Vital Signs: Screening: Saliva Test for Cytomegalovirus Proves Accurate

A new test offers a rapid, inexpensive and highly accurate method for screening newborns for cytomegalovirus, which can cause permanent hearing loss, researchers said on Wednesday.

Though one in 150 babies are born infected with cytomegalovirus — known as CMV and part of the herpes virus family — current tests are not effective for widespread screening, the scientists said.

The new test does not require the culturing of blood samples; it employs saliva, easily obtained by swabbing the inside of a baby’s mouth.

Of 17,662 newborns screened, all 85 infants identified as infected with CMV by a blood culture test also were identified by the new test, researchers reported in a paper published in The New England Journal of Medicine. Another 17,327 newborns were screened with a different saliva test. It was slightly less accurate, detecting CMV in 74 of 76 infants identified by culturing.

Infected babies must be monitored and tested frequently for hearing loss so that support services can be provided if necessary, said Dr. Suresh B. Boppana, a professor of pediatrics at University of Alabama at Birmingham and one of the paper’s authors.

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Signs of an Urban River’s Revival in Virginia

Ten years ago, bathers in the James River, which wends through this old Southern city, wore ear and nose plugs to stave off infections from sewage runoff. Now, the river is stalked by blue herons and shad — symbols as potent as the belching riverbank ironworks and factories of the unfiltered, blue-collar past.

After huge cleanup efforts, unprecedented numbers of tubers, kayakers and fishermen converge here, steps below downtown skyscrapers. On a sunny weekday morning, preparing for his gallery exhibit opening, Aaron Pavelis, 29, was trying to capture the river — his river, an artist’s vision, present tense — with paint and palette: a shimmering contrast of old railroad bridges and trees deep in shadow.

Inspired by the Dutch masters, Mr. Pavelis spread hand-mixed paint “with no modern additives” and delighted in the splashing of the shad. But he was a realist about the river, too. He said he would eat the shad, which have come in from the Atlantic for their spring spawning mission. But what of the catfish that inhabit it year-round?

“I still have my doubts,” he said, watching as a freight train thundered overhead.

Residents remain cautious, too. To protest water pollution in February, a University of Richmond student floated the “James River UFO,” a disc made of feathers, downriver. And in April, the public utilities’ Twitter account warned: “Green water in the James tomorrow is a V.C.U. art student project. Don’t panic. Don’t call. Don’t worry.”

Bathers needed reassurance as well when shad were seen floating on the surface of the river, looking like so many textured brushstrokes of paint. As it turned out, biologists from Virginia Commonwealth University and state agencies were sending electric currents into the water, momentarily stunning but not harming the fish so they could measure the shad’s resurgence.

After almost 20 years of restocking and a fishing moratorium, the fish are a food source for the herons, now some 200 strong, with a rookery on an island in the river. Observant visitors — a record one million are expected this year — can spot the rookery by parking under the elevated train tracks and walking along a narrow gangway built atop a city water pipeline.

Ralph White, the manager of the James River Park System for more than three decades, has watched the river’s transformation from a dammed and divided symbol of Richmond’s Confederate past to a point of modern union. Because of mercury, the biggest catfish — some run to 50 pounds — are still not yet fit to eat, he concedes.

But “a five-pounder,” he adds reassuringly, “is quite excellent.”

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Memo From Moscow: Bulldogs Under the Rug? Signs of a Putin-Medvedev Rift

 

But lately the tandem has begun to hiccup and backfire. It is impossible to say whether trust has broken down between the two men, one of whom will increase his power in next spring’s presidential election. But a universe of officials, businessmen and political hangers-on — uncertain whether to show loyalty to one man, the other or both — has “spent the whole last month on the verge of a nervous breakdown,” the economist Vladislav L. Inozemtsev wrote last week in the newspaper Moskovsky Komsomolets.

Mr. Putin invented the arrangement in 2008 when term limits prevented him from seeking the presidency again, and it is largely his choice whether to continue it. He has tried to put a lid on speculation even while working to delay an announcement until the fall on who the presidential candidate will be, but he may be too late.

Winston Churchill compared Kremlin power struggles to bulldogs fighting under a carpet: “An outsider only hears the growling, and when he sees the bones fly out from beneath, it is obvious who won.”

That dynamic has returned in the past few weeks, as minor political figures began thrusting rumors into the public domain. Take the case of Konstantin F. Zatulin, a member of Parliament for the governing party, United Russia, which stripped him of a committee post after he vocally supported Mr. Putin’s views on Libya over the president’s, effectively driving a wedge between the two. He then began saying publicly that Mr. Medvedev had broken his agreement with Mr. Putin and was trying to undermine him.

“The oldest story in history has occurred here: having received grandiose authorities, a young president, and to a greater extent his inner circle and his family,” are determined to keep them, Mr. Zatulin said in an interview in his ornate office. He said that Mr. Medvedev was backed by powerful industrialists, known as oligarchs, who hoped to reclaim the influence they lost under Mr. Putin.

“I think they are much more comfortable with a weak president than a strong one, and have found a person they can manipulate,” Mr. Zatulin said.

He said distrust between the teams was so high that the tandem was unlikely to continue after the elections, and that Mr. Medvedev might use the single advantage he has over his mentor. “I cannot exclude that some of Medvedev’s advisers consider that Medvedev, in order to win, should fire Putin from the position of prime minister,” Mr. Zatulin said. “I can’t confirm it, but it would be strange if they had not considered this possibility.”

Not long after Mr. Zatulin’s punishment was made public, an oddly symmetrical story appeared in the press. This time, it was Gleb O. Pavlovsky, a political consultant, who said that he had been rebuked for saying that Mr. Putin should not return to the presidency. He said that officials in the Kremlin had complained for many months about his comments, which violated the unspoken order to “say nothing about a candidate until everything is decided.” In mid-April they severed a 15-year relationship. “Putin and his team are very nervous about this kind of statement, probably more touchy than Medvedev’s team,” Mr. Pavlovsky said.

He said that there was no personal split between the two men — “I can confirm this,” he said — but that the tandem had been carefully constructed to maintain balance, and that neither man’s team was strong enough to end the standoff. He said that Mr. Putin began considering a return to the presidency because of “a virtual fear that some awful liberals will come to power” and weaken the strong state that Mr. Putin had built.

“Where are those liberals? They don’t exist,” Mr. Pavlovsky said. “This is the problem. I’ve been hearing about these liberals for 20 years.”

For now, his main complaint is that paralysis over the candidate makes it impossible to get to work on substantive issues, like what path Russia should take after the elections. “It’s absurd; debates are necessary today” about the next president’s platform and his team, Mr. Pavlovsky said. “It’s very difficult to make up a team without having a leader. It’s like learning how to swim in a dry pool.”

In these interviews, as in all of Russian politics, it is difficult to say what is real and what is artificial. Neither Mr. Zatulin nor Mr. Pavlovsky is a member of the leaders’ inner circles, and their motives are unclear. Mr. Zatulin lost a powerful ally in September when Yuri M. Luzhkov was driven from his post as Moscow’s mayor on the president’s orders. Mr. Pavlovsky, meanwhile, has a 15-year résumé of virtuosic political gamesmanship.

But it is clear that the public gap between Mr. Putin and Mr. Medvedev has widened. First, they staked out different positions on NATO’s operation in Libya, which Mr. Putin has passionately condemned. When Mr. Medvedev told Chinese television that the presidential candidate would be announced shortly, Mr. Putin contradicted him, making it clear he preferred to wait as long as possible.

History suggests that could be quite a long time. Boris Yeltsin announced his resignation on Dec. 31, 1999, a few days after parliamentary elections; in 2007, Mr. Putin identified Mr. Medvedev as his successor on Dec. 10, a few days after parliamentary elections. This year’s parliamentary elections are scheduled for Dec. 4.

In the meantime, Moscow’s political circles will be watching for bulldogs under the rug.

Mr. Putin stoked a new round of speculation on Friday when he announced the creation of a nationwide “popular front,” which some saw as laying the groundwork for a possible presidential run. Mr. Medvedev has called a rare news conference for May 18, to the same effect.

Prolonged tension risks setting off a major split within the elite, said Dmitri K. Simes, a veteran Russia watcher who heads the Center for the National Interest, a Washington-based think tank. He returned from a recent trip to Moscow struck by the shift in the political atmosphere, now rife with distrust. “Never forget the number of people who are playing double games,” he said. “People run around saying one thing in the morning and another thing in the afternoon.”

 

Fatal Bomb in Morocco Shows Signs of Al Qaeda

The bomb appeared to have all the hallmarks of Al Qaeda in the Islamic Maghreb, Interior Minister Taieb Cherkaoui said, briefing the government in Rabat. “The manner reminds us of the style used generally by Al Qaeda,” he said. “And this leads us to think that there is a possibility of more dangers to come.”

But there was no claim of responsibility on Friday by Al Qaeda or any other group.

“This was not a suicide attack,” Mr. Cherkaoui said, adding that “it appears the bomb was set off remotely,” in remarks carried by the official news agency, MAP. He said the bomb contained ammonium nitrate. A Moroccan security official, asking for anonymity, said the bomb also contained triacetone triperoxide, or TATP, an explosive easily made and popular among bombers in the Middle East, including those from Al Qaeda.

The bombing is a serious blow to Morocco’s tourism industry, already hurt by the economic crisis and anxieties about popular protests that are stirring much of the Arab world. The site — a popular cafe facing the historic Djemma el Fna square — is a regular tourist stop, and the bombing appeared aimed at foreigners.

Fourteen of the 16 dead were foreigners, mostly French citizens, as well as two Canadians, a Briton and a Dutch tourist, officials said. There were 25 people wounded, 14 of whom remained in hospitals, Mr. Cherkaoui said.

Morocco’s king, Mohammed VI, has tried to respond to popular demands for more democracy by beginning constitutional reforms and releasing or commuting the sentences of 190 radical Islamic prisoners arrested after the last big terrorist bombing, in Casablanca in 2003, when 45 people died, including 12 suicide bombers.

On May 1, protesters plan another rally in Moroccan cities to demand a faster transition to a constitutional monarchy, the third such protest since Feb. 20.

Mohamed Darif, a political scientist at King Hassan University in Casablanca, said, “The finger is pointed at Al Qaeda,” and suggested that Al Qaeda in the Islamic Mahgreb had singled out a cafe popular with French tourists. The same group holds four French hostages and demands that for their return, France pull its troops out of Afghanistan.

“They would find no better spot than Marrakesh, which has become a French village, with a strong French presence,” Mr. Darif said.

But he suggested other possible culprits, including radical Islamists who want all their colleagues released from prison — nearly 2,000 or so are detained — and those who do not favor the king’s recent movement toward democratic reform.

Jean-Yves Moisseron, editor in chief of the France-based magazine Maghreb-Machrek, said the way the bombing was carried out pointed to Al Qaeda in the Islamic Maghreb, “since Marrakesh is a very touristy place with a bad reputation, a spot for prostitution and sexual tourism, with international jet-setters” who own houses in the old city.

“There is a very clear will to target tourists; otherwise they would have bombed 50 meters away,” he said, adding that the bombers had to get through significant police controls to hit the square, which is well protected. “They were surely well organized and significantly trained.”

Two of the dead were Michal Zekry, 29, an Israeli-Canadian who was pregnant, and her husband, Messod Wizman, 30, a Moroccan-Canadian. They had come from Shanghai to visit Mr. Wizman’s parents, who live in Casablanca, for Passover, and then took a trip to see Marrakesh.

“They were lovely together, married for three years and have a boy, 2,” said Mr. Wizman’s aunt. “She was pregnant. What happened was that they went to the hotel in Marrakesh, but their room was not ready, so they thought, ‘Why not have a coffee?’ and went to the Argana.” She paused, then said: “There are no words for that.” The couple had left their son with his grandparents.

Mr. Wizman, she said, grew up in Casablanca, studied in Paris and then went to Montreal, where he met his wife.

On Friday evening, the square was packed with people, but the coffee shops and restaurants normally filled with tourists were nearly empty.

Around the corner, the Mabrouka cinema was open, showing “Femmes en Miroirs,” about a young Moroccan photographer living in Paris who returns home to see her sick mother. Rashiq Moulay Alarbi, a literature student, said: “We are not afraid, we are going out. I want these people who did this to us to know that they have not succeeded.”

His friend Abdellah al-Khalaoui, a driver, expressed sorrow for the deaths and concern for the city. “We fear that the tourism will drop; it has already started,” he said. “Already the coffee shops in which people used to sit are empty.”

Nearby, a Spanish couple ate with friends at a small restaurant, undeterred. They were near the square on Thursday but did not hear the explosion. “We’re very sad for the people, but something like this could have happened in Barcelona or Paris as well,” said Manuel Sanroma, a mathematics professor at the University of Barcelona who was making his second visit to Marrakesh.

“We love the Arab world,” he said. “Terrorists can attack you anywhere.”

Souad Mekhennet reported from Marrakesh, and Steven Erlanger from Washington. Ma?a de la Baume contributed reporting from Paris.

 

Vital Signs: Risks: Focus on Heart Deaths in Student-Athletes

  The bane of political correctness, in film, television, literature and life.

    Imam Abdullah Antepli of Duke University and Mollie Ziegler Hemingway of GetReligion.org debate Americans’ views of Islam.

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Broad signs new deal with Notts

  Stuart Broad last turned out for Notts on Twenty20 finals day last summer Stuart Broad has signed a new three-year contract with Nottinghamshire.

The 24-year-old England fast bowler, who arrived at Trent Bridge from Leicestershire in 2007, is still on an ECB central contract.

His new deal with Notts, which runs until 2013, will only come into effect should he lose his England deal.

"We fully expect Stuart will maintain his England place for years to come but this re-affirms his commitment to us," said director of cricket Mick Newell.

Broad has made just a single one-day appearance, as well as playing three games in the Twenty20 and seven County Championship matches in his four years at Trent Bridge.

But he may be due to get in a few early season appearances once he has recovered from the side strain that forced him home early from England's unsuccessful World Cup adventure last month.

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Although his county apperances have been limited, he has always performed exceptionally well when he's turned out for us.

Mick Newell Nottinghamshire coach

And Notts can only hope that Broad, who played for them in the FP t20 finals day at the Rose Bowl last August, will hope that he turns in a repeat of the match-winning performance he produced on his last County Championship appearance.

Broad took 11 wickets in the match in his side's 10-wicket win over Warwickshire at Edgbaston in July, claiming a career best 8-52 in the second innings.

"We knew he was in the England selectors' thoughts when we signed him in 2008," added Newell.

"Although his county apperances have been limited, he has always performed exceptionally well when he's turned out for us."