Monday, April 30, 2012
Friday, April 27, 2012
In New Tack, Syrians Protest at Night to Elude Forces
The new tactics underline the evolution of the nine-week uprising, which has shown growing signs of resilience as it has weathered a ferocious crackdown. Since the uprising erupted with protests in a poor town in southern Syria, activists have tried to bring more organization and coordination to demonstrations that once seemed spontaneous.
Human rights activists estimate the death toll since the uprising started in mid-March at 1,000, and they say that at least 10,000 protesters are in jail. In addition to using live ammunition, security forces have beaten demonstrators with batons and dispersed them with water cannons, all tactics that organizers contend are more difficult to carry out after nightfall.
“The evening demonstrations are not the last thing,” said one activist in the northern city of Aleppo, who provided only his first name, Hudaifah. “We have other tactics for the coming weeks and months. We expect our uprising to continue for a long time.”
The revolt has posed a serious challenge to the authoritarian government of Mr. Assad, 44, an ophthalmologist who received his training in England and inherited his office in 2000 from his father, Hafez. Together, the Assad family has led this country, a strategic linchpin in the region, for four decades.
Activists say that demonstrations occur every evening in cities and towns across the country, including Damascus and its suburbs; Deir al Zour, to the northeast of the capital; Homs and Hama, in central Syria; and Aleppo and Idleb in the north.
Protesters are also gathering at night in the south, in villages near Dara’a, the impoverished town that became a flash point of the uprising when teenagers were arrested after being caught scrawling antigovernment graffiti on walls there.
The protests attract far fewer participants than those held after Friday Prayer. Some put the number just in the few hundreds. But protesters contend that they keep the pressure on the government and exhaust its security forces, which then spend the night patrolling neighborhoods and streets where demonstrations were held.
Organizers said evening protests were popular because they could attract people after they had left work and school. They also argue that it is easier for them to run away and hide from security forces in houses, shops, or dark, narrow alleys, and that the smaller numbers, dispersing quickly, help avoid widespread casualties and arrests.
The strategy is called “tayyara,” which translates as “flying.”
“We come up with ideas that security forces don’t expect,” Hudaifah, 28, said. “The Tunisian and Egyptian uprisings sparked our movement, but we are improving the tactics day by day.”
Hudaifah, like many others interviewed for this article, would not give his full name for fear of reprisal. He said he worked during the day for long hours as a tailor in his father’s shop and at night organized small demonstrations in his neighborhood.
Syrian officials have contended that they can end the uprising through force. But the longer the protests continue, the more untenable the government’s position becomes, both to its critics and its own constituents. That has put a premium on organizers to keep up the show of dissent, even on a small scale.
Organizers have begun filming the demonstrations with digital cameras, offering better quality images to the outside world than those of cellphone cameras. In small meetings, activists say, they have also tried to come up with other tactics, like seeking to deceive plainclothes security forces by pretending to be one of them or melting into the neighborhood.
“A few days ago I was in a protest when the security forces came,” said Tarek, 31, who works for a state-run construction company in Damascus. “I acted like an ordinary citizen and walked beside them, without panicking. They couldn’t recognize me. Some others are even behaving like security men.”
By all accounts, the uprising took Syrian officials by surprise. A few weeks before it started, Mr. Assad had declared in an interview that his country would not be affected by the uprisings that toppled leaders in Tunisia and Egypt.
As it has persisted, international criticism has mounted, and both the United States and European countries have imposed sanctions on Mr. Assad himself. The opposition abroad, meanwhile, plans to convene in Turkey next week in a bid to establish a more unified front.
“The protests will continue and will get bigger and stronger because the protesters are now more organized and more experienced,” said Bourhan Ghalioun, director of the Center for Contemporary Oriental Studies at the Sorbonne in Paris, who is also a prominent Syrian opposition figure.
“And they will keep protesting until they realize all their demands,” he said. “They will no longer accept a government imposed on them by the power of tanks.”
Sunday, April 8, 2012
Study Questions Treatment Used in Heart Disease
The study could change the way doctors treat millions of patients with heart disease. Common wisdom has been that such patients should take a statin drug like Lipitor or Zocor to lower bad cholesterol and, in many cases, the vitamin niacin to raise their good cholesterol. But in the trial, niacin provided no benefit over simple statin therapy.
The results are part of a string of studies that suggest that what doctors thought they knew about cholesterol may be wrong. Studies that track patients over time have for decades shown that patients with higher levels of high-density lipoproteins (H.D.L., or good cholesterol) tend to live longer and have fewer heart problems than those with lower levels of this cholesterol.
Not surprisingly, doctors thought that if they could raise H.D.L. levels, their patients would benefit. So far, that assumption is not panning out. Nobody knows why.
In 2006, Pfizer halted development of a drug that raised good cholesterol levels after studies showed that the medicine increased the risks of death. And on Thursday, government scientists announced that Niaspan, an extended release form of niacin, not only did not provide any protection against heart attacks when taken with Zocor in patients with heart disease but also slightly increased their risk of stroke.
“We were stunned, to say the least,” said Dr. William E. Boden, a professor of medicine and preventive medicine at the University at Buffalo who was a trial investigator.
What is remarkable about the study is that niacin seemed to be working. Patients taking the medicine along with Zocor had higher levels of H.D.L. and lower levels of triglycerides, a fat in the blood. Despite these seeming improvements, the patients fared no better and may have done slightly worse than those taking Zocor alone. That is why the entire theory behind trying to increase H.D.L. levels in patients with heart disease may need rethinking.
The study results may be greeted as a mixed blessing by some patients. A drug many had hoped would help is now thought to be at best useless. But for many people, niacin is hard to take because it can cause flushing and headaches. Doctors have for years wheedled patients into tolerating these side effects in hopes that the medicine would save their lives. Now, they will not have to.
Dr. William M. Schreiber, a Louisville, Ky., internist, said he had stopped prescribing niacin because so many patients told him they could not abide its effects. “I’m delighted to hear that statins alone are just as good as statins and niacin,” he said.
The study is bad news for the maker of Niaspan, Abbott Laboratories, for the drug industry as a whole and even for the Food and Drug Administration. Abbott last year had $927 million in Niaspan sales, and the company spent $32 million on the study (the government spent $21 million) in the hope that it would increase sales. Instead, the results are bound to lower use of the drug.
In a statement, Dr. Eugene Sun, a vice president at Abbott, said, “Based on its long history of clinical evidence, Niaspan remains an important agent for patients with” blood lipid problems.
The study gives no comfort to other drug makers, many of which have been trying to come up with new drugs to raise levels of good cholesterol or otherwise lower heart attack risks. Statins and other drugs have proven so effective in treating heart disease that improvements are proving very tough to find.
The study is also bad news for the F.D.A., which heavily relies on laboratory results to decide whether to approve drugs.
“This study shows that approving drugs and allowing them to stay on the market on the basis of how they affect lipids and other biomarkers is not good policy,” said Dr. Steven Nissen, chairman of cardiovascular medicine at the Cleveland Clinic. “It’s time to have a new regulatory approach.”
In the trial, 3,414 participants with heart and vascular disease were given either Zocor and a placebo or Zocor and Niaspan and followed for 32 months. The trial ended 18 months early because it was found that there was almost no chance taking Niaspan would prove beneficial. Zocor and other medications did a good job of keeping patients’ bad cholesterol levels relatively low.
Researchers said patients should not stop taking Niaspan without talking to their doctors first.
“We have great evidence that lowering L.D.L. is beneficial,” said Dr. Bruce Psaty, a professor of medicine and epidemiology at the University of Washington. “We lack good evidence that changing H.D.L. or triglycerides does much.”
Wednesday, April 4, 2012
Signs That Bin Laden Weighed Seeking Pakistani Protection
The documents, which officials said included messages between Bin Laden and his top operations chief over the past year, provide the first suggestion that Bin Laden considered Pakistan’s government amenable to a bargain that would ensure the safety of top Qaeda leaders.
The officials emphasized that they had found no evidence that such a proposal, which one American official said was in the “discussion phase,” was ever raised with Pakistani military or intelligence operatives.
But the fact that Bin Laden even considered a truce with Pakistan suggests that he thought the idea might have had some support inside the country’s national security establishment. At the same time, Pakistan could argue that the discussions provided evidence that there was no deal already in place allowing Bin Laden to hide in the sprawling compound in Abbottabad, a middle-class town 75 miles by road from the Pakistani capital.
The Central Intelligence Agency is poring over a huge electronic database that Navy Seal commandos seized during the raid that killed Bin Laden this month. The new details about the information came as American officials said that Pakistan had granted permission for the C.I.A. to send a forensics team to search Bin Laden’s compound.
Many American officials are skeptical that Bin Laden could have hidden for so long inside Pakistan without at least the tacit approval of some Pakistani officials.
Top American officials said they had yet to see any evidence of official approval from the electronic files. But new information is being discovered about Al Qaeda’s structure, particularly about a tier of operatives Bin Laden corresponded with who were in charge of the network’s daily operations.
In particular, the documents highlight the central role played by Atiya Abdul Rahman, the operations chief with whom American officials said Bin Laden discussed a possible truce with Pakistan. Mr. Rahman is a Libyan operative who came into the job after a drone strike in 2010 killed his boss, Sheik Saeed al-Masri.
The job of Qaeda operations head is particularly perilous, as C.I.A. drone strikes in Pakistan have killed a number of people holding that position over the past year. American officials and terrorism experts said the position was dangerous because the operations chief had to communicate with Qaeda operatives outside Pakistan, communications that are often intercepted by American eavesdropping.
Last year, American officials said, Mr. Rahman notified Bin Laden of a request by the leader of Al Qaeda’s affiliate in Yemen to install Anwar al-Awlaki, the radical American-born cleric, as the leader of the group in Yemen. That group, known as Al Qaeda in the Arabian Peninsula, apparently thought Mr. Awlaki’s knowledge of the United States and his status as an Internet celebrity might help the group’s operations and fund-raising efforts.
But, according to American officials, Bin Laden decided that the group’s leadership should remain unchanged.
Pakistan’s decision to allow a C.I.A. forensic team to search the compound, first reported on Thursday by The Washington Post, comes after weeks of private talks between uneasy allies.
It may be more important for symbolic than substantive reasons, as the Obama administration does not appear optimistic that the team would uncover secret tunnels or buried clues that could yield fresh information about Qaeda operations.
Still, American and Pakistani officials are, at least publicly, trying to play down tensions in a deeply fractured relationship. In another move aimed at thawing relations, Pakistan last week returned to the Americans the severed tail of a Black Hawk helicopter that crashed at the Abbottabad compound on the night of the raid.
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