Well: Warning Too Late for Some Babies

Six weeks after Jack Mahoney was born prematurely on Feb. 3, 2011, the neonatal staff at WakeMed Hospital in Raleigh, N.C., noticed that his heart rate slowed slightly when he ate. They figured he was having difficulty feeding, and they added a thickener to help.

When Jack was discharged, his parents were given the thickener, SimplyThick, to mix into his formula. Two weeks later, Jack was back in the hospital, with a swollen belly and in inconsolable pain. By then, most of his small intestine had stopped working. He died soon after, at 66 days old.

A month later, the Food and Drug Administration issued a caution that SimplyThick should not be fed to premature infants because it may cause necrotizing enterocolitis, or NEC, a life-threatening condition that damages intestinal tissue.

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Catherine Saint Louis speaks about using SimplyThick in premature infants.

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Experts do not know how the product may be linked to the condition, but Jack is not the only child to die after receiving SimplyThick. An F.D.A. investigation of 84 cases, published in The Journal of Pediatrics in 2012, found a “distinct illness pattern” in 22 instances that suggested a possible link between SimplyThick and NEC. Seven deaths were cited; 14 infants required surgery.

Last September, after more adverse events were reported, the F.D.A. warned that the thickener should not be given to any infants. But the fact that SimplyThick was widely used at all in neonatal intensive care units has spawned a spate of lawsuits and raised questions about regulatory oversight of food additives for infants.

SimplyThick is made from xanthan gum, a widely-used food additive on the F.D.A.’s list of substances “generally recognized as safe.” SimplyThick is classified as a food and the F.D.A. did not assess it for safety.

John Holahan, president of SimplyThick, which is based in St. Louis, acknowledged that the company marketed the product to speech language pathologists who in turn recommended it to infants. The patent touted its effectiveness in breast milk.

However, Mr. Holahan said, “There was no need to conduct studies, as the use of thickeners overall was already well established. In addition, the safety of xanthan gum was already well established.”

Since 2001, SimplyThick has been widely used by adults with swallowing difficulties. A liquid thickened to about the consistency of honey allows the drinker more time to close his airway and prevent aspiration.

Doctors in newborn intensive care units often ask non-physician colleagues like speech pathologists to determine whether an infant has a swallowing problem. And those auxiliary feeding specialists often recommended SimplyThick for neonates with swallowing troubles or acid reflux.

The thickener became popular because it was easy to mix, could be used with breast milk, and maintained its consistency, unlike alternatives like rice cereal.

“It was word of mouth, then neonatologists got used to using it. It became adopted,” said Dr. Steven Abrams, a neonatologist at Texas Children’s Hospital in Houston. “At any given time, several babies in our nursery — and in any neonatal unit — would be on it.”

But in early 2011, Dr. Benson Silverman, the director of the F.D.A.’s infant formula section, was alerted to an online forum where doctors had reported 15 cases of NEC among infants given SimplyThick. The agency issued its first warning about its use in babies that May. “We can only do something with the information we are provided with,” he said. “If information is not provided, how would we know?”

Most infants who took SimplyThick did not fall ill, and NEC is not uncommon in premature infants. But most who develop NEC do so while still in the hospital. Some premature infants given SimplyThick developed NEC later than usual, a few after they went home, a pattern the F.D.A. found unusually worrisome.

Even now it is not known how the thickener might have contributed to the infant deaths. One possibility is that xanthan gum itself is not suitable for the fragile digestive systems of newborns. The intestines of premature babies are “much more likely to have bacterial overgrowth” than adults’, said Dr. Jeffrey Pietz, the chief of newborn medicine at Children’s Hospital Central California in Madera.

“You try not to put anything in a baby’s intestine that’s not natural.” If you do, he added, “you’ve got to have a good reason.”

A second possibility is that batches of the thickener were contaminated with harmful bacteria. In late May 2011, the F.D.A. inspected the plants that make SimplyThick and found violations at one in Stone Mountain, Ga., including a failure to “thermally process” the product to destroy bacteria of a “public health significance.”

The company, Thermo Pac, voluntarily withdrew certain batches. But it appears some children may have ingested potentially contaminated batches.

The parents of Jaden Santos, a preemie who died of NEC while on SimplyThick, still have unused packets of recalled lots, according to their lawyer, Joe Taraska.

The authors of the F.D.A. report theorized that the infants’ intestinal membranes could have been damaged by bacteria breaking down the xanthan gum into too many toxic byproducts.

Dr. Qing Yang, a neonatologist at Wake Forest University, is a co-author of a case series in the Journal of Perinatology about three premature infants who took SimplyThick, developed NEC and were treated. The paper speculates that NEC was “most likely caused by the stimulation of the immature gut by xanthan gum.”

Dr. Yang said she only belatedly realized “there’s a lack of data” on xanthan gum’s use in preemies. “The lesson I learned is not to be totally dependent on the speech pathologist.”

Julie Mueller’s daughter Addison was born full-term and given SimplyThick after a swallow test showed she was at risk of choking. It was recommended by a speech pathologist at the hospital.

Less than a month later, Addison was dead with multiple holes in her small intestine. “It was a nightmare,” said Ms. Mueller, who has filed a lawsuit against SimplyThick. “I was astounded how a hospital and manufacturer was gearing this toward newborns when they never had to prove it would be safe for them. Basically we just did a research trial for the manufacturer.”

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Bits Blog: Most Facebook Users Have Taken a Break From the Site, Study Finds

Facebook is the most popular social network in America — roughly two-thirds of adults in the country use it on a regular basis.

But that doesn’t mean they don’t get sick of it.

A new study released on Tuesday by the Pew Research Center‘s Internet and American Life Project found that 61 percent of current Facebook users admitted that they had voluntarily taken breaks from the site, for as many as several weeks at a time.

The main reason for their social media sabbaticals?

Not having enough time to dedicate to pruning their profiles, an overall decrease in their interest in the site as well as the general sentiment that Facebook was a major waste of time. About 4 percent cited privacy and security concerns as contributing to their departure. Although those users eventually resumed their regular activity, another 20 percent of Facebook users admitted to deleting their accounts.

Of course, even as some Facebook users pull back on their daily consumption of the service, the vast majority — 92 percent — of all social network users still maintain a profile on the site. But while more than half said that the site was just as important to them as it was a year ago, only 12 percent said the site’s significance increased over the last year — indicating the makings of a much larger social media burnout across the site.

The study teases out other interesting insights, including the finding that young users are spending less time overall on the site. The report found that 42 percent of Facebook users from the ages of 18 to 29 said that the average time they spent on the site in a typical day had decreased in the last year. A much smaller portion, 23 percent, of older Facebook users, those over 50, reported a drop in Facebook usage over the same period.

Facebook’s biggest challenge revolves around figuring out how to continue to profit from its rich reservoir of one billion users — and a large part of that involves keeping them entertained and returning to the site on a regular basis. Most recently, the company introduced a tool called Graph Search, a research tool that promises to help its users find answers on everything from travel recommendations to potential jobs and even love connections.

Lee Rainie, the director of the Pew Research Center’s Internet & American Life Project, which conducted the survey, described the results as a kind of “social reckoning.”

“These data show that people are trying to make new calibrations in their life to accommodate new social tools,” said Mr. Rainie, in an e-mail. Facebook users are beginning to ask themselves, ” ‘What are my friends doing and thinking and how much does that matter to me?,’ ” he said. “They are adding up the pluses and minuses on a kind of networking balance sheet and they are trying to figure out how much they get out of connectivity vs. how much they put into it.”

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Manson follower parole decision in Gov. Jerry Brown's hands

Bruce Davis, a former member of the Manson Family, moments before the start of his parole hearing in October. (Joe Johnston, The Tribune)

By Paige St. John

February 4, 2013, 2:58 p.m.

It is up to Gov. Jerry Brown whether to release a now-70 follower of murderer Charles Manson.

For at least the second time, the California Board of Parole Hearings has recommended the release of Bruce Davis, imprisoned since 1972 for his role in the murder of two men, a musician and a stuntman. Brown has 30 days to decide whether to allow Davis' release, refer it for a full parole board hearing or follow then-Gov. Arnold Schwarzenegger's example and deny parole.

Manson and his followers killed nine people in July and August 1969, including actress Sharon Tate, and attempted to blame the slaying on black militants. Manson was already standing trial in 1970 for the Tate murders when Davis turned himself in at the Los Angeles County courthouse. He was convicted in two slayings and sentenced to life in prison.

California corrections officials previously rejected Davis' bid for parole 25 times before recommending in 2010 and again in October that parole be granted.

On Friday, the Board of Parole Hearings determined that the recommendation contained no legal errors and forwarded it to Brown.

"I am sorry for who I was and what I did," Davis wrote in a letter submitted to the earlier parole board. "I am now focused on compensating for the lives I destroyed by promoting life-enriching and violence-preventing lifestyles at every opportunity."

L.A. County Dist. Atty. Jackie Lacey wrote a letter to the Board of Parole Hearings objecting to Davis' release.

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Report: Is Marvel Firing the Hulk Into Space in <i>Avengers 2</i>?

If there was one breakout star of last year’s Marvel’s The Avengers, it was undoubtedly Mark Ruffalo’s Bruce Banner, aka the Hulk. But given that the incredible green hero has already headlined two relatively unsuccessful attempts at a major motion picture, how could Marvel Studios capitalize on the newfound interest in the character without repeating the same mistakes that sent the earlier Hulk films astray? One report may have the answer: Send the character into space.

Latino Review, citing anonymous “trusted sources,” ran a report this morning that Marvel Studios plans to adapt the 2006 comic book storyline “Planet Hulk” — where the smash-prone anti-hero gets launched into space for the good of humanity – during the second Avengers movie, followed by a stand-alone Hulk film where he goes on to conquer the war-torn alien planet where he lands. According to the site’s pseudonymous “El Mayimbe,” the plan would also include a third Avengers movie adapting World War Hulk, the final installment of “Planet Hulk” where the Hulk returns to Earth with an alien army to revenge himself against Earth’s Mightiest Heroes.

If true, this approach makes a lot of sense; it avoids the pitfalls of the two earlier Hulk movies by placing the character not just in an entirely different environment, but an entirely different world full of aliens who — as we learned in The Avengers – can be smashed without a second thought. It also takes advantage of the outer-space setting that will serve as the backdrop for upcoming Marvel movies like 2014′s Guardians of The Galaxy.

But if that’s why it makes sense, there are also quite a few reasons why Marvel Studios might not want to go for this plan. Firstly, “Planet Hulk” as a whole — and especially World War Hulk — turns the Hulk into a villain, specifically a villain who invades Earth to subjugate the human race. Secondly, the basic plot arc of the first half of “Planet Hulk” isn’t a million miles away from Edgar Rice Burroughs’ 1917 novel A Princess of Mars, which was adapted last year into a costly and embarrassing box office bomb called John Carter for Marvel’s parent company, Disney.

Thirdly, and most importantly, almost all of “Planet Hulk” revolves around the Hulk, and not Bruce Banner. Even a rewrite to add more “puny Banner” to the movie is likely to leave him interacting with CGI aliens instead of other humans, and is that really the best way to use Mark Ruffalo, considering how well he played off against Robert Downey Jr. and Chris Evans in Avengers?

While the report remains unconfirmed, Marvel Studios President Kevin Feige himself confirmed that the studio was planning its third “phase” of releases last month, with Ant-Man and Doctor Strange named as two of the films the studio planned to release after 2015.

Marvel Studios did not respond to Wired’s request for comment on this story.

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Well: Gluten-Free for the Gluten Sensitive

Eat no wheat.

That is the core, draconian commandment of a gluten-free diet, a prohibition that excises wide swaths of American cuisine — cupcakes, pizza, bread and macaroni and cheese, to name a few things.

For the approximately one-in-a-hundred Americans who have a serious condition called celiac disease, that is an indisputably wise medical directive.

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Kenneth Chang speaks about gluten.

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Now medical experts largely agree that there is a condition related to gluten other than celiac. In 2011 a panel of celiac experts convened in Oslo and settled on a medical term for this malady: non-celiac gluten sensitivity.

What they still do not know: how many people have gluten sensitivity, what its long-term effects are, or even how to reliably identify it. Indeed, they do not really know what the illness is.

The definition is less a diagnosis than a description — someone who does not have celiac, but whose health improves on a gluten-free diet and worsens again if gluten is eaten. It could even be more than one illness.

“We have absolutely no clue at this point,” said Dr. Stefano Guandalini, medical director of the University of Chicago’s Celiac Disease Center.

Kristen Golden Testa could be one of the gluten-sensitive. Although she does not have celiac, she adopted a gluten-free diet last year. She says she has lost weight and her allergies have gone away. “It’s just so marked,” said Ms. Golden Testa, who is health program director in California for the Children’s Partnership, a national nonprofit advocacy group.

She did not consult a doctor before making the change, and she also does not know whether avoiding gluten has helped at all. “This is my speculation,” she said. She also gave up sugar at the same time and made an effort to eat more vegetables and nuts.

Many advocates of gluten-free diets warn that non-celiac gluten sensitivity is a wide, unseen epidemic undermining the health of millions of people. They believe that avoiding gluten — a composite of starch and proteins found in certain grassy grains like wheat, barley and rye — gives them added energy and alleviates chronic ills. Oats, while gluten-free, are also avoided, because they are often contaminated with gluten-containing grains.

Others see the popularity of gluten-free foods as just the latest fad, destined to fade like the Atkins diet and avoidance of carbohydrates a decade ago.

Indeed, Americans are buying billions of dollars of food labeled gluten-free each year. And celebrities like Miley Cyrus, the actress and singer, have urged fans to give up gluten. “The change in your skin, physical and mental health is amazing!” she posted on Twitter in April.

For celiac experts, the anti-gluten zeal is a dramatic turnaround; not many years ago, they were struggling to raise awareness among doctors that bread and pasta can make some people very sick. Now they are voicing caution, tamping down the wilder claims about gluten-free diets.

“It is not a healthier diet for those who don’t need it,” Dr. Guandalini said. These people “are following a fad, essentially.” He added, “And that’s my biased opinion.”

Nonetheless, Dr. Guandalini agrees that some people who do not have celiac receive a genuine health boost from a gluten-free diet. He just cannot say how many.

As with most nutrition controversies, most everyone agrees on the underlying facts. Wheat entered the human diet only about 10,000 years ago, with the advent of agriculture.

“For the previous 250,000 years, man had evolved without having this very strange protein in his gut,” Dr. Guandalini said. “And as a result, this is a really strange, different protein which the human intestine cannot fully digest. Many people did not adapt to these great environmental changes, so some adverse effects related to gluten ingestion developed around that time.”

The primary proteins in wheat gluten are glutenin and gliadin, and gliadin contains repeating patterns of amino acids that the human digestive system cannot break down. (Gluten is the only substance that contains these proteins.) People with celiac have one or two genetic mutations that somehow, when pieces of gliadin course through the gut, cause the immune system to attack the walls of the intestine in a case of mistaken identity. That, in turn, causes fingerlike structures called villi that absorb nutrients on the inside of the intestines to atrophy, and the intestines can become leaky, wreaking havoc. Symptoms, which vary widely among people with the disease, can include vomiting, chronic diarrhea or constipation and diminished growth rates in children.

The vast majority of people who have celiac do not know it. And not everyone who has the genetic mutations develops celiac.

What worries doctors is that the problem seems to be growing. After testing blood samples from a century ago, researchers discovered that the rate of celiac appears to be increasing. Why is another mystery. Some blame the wheat, as some varieties now grown contain higher levels of gluten, because gluten helps provide the springy inside and crusty outside desirable in bread. (Blame the artisanal bakers.)

There are also people who are allergic to wheat (not necessarily gluten), but until recently, most experts had thought that celiac and wheat allergy were the only problems caused by eating the grain.

For 99 out of 100 people who don’t have celiac — and those who don’t have a wheat allergy — the undigested gliadin fragments usually pass harmlessly through the gut, and the possible benefits of a gluten-free diet are nebulous, perhaps nonexistent for most. But not all.

Anecdotally, people like Ms. Golden Testa say that gluten-free diets have improved their health. Some people with diseases like irritable bowel syndrome and arthritis also report alleviation of their symptoms, and others are grasping at gluten as a source of a host of other conditions, though there is no scientific evidence to back most of the claims. Experts have been skeptical. It does not make obvious sense, for example, that someone would lose weight on a gluten-free diet. In fact, the opposite often happens for celiac patients as their malfunctioning intestines recover.

They also worried that people could end up eating less healthfully. A gluten-free muffin generally contains less fiber than a wheat-based one and still offers the same nutritional dangers — fat and sugar. Gluten-free foods are also less likely to be fortified with vitamins.

But those views have changed. Crucial in the evolving understanding of gluten were the findings, published in 2011, in The American Journal of Gastroenterology, of an experiment in Australia. In the double-blind study, people who suffered from irritable bowel syndrome, did not have celiac and were on a gluten-free diet were given bread and muffins to eat for up to six weeks. Some of them were given gluten-free baked goods; the others got muffins and bread with gluten. Thirty-four patients completed the study. Those who ate gluten reported they felt significantly worse.

That influenced many experts to acknowledge that the disease was not just in the heads of patients. “It’s not just a placebo effect,” said Dr. Marios Hadjivassiliou, a neurologist and celiac expert at the University of Sheffield in England.

Even though there was now convincing evidence that gluten sensitivity exists, that has not helped to establish what causes gluten sensitivity. The researchers of the Australian experiment noted, “No clues to the mechanism were elucidated.”

What is known is that gluten sensitivity does not correlate with the genetic mutations of celiac, so it appears to be something distinct from celiac.

How widespread gluten sensitivity may be is another point of controversy.

Dr. Thomas O’Bryan, a chiropractor turned anti-gluten crusader, said that when he tested his patients, 30 percent of them had antibodies targeting gliadin fragments in their blood. “If a person has a choice between eating wheat or not eating wheat,” he said, “then for most people, avoiding wheat would be ideal.”

Dr. O’Bryan has given himself a diagnosis of gluten sensitivity. “I had these blood sugar abnormalities and didn’t have a handle where they were coming from,” he said. He said a blood test showed gliadin antibodies, and he started avoiding gluten. “It took me a number of years to get completely gluten-free,” he said. “I’d still have a piece of pie once in a while. And I’d notice afterwards that I didn’t feel as good the next day or for two days. Subtle, nothing major, but I’d notice that.”

But Suzy Badaracco, president of Culinary Tides, Inc., a consulting firm, said fewer people these days were citing the benefits of gluten-free diets. She said a recent survey of people who bought gluten-free foods found that 35 percent said they thought gluten-free products were generally healthier, down from 46 percent in 2010. She predicted that the use of gluten-free products would decline.

Dr. Guandalini said finding out whether you are gluten sensitive is not as simple as Dr. O’Bryan’s antibody tests, because the tests only indicate the presence of the fragments in the blood, which can occur for a variety of reasons and do not necessarily indicate a chronic illness. For diagnosing gluten sensitivity, “There is no testing of the blood that can be helpful,” he said.

He also doubts that the occurrence of gluten sensitivity is nearly as high as Dr. O’Bryan asserts. “No more than 1 percent,” Dr. Guandalini said, although he agreed that at present all numbers were speculative.

He said his research group was working to identify biological tests that could determine gluten sensitivity. Some of the results are promising, he said, but they are too preliminary to discuss. Celiac experts urge people to not do what Ms. Golden Testa did — self-diagnose. Should they actually have celiac, tests to diagnose it become unreliable if one is not eating gluten. They also recommend visiting a doctor before starting on a gluten-free diet.

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This post has been revised to reflect the following correction:

Correction: February 4, 2013

An earlier version of this article misspelled the surname of Thomas O'Bryan. It is O'Bryan, not O'Brien.

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On The Road: Glow of Familiar Hotel Brands in Unfamiliar Places

I KNOW that travel is enriching and that locally managed hotels in exotic places can provide wonderful experiences.

Still, when I’m traveling abroad on business, the last thing I want in a hotel is cultural adventure. Instead, I want predictability and value. I want a comfortable bed in a clean, quiet room with a nice bathroom — in a place that’s conveniently located and doesn’t cost too much. Oh, and dependable Wi-Fi service and a friendly front-desk staff who have at least some proficiency in English.

Does that make me the prototypical Ugly American?

“Well, that phrase did just come to mind,” Robert Mandelbaum, the director of research information services at the consulting firm PKF Hospitality Research, said with a laugh. We were talking in general about conditions in the hotel industry, which is continuing a steady recovery.

But one of the trends in the industry is the international expansion of midlevel hotels by major hotel companies.

The big chains have come a long way since the 1950s, when four-star Hilton Hotels spread through postwar Europe to cater to American tourists. So while top luxury hotels, like Marriott International’s Ritz-Carlton, are established in major and even secondary cities around the world, midlevel brands have only recently begun to turn up in large numbers in foreign cities.

Certainly, we all welcome the local experience, within reason. But, as Mr. Mandelbaum acknowledged, there’s virtue in “coming back at night knowing that the hotel room is safe, that the bathroom works and the Wi-Fi is available.”

I appreciated that in a hotel that otherwise looked right at home near the teeming historic Zócalo plaza in central Mexico City, where my wife and I recently stayed at a Hilton Hampton Inn on a short business trip.

Beautifully renovated from an 18th-century monastery, the hotel had the standard Hampton Inn amenities, including a big, comfortable suite with free (working) Wi-Fi, and a free buffet breakfast, all for $116 a night. The staff was helpful — and they even kept at the front desk a supply of chargers for various laptop and smartphone models for guests who’d forgotten theirs.

Intensely trained in adhering to Hampton brand standards, employees there have “skin in the game,” according to Phil Cordell, the worldwide brand manager for Hampton.

A few days later, we had an example of standards not being so well enforced. It involved a frustrating exchange of e-mails with a manager and reservations clerk at the Hilton DoubleTree in Querétaro, 124 miles northwest of Mexico City, where we attended the Mexico Business Summit.

We finally canceled our reservation in annoyance and booked elsewhere, after being curtly informed by a hotel representative that we would need to show proof of being 65 to qualify for a measly 5 percent AARP discount on the $128 rate. (In fact, the age requirement for AARP membership and travel discounts is 50.)

Instead, we stayed at the Fiesta Americana, a highly recommended local hotel, which turned out to be more expensive ($175), less convenient and maddeningly noisy because it was near a major highway.

Brand standards matter. When the international hotel company IHG opened a Crowne Plaza Hotel recently in Kochi, a commercial center on the west coast of India, the company’s head of regional operations, Douglas Martell, said that “business and leisure travelers in India are seeking a hotel with a brand name they can trust.”

Like its competitors, IHG, whose brands include Intercontinental Hotels and Holiday Inn, has been expanding in Asia, where it has 160 hotels in 60 cities. Also active in Asia is Marriott, which has about 60 hotels in China, from its Ritz-Carlton brand to its midlevel Courtyards, with plans to double that.

The hotel brands are also expanding in Latin America. Even in Europe, a well-established midlevel brand market is getting greater attention. In Germany, Starwood Hotels recently announced plans to open Aloft hotels in Munich and Stuttgart, underscoring the Aloft brand’s intention to “shake up the traditional midmarket hotel sector.”

Hilton’s DoubleTree hotels are growing rapidly internationally, too. Five years ago, DoubleTree had no hotels in Britain. Now it has 18. It has 12 in China, and 30 in development. DoubleTree plans to expand in India from three hotels to two dozen. Last year, DoubleTree entered markets in Japan, Thailand, Croatia and Spain. This year it will enter South Africa, Poland and Indonesia, said the global brand manager, Rob Palleschi.

Maintaining strict brand standards is the goal, he said.

“Part of the challenge is educating our team members,” he added. “Many of our team members out there, particularly in the emerging markets, have never actually stayed in a hotel, so you really have to take things from ground zero.”

E-mail: jsharkey@nytimes.com

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Court urges charges be reinstated for paparazzo in Bieber chase

An appeals court has recommended that charges be reinstated for a photographer who chased singer Justin Bieber on the 101 Freeway in the first case involving a California anti-paparazzi law that was deemed unconstitutional by a Los Angeles County judge.

The conclusion of the court's preliminary analysis of the case means that the judge who invalidated the law as a violation of the 1st Amendment must reconsider his decision or stand by it and have the three-judge appeals panel conduct a full hearing.

Superior Court Judge Thomas Rubinson ruled in November that although Los Angeles city prosecutors could proceed with traffic-related charges against Paul Raef, the two other charges related to the anti-paparazzi driving law did not pass constitutional muster.

But City Atty. Carmen Trutanich appealed Rubinson's decision.

The appeals court indicated in its initial analysis last week that the special vehicle code for punishing photographers who drive dangerously to obtain images to sell does not violate the 1st Amendment.

"The statute is not constitutionally infirm because it is neither vague nor over-broad," the panel wrote.

The notice of intent is not an order or a ruling, but the trial judge can revisit the decision based on the preliminary conclusions.

"The city attorney continues to believe that the law is constitutional, protects public safety and welcomes the notice issued by the appellate division," the city attorney's office said in a statement. "We look forward to another opportunity to hear the matter in the trial court."

The appellate division gave Rubinson 15 days to vacate his ruling and hold a hearing. If the judge declines to vacate his decision, the appellate judges will proceed to a briefing and oral arguments.

"We are optimistic that the trial judge will stand by the ruling," Dmitry Gorin, one of Raef's lawyers, said.

In his November ruling, Rubinson said the law passed by the state Legislature violated 1st Amendment protections by overreaching and by potentially affecting such people as wedding photographers or photographers speeding to a location where a celebrity was present.

His ruling came less than six months after Bieber was pulled over by the California Highway Patrol on the 101 Freeway in the San Fernando Valley and cited for driving his Fisker sports car at high speed. The pop star said he was being chased by a freelance paparazzo later identified as Raef.

Los Angeles city prosecutors filed charges against the 30-year-old photographer for allegedly chasing Bieber and then speeding off when police tried to pull over both Bieber and Raef.

Raef was charged with reckless driving, failing to obey a peace officer, two counts of following another vehicle too closely and reckless driving with the intent to capture pictures for commercial gain.

richard.winton@latimes.com

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Wired Science Space Photo of the Day: Wheatley Crater on Venus

Magellan radar image of Wheatley crater on Venus. This 72 km diameter crater shows a radar bright ejecta pattern and a generally flat floor with some rough raised areas and faulting. The crater is located in Asteria Regio at 16.6N,267E.

Image: NASA/GSFC [high-resolution]

Caption: NASA

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Country singer Gary Allan bests Grammy nominees for Billboard No. 1

LOS ANGELES (Reuters) – Country singer Gary Allan scored his first No. 1 album on the Billboard 200 chart on Wednesday, keeping Grammy-nominated favorites from the top spot.

Allan’s ninth studio album “Set You Free” sold 106,000 copies in its first week, according to figures from Nielsen SoundScan, garnering the singer his best sales week in his 17-year career.

The Billboard 200 is the album chart for all music genres.

Allan, 45, who is a staple within the country music scene, has notched three No. 1 albums in the Billboard country music chart.

The lead song from his new album “Every Storm (Runs Out of Rain)” started gaining chart popularity in September last year, and Allan’s label decided to push forward the release of the album from March of this year to January.

Allan told Reuters the song struck a chord among audiences with its message of hope. “This is a time when our country needs hope and I think that’s why it’s doing so well,” he said.

Allan’s album kept Grammy nominees The Lumineers at No. 2 with their debut self-titled record, which was released last April but has steadily been rising on the charts after the band picked up two Grammy nominations.

The official “2013 Grammy Nominees” compilation album, the only other new record in this week’s top 10, landed at No. 4 this week after selling 41,000 copies, coming behind the soundtrack for last year’s comedy “Pitch Perfect.”

Allan’s reign atop the Billboard 200 is likely to be short-lived, for Canadian pop phenomenon Justin Bieber’s latest album, “Believe Acoustic” is set to debut at the top next week, making Bieber the youngest artist to score five No. 1 albums.

On the Digital Songs chart, rapper Macklemore and Ryan Lewis’ “Thrift Shop” held onto the top spot for a third week, ahead of Taylor Swift’s “I Knew You Were Trouble” at No. 2 and Lil Wayne’s “Love Me” at No. 3.

Justin Timberlake’s “Suit & Tie,” his first new single in five years, dropped from No. 2 to No. 8 this week on the Digital Songs chart.

(Editing by Philip Barbara)

Music News Headlines – Yahoo! News

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Concerns About A.D.H.D. Practices and Amphetamine Addiction

Before his addiction, Richard Fee was a popular college class president and aspiring medical student. "You keep giving Adderall to my son, you're going to kill him," said Rick Fee, Richard's father, to one of his son's doctors.

VIRGINIA BEACH — Every morning on her way to work, Kathy Fee holds her breath as she drives past the squat brick building that houses Dominion Psychiatric Associates.

Matt Eich for The New York Times

MENTAL HEALTH CLINIC Dominion Psychiatric Associates in Virginia Beach, where Richard Fee was treated by Dr. Waldo M. Ellison. After observing Richard and hearing his complaints about concentration, Dr. Ellison diagnosed attention deficit hyperactivity disorder and prescribed the stimulant Adderall.

It was there that her son, Richard, visited a doctor and received prescriptions for Adderall, an amphetamine-based medication for attention deficit hyperactivity disorder. It was in the parking lot that she insisted to Richard that he did not have A.D.H.D., not as a child and not now as a 24-year-old college graduate, and that he was getting dangerously addicted to the medication. It was inside the building that her husband, Rick, implored Richard’s doctor to stop prescribing him Adderall, warning, “You’re going to kill him.”

It was where, after becoming violently delusional and spending a week in a psychiatric hospital in 2011, Richard met with his doctor and received prescriptions for 90 more days of Adderall. He hanged himself in his bedroom closet two weeks after they expired.

The story of Richard Fee, an athletic, personable college class president and aspiring medical student, highlights widespread failings in the system through which five million Americans take medication for A.D.H.D., doctors and other experts said.

Medications like Adderall can markedly improve the lives of children and others with the disorder. But the tunnel-like focus the medicines provide has led growing numbers of teenagers and young adults to fake symptoms to obtain steady prescriptions for highly addictive medications that carry serious psychological dangers. These efforts are facilitated by a segment of doctors who skip established diagnostic procedures, renew prescriptions reflexively and spend too little time with patients to accurately monitor side effects.

Richard Fee’s experience included it all. Conversations with friends and family members and a review of detailed medical records depict an intelligent and articulate young man lying to doctor after doctor, physicians issuing hasty diagnoses, and psychiatrists continuing to prescribe medication — even increasing dosages — despite evidence of his growing addiction and psychiatric breakdown.

Very few people who misuse stimulants devolve into psychotic or suicidal addicts. But even one of Richard’s own physicians, Dr. Charles Parker, characterized his case as a virtual textbook for ways that A.D.H.D. practices can fail patients, particularly young adults. “We have a significant travesty being done in this country with how the diagnosis is being made and the meds are being administered,” said Dr. Parker, a psychiatrist in Virginia Beach. “I think it’s an abnegation of trust. The public needs to say this is totally unacceptable and walk out.”

Young adults are by far the fastest-growing segment of people taking A.D.H.D medications. Nearly 14 million monthly prescriptions for the condition were written for Americans ages 20 to 39 in 2011, two and a half times the 5.6 million just four years before, according to the data company I.M.S. Health. While this rise is generally attributed to the maturing of adolescents who have A.D.H.D. into young adults — combined with a greater recognition of adult A.D.H.D. in general — many experts caution that savvy college graduates, freed of parental oversight, can legally and easily obtain stimulant prescriptions from obliging doctors.

“Any step along the way, someone could have helped him — they were just handing out drugs,” said Richard’s father. Emphasizing that he had no intention of bringing legal action against any of the doctors involved, Mr. Fee said: “People have to know that kids are out there getting these drugs and getting addicted to them. And doctors are helping them do it.”

“...when he was in elementary school he fidgeted, daydreamed and got A’s. he has been an A-B student until mid college when he became scattered and he wandered while reading He never had to study. Presently without medication, his mind thinks most of the time, he procrastinated, he multitasks not finishing in a timely manner.”

Dr. Waldo M. Ellison

Richard Fee initial evaluation

Feb. 5, 2010

Richard began acting strangely soon after moving back home in late 2009, his parents said. He stayed up for days at a time, went from gregarious to grumpy and back, and scrawled compulsively in notebooks. His father, while trying to add Richard to his health insurance policy, learned that he was taking Vyvanse for A.D.H.D.

Richard explained to him that he had been having trouble concentrating while studying for medical school entrance exams the previous year and that he had seen a doctor and received a diagnosis. His father reacted with surprise. Richard had never shown any A.D.H.D. symptoms his entire life, from nursery school through high school, when he was awarded a full academic scholarship to Greensboro College in North Carolina. Mr. Fee also expressed concerns about the safety of his son’s taking daily amphetamines for a condition he might not have.

“The doctor wouldn’t give me anything that’s bad for me,” Mr. Fee recalled his son saying that day. “I’m not buying it on the street corner.”

This article has been revised to reflect the following correction:

Correction: February 3, 2013

An earlier version of a quote appearing with the home page presentation of this article misspelled the name of a medication. It is Adderall, not Aderall.

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