Surgery Returns to NYU Langone Medical Center

Chang W. Lee/The New York Times

Senator Charles E. Schumer spoke at a news conference Thursday about the reopening of NYU Langone Medical Center.

NYU Langone Medical Center opened its doors to surgical patients on Thursday, almost two months after Hurricane Sandy overflowed the banks of the East River and forced the evacuation of hundreds of patients.

While the medical center had been treating many outpatients, it had farmed out surgery to other hospitals, which created scheduling problems that forced many patients to have their operations on nights and weekends, when staffing is traditionally low. Some patients and doctors had to postpone not just elective but also necessary operations for lack of space at other hospitals.

The medical center’s Tisch Hospital, its major hospital for inpatient services, between 30th and 34th Streets on First Avenue, had been closed since the hurricane knocked out power and forced the evacuation of more than 300 patients, some on sleds brought down darkened flights of stairs.

“I think it’s a little bit of a miracle on 34th Street that this happened so quickly,” Senator Charles E. Schumer of New York said Thursday.

Mr. Schumer credited the medical center’s leadership and esprit de corps, and also a tour of the damaged hospital on Nov. 9 by the administrator of the Federal Emergency Management Agency, W. Craig Fugate, whom he and others escorted through watery basement hallways.

“Every time I talk to Fugate there are a lot of questions, but one is, ‘How are you doing at NYU?’ ” the senator said.

The reopening of Tisch to surgery patients and associated services, like intensive care, some types of radiology and recovery room anesthesia, was part of a phased restoration that will continue. Besides providing an essential service, surgery is among the more lucrative of hospital services.

The hospital’s emergency department is expected to delay its reopening for about 11 months, in part to accommodate an expansion in capacity to 65,000 patient visits a year, from 43,000, said Dr. Andrew W. Brotman, its senior vice president and vice dean for clinical affairs and strategy.

In the meantime, NYU Langone is setting up an urgent care center with 31 bays and an observation unit, which will be able to treat some emergency patients. It will initially not accept ambulances, but might be able to later, Dr. Brotman said. Nearby Bellevue Hospital Center, which was also evacuated, opened its emergency department to noncritical injuries on Monday.

Labor and delivery, the cancer floor, epilepsy treatment and pediatrics and neurology beyond surgery are expected to open in mid-January, Langone officials said. While some radiology equipment, which was in the basement, has been restored, other equipment — including a Gamma Knife, a device using radiation to treat brain tumors — is not back.

The flooded basement is still being worked on, and electrical gear has temporarily been moved upstairs. Mr. Schumer, a Democrat, said that a $60 billion bill to pay for hurricane losses and recovery in New York and New Jersey was nearing a vote, and that he was optimistic it would pass in the Senate with bipartisan support. But the measure’s fate in the Republican-controlled House is far less certain.

The bill includes $1.2 billion for damage and lost revenue at NYU Langone, including some money from the National Institutes of Health to restore research projects. It would also cover Long Beach Medical Center in Nassau County, Bellevue, Coney Island Hospital and the Veterans Affairs hospital in Manhattan.

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China becoming mighty oak of world's paper industry

JIN JILING, China — In silent, temperature-controlled labs in a desolate part of Hainan, China's most tropical province, rows of women in medical masks and lab coats clone trees that grow freakishly fast.

The trees have official names, such as APP-22 or DH32-29, but Wending Huang, Asia Pulp & Paper Co.'s chief forester in China, calls them his "Yao Mings" after the towering Chinese basketball star. The tiny green tissue samples, methodically implanted in petri jars, will become hardwood eucalyptus trees that need only four to six years to reach full height, up to 90 feet or more.

The test-tube forests have helped undo the long-standing natural advantage of papermaking states such as Wisconsin, where hardwood trees are plentiful but can take up to 10 times as long to reach harvesting height.

What's more, boosted by billions in government subsidies, China has been building massive new mills with automated machines that can produce a mile of glossy publishing-grade paper a minute.

Over the course of the last decade, China tripled its paper production and in 2009 overtook the United States as the world's biggest papermaker. It can now match the annual output of Wisconsin, America's top papermaking state, in the span of three weeks.

China also created the world's biggest and most efficient paper recycling scheme. It now buys about 27 million tons of scrap paper and used cardboard from around the world each year, then de-inks and re-pulps it for about two-thirds of its own paper and cardboard production.

But that is still not enough — for China's needs or its ambition.

China imports the vast majority of virgin timber and processed pulp from around the world — 14.5 million tons last year from places like Russia, Indonesia and Vietnam. That has earned the ire of environmental groups, which say China's insatiable appetite for wood pulp is destroying the world's forests. It has drawn the fire of politicians who accuse China of unfairly subsidizing its mills and dumping paper on the U.S. market, putting domestic operations out of business and an entire industry at risk.

With 20 modern mega-mills spread across China, Indonesia-based Asia Pulp & Paper is at the center of the accusations.

It is an unusual place to find a guy from Wisconsin.

Jeff Lindsay, 52, is a 20-year veteran of that state's paper industry who was recruited by Asia Pulp & Paper in 2011 to run its growing portfolio of patents.

He holds a doctorate in chemical engineering, was on the faculty of the now-defunct Institute of Paper Chemistry in Appleton, Wis., and later joined Kimberly-Clark Corp., which gave the world Kleenex. He holds 130 patents and co-authored a 2009 book, "Conquering Innovation Fatigue," which took aim at barriers to U.S. innovation.

He noted that paper was invented in China (AD 105) and remains a potent national symbol. It is taught in Chinese classrooms as one of the four "great inventions," along with the compass (200 BC), gunpowder (AD 850) and printing presses with movable type (1313).

"These inventions came from China," Lindsay said. "When people go pointing their finger at the Chinese paper industry or saying we shouldn't be buying paper from China — paper came from China."

The West, he says, is in denial about the competitive edge offered by Chinese science, engineering and ingenuity. "You have to innovate to survive in this world," he said.

A heavy infusion of government money helped fund innovation. The Washington-based Economic Policy Institute estimates that the Chinese government doled out at least $33 billion in subsidies to its paper industry from 2002 to 2009 — the period that coincides with its stunning growth.

Schmid writes for the Milwaukee Journal Sentinel. Emily Yount contributed to this report.

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Regulators ask Edison questions about San Onofre restart plan

Federal regulators have sent Southern California Edison a new set of detailed questions that will help them evaluate the feasibility of a partial restart of the shuttered San Onofre nuclear plant.

The plant, which once supplied enough power for about 1.4 million homes, has been out of service for close to a year because of unusual wear on steam generator tubes that carry radioactive water.

Edison has requested permission to restart one of two reactor units at the plant and run it at 70% capacity for five months. The company provided analysis to show that the lower power level would alleviate the conditions that caused the tubes to vibrate excessively and knock against support structures and adjacent tubes.

In questions submitted Wednesday, the U.S. Nuclear Regulatory Commission asked Edison to provide additional analysis showing what the extent of the tube-to-tube wear would be and whether the plant would meet standards for tube integrity if the unit were operated at 100% of its licensed power.

Activists opposed to the plant's restart expressed hope that if Edison can't show that the plant could operate safely at 100% power, it might be required to apply for a license amendment and go through a courtroom-like hearing to operate at reduced power — something they have been pushing for.

NRC spokesman Victor Dricks declined to comment on that issue.

Edison spokeswoman Jennifer Manfre said the company would be answering all of the NRC's questions as part of a thorough review process. She declined to comment on how Edison's response might affect that process, but said the company is "confident that Unit 2 at San Onofre can be operated safely and within industry norms."

Dricks said he did not anticipate that the latest round of NRC questions would extend the timetable for reviewing the restart plan. The NRC has said tentatively that it could reach a decision on the restart proposal in March.

The questions submitted Wednesday addressed some other issues discussed at a public meeting between Edison representatives and NRC staff earlier this month. NRC senior materials engineer Emmett Murphy questioned whether tubes that have been plugged to take them out of service — either because of wear or as a precaution — could eventually pose problems.

Some of the tubes, Murphy pointed out, "are adjacent to a retainer bar that vibrates, and this vibration was the cause of wear in some tubes." In the long term, he said, the plugged tubes could wear through and break, damaging other tubes.

The NRC also queried Edison on details of an upgraded loose parts monitoring system the company proposed to install.

Edison has not proposed a restart plan for the plant's second reactor, where the tube damage was more extensive.

But Mitsubishi Heavy Industries, the manufacturer of the steam generators, has been testing mock-ups of redesigned support structures that could be part of a longer term repair plan for the plant. Inadequate support structures in the steam generators have been blamed in part for the wear problems.

The NRC last month cited some procedural issues with the testing. A Mitsubishi spokesman said that the issues had to do with documentation and that the test results were accurate.

abby.sewell@latimes.com

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Patrick Dempsey brews up coffee shop purchase

LOS ANGELES (AP) — Patrick Dempsey says he wants to rescue a coffee house chain and more than 500 jobs.

The "Grey's Anatomy" star said Wednesday he's leading a group attempting to buy Tully's Coffee. The Seattle-based company filed for Chapter 11 bankruptcy protection in October.

Dempsey said he's excited about the chance to help hundreds of workers and give back to Seattle.

The actor has a strong TV tie to the city: He plays Dr. Derek Shepherd on "Grey's Anatomy," the ABC drama set at fictional Seattle Grace Hospital.

Tully's has 47 company-run stores in Washington and California, as well as five franchised stores and 58 licensed locations in the U.S.

Any sale would have to be approved by a judge. A bankruptcy court hearing is set for Jan. 11 in Seattle.

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Creating the Ultimate Housework Workout

Robert Wright for The New York Times

Chris Ely, an English butler, and Carol Johnson, a fitness instructor at Crunch NYC, perfecting a houseworkout.

CAN housework help you live longer? A New York Times blog post by Gretchen Reynolds last month cited research linking vigorous activity, including housework, and longevity. The study, which tracked the death rates of British civil servants, was the latest in a flurry of scientific reports crediting domestic chores with health benefits like a lowered risk for breast and colon cancers. In one piquant study published in 2009, researchers found that couples who spent more hours on housework had sex more frequently (with each other) though presumably not while vacuuming. (The report did not specify.)

Intrigued by science that merged the efforts of a Martha with the results of an Arnold (a buffer buffer?), this reporter challenged a household expert and a fitness authority to create the ultimate housework workout — a houseworkout — in her East Village apartment. Perhaps she could add a few years to her own life while learning some fancy new moves for her Swiffer. Christopher Ely, once a footman at Buckingham Palace, and Brooke Astor’s longtime butler, was appointed cleaner-in-chief. Mr. Ely is a man who approaches what the professionals call household management with the range and depth of an Oxford don. Although he is working on his memoirs (he described his book as a room-by-room primer with anecdotes from his years in service), he was happy enough to put his writing aside for an afternoon. His collaborator was Carol Johnson, a dancer and fitness instructor who develops classes at Crunch NYC, including those based on Broadway musicals like “Legally Blonde” and “Rock of Ages.”

Mr. Ely arrived first, beautifully dressed in dark gray wool pants, a black suit coat and a crisp white shirt with silver cuff links. He cleans house in a white shirt? “I know how to clean it,” he countered, meaning the shirt. When Ms. Johnson appeared (in black spandex and a ruffly white chiffon blouse, which she switched out for a Crunch T-shirt), theory, method and materials were discussed.

“If you’re dreading the laundry,” Ms. Johnson said, “why not create a space where it’s actually fun to do by putting on some music?” If fitness is defined by cardio health, she added, it will be a challenge to create housework that leaves you slightly out of breath. “I’m thinking interval training,” she said. As it happens, one trend in exercise has been workouts that are inspired by real-world chores, or what Rob Morea, a high-end Manhattan trainer, described the other day as “mimicking hard labor activities.” In his NoHo studio, Mr. Morea has clients simulate the actions of construction workers hefting cement bags over their shoulders (Mr. Morea uses sand bags) or pushing a wheelbarrow or chopping wood.

Mr. Ely averred that service — extreme housekeeping — is physically demanding, with sore feet and bad knees the least of its debilitating byproducts. Mr. Ely still suffers from an injury he incurred while carrying a poodle to its mistress over icy front steps in Washington When the inevitable occurred, and Mr. Ely wiped out, he threw the dog to his employer before falling hard on his backside. And the right equipment matters: After two weeks’ employ in an Upper East Side penthouse, he was handed a pair of Reeboks by his new boss, the better to withstand the apartment’s wall-to-wall granite floors. (For cleaning, Mr. Ely wears slippers, deck shoes or socks.)

Mr. Ely, whose talents and expertise are wide-ranging (he can stock a wine cellar, do the flowers, set a silver service, iron like a maestro and clean gutters, as he did once or twice at Holly Hill, Mrs. Astor’s Westchester estate), is a minimalist when it comes to materials. He favors any simple dish detergent as a multipurpose cleaner, along with a little vinegar, for glass, and not much else. “Dish detergent is designed for cutting grease; there’s nothing better,” he said. He’s anti-ammonia, anti-bleach. He said bleach destroys fabric, particularly anything with elastic in it. “Knickers and bleach are a terrible combination,” he said. “I had a boss who thought he had skin cancer. His entire trunk had turned red and itchy.” It seems his underpants were being washed in bleach. (Collective wince.) “It’s horrible stuff.”

As for tools, he likes a cobweb cleaner — this reporter had bought Oxo’s extendable duster, which has a fluffy orange cotton duster that snaps onto a sort of wand, but Mr. Ely prefers the kind that looks like a round chimney brush. (If you live in a house, he also suggests leaving the cobwebs by the front and back doors, so the spiders can eat any mosquitoes coming or going.) Choose a mop with microfiber fronds (he suggested the O Cedar brand) because it dries quickly and doesn’t smell. And a sturdy vacuum. Also, stacks of microfiber cloths or a terry cloth towel ripped up.

But first, to stretch. Ms. Johnson took hold of this reporter’s Bona floor mop (it’s like a Swiffer, but with a reusable washcloth) and Mr. Ely followed along with an old-fashioned string mop. Though Mr. Ely has a kind of loose-limbed elegance, he is not exactly limber. He grimaced as he parroted Ms. Johnson, who used her mop as Gene Kelly did his umbrella, stretching her arms overhead, one by one, twisting from side to side, sucking in her stomach, rising up on tip toes. (Mr. Ely said his old poodle-hurling injury was kicking in.) Ms. Johnson adjusted his chin — “You’re going to hurt yourself if you keep sticking your neck out,” she warned — and Mr. Ely raised a black-socked foot napped with cat hair and chastised this reporter: “Would you look at that?” (The cat had vanished early on, but his “debris,” as Mr. Ely put it, was still very much in evidence. The reporter hung her head. Did she know that cat spit is toxic? Mr. Ely wondered.)

“We’re warming up the spine,” said Ms. Johnson. “Squeeze your abdominals.”

Mr. Ely looked worried: “I don’t think I have abdominals!”

MR. ELY’S technique is to clean a room from top to bottom. That means he begins with the cobweb cleaner, wafting it along ceiling corners, moldings, soffits and, uh, the top of the fridge (major dust harvest there). His form was pretty, like a serve by Roger Federer, if not exactly aerobic. For Mr. Ely kept stopping to lecture this reporter — on condensation; on the basic principles of heat transfer and why one needs to vacuum the refrigerator coils; on the movement of moist air in a kitchen; on floor care, which involved a long story about a Belgian monastery whose inhabitants never washed the kitchen floor; on how to dust the halogen spot lights (use a cotton cloth, not a microfiber one, and make sure the lights are off, and cool).  “I do rabbit on, don’t I?” he said. Ms. Johnson gamely hustled him along, noting that anytime you raise your arms over your head you can raise your heart rate. “What about a balance exercise?” she cajoled, executing a neat series of leg lifts. “That’s good for the butler’s booty!”

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Contested UTLA panel elections signal internal fissures

The young staff at the Alexander Science Center has been hard hit by seniority-based layoffs, the main factor behind a turnover of at least 28 teachers in the last five years — this in a school with a faculty of about 28.

Teachers say that the students at the USC-adjacent campus have suffered from the lack of stability and that the faculty has felt frustrated and voiceless.

But now, three instructors from the Alexander science school are among the freshman class of delegates to the House of Representatives for United Teachers Los Angeles, the teachers union in the L.A. Unified School District.

The House is the union's official decision-making body: It selects candidates to endorse in elections and has the final say on policy — taking precedence over the president and the board of directors.

The recent elections, concluded this month, were the most contested in years, by far.

Of 32 election districts, 22 featured contested bids for seats that typically could be had for the asking through a self-nomination process. In all, 396 candidates vied for 209 positions, with 100 won by teachers not in the current House.

The ideology of the new delegates is varied, and still evolving. They are concerned about job security, teacher turnover, performance evaluations and funding levels. But they are also worried about what some see as a combative but ineffectual and sometimes wrongheaded union and a demanding, ossified district bureaucracy.

The level of interest in the House elections surprised union leaders and veteran teachers alike — some of whom greeted the nouveau activism with concern. They note that outside groups encouraged teachers to run and worry that such groups will try to influence union policy.

Two outside groups are local arms of national organizations, Educators 4 Excellence and Teach Plus. A third group, Teachers for a New Unionism, is headed by Mike Stryer, a Fairfax High teacher on leave who lost a bid for the school board four years ago. His team reached teachers through home mailings, urging them to run.

All the groups are funded by major nonprofits, such as the Bill & Melinda Gates Foundation, which has huge investments in education research and sometimes controversial policy positions. And all assert their desire for a union that better serves the interests of teachers as well as students.

Some in UTLA perceive an unholy alliance among these groups, their sponsoring foundations and L.A. schools Supt. John Deasy, a former Gates official.

"Taking over our House of Reps is clearly their strategy to destroy us," wrote teacher Anne Zerrien-Lee in an email posted to an online teachers forum.

"We have enough enemies outside of UTLA that we shouldn't have to deal with school district and Gates puppets within," said regional union leader Scott Mandel in an interview.

Without question, the outside groups see things differently than the leadership of UTLA.

Notably, the union has wanted to limit, as much as possible, the effect of test scores on a teacher's performance evaluation. The outside groups or their funders have backed the use of standardized test scores — or formulas based on them — as one key measure of a teacher's effectiveness.

Secondly, the outside groups want layoffs based on teacher effectiveness rather than seniority; the unions defend the seniority system as the most equitable approach.

Still, Teach Plus wasn't trying to recruit candidates who passed a litmus test, said Executive Director John Lee.

"Our desire wasn't to have a Teach Plus caucus but to connect teachers with leadership opportunities," Lee said.

The new delegates emphasize their loyalty to their profession and to their mission.

"I love teaching," said 35-year-old Antoinette Pippin, a fourth-grade teacher at Alexander Science Center. "I love my students, but I'm seeing a lot of things right now that are bad for my students and bad for teachers."

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Huawei shows off 6.1-inch Android phablet ahead of CES [video]

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Jessica Simpson's Christmas gift: She's pregnant

NEW YORK (AP) — Jessica Simpson's daughter has the news all spelled out: "Big Sis."

Simpson on Tuesday tweeted a photo of her baby daughter Maxwell playing in the sand, the words "Big Sis" spelled out.

The 32-year-old old singer and personality has been rumored to be expecting again. The tweet appears to confirm the rumors.

"Merry Christmas from my family to yours" is the picture's caption. Simpson used a tweet on Halloween in 2011 to announce she was pregnant with Maxwell. She is engaged to Eric Johnson and gave birth to Maxwell in May.

One possible complication regarding her pregnancy: She is a spokeswoman for Weight Watchers.

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Recipes for Health: Penne With Mushroom Ragout and Spinach

Andrew Scrivani for The New York Times

Penne with mushroom ragout and spinach.

​​Mushrooms and spinach together is always a match made in heaven. I use a mix of wild and regular white or cremini mushrooms for this, but don’t hesitate to make it if regular mushrooms are all that is available.

 

1/2 ounce (about 1/2 cup) dried porcini mushrooms

2 tablespoons extra virgin olive oil

1/2 medium onion or 2 shallots, chopped

2 garlic cloves, minced

1 pound mixed regular and wild mushrooms or 1 pound regular white or cremini mushrooms, trimmed and cut in thick slices (or torn into smaller pieces, depending on the type of mushroom)

Salt and freshly ground pepper

1/4 cup fruity red wine, such as a Côtes du Rhone or Côtes du Luberon

2 teaspoons chopped fresh thyme or a combination of thyme and rosemary

6 ounces baby spinach or 12 ounces bunch spinach (1 bunch), stemmed and thoroughly cleaned

3/4 pound penne

Freshly grated Parmesan to taste

 

1. Place the dried mushrooms in a Pyrex measuring cup and pour on 2 cups boiling water. Let soak 30 minutes, while you prepare the other ingredients. Place a strainer over a bowl, line it with cheesecloth or paper towels, and drain the mushrooms. Squeeze the mushrooms over the strainer to extract all the flavorful juices. Then rinse the mushrooms, away from the bowl with the soaking liquid, until they are free of sand. Squeeze dry and set aside. If very large, chop coarsely. Measure out 1 cup of the soaking liquid and set aside.

2. Heat the olive oil in a large, heavy, nonstick skillet over medium heat and add the onion or shallots. Cook, stirring often, until tender, about 5 minutes. Turn up the heat to medium-high and add the fresh mushrooms. Cook, stirring often, until they begin to soften and sweat, about 5 minutes. Add the garlic and salt to taste, stir together for about 30 seconds, then add the reconstituted dried mushrooms and the wine and turn the heat to high. Cook, stirring, until the liquid boils down and glazes the mushrooms. Add the herbs and the mushroom soaking liquid. Bring to a simmer, add salt to taste, and cook over medium-high heat, stirring often, until the mushrooms are thoroughly tender and fragrant. Turn off the heat, stir in some freshly ground pepper, taste and adjust salt.

3. Bring a large pot of water to a boil and salt generously. Fill a bowl with ice water. Add the spinach to the boiling water and blanch for 20 seconds only. Remove with a skimmer and transfer to the ice water, then drain and squeeze out water. Chop coarsely and add to the mushrooms. Reheat gently over low heat.

4. Bring the water back to a boil and cook the pasta al dente following the timing suggestions on the package. If there is not much broth in the pan with the mushrooms and spinach, add a ladleful of pasta water. Drain the pasta, toss with the mushrooms and spinach, add Parmesan to taste, and serve at once.

Yield: Serves 4

Advance preparation: The mushroom ragout will keep for 3 or 4 days in the refrigerator and tastes even better the day after you make it.

Nutritional information per serving: 437 calories; 9 grams fat; 1 gram saturated fat; 2 grams polyunsaturated fat; 5 grams monounsaturated fat; 0 milligrams cholesterol; 73 grams carbohydrates; 5 grams dietary fiber; 48 milligrams sodium (does not include salt to taste or Parmesan); 17 grams protein

​

Up Next: Spinach Gnocchi

 

Martha Rose Shulman is the author of “The Very Best of Recipes for Health.”

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