Doctor and Patient: The Drawn Out Process of the Medical Lawsuit

She was one of the most highly sought radiologists in her hospital, a doctor with the uncanny ability to divine the source of maladies from the shadows of black and white X-ray films.

But one afternoon my colleague revealed that she had been named in a lawsuit, accused of overlooking an irregularity on a scan several years earlier. The plaintiff suing believed my colleague had missed the first sign of a now rampant cancer.

While other radiologists tried to assure her that the “irregularity” was well within what might be considered normal, my colleague became consumed by the what-if’s. What if she had lingered longer on the fateful film? What if she had doubled-checked her reading before signing off on the report?

She began staying late at the hospital to review, and review again, her work. And she worried about her professional reputation, asking herself if colleagues were avoiding her and wondering if she would have trouble renewing her license or hospital privileges. At home she felt distracted, and her husband complained that she had become easy to anger.

After almost a year of worry, my colleague went to court and was cleared. But it was, at best, a Pyrrhic victory. “I lost year of my life,” she told me. “That lawsuit completely consumed me.”

She was not the first colleague to recount such an experience. And far from overstating the issue, doctors may in fact be underestimating the extent to which malpractice not only consumes their time but also undermines their ability to care for patients, according to a new study in Health Affairs.

For more than 150 years, the medical malpractice system has loomed over health care, and doctors, the vast majority of whom will face a lawsuit sometime in their professional lives, remain ever vocal in their criticism of the system. But with few malpractice claims resulting in payments and liability premiums holding steady or even declining, doctors have started to shift their focus from the financial aspects of malpractice to the untold hours spent focused on lawsuits instead of patient care.

Now researchers are putting numbers to those doctors’ assertions. For the current study, they combed through the malpractice claims records of more than 40,000 doctors covered by a national liability insurer. They took note of the length of each claim, any payments made, severity of the injury and the specialty practiced by the physician being sued.

Most claims required almost two years to resolve from initiation of the lawsuit — and almost four years from the event in question. Cases that resulted in payment or that involved more severe patient injuries almost always took longer.

The researchers then looked at the proportion of a doctor’s career spent on an open claim. They discovered that on average, doctors spent more than four years of their careers — more time than they spent in medical school — working through one or more lawsuits. Certain specialists were more vulnerable than others. Neurosurgeons, for example, averaged well over 10 years, or more than a quarter of their professional lives, embroiled in lawsuits.

“These findings help to show why doctors care so intensely about malpractice and what they might face over the course of a lifetime,” said Seth A. Seabury, lead author and a senior economist at the RAND Corporation in Santa Monica, Calif.

The results also underscored what plaintiffs must endure. Previous studies have shown that when medical errors occur, patients prefer to have physicians acknowledge the mistake quickly and apologize as soon as possible. Though less than 5 percent of all errors lead to a malpractice claim, lengthy claims drag out the process and, in certain cases, hold up what may be appropriate compensation.

Patients not directly involved can be affected as well. A legitimate malpractice lawsuit sometimes results in doctors or even entire institutions changing how they practice in order to prevent similar events. Lengthy legal wrangling can slow down these potentially important improvements.

While the findings are only an indirect measure of the extent to which malpractice claims can affect doctors’ and patients’ lives, the study makes clear the importance of considering time, as well as cost, when looking at malpractice reform.

“If we could get these cases resolved faster, we might be able to improve the efficiency of the system, lower costs and even improve quality of care for patients,” Dr. Seabury said.

“Having these things drag on is a problem for doctors and patients.”

Read More..

Doctor and Patient: The Drawn Out Process of the Medical Lawsuit

She was one of the most highly sought radiologists in her hospital, a doctor with the uncanny ability to divine the source of maladies from the shadows of black and white X-ray films.

But one afternoon my colleague revealed that she had been named in a lawsuit, accused of overlooking an irregularity on a scan several years earlier. The plaintiff suing believed my colleague had missed the first sign of a now rampant cancer.

While other radiologists tried to assure her that the “irregularity” was well within what might be considered normal, my colleague became consumed by the what-if’s. What if she had lingered longer on the fateful film? What if she had doubled-checked her reading before signing off on the report?

She began staying late at the hospital to review, and review again, her work. And she worried about her professional reputation, asking herself if colleagues were avoiding her and wondering if she would have trouble renewing her license or hospital privileges. At home she felt distracted, and her husband complained that she had become easy to anger.

After almost a year of worry, my colleague went to court and was cleared. But it was, at best, a Pyrrhic victory. “I lost year of my life,” she told me. “That lawsuit completely consumed me.”

She was not the first colleague to recount such an experience. And far from overstating the issue, doctors may in fact be underestimating the extent to which malpractice not only consumes their time but also undermines their ability to care for patients, according to a new study in Health Affairs.

For more than 150 years, the medical malpractice system has loomed over health care, and doctors, the vast majority of whom will face a lawsuit sometime in their professional lives, remain ever vocal in their criticism of the system. But with few malpractice claims resulting in payments and liability premiums holding steady or even declining, doctors have started to shift their focus from the financial aspects of malpractice to the untold hours spent focused on lawsuits instead of patient care.

Now researchers are putting numbers to those doctors’ assertions. For the current study, they combed through the malpractice claims records of more than 40,000 doctors covered by a national liability insurer. They took note of the length of each claim, any payments made, severity of the injury and the specialty practiced by the physician being sued.

Most claims required almost two years to resolve from initiation of the lawsuit — and almost four years from the event in question. Cases that resulted in payment or that involved more severe patient injuries almost always took longer.

The researchers then looked at the proportion of a doctor’s career spent on an open claim. They discovered that on average, doctors spent more than four years of their careers — more time than they spent in medical school — working through one or more lawsuits. Certain specialists were more vulnerable than others. Neurosurgeons, for example, averaged well over 10 years, or more than a quarter of their professional lives, embroiled in lawsuits.

“These findings help to show why doctors care so intensely about malpractice and what they might face over the course of a lifetime,” said Seth A. Seabury, lead author and a senior economist at the RAND Corporation in Santa Monica, Calif.

The results also underscored what plaintiffs must endure. Previous studies have shown that when medical errors occur, patients prefer to have physicians acknowledge the mistake quickly and apologize as soon as possible. Though less than 5 percent of all errors lead to a malpractice claim, lengthy claims drag out the process and, in certain cases, hold up what may be appropriate compensation.

Patients not directly involved can be affected as well. A legitimate malpractice lawsuit sometimes results in doctors or even entire institutions changing how they practice in order to prevent similar events. Lengthy legal wrangling can slow down these potentially important improvements.

While the findings are only an indirect measure of the extent to which malpractice claims can affect doctors’ and patients’ lives, the study makes clear the importance of considering time, as well as cost, when looking at malpractice reform.

“If we could get these cases resolved faster, we might be able to improve the efficiency of the system, lower costs and even improve quality of care for patients,” Dr. Seabury said.

“Having these things drag on is a problem for doctors and patients.”

Read More..

Davos 2013: On Russia's To-Do List at Davos: Buff Image

DAVOS, SWITZERLAND — This year at Davos, the Russians are working hard to make a splash.

There is a House of Russia near a main hotel and a media center for Russia at the opposite end of this ski village. And then there is the bevy of Russian politicians, business folk and cultural figures on hand trying to encourage more foreign investment and correct what many of them privately concede is a poor image abroad.

Even Dmitri A. Medvedev, the former president and now prime minister, whose political standing in Russia was tarnished by a swap of offices with Vladimir V. Putin announced in September 2011, subjected himself to a highly unusual spectacle here.

Scores of Russian experts had worked with the World Economic Forum, as the conference here is known, on a presentation they called Scenarios for Russia.

The session on Wednesday, with Mr. Medvedev gamely sitting through the judgment before speaking himself, sketched out three ways that Russia, whose economy is heavily dependent on oil and gas extraction, could develop in the near future.

Based on assumptions like falling energy prices, regional inequalities and even an open split among Russian elites, none of the three possibilities was particularly optimistic. In addition, when the audience was asked to vote on the most needed development for Russia’s near future, it overwhelmingly chose the need to improve governance and overhaul government.

Given recent developments in Moscow, that may come as no surprise. Many political analysts see moves like the recent clampdown on demonstrations and the banning of American adoptions of Russian children as signals that the government is digging in, rather than opening up to change.

Mr. Medvedev’s response, though, was more tepid than many in the audience presumably hoped to hear. He simply repeated past promises, so far unrealized, that Russia will respond positively to demographic, political and economic shifts that could change the status quo.

Sergey Guriyev, a Russian economist, presented perhaps the gloomiest situation: A schism in the Russian elite that could force eventual, possibly sudden, change, in a country still haunted by memories of the 1917 Bolshevik Revolution and all that followed.

The status quo “is not sustainable simply because the Russian middle class will grow and demand reforms,” Mr. Guriyev said.

Over the past 10 years, oil and gas riches trickled down to a new middle class, he argued. “Now, more income doesn’t make people happy,” he said, adding that this Russian class “is unprecedentedly educated and rich for a country with such outdated political institutions.”

Unlike Prime Minister David Cameron of Britain, whose experience on the hustings of British politics lend him an ability to think on his feet and deliver punchy lines, Mr. Medvedev barely opened up to questioning from an audience that was about half the size of the one that packed the hall to hear Mr. Cameron on Thursday, a day after his gamble on European Union membership.

In private conversation, Russian businessmen deplored what they saw as a missed opportunity for Mr. Medvedev to give a forceful speech to the Davos crowd. But foreign investors invited to private sessions with the prime minister later Wednesday and earlier Thursday were much less inclined to criticize him.

Like the Russian business community, these investors are reluctant to speak on the record, citing the uncertainty of doing business in the country. What they also do not speak much about is the healthy return on their money.

While Russian business and the state accounted for most of the estimated $400 billion said by officials to have been invested in 2012, foreign investors get a good return on their money — some in high double digits, one banker said.

Russians often particularly cite China as a rival for foreign attention and money. Ruben Vardanian, a financier now at Russia’s giant Sberbank, said that while many businesspeople, domestic and foreign, saw that their activities “are much more profitable in Russia than in China,” the Chinese gave a greater sense of certainty.

While the circle of foreigners now interested in Russia is widening, Mr. Vardanian told a meeting of mostly Russian reporters, foreigners still often lament that “we can’t understand the rules of the game.”

“They don’t want to deal with, say, Mr. Vardanian, who is then replaced by Mr. Ivanov, and then by Mr. X,” he said. “They want to deal with rules.”

This article has been revised to reflect the following correction:

Correction: January 25, 2013

An earlier version of this article misspelled the first name of Ruben Vardanian, a financier at Sberbank, as Reuben.

This article has been revised to reflect the following correction:

Correction: January 25, 2013

An earlier version of the correction for this article misspelled the first name of Ruben Vardanian. It is Ruben, not Reuben.

Read More..

Britain Warns of ‘Imminent’ Threat to Westerners in Benghazi

LONDON — Days after the deadly hostage crisis in Algeria, Britain on Thursday announced a “specific, imminent threat to Westerners” in neighboring Libya and urged any British citizens in the eastern Libyan city of Benghazi to leave immediately.

Travel advice updated by the British Foreign Office also warned against “all but essential travel” to several other Libyan cities, citing a “high threat from terrorism” and a possibility of retaliatory attacks targeting Western interest in the region after the French military intervention in Mali, which preceded last week’s Islamist attack on a remote Algerian gas field near the Libyan border.

The Foreign Office did not describe the nature of the reported threat in Benghazi, where an attack on the United States diplomatic compound in September killed four Americans including Ambassador J. Christopher Stevens.

Since September, the British authorities have warned against all travel to Benghazi.

Earlier this week, a senior Algerian official said that several Egyptian members of the squad that attacked the Algerian gas complex were also among those who had attacked the American mission in Benghazi.

The Egyptians were among 29 kidnappers killed by Algerian forces during the four-day siege of the gas plant in which at least 37 foreign hostages and one Algerian died. Three militants were captured alive and one of them, under interrogation by Algerian security forces, recounted the Egyptians’ involvement in both attacks, the Algerian official said.

“We are aware of a specific, imminent threat to Westerners in Benghazi,” the Foreign Office advisory said. “We advise against all travel to Benghazi and urge any British nationals who are there against our advice to leave immediately.”

In other Libyan places, it said, “there is a high threat from terrorism. Attacks could be indiscriminate, including in places frequented by expatriates and foreign travelers.” The advisory did not specifically link its warnings to the kidnappings in Algeria.

Foreign Office officials declined to elaborate on the warnings.

As the crisis in Algeria unfolded, Prime Minister David Cameron of Britain repeatedly warned that Al Qaeda-linked extremists and other Islamist militants in North Africa presented a growing threat to Western interests.

“Just as we have reduced the scale of the Al Qaeda threat in other parts of the world, including in Pakistan and Afghanistan, so it has grown in other parts of the world,” he said. “We need to be equally concerned about that, and equally focused on it.”

During the Algerian hostage crisis, the kidnappers depicted their attack as linked to the French intervention in Mali, in turn provoked by a lightning advance south by Islamists who have turned Mali’s desert north into a separatist redoubt.

Read More..

Nokia Shows a Profit, but Shares Drop

BERLIN — The Finnish phone maker Nokia on Thursday reported its first quarterly profit in almost two years since entering its smartphone alliance with Microsoft, but the company’s shares fell as doubts persisted about the company’s ability to accomplish a turnaround.

The company, based in Espoo, Finland, said it had a profit of €202 million, or $269 million, in the three months through December, up from a loss of €1.1 billion loss a year earlier. Sales fell 20 percent to €8 billion from €10 billion as it phased out an older line of smartphones that used the Symbian operating system.

The company’s shares fell as much as 8.4 percent in afternoon trading in Helsinki, to 3.194, as Nokia announced that it would not pay a dividend for 2012, which would save the company about €750 million. It was the first time Nokia had not paid a dividend in recent memory, according to the company.

Mats Nystrom, an analyst at SEB Enskilda Bank in Stockholm, said that Nokia had raised investor hopes earlier this month when it said it would report a quarterly profit, but that the company had not met those expectations with results that showed less-than-expected growth in the average selling prices of its flagship Lumia smartphone line and falling cellphone prices. “I still think it is far from a certainty that this turnaround will be a success,” Mr. Nystrom said.

In a conference call with journalists, the Nokia chief executive, Stephen Elop, said the company had successfully eliminated investor concerns about its future and ability to pull off a turnaround. Nokia’s net cash on hand at the end of December, bolstered by the decision to forgo a dividend payment, rose to €4.4 billion from €3.6 billion in September.

“For investors, it was a solid quarter in which we removed concerns about our cash situation,” Mr. Elop said. The former Microsoft senior executive has closed factories across Europe and eliminated 16,500 workers from Nokia’s phone business over the past year.

The quarterly net profit was the first since Nokia announced its alliance with Microsoft in February 2011, which set off a turbulent transition that led to about €5 billion in combined losses, the laying off of a third of the company’s work force and a steep decline in its market share in smartphones, the industry’s defining segment.

While sales of Nokia’s new Lumia line, which uses Microsoft’s Windows Phone operating system, are accelerating, to 4.4 million units in the fourth quarter from 2.9 million in the third, the company is now a distant challenger to the industry leaders Apple and Google. The Android operating system from Google is now running nearly two-thirds of all new smartphones sold around the world.

Apple sold more than 10 times the number of iPhones during the fourth quarter, 47.8 million, and sales of Android smartphones, according to International Data Corp., reached 136 million in the third quarter. But as the largest maker of smartphones running Microsoft’s new Windows Phone 8, Nokia can build on its gains.

“This is really the time now for Nokia to put up results,” said Francisco Jeronimo, an I.D.C. analyst in London. “They are almost exclusively out there with Windows 8, and Microsoft is strongly promoting the operating system. There can be no more excuses now.”

In North America, Nokia increased its sale of phone handset sales by 40 percent in the fourth quarter to 700,000 units, up from 500,000 in the third quarter. Mr. Jeronimo said those results were weak considering the sizable marketing investment in the United States and Canada by Nokia and Microsoft on Windows 8.

Nokia’s share price has fallen by more than half during its software alliance with Microsoft. The shares have risen about 13 percent this year.

In the fourth quarter, Nokia’s profit was fueled by continued cost-cutting and the introduction of the Lumia 820 and 920 smartphones running Windows Phone 8.

The new handsets helped Nokia raise the average selling price of Lumia phones in the quarter to €186, up 33 percent from €140 in the same quarter a year earlier. But the average price of Nokia’s basic cellphones, which still make up almost two-thirds of its total phone sales, fell by 3 percent to €31 from €32.

Read More..

Well: Can You Read the Face of Victory?

Picture a tennis player in the moment he scores a critical point and wins a tournament. Now picture his opponent in the instant he loses the point that narrowly cost him the title. Can you tell one facial expression from the other, the look of defeat from the face of victory?

Try your hand at the images below, of professional tennis players at competitive tournaments. All were included in a new study that suggests that the more intense an emotion, the harder it is to distinguish it in a facial expression.

(Photos: Reuters/ASAP)

---

The researchers found that when overwhelming feelings set in, the subtle cues that convey emotion are lost, and facial expressions tend to blur. The face of joy and celebration often appears no different from the look of grief and devastation. Winning looks like losing. Pain resembles pleasure.

But that is not the case when it comes to body language. In fact, the new study found, people are better able to identify extreme emotions by reading body language than by looking solely at facial expressions. But even though we pick up on cues from the neck down to interpret emotion, we instinctively assume that it is the face that tells us everything, said Hillel Aviezer, a psychologist who carried out the new research with colleagues at Princeton University.

“When emotions run high, the face becomes more malleable: it’s not clear if there’s positivity or negativity going on there,” he said. “People have this illusion that they’re reading all this information in the face. We found that the face is ambiguous in these situations and the body is critical.”

Dr. Aviezer and his colleagues, who published their work in the journal Science, carried out four experiments in which subjects were asked to identify emotions by looking at photographs of people in various situations. In some cases, the subjects were shown facial expressions alone. In others, they looked at body language, either alone or in combination with faces. The researchers chose photographs taken in moments when emotions were running high – as professional tennis players celebrated or agonized, as loved ones grieved at funerals, as needles punctured skin during painful body piercings.

According to classic behavioral theories, facial expressions are universal indicators of mood and emotion. So the more intense a particular emotion, the easier it should be to identify in the face. But the study showed the exact opposite. As emotions peaked in intensity, expressions became distorted, similar to the way cranking up the volume on a stereo makes the music unrecognizable.

“When emotions are extremely high, it’s as if the speakers are blaring and the signal is degraded,” said Dr. Aviezer, who is now at Hebrew University in Jerusalem. “When the volume is that high, it’s hard to tell what song is playing.”

In one experiment, three groups of 15 people were shown photographs of professional tennis players winning and losing points in critical matches. When the subjects were shown the players’ expressions alone — separated from their bodies — they correctly identified their emotion only half of the time, which was no better than chance. When they looked at images of just the body with the face removed — or the body with the face intact — they were far more accurate at identifying emotions. Yet when asked, 80 percent said they were relying on the facial expressions alone. Twenty percent said they were going by body and facial cues together, and not a single one said they were looking only for gestures from the neck down.

Then, the researchers scrambled the photos, mixing faces and bodies together. The upset faces of players were randomly spliced onto the bodies of celebrating players, and vice versa.

When asked to judge the emotions, the subjects answered according to the body language. The facial expression did not seem to matter. If a losing face was spliced onto a celebrating body, the subjects tended to guess victory and jubilation. If they were looking at the face of an exuberant player placed on the body of an anguished player, the subjects guessed defeat and disappointment.

Although they were not aware of it, the subjects were clearly looking at body language, Dr. Aviezer said. Clenched fists, for example, suggested victory and celebration, while open or outstretched hands indicated a player’s disappointment.

In another experiment, the researchers looked at four other emotional “peaks.” For pain, they used the faces of men and women undergoing piercings. Grief was captured in images of mourners at a funeral. For joy, they used images of people on the reality television show “Extreme Makeover: Home Edition,” capturing their impassioned faces at the very moment they were shown their beautiful, brand new homes. And for pleasure, they went with a rather risqué option: images from an erotic Web site that showed faces at the height of orgasm.

Once again, the subjects could not correctly guess the emotions by looking at facial expressions alone. In fact, they were more likely to interpret “positive” faces as being “negative” more than the actual negative ones. When faces showing pleasure were spliced onto the body of someone in pain, for example, the subjects relied on body language and were often unaware that the facial expression was conveying the opposite emotion.

“There’s this point on ‘Extreme Makeover’ where people see their new house for the first time and the camera is on their face, so we have these wonderful photos of their expressions,” Dr. Aviezer said. “At that moment, they look like the most miserable people in the world. For a few seconds, it’s as if they are seeing their house burn down. They don’t look like you would expect.”

The researchers noted that they were not suggesting that facial expressions never indicate specific feelings – only that when the emotion is intense and at its peak, for those first few seconds, the expression is ambiguous. Dr. Aviezer said the facial musculature simply might not be suited for accurately conveying extremely intense feelings – in part because in the real world, so much of that is conveyed through situational context.

And this may not be limited to facial cues.

“Consider intense vocal expressions of grief versus joy or pleasure versus pain,” the researchers wrote in their paper. For example, imagine sitting in a coffee shop and hearing someone behind you shriek. Is it immediately obvious whether the emotion is a positive or negative one?

“When people are experiencing a very high level of excitation,” Dr. Aviezer said, “then we see this overlap in expressions.”

Read More..

Well: Can You Read the Face of Victory?

Picture a tennis player in the moment he scores a critical point and wins a tournament. Now picture his opponent in the instant he loses the point that narrowly cost him the title. Can you tell one facial expression from the other, the look of defeat from the face of victory?

Try your hand at the images below, of professional tennis players at competitive tournaments. All were included in a new study that suggests that the more intense an emotion, the harder it is to distinguish it in a facial expression.

(Photos: Reuters/ASAP)

---

The researchers found that when overwhelming feelings set in, the subtle cues that convey emotion are lost, and facial expressions tend to blur. The face of joy and celebration often appears no different from the look of grief and devastation. Winning looks like losing. Pain resembles pleasure.

But that is not the case when it comes to body language. In fact, the new study found, people are better able to identify extreme emotions by reading body language than by looking solely at facial expressions. But even though we pick up on cues from the neck down to interpret emotion, we instinctively assume that it is the face that tells us everything, said Hillel Aviezer, a psychologist who carried out the new research with colleagues at Princeton University.

“When emotions run high, the face becomes more malleable: it’s not clear if there’s positivity or negativity going on there,” he said. “People have this illusion that they’re reading all this information in the face. We found that the face is ambiguous in these situations and the body is critical.”

Dr. Aviezer and his colleagues, who published their work in the journal Science, carried out four experiments in which subjects were asked to identify emotions by looking at photographs of people in various situations. In some cases, the subjects were shown facial expressions alone. In others, they looked at body language, either alone or in combination with faces. The researchers chose photographs taken in moments when emotions were running high – as professional tennis players celebrated or agonized, as loved ones grieved at funerals, as needles punctured skin during painful body piercings.

According to classic behavioral theories, facial expressions are universal indicators of mood and emotion. So the more intense a particular emotion, the easier it should be to identify in the face. But the study showed the exact opposite. As emotions peaked in intensity, expressions became distorted, similar to the way cranking up the volume on a stereo makes the music unrecognizable.

“When emotions are extremely high, it’s as if the speakers are blaring and the signal is degraded,” said Dr. Aviezer, who is now at Hebrew University in Jerusalem. “When the volume is that high, it’s hard to tell what song is playing.”

In one experiment, three groups of 15 people were shown photographs of professional tennis players winning and losing points in critical matches. When the subjects were shown the players’ expressions alone — separated from their bodies — they correctly identified their emotion only half of the time, which was no better than chance. When they looked at images of just the body with the face removed — or the body with the face intact — they were far more accurate at identifying emotions. Yet when asked, 80 percent said they were relying on the facial expressions alone. Twenty percent said they were going by body and facial cues together, and not a single one said they were looking only for gestures from the neck down.

Then, the researchers scrambled the photos, mixing faces and bodies together. The upset faces of players were randomly spliced onto the bodies of celebrating players, and vice versa.

When asked to judge the emotions, the subjects answered according to the body language. The facial expression did not seem to matter. If a losing face was spliced onto a celebrating body, the subjects tended to guess victory and jubilation. If they were looking at the face of an exuberant player placed on the body of an anguished player, the subjects guessed defeat and disappointment.

Although they were not aware of it, the subjects were clearly looking at body language, Dr. Aviezer said. Clenched fists, for example, suggested victory and celebration, while open or outstretched hands indicated a player’s disappointment.

In another experiment, the researchers looked at four other emotional “peaks.” For pain, they used the faces of men and women undergoing piercings. Grief was captured in images of mourners at a funeral. For joy, they used images of people on the reality television show “Extreme Makeover: Home Edition,” capturing their impassioned faces at the very moment they were shown their beautiful, brand new homes. And for pleasure, they went with a rather risqué option: images from an erotic Web site that showed faces at the height of orgasm.

Once again, the subjects could not correctly guess the emotions by looking at facial expressions alone. In fact, they were more likely to interpret “positive” faces as being “negative” more than the actual negative ones. When faces showing pleasure were spliced onto the body of someone in pain, for example, the subjects relied on body language and were often unaware that the facial expression was conveying the opposite emotion.

“There’s this point on ‘Extreme Makeover’ where people see their new house for the first time and the camera is on their face, so we have these wonderful photos of their expressions,” Dr. Aviezer said. “At that moment, they look like the most miserable people in the world. For a few seconds, it’s as if they are seeing their house burn down. They don’t look like you would expect.”

The researchers noted that they were not suggesting that facial expressions never indicate specific feelings – only that when the emotion is intense and at its peak, for those first few seconds, the expression is ambiguous. Dr. Aviezer said the facial musculature simply might not be suited for accurately conveying extremely intense feelings – in part because in the real world, so much of that is conveyed through situational context.

And this may not be limited to facial cues.

“Consider intense vocal expressions of grief versus joy or pleasure versus pain,” the researchers wrote in their paper. For example, imagine sitting in a coffee shop and hearing someone behind you shriek. Is it immediately obvious whether the emotion is a positive or negative one?

“When people are experiencing a very high level of excitation,” Dr. Aviezer said, “then we see this overlap in expressions.”

Read More..

U.S. Jobless Claims Reach Lowest Mark in Five Years

The number of Americans seeking unemployment aid fell last week to the lowest level in five years, evidence that employers are cutting fewer jobs and may step up hiring. And another measure of the United States economy intended to signal future activity increased in December from November, suggesting growth may strengthen in 2013.

The Labor Department said weekly unemployment benefit applications dropped 5,000 to a seasonally adjusted 330,000. That is the fewest since January 2008. The four-week average, a less volatile measure, fell to 351,750. That is also the lowest in nearly five years.

The decline may reflect the government’s difficulty adjusting its numbers to account for layoffs after the holiday shopping season. Layoffs typically spike in the second week of January and then plummet. The department seeks to adjust for those trends, but the figures can still be volatile.

Applications are a proxy for layoffs. While layoffs are falling, hiring has been modest in recent months.

The Conference Board says its index of leading indicators rose 0.5 percent in December, the best showing since September. In November, the index was unchanged. The gauge is intended to anticipate economic conditions three to six months out.

A decline in applications for unemployment benefits, gains on Wall Street and increases in applications for building permits drove the index higher in December.

Read More..

The Lede Blog: Clinton Testifies on Benghazi Attacks

Visit NBCNews.com for breaking news, world news, and news about the economy

The Lede is following Secretary of State Hillary Rodham Clinton’s testimony before the Senate Foreign Relations Committee about the Sept. 11, 2012, attacks on the American Consulate in the eastern city of Benghazi, Libya, that killed Ambassador Chris Stevens and three other Americans.

Mrs. Clinton had been scheduled to testify before Congress last month, but an illness, a concussion and a blood clot near her brain forced her to postpone her appearance.

As our colleagues Michael R. Gordon and Eric Schmitt reported, four State Department officials were removed from their posts on last month after an independent panel criticized the “grossly inadequate” security at a diplomatic compound in Benghazi.

Read More..

DealBook: Microsoft May Back Dell Buyout

The effort to take Dell private has gained a prominent, if unusual, backer: Microsoft.

The software giant is in talks to help finance a takeover bid for Dell that would exceed $20 billion, a person briefed on the matter said on Tuesday. Microsoft is expected to contribute up to several billion dollars.

An investment by Microsoft — if it comes to pass — could be enough to push a leveraged buyout of the struggling computer maker over the goal line. Silver Lake, the private equity firm spearheading the takeover talks, has been seeking a deep-pocketed investor to join the effort. And Microsoft, which has not yet made a commitment, has more than $66 billion in cash on hand.

Microsoft and Silver Lake, a prominent investor in technology companies, are no strangers. The private equity firm was part of a consortium that sold Skype, the online video-chatting pioneer, to Microsoft for $8.5 billion nearly two years ago. And the two companies had discussed teaming up to make an investment in Yahoo in late 2011, before Yahoo decided against selling a minority stake in itself.

A vibrant Dell is an important part of Microsoft’s plans to make Windows more relevant for the tablet era, when more and more devices come with touch screens. Dell has been one of the most visible supporters of Windows 8 in its products.

That has been crucial at a time when Microsoft’s relationships with many PC makers have grown strained because of the company’s move into making computer hardware with its Surface family of tablets.

Frank Shaw, a spokesman for Microsoft, declined to comment.

If completed, a buyout of Dell would be the largest leveraged buyout since the financial crisis, reaching levels unseen since the takeovers of Hilton Hotels and the Texas energy giant TXU. Such a deal is taking advantage of Dell’s still-low stock price and the abundance of investors willing to buy up the debt issued as part of a transaction to take the company private. And Silver Lake has been working with Dell’s founder, Michael S. Dell, who is expected to contribute his nearly 16 percent stake in the company to a takeover bid.

Yet while many aspects of the potential deal have fallen into place, including a potential price of up to around $14 a share, talks between Dell and its potential buyers may still fall apart.

Shares of Dell closed up 2.2 percent on Tuesday, at $13.12. They began rising after CNBC reported Microsoft’s potential involvement in a leveraged buyout. Microsoft shares slipped 0.4 percent, to $27.15.

Microsoft’s lending a hand to Dell could make sense at a time when the PC industry is facing some of the biggest challenges in its history. Dell is one of Microsoft’s most significant, longest-lasting partners in the PC business and among the most committed to creating machines that run Windows, the operating system that is the foundation of much of Microsoft’s profits.

But PC sales were in a slump for most of last year, as consumers diverted their spending to other types of devices like tablets and smartphones. Dell, the third-biggest maker of PCs in the world, recorded a 21 percent decline in shipments of PCs during the fourth quarter of last year from the same period in 2011, according to IDC.

In a joint interview in November, Mr. Dell and Steven A. Ballmer, Microsoft’s chief executive, exchanged friendly banter, as one would expect of two men who have been in business together for decades.

Mr. Dell said Mr. Ballmer had gone out of his way to reassure him that Microsoft’s Surface computers would not hurt Dell sales.

“We’ve never sold all the PCs in the world,” said Mr. Dell, sitting in a New York hotel room brimming with new Windows 8 computers made by his company. “As I’ve understood Steve’s plans here, if Surface helps Windows 8 succeed, that’s going to be good for Windows, good for Dell and good for our customers. We’re just fine with all that.”

Microsoft has been willing to open its purse strings in the past to help close partners. Last April, Microsoft committed to invest more than $600 million in Barnes & Noble’s electronic books subsidiary, in a deal that ensures a source of electronic books for Windows devices. Microsoft also agreed in 2011 to provide the Finnish cellphone maker Nokia billions of dollars’ worth of various forms of support, including marketing and research and development assistance, in exchange for Nokia’s adopting Microsoft’s Windows Phone operating system.

A version of this article appeared in print on 01/23/2013, on page B1 of the NewYork edition with the headline: Microsoft May Back Dell Buyout.

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