Final “Spartacus” Season to Enter the Arena January 25

LOS ANGELES (TheWrap.com) – Starz’s “Spartacus” series will engage in one last round of battle in January, the cable network said Tuesday.

“Spartacus: War of the Damned” will premiere January 25, 2013 at 9 p.m., marking the beginning of the end for the blood-and-sex soaked franchise, whose previous installments included “Spartacus: Vengeance” and “Spartacus: Blood and Sand.”

“Spartacus: War of the Damned” sees Liam McIntyre returning as the titular gladiator, and takes place following the defeat of Roman commander Gaius Claudius Glaber. Following successful battles against the Romans after the Battle of Vesuvius, the ranks of the rebellious slaves have swelled, with Rome trembling at Spartacus’ increased threat to the empire.

This season also sees the addition of new cast members Todd Lasance as Gaius Julius Caesar, Simon Merrells as Marcus Crassus and Anna Hutchison as Laeta.

TV News Headlines – Yahoo! News

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Doctor and Patient: Comparative Effectiveness Studies Lack Impact

“Comparative effectiveness” studies, which compare one treatment for a particular illness against another to determine which works better, have received a lot of attention and billions of dollars in federal support in the last few years. But when I mentioned comparative effectiveness research recently to a colleague who I know is particularly interested in treatments and the clinical trials behind them, he let out a loud snort and guffaw before I even finished saying the words.

“It’s a great idea, but it’s not real life,” he said, regaining his composure. “Or at least not the real life of a lot of doctors and patients.”

To explain, he described a newly published study on treating children who are thought to have swallowed a small foreign object, like a coin or a toy. He reeled off a long list of laboratory tests, scans, scopes and X-rays that the researchers recommended for such cases, adding, “Those experts assume that everyone lives near big medical centers like theirs, but not all of my patients do. And what are we going to do if the insurance company doesn’t approve of all the tests we order?”

It took only a cursory review of comparative effectiveness research over the last decade for me to realize that my colleague was right. Despite many useful and even potentially cost-saving findings, many of them failed to change doctors’ practice and patient care.

Now a group of researchers has offered a cogent analysis in the journal Health Affairs to explain this failure. And they have done so using methods about as different from comparative effectiveness as research can be.

The researchers talked to more than 50 doctors, patient advocates and other health care experts, each of whom had created, conducted or evaluated comparative effectiveness research or helped introduce the findings into clinical practice. During the interviews, they referred to trials of blood pressure medications, spine surgery, antipsychotic drugs, a heart rhythm device, heart catheterizations and bone marrow transplantation, and then asked why some of these studies seemed to inspire enduring changes while others did not.

A handful of factors came up again and again. Those interviewed frequently referred to the fact that many of these studies did not address the actual needs of practicing clinicians and patients. For instance, one study of medications for treating psychosis focused on the differences in efficacy among the drugs, but mental health care providers really wanted to know about differences in safety.

Sometimes, too, a study’s conclusions required such a significant shift in thinking that doctors and patients had difficulty adjusting to the change, like the recent recommendations against using measures of the prostate-specific antigen, or PSA, as a screening test for cancer. Other times, the findings were so nuanced or ambiguous, with such complicated restrictions on what worked best when, that they simply were not incorporated into professional guidelines or recommendations.

But perhaps the most common reason for these studies’ failures came down to dollars. In the current health care system, clinicians are rewarded for doing and ordering more. Pharmaceutical and medical device firms reap fortunes from physicians’ orders, and a single change could cost them billions. Studies that endorse anything less than another expensive procedure or a newer and more expensive medication or the latest device are often destined for failure or a protracted struggle against drug and device companies that are willing to put up a costly fight.

“The incentives are all out of whack,” said Justin W. Timbie, the lead author and a health policy researcher at the RAND Corporation in Arlington, Va. “The current system favors treatments that are well paid, not necessarily those that are most effective.”

For example, one study found that generic diuretic pills that cost pennies a day worked better for patients with high blood pressure than newer drugs that could be as much as 20 times as expensive. Because hypertension affects tens of millions of Americans, this finding had the potential to save the health care system billions of dollars.

But the finding never really took hold; the percentage of patients taking the cheaper diuretics barely increased. Physicians had a difficult time changing their prescribing habits; limited funding prevented researchers from widely disseminating the results; and pharmaceutical companies waged an aggressive marketing campaign that included paying health care experts to speak about the study in a way that made their expensive drugs seem better.

Based on their findings from these interviews, Dr. Timbie and his fellow investigators offer several suggestions that may improve the impact of these studies. These include realigning financial incentives to support recommended changes in practice; incorporating a broad range of perspectives, like those of practicing doctors and patients, in the design, goals and interpretation of such studies; and, above all, proceeding with a clear strategy for all future comparative effectiveness research.

Despite the challenges, the researchers remain optimistic about the future. And for good reason. Their study was initiated by policy makers and financed by the federal office responsible for health care policy coordination and planning. And representatives from the new national organization, the Patient-Centered Outcomes Research Institute, whose mission is to develop and oversee such studies, have reviewed and discussed the suggestions with Dr. Timbie and the other authors of the study.

“The track record to now has not been great, but for the first time, comparative effectiveness research is a priority for the country,” Dr. Timbie said. “The whole process of generating new evidence has a degree of governance that has never existed before.”

“It’s all about impact now,” he added.

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McDonald's sales drop, first time since 2003

McDonald's Corp. reported its first decline in monthly U.S. same store sales in nine years Thursday, as the chain began to suffer problems plaguing the rest of the fast food industry for several years.

Sales at restaurants open more than a year declined 2.2 percent. Same store sales also declined in Europe, 2.2 percent, and the Asia Pacific, Middle East and Africa region, 2.4 percent.

The chain cited lower demand and greater competition for the lower sales. While hamburger competitors Burger King and Wendy’s were walloped by the onset of the recession, both  have changed hands in recent years and launched new menu items that better compete with McDonald’s including expanded breakfast offerings, improved coffee options and more innovative salads.

"Though October's sales results reflect the pervasive challenges of today's global marketplace, I am confident that our strategies and the adjustments we are making in response to the current business headwinds will build sales momentum and drive sustained, profitable growth," McDonald's CEO Don Thompson said. 

Although the decline is historic for the world's largest restaurant chain, which has been on a roll since the beginning of its historic turnaround in 2003, it was not unexpected. Analysts have been tempering expectations and downgrading the stock for months.

To rev up sales, McDonald's has been working to emphasize value in markets around the world.

In the U.S., for example, McDonald's is stepping up advertising for its Dollar Menu after its attempt to market an "Extra Value Menu" for slightly higher prices fell flat. But the company said Thursday that the efforts were offset by "modest consumer demand" and competition.

In particular, McDonald's is facing stiffer competition from longtime rivals Burger King and Wendy's, which are both in the midst of reviving their brands with new ad campaigns and improved menus. Taco Bell, owned by Yum Brands Inc., is also enjoying growth with the help of new offerings such as it Doritos Locos Tacos and higher-end Cantina Bell bowls and burritos.

Stock slipped 0.99 percent in pre-market trades, to $86 in early trading. McDonald's hit an all-time high of $101.74 in February.

Baird analyst David Tarantino maintained an outperform rating on McDonald's, saying in a research note that, "We are cautiously optimistic that better trends can emerge as McDonald's gets past a wall of challenging comparisons in upcoming months."

Tarrantino added that though results "could remain soft" through early 2013, "we see opportunity for better performance to emerge in 2013 as a whole," because of emphasis on value offerings, lower ingredient costs, and reduced currency impact.

eyork@tribune.com | Twitter: @emilyyork

- Reuters contributed to this report

MCD Net Income Quarterly data by YCharts

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Nor'easter wary United cancels 269 flights -- 116 at O'Hare

United Airlines has canceled 269 flights as a result of a Nor'easter poised to hit the East Coast. The same storm also caused more than 100 flights at O'Hare International Airport to be canceled Wednesday.

Chicago-based United said it would suspend most service to and from the New York and Philadelphia areas between noon Wednesday and noon Thursday.

As of Wednesday afternoon, United was the most-affected airline, canceling 269 flights, according to FlightStats.com. That's followed by 251 canceled flights by ExpressJet, 146 by American Eagle and 140 by American Airlines.

The three major New York-area airports and Philadelphia International were most affected, but fifth on the list was O'Hare, with 116 cancellations, according to FlightStats data.

At Newark Liberty International Airport, United canceled all departures, including international flights, after 4 p.m. Wednesday and will cancel selected inbound flights, according to an update at United Hub online. It also canceled all United Express operations at the airport from 2 p.m. Wednesday through 10 a.m. Thursday.

At John F. Kennedy International, United planned departures through the early afternoon Wednesday. It won't resume operating until noon Thursday.

At LaGuardia, no United flights will operate between noon Wednesday and noon Thursday.

United said it has, where possible, rebooked travelers ticketed with connections at Newark through the airline's other hubs.

The airline will waive change fees and any additional fare that might apply to customers ticketed on flights to, from or through airports in the path of the storm from Nov. 6 through Nov. 8. Customers may reschedule itineraries no later than Nov. 15 with a one-time date or time change. Customers may also request refunds.

Airports affected acted are Allentown, Pa.; Hartford, Conn.; Manchester, N.H.; New York/Newark (Liberty, Kennedy and LaGuardia); Philadelphia and White Plains, N.Y.

Details and specific flight information is available at United.com.

gkarp@tribune.com

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Apple slides to five-month low, uncertainty grows

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Phase 4 Films Acquires “Precious” Producer’s Directorial Debut “Long Time Gone”

NEW YORK (TheWrap.com) – Phase 4 Films has acquired U.S. and Canadian rights to Sarah Siegel-Magness‘ “Long Time Gone,” a drama starring Virginia Madsen, Amanda Crew and Zach Gilford.

Connecticut resident who has a nervous breakdown after discovering her husband is having an affair. Her son tries to comfort her with the help of his older brother (Gilford) and live-in girlfriend (Crew).

Anthony LaPaglia and Eva Longoria also star in the directorial debut of Siegel-Magness, who produced “Precious.”

“We are thrilled to be working with Sarah on her directorial debut after her past success as a producer,” Phase 4 president and CEO Ben Meyerowitz said in a statement. “We cannot wait until audiences see the great performances by Virginia Madsen and the rest of the wonderful cast involved.”

Phase 4 will release the film day-and-date in theaters and across all VOD and digital platforms Spring 2013.

“I am thrilled to have Phase 4 release my directorial debut. From the very start, they understood and appreciated our film and their enthusiasm has us very excited to move forward in the next chapter of our film’s journey,” Siegel-Magness said in a statement. “Their understanding of the ever changing landscape of the marketplace has us feeling confident that our film is in the right hands.”

Movies News Headlines – Yahoo! News

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A Collective Effort to Save Decades of Research at N.Y.U.

The calls started coming in late on Tuesday and early Wednesday: offers of dry ice, freezer space, coolers. By the end of Thursday there were dozens more: A researcher at Weill Cornell Medical College would clear 1,000 tanks to save threatened zebra fish; another, at Cold Spring Harbor Laboratory, promised to replace some genetically altered mice that were lost; and a doctor at the Children’s Hospital of Philadelphia even offered take over entire experiments, to keep them going.

As hurricane-driven waters surged into New York University research buildings in Kips Bay, on the East Side of Manhattan, investigators in New York and around the world jumped on the phone to offer assistance — executing a reverse Noah’s ark operation, to rescue lab animals and other assets from a flooding vessel.

“I’ve had 43 people who have offered to help so far, and some of them are direct competitors,” said Gordon Fishell, associate director of the N.Y.U. Neuroscience Institute, who lost more than 5,000 genetically altered mice when storm waters surged the night of Oct. 30, cutting off power. “It’s just been unbelievable,” he said. “It really buoys my spirits and my lab’s.”

Staff members at N.Y.U. worked around the clock to preserve research materials, running in and out of darkened buildings without elevator service, hauling dry ice and other supplies up anywhere from 2 to more than 15 floors.

The university’s medical center also got instant help, from almost every major research institution in the area.

The response reflects large shifts in the way that science is conducted over the past generation or so. Individual labs always compete to be first, but researchers increasingly share materials that are enormously expensive and time-consuming to reproduce. The loss of a single cell line or genetically altered animal can slow progress for years in some areas of biomedical research.

“We are totally dependent on each other in the life sciences now, for a very large number of cell lines and extracts, research animals and unique chemical tools and antibodies that might not have backup copies anywhere in the world, or in very few places,” said Dr. Steven Hyman, director of the Stanley Center for Psychiatric Research at the Broad Institute of M.I.T. and Harvard. “Losing any of these tools tears a significant hole in the entire field.”

Danny Reinberg, a professor of biochemistry at N.Y.U.’s medical school, has studied genetics for 30 years, accumulating valuable mice strains and stocks of extracts from cell nuclei that would be extremely difficult to replace. The extracts must be stored at minus 112 degrees Fahrenheit.

Dr. Reinberg said he lost all of his mice: nine strains, including more than 1,000 animals that died in the storm surge. But he managed to save all of the cell extracts by moving some containers into freezers at N.Y.U. labs that weren’t affected and others to the Rockefeller, Columbia and Cornell medical centers, each of which cleared space, he said.

“We were able to save many things; it was just phenomenal to get that kind of help,” said Dr. Reinberg, whose house in New Jersey has had no power.

“Later in the week, at a Starbucks, I could finally download all my e-mail, and there were messages from people at the University of Pennsylvania and the Howard Hughes Medical Institute, asking how they could help us re-establish the mouse lines we lost,” he said.

Some scientists have become interdependent because their students, who develop a specialty in specific tissues or animals, often move among labs. Research projects sometimes draw on experiments or analyses the students worked on at more than one place.

One researcher working in Dr. Fishell’s lab was formerly a student of Dr. Stewart Anderson of the Children’s Hospital of Philadelphia, who sent Dr. Fishell a text message on Wednesday to offer help. “I told him that even if it costs money, we’re happy to keep experiments rolling, if we’re able to,” Dr. Anderson said.

By late Thursday, freezer space in minus-112-degree units was extremely tight in the city. So was dry ice.

Susan Zolla-Pazner, director of AIDS research at the Manhattan Veterans Affairs Medical Center, had lost power in her 18th-floor lab in the department’s building at 23rd Street and First Avenue. She finally hired a company to haul her 20 freezers-full of specimens, for safekeeping.

“We spent all of Tuesday and Wednesday hauling 1,300 pounds of dry ice up to the 18th floor, using the stairs, to stabilize the freezers first,” said Dr. Zolla-Pazner, who is also a professor of pathology at N.Y.U. School of Medicine. “And the dry ice people would only take cash. I have about 25 to 30 people working for me, and everyone was out there on 23rd Street, reaching into their pockets to get what we needed. It was a herculean and heroic effort on the part of everyone here, and that is the story that needs to be told.”

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'Fiscal cliff' takes center stage

Now that Wall Street knows President Obama will stay in the White House, investors' attention has returned to looming crises facing the U.S. and European economies.

Major stock indexes were down more than 2 percent midway through the first trading session after election day.

At the top of the agenda is the "fiscal cliff," the automatic spending cuts and tax hikes looming at year's end. If Obama cannot successfully resolve the crisis with a House still controlled by Republicans, economists have warned that the "cliff" could slow growth and push the U.S. back into recession.

"We've gotten certainty on the presidency and now we move into the uncertainty of where we were before -- the fiscal cliff," said Quincy Krosby, a market strategist at Prudential Financial. "The market's not going to have much patience to wait to see when the negotiations begin in earnest and how they evolve."

The Dow Jones industrial average regained some ground but was still down 303 points, or 2.3 percent, to 12,943 in midday trading.

The broader Standard & Poor's 500 index was down 32 points, or 2.2 percent, to 1,396. The Nasdaq was down 71 points, or 2.4 percent, to 2,941.

Corporations reported sluggish revenues in the third quarter, signaling slowing economic growth regardless of the fiscal cliff, Krosby noted. Declining company fortunes could lead to job cuts and further drags on economic growth as consumer demand falls.

Also weighing on investors' minds: Continuing worries out of Europe. Economic data out of Germany indicate that not even the continent's most powerful economy is immune to the Eurozone slowdown, as European Central Bank President Mario Draghi noted in remarks Wednesday.

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Nation decides after long campaign

Election Day arrives, sending voters streaming to the polls to pick the next president and the candidates themselves scrounging for last-minute votes. The presidential contest is likely to be close, hinging on a few key states like Ohio

President Barack Obama and former Massachusetts Gov. Mitt Romney dueled for the White House on Tuesday in a tight-to-the-finish election shadowed by a weak economy and high unemployment that crimped middle class dreams for millions.

Voters also chose a new Congress to serve alongside the man who will be inaugurated president in January, Democrats defending their majority in the Senate, and Republicans in the House. Eleven states picked governors, and ballot measures ranging from gay marriage to gambling dotted ballots.

The first votes tallied in the presidential race were from reliably Republican Indiana and Kentucky, and favored Romney by a margin of 2-1.

The economy was rated the top issue by about 60 percent of voters surveyed as they left their polling places. About 4 in 10 said it is on the mend.

More than that said conditions are as bad or getting worse, but a significant fraction said former President George W. Bush bears more of the responsibility than Obama. The survey was conducted for The Associated Press and a group of television networks.

The long campaign's cost soared into the billions, much of it spent on negative ads, some harshly so.

In the presidential race, an estimated one million commercials aired in nine battleground states where the rival camps agreed the election was most likely to be settled — Ohio, New Hampshire, Virginia, Florida, North Carolina, Wisconsin, Iowa, Colorado and Nevada. They accounted for 110 of the 270 electoral votes needed for victory, and they drew repeated appearances by the 51-year-old president and Romney, 65.

Romney raced to Ohio and Pennsylvania for Election Day campaigning and projected confidence as he flew home to Massachusetts to await the results. "We fought to the very end, and I think that's why we'll be successful," he said, adding that he had finished writing a speech anticipating victory.

Obama made get-out-the-vote calls from a campaign office near his home in Chicago and found time for his traditional Election Day basketball game with friends. Addressing his rival, he said, "I also want to say to Gov. Romney, 'Congratulations on a spirited campaign.' I know his supporters are just as engaged, just as enthusiastic and working just as hard today." Romney, in turn, congratulated the president for running a "strong campaign."

Other than the battlegrounds, big states were virtually ignored in the final months of the campaign. Romney wrote off New York, Illinois and California, while Obama made no attempt to carry Texas, much of the South or the Rocky Mountain region other than Colorado.

There were 33 Senate seats on the ballot, 23 of them defended by Democrats and the rest by Republicans.

The GOP needed a gain of three for a majority if Romney won, and four if Obama was re-elected. Neither Majority Leader Harry Reid of Nevada nor GOP leader Mitch McConnell of Kentucky was on the ballot, but each had high stakes in the outcome.

All 435 House seats were on the ballot, including five where one lawmaker ran against another as a result of once-a-decade redistricting to take population shifts into account. Democrats needed to pick up 25 seats to gain the majority they lost two years ago.

Depending on the outcome of a few races, it was possible that white men would wind up in a minority in the Democratic caucus for the first time.

Speaker John A. Boehner, R-Ohio, raised millions to finance get-out-the-vote operations in states without a robust presidential campaign, New York, Illinois and California among them. His goal was to minimize any losses, or possibly even gain ground, no matter Romney's fate. House Democratic leader Rep. Nancy Pelosi of California campaigned aggressively, as well, and faced an uncertain political future if her party failed to win control.

In gubernatorial races, Republicans hoped to gain seats after Democratic retirements in New Hampshire, Washington, Montana and especially North Carolina.

Romney was in Massachusetts after his Election Day dash to Ohio and Pennsylvania.

In a campaign that traversed contested Republican primaries last winter and spring, a pair of political conventions this summer and three presidential debates, Obama, Romney, Vice President Joe Biden and Republican running mate Paul Ryan spoke at hundreds of rallies, were serenaded by Bruce Springstein and Meat Loaf and washed down hamburgers, pizza, barbecue and burrito bowls.

Obama was elected the first black president in 2008, and four years later, Romney became the first Mormon to appear on a general election ballot. Yet one man's race and the other's religion were never major factors in this year's campaign for the White House, a race dominated from the outset by the economy.

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Exclusive - Amazon to win EU e-book pricing tussle with Apple

BRUSSELS (Reuters) - European Union regulators are to end an antitrust probe into e-book prices by accepting an offer by Apple and four publishers to ease price restrictions on Amazon, two sources said on Tuesday.

That decision would hand online retailer Amazon a victory in its attempt to sell e-books cheaper than rivals in the fast-growing market publishers hope will boost revenue and increase customer numbers.

"Faced with years of court battles and uncertainty I can understand why some of these guys decided to fold their cards and take the whipping," said Mark Coker, founder of Smashwords, an ebook publisher and distributor that works with Apple.

"It's certainly another win for Amazon," he added. "I have not seen the terms of the final settlement, but my initial reaction is that it places restrictions on what publishers can do, slowing them down just when they need to be more nimble."

A spokesman at the EU Commission said its investigation was not yet finished. Amazon and Apple declined to comment.

In September, Apple and the publishers offered to let retailers set prices or discounts for a period of two years, and also to suspend "most-favored nation" contracts for five years.

Such clauses bar Simon & Schuster, News Corp. unit HarperCollins, Lagardere SCA's Hachette Livre and Verlagsgruppe Georg von Holtzbrinck, the owner of German company Macmillan, from making deals with rival retailers to sell e-books more cheaply than Apple.

The agreements, which critics say prevent Amazon and other retailers from undercutting Apple's charges, sparked an investigation by the European Commission in December last year.

Pearson Plc's Penguin group, which is also under investigation, did not take part in the offer.

The EU antitrust authority, which in September asked for feedback from rivals and consumers about the proposal, has not asked for more concessions, said one of sources.

"The Commission is likely to accept the offer and announce its decision next month," the source said on Tuesday.

Antoine Colombani, spokesman for competition policy at the European Commission, said: "We have launched a market test in September and our investigation is still ongoing."

Amazon declined to comment, while Apple did not respond to an email seeking comment.

Companies found guilty of breaching EU rules could be fined up to 10 percent of their global sales, which in Apple's case could reach $15.6 billion, based on its 2012 fiscal year.

AGGREGATE PRICING

UBS analysts estimate that e-books account for about 30 percent of the U.S. book market and 20 percent of sales in Britain but are minuscule elsewhere. When Amazon launched its Kindle e-reader, it charged $9.99 per book.

Apple's agency model let publishers set prices in return for a 30 percent cut to the maker of iPhone and iPad.

The U.S. Department of Justice is investigating e-book prices. HarperCollins, Simon & Schuster and Hachette have settled, but Apple, Pengin Group and Macmillan have not.

The DOJ settlement required that retailers must at least break even selling all ebooks from a publisher's available list, according to Coker and Joe Wikert, general manager and publisher at O'Reilly Media Inc.

It was not clear if EU regulators will include a similar requirement, which would prohibit Amazon from pricing all ebooks at a loss, said Wikert, a former publishing executive.

In the United States, Amazon will likely price popular titles at a loss and try to make up the difference on a publisher's other ebooks, he said.

Coker said any such rule could be dangerous in Europe, which still has distinct markets.

"It could allow a single retailer to charge full price in a large market like the U.K., and then sell below cost or for free in multiple smaller markets as a strategy to kill regional ebook retailing upstarts before they take root," Coker said.

FROWNING ON ONLINE TRADE CURBS

Antitrust regulators tend to frown on restrictions on online trade and the case is a good example, said Mark Tricker, a partner at Brussels-based law firm Norton Rose.

"This case shows the online world continues to be a major focus for the Commission," he said.

"These markets change very quickly and if you don't stamp down on potential infringements of competition rules, you can have significant consequences."

(Additional reporting by Alistair Barr in San Francisco; Editing by Rex Merrifield, David Goodman and David Gregorio)

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