above all, volume.

Aravind’s efficiency allows its paying patients to subsidize the free ones, while still paying far less than they would at other Indian hospitals. Each year, Aravind does 60 percent as many eye surgeries as the United Kingdom’s National Health System, at one one-thousandth of the cost.

Aravind’s ideas reach around the world. It runs hospitals in other parts of India with partners. It is also host to a parade of people who come to learn how it works, and it sends staff to work with other organizations. So far about 300 hospitals in India and in other countries are using the Aravind model. All are eye hospitals. But Aravind has also trained staff from maternity hospitals, cancer centers, and male circumcision clinics, among other places. Some share Aravind’s social mission. Others simply want to operate more efficiently.

The vast majority of people blind from cataracts in rural India have no idea why they are blind, nor that a surgery exists that can restore their sight in a few minutes. Aravind attracts these patients in two ways. First, it holds eye camps — 40 a week around the states of Tamil Nadu and Kerala. The camps visit villages every few months, offering eye exams, basic treatments, and fast, cheap glasses. Patients requiring surgery are invited with a family member to come to the nearest of Aravind’s nine hospitals; all transport and lodging, like the surgery, is free.

When Aravind surveyed the impact of its camps, it found to its dismay that they only attracted 7 percent of people in a village who needed care, mainly because they were infrequent. To provide a permanent presence in rural areas, Aravind established 36 storefront vision centers. They are staffed by rural women recruited and given two years’ training by Aravind. They have cameras, so doctors at Aravind’s hospitals can do examinations remotely. These centers increase Aravind’s market penetration to about 30 percent within one year of operation.

At Aravind’s hospitals, free patients lodge on a mat on the floor in a 30-person dormitory. Paying patients can choose various levels of luxury, including private, air-conditioned rooms. All patients get best-practice cataract surgeries, but paying patients can choose more sophisticated surgeries with faster recoveries (but not higher success rates). The doctors are identical, rotating between the free and paid wings.

Also standard for all patients is the Aravind assembly line. Dr. V spent a few days at McDonalds’ Hamburger University in Oak Brook,, Ill., but that visit was a product of his longstanding obsession with efficiency. “This man would go into an airport and walk around with the janitor and see how he cleans the toilet,” said Dr. S. Aravind, an eye surgeon with a masters degree in business who is Aravind’s director of projects. (He is Dr. V’s nephew, also named for Sri Aurobindo.) “He would go to a five star hotel and follow the catering people.”

Doctors are hard to find and expensive, so the surgical system is set up to get the most out of them. Patients are prepared before surgery and bandaged afterwards by Aravind-trained nurses. The operating room has two tables. The doctor performs a surgery — perhaps 5 minutes — on Table 1, sterilizes her hands and turns to Table 2. Meanwhile, a new patient is prepped on Table 1. Aravind doctors do more than 2,000 surgeries a year; the average at other Indian hospitals is around 300. As for quality, Aravind’s rate of surgical complications is half that of eye hospitals in Britain.

This volume is key to Aravind’s ability to offer free care. The building and staff costs are the same no matter how many surgeries each doctor performs. High volume means that these fixed costs are spread among vastly more people.

In the 1980s, Aravind faced a dilemma. A new surgery, which implanted a lens in the patient’s eye, had become the gold standard for treating cataracts. But these lenses were not made in India, and Aravind could persuade manufacturers to reduce their cost only from $100 to $70 per lens. Should Aravind begin providing first-class treatment for paying patients and second-class treatment for free ones? Or should it try to get enough money from paid patients to cover intraocular lenses for all? Neither was acceptable.

The solution was to get into manufacturing. In 1992, Aravind set up Aurolab, which now makes lenses (for $2 apiece), sutures and medicines. Aurolab is now a major global supplier of intraocular lenses and has driven down the price of lenses made by other manufacturers as well.

Aravind could not do its work without paying patients, of course — they subsidize free patients. They also improve service, by demanding high quality for their money. But it also works the other way around: the free patients improve service and price for patients who pay. “One of our big advantages is the scale of the work we do,” said Dr. Aravind. “You become a good resource center for training doctors, nurses, everybody. Because of high volume, doctors get better at what they do. They can develop subtle specialties.” And free patients make cost control a priority. “If 60 percent of your patients are paying very little or nothing, your cost structure is attuned towards that,” Dr. Aravind said.

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Whenever there is an innovator like Aravind, the question arises: how replicable is this? Do you need a Dr. V? Or is there a system that ordinary mortals can adapt?

The answer is a little of both. Other hospitals can and do successfully use the model. Lions Clubs International, which has worked to prevent blindness for more than a century, finances and supports a training institute. Aravind also works with the Berkeley-based Seva Foundation to grow eye hospitals in other countries. “There are a lot of eye hospitals in the developing world. Almost every single one is considerably underproducing,” said Suzanne Gilbert, the director of Seva’s Center for Innovation in Eye Care. “Surgical programs so often focus on the technique being used. Often the same level of scrutiny not applied to management, human resources and other systems that make the surgery work.”

Seva has worked with Aravind to establish hospitals in other countries (the Lumbini Eye Institute in Nepal has been particularly successful).  But its campaign to turn those hospitals into training centers has gone slowly. It’s hard to build those hospitals to be able to reach out while keeping good quality,” said Gilbert.   Seva was aiming to have 100 hospitals in the network by 2015, but has scaled back that goal.

“Of the 300 hospitals (that use Aravind’s model), I’d say 20 percent get the whole thing,” said Dr. Aravind. “Another 50 percent pick up pieces — how to make your operating tables more efficient, for example.  And the rest struggle.”

Combining paid and free care in a self-sufficient hospital is not possible for most health specialties. “The essential ingredient is volume that straddles the socioeconomic spectrum,” said Jaspal Sandhu, a Berkeley engineer who has studied Aurolab, and who is co-founder of the Gobee Group, a design firm that works with organizations to increase their social impact. “If you’re focusing on rich diseases or poor diseases, this model in existing form can’t really play out. The nice thing about cataracts is that it doesn’t greatly discriminate. And a cataract is a one-time hit. There’s a cure for it. You can treat it in a couple of days and it won’t come back.”

Male circumcision — an AIDS prevention measure — fits this description, and the World Health Organization’s guidelines for scaling up male circumcision uses Aravind’s principles. “When I was a doctor in a government hospital we did between 8 and maybe 12 circumcisions in a day per doctor,” said Dino Rech, a South African physician who has overseen the expansion of circumcision in several countries.  “With this model, the slowest doctors are doing 40 in a day — up to 60 for the faster ones.”

The McDonald’s part is the easiest piece of the Aravind model to export. More difficult to replicate is Aravind’s commitment to serving the largest number of free patients possible — indeed, to aim to eventually serve all of them. What’s needed, said Dr. Aravind, “is not leadership in the sense of organizing and making it work. It’s leadership that comes from empathizing with the community.”

Aravind spends a lot of resources recruiting free patients. “Never restrict demand. Build your capacity to meet the demand,” Dr. Aravind said. This community outreach work is the easiest part to sacrifice, he said. “This is where mission and leadership come in. People try to justify it with many things — we’ll build a bigger organization, then we’ll go back to community. If you have a choice between your paying and your free patients — well, the team is watching how you prioritize. Here’s its been internalized that this is the way we deal with any issue.  If someone can embody that, they can be like our founder.”

Join Fixes on Facebook and follow updates on twitter.com/nytimesfixes.

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Tina Rosenberg won a Pulitzer Prize for her book “The Haunted Land: Facing Europe’s Ghosts After Communism.” She is a former editorial writer for The Times and the author of, most recently, “Join the Club: How Peer Pressure Can Transform the World” and the World War II spy story e-book “D for Deception.”

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Commentary: Background Checks? Yes, but Leave Video Games Alone

COMMENTARY | I have mixed feelings toward the White House‘s gun violence response. I agree that background checks should be required before people are allowed to buy a firearm and that an assault weapon ban should be reinstated into law. While limiting the number of bullets in a weapon’s magazine will decrease the number of deaths in a mass shooting, the public does not need high-capacity magazines. Therefore any weapon using high-capacity magazines should be banned from public use, not just capping the magazines to 10 bullets.

But violent video games and other media images and scenes real-life violence? These media do not kill people. The shooters kill the people. Those who are mentally unstable may not understand that violent video games are not real life and should not be duplicated in real life. As long as gamers understand the difference between video games and real life, that shouldn’t be touched.

– Edmond, Okla.

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Story of Te'o girlfriend death apparently a hoax

SOUTH BEND, Ind. (AP) — The wrenching story of Notre Dame football star Manti Te'o's girlfriend dying of leukemia — a loss he said inspired him to play his best all the way to the BCS championship — was dismissed by the school as a hoax perpetrated against the linebacker.

Notre Dame said Wednesday night it believes the Heisman Trophy finalist was duped into an online relationship with a woman whose "death" was then faked by the perpetrators of the hoax.

The school made the statement following a lengthy story by Deadspin.com, saying it could find no record that Lennay Kekua ever existed. The website story suggests a friend of Te'o may have carried out the hoax and that the football player may have been in on it.

"This is incredibly embarrassing to talk about, but over an extended period of time, I developed an emotional relationship with a woman I met online," Te'o said in a statement. "We maintained what I thought to be an authentic relationship by communicating frequently online and on the phone, and I grew to care deeply about her. "

However, he stopped short of saying he had ever met her in person or correcting reports that said he had, though he did on numerous occasions talk about how special the relationship was to him.

"To realize that I was the victim of what was apparently someone's sick joke and constant lies was, and is, painful and humiliating," he said.

"In retrospect, I obviously should have been much more cautious. If anything good comes of this, I hope it is that others will be far more guarded when they engage with people online than I was."

Notre Dame athletic director Jack Swarbrick said at a news conference that Te'o told coaches on Dec. 26 he had received a call while at an awards ceremony earlier in the month from Kekua's phone number.

"When he answered it, it was a person whose voice sounded like the same person he had talked to, who told him that she was, in fact, not dead. Manti was very unnerved by that, as you might imagine," Swarbrick said.

Swarbrick said the school hired investigators and their report indicated those behind the hoax were in contact with each other, discussing what they were doing.

The investigators "were able to discover online chatter among the perpetrators that was certainly the ultimate proof of this, the joy they were taking," Swarbrick said. "The casualness among themselves they were talking about what they accomplished."

Swarbrick said for Te'o "the pain was real."

"The grief was real. The affection was real," he said. "That's the nature of this sad, cruel game."

Swarbrick said Notre Dame did not take the matter to the police, saying that the school left it up to Te'o and his family to do so. He added that Notre Dame did not plan to release the findings of its investigation.

"We had no idea of motive, and that was really significant to us. ... Was somebody trying to create an NCAA violation at the core of this? Was there somebody trying to impact the outcome of football games by manipulating the emotions of a key player? Was there an extortion request coming? When you match the lack of sort of detail we lacked until we got some help investigating it with the risk involved, it was clear to me until we knew more we had to just to continue to work to try to gather the facts," Swarbrick said.

The Deadspin report changed all that.

Friends and relatives of Ronaiah Tuiasosopo told Deadspin they believe he created Kekua. The website said Te'o and Tuiasosopo knew each other. Attempts by The Associated Press to reach Tuiasosopo by telephone were unsuccessful.

As for Kekua, Deadspin said she does not have a death certificate. Stanford, where she reportedly went to school, has no record of anybody by that name, the website said. Deadspin said a record search produced no obituary or funeral announcement. There is no record of her birth in the news.

There are a few Twitter and Instagram accounts registered to Lennay Kekua, but the website reported photographs identified as Kekua online and in TV news reports are pictures from the social-media accounts of a 22-year-old California woman who is not named Lennay Kekua, the website reported.

Still, Swarbrick said, "Nothing about what I have learned has shaken my faith in Manti Te'o one iota."

Te'o talked freely about their relationship after her supposed death and how much she meant to him.

In a story that appeared in The South Bend Tribune on Oct. 12, Manti's father, Brian, recounted an anecdote about how his son and Kekua met after Notre Dame had played at Stanford in 2009. Brian Te'o also told the newspaper that Kekua had visited Hawaii and met with his son. Brian Te'o told the AP in an interview in October that he and his wife had never met Manti's girlfriend but they had hoped to at the Wake Forest game in November. The father said he believed the relationship was just beginning to get serious when she died.

The Tribune released a statement saying: "At the Tribune, we are as stunned by these revelations as everyone else. Indeed, this season we reported the story of this fake girlfriend and her death as details were given to us by Te'o, members of his family and his coaches at Notre Dame."

The week before Notre Dame played Michigan State on Sept. 15, coach Brian Kelly told reporters when asked that Te'o's grandmother and a friend had died. Te'o didn't miss the game. He said Kekua had told him not to miss a game if she died. Te'o turned in one of his best performances of the season in the 20-3 victory in East Lansing, and his playing through heartache became a prominent theme during the Irish's undefeated regular season.

"My family and my girlfriend's family have received so much love and support from the Notre Dame family," he said after that game. "Michigan State fans showed some love. And it goes to show that people understand that football is just a game, and it's a game that we play, and we have fun doing it. But at the end of the day, what matters is the people who are around you, and family. I appreciate all the love and support that everybody's given my family and my girlfriend's family."

He was asked again about his girlfriend on Jan. 3 prior to the BCS title game, saying: "This team is very special to me, and the guys on it have always been there for me, through the good times and the bad times. I rarely have a quiet time to myself because I always have somebody calling me, asking, 'Do you want to go to the movies?' Coach is always calling me asking me, 'Are you OK? Do you need anything?'"

Te'o finished second in Heisman voting, and led Notre Dame to its first appearance in the BCS championship. His widely reported story was among the most heartwarming of the season.

"It further pains me that the grief I felt and the sympathies expressed to me at the time of my grandmother's death in September were in any way deepened by what I believed to be another significant loss in my life," Te'o said in his statement.

"I am enormously grateful for the support of my family, friends and Notre Dame fans throughout this year. To think that I shared with them my happiness about my relationship and details that I thought to be true about her just makes me sick. I hope that people can understand how trying and confusing this whole experience has been."

Te'o and the Irish lost the title game to Alabama, 42-14 on Jan. 7. He has graduated and was set to begin preparing for the NFL combine and draft at the IMG Academy in Bradenton, Fla., this week.

"Fortunately, I have many wonderful things in my life," he said in his statement, "and I'm looking forward to putting this painful experience behind me as I focus on preparing for the NFL Draft."

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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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Dreamliner Jet Makes Emergency Landing in Japan Due to Battery

TOKYO (AP) — Boeing Co.'s 787 planes were grounded for safety checks Wednesday by two major Japanese airlines after one was forced to make an emergency landing in the latest blow for the new jet.

All Nippon Airways said a cockpit message showed battery problems and a burning smell was detected in the cockpit and the cabin, forcing the 787 on a domestic flight to land at Takamatsu airport in western Japan.

The 787, known as the Dreamliner, is Boeing's newest and most technologically advanced jet, and the company is counting heavily on its success. Since its launch, which came after delays of more than three years, the plane has been plagued by a series of problems including a battery fire and fuel leaks. Japan's ANA and Japan Airlines are major customers for the jet and among the first to fly it.

Japan's transport ministry said it got notices from ANA, which operates 17 of the jets, and Japan Airlines which has seven, that all their 787 aircraft would not be flying. The grounding was done voluntarily by the airlines.

The ministry categorized the problem Wednesday as a "serious incident" that could have led to an accident, and sent officials for further checks to Takamatsu airport. The airport was closed.

ANA executives apologized, bowing deeply at a hastily called news conference in Tokyo.

"We are very sorry to have caused passengers and their family members so much concern," said ANA Senior Executive Vice President Osamu Shinobe.

One male in his 60s was taken to the hospital for minor hip injuries after going down the emergency slides at the airport, the fire department said. The other 128 passengers and eight crew members of the ANA domestic flight were uninjured, according to ANA.

The grounding in Japan was the first for the 787, whose problems had been brushed off by Boeing as teething pains for a new aircraft. The ministry had already started a separate inspection Monday on another 787 jet, operated by Japan Airlines, which had leaked fuel at Tokyo's Narita airport after flying back from Boston, where it had also leaked fuel.

A fire ignited Jan. 7 in the battery pack of an auxiliary power unit of a Japan Airlines 787 empty of passengers as the plane sat on the tarmac at Boston's Logan International Airport. It took firefighters 40 minutes to put out the blaze.

ANA cancelled a domestic flight to Tokyo on Jan. 9 after a computer wrongly indicated there was a problem with the Boeing 787's brakes. Two days later, the carrier reported two new cases of problems with the aircraft, a minor fuel leak and a cracked windscreen in a 787 cockpit.

The 787 relies more than any other modern airliner on electrical signals to help power nearly everything the plane does. It's also the first Boeing plane to use rechargeable lithium ion batteries, which charge faster and can be molded to space-saving shapes compared to other airplane batteries. The plane is made with lightweight composite materials instead of aluminum.

The U.S. Federal Aviation Administration said in a statement that it is "monitoring a preliminary report of an incident in Japan earlier today involving a Boeing 787."

It said the incident will be included in the comprehensive review the FAA began last week of the 787 critical systems, including design, manufacture and assembly. U.S. government officials were quick to say that the plane is safe — nearly 50 of them are in the skies now.

GS Yuasa Corp., the Japanese company that supplies all the lithium ion batteries for the 787, had no comment as the investigation was still ongoing.

In Tokyo, the transport minister, Akihiro Ota, said authorities were taking the incidents seriously.

"These problems must be fully investigated," he said.

Boeing has said that various technical problems are to be expected in the early days of any aircraft model.

"Boeing is aware of the diversion of a 787 operated by ANA to Takamatsu in western Japan. We will be working with our customer and the appropriate regulatory agencies," Boeing spokesman Marc Birtel said.

In Wednesday's incident, a cockpit instrument showed a problem with the 787's battery and the pilot noticed an unusual smell, the airline said. The flight requested and was granted permission to make an emergency landing at Takamatsu airport.

Aviation safety expert John Goglia, a former National Transportation Safety Board member, said the ANA pilot had made the right choice.

"They were being very prudent in making the emergency landing even though there's been no information released so far that indicates any of these issues are related," he said.

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New photos of BlackBerry X10 with QWERTY keyboard leak

New images of Research In Motion’s (RIMM) first BlackBerry 10-powered smartphone equipped with a full QWERTY keyboard have leaked ahead of the handset’s unveiling later this month. BlackBerry blog BlackBerry Empire on Monday evening published a pair of photos showing the face of the upcoming N-series smartphone along with the home screen and the app launcher.

[More from BGR: HTC One SV review]

As revealed by earlier images of the phone, the device closely resembles RIM’s previous-generation BlackBerry Bold 9900 from the front, sporting a slim flat design with a touchscreen situated above the famous four-row BlackBerry keyboard.

[More from BGR: Extensive BlackBerry Z10 demo video posted by German website [video]]

RIM will unveil the new handset, thought to be launching as the “BlackBerry X10,” during a press conference on January 30th where BGR will be reporting live. RIM’s first full touch BlackBerry 10 phone, the “BlackBerry Z10,” will also be unveiled at the event.

This article was originally published on BGR.com

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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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