In Nigeria, Polio Vaccine Workers Are Killed by Gunmen

At least nine polio immunization workers were shot to death in northern Nigeria on Friday by gunmen who attacked two clinics, officials said.

The killings, with eerie echoes of attacks that killed nine female polio workers in Pakistan in December, represented another serious setback for the global effort to eradicate polio.

Most of the victims were women and were shot in the back of the head, local reports said.

A four-day vaccination drive had just ended in Kano State, where the killings took place, and the vaccinators were in a “mop-up” phase, looking for children who had been missed, said Sarah Crowe, a spokeswoman for the United Nations Children’s Fund, one of the agencies running the eradication campaign.

Dr. Mohammad Ali Pate, Nigeria’s minister of state for health, said in a telephone interview that it was not entirely clear whether the gunmen were specifically targeting polio workers or just attacking the health centers where vaccinators happened to be gathering early in the morning. “Health workers are soft targets,” he said.

No one immediately took responsibility, but suspicion fell on Boko Haram, a militant Islamist group that has attacked police stations, government offices and even a religious leader’s convoy.

Polio, which once paralyzed millions of children, is now down to fewer than 1,000 known cases around the world, and is endemic in only three countries: Nigeria, Pakistan and Afghanistan.

Since September — when a new polio operations center was opened in the capital and Nigeria’s president, Goodluck Jonathan, appointed a special adviser for polio — the country had been improving, said Dr. Bruce Aylward, chief of polio eradication for the World Health Organization. There have been no new cases since Dec. 3.

While vaccinators have not previously been killed in the country, there is a long history of Nigerian Muslims shunning the vaccine.

Ten years ago, immunization was suspended for 11 months as local governors waited for local scientists to investigate rumors that it caused AIDS or was a Western plot to sterilize Muslim girls. That hiatus let cases spread across Africa. The Nigerian strain of the virus even reached Saudi Arabia when a Nigerian child living in hills outside Mecca was paralyzed.

Heidi Larson, an anthropologist at the London School of Hygiene and Tropical Medicine who tracks vaccine issues, said the newest killings “are kind of mimicking what’s going on in Pakistan, and I feel it’s very much prompted by that.”

In a roundabout way, the C.I.A. has been blamed for the Pakistan killings. In its effort to track Osama bin Laden, the agency paid a Pakistani doctor to seek entry to Bin Laden’s compound on the pretext of vaccinating the children — presumably to get DNA samples as evidence that it was the right family. That enraged some Taliban factions in Pakistan, which outlawed vaccination in their areas and threatened vaccinators.

Nigerian police officials said the first shootings were of eight workers early in the morning at a clinic in the Tarauni neighborhood of Kano, the state capital; two or three died. A survivor said the two gunmen then set fire to a curtain, locked the doors and left.

“We summoned our courage and broke the door because we realized they wanted to burn us alive,” the survivor said from her bed at Aminu Kano Teaching Hospital.

About an hour later, six men on three-wheeled motorcycles stormed a clinic in the Haye neighborhood, a few miles away. They killed seven women waiting to collect vaccine.

Ten years ago, Dr. Larson said, she joined a door-to-door vaccination drive in northern Nigeria as a Unicef communications officer, “and even then we were trying to calm rumors that the C.I.A. was involved,” she said. The Iraq and Afghanistan wars had convinced poor Muslims in many countries that Americans hated them, and some believed the American-made vaccine was a plot by Western drug companies and intelligence agencies.

Since the vaccine ruse in Pakistan, she said, “Frankly, now, I can’t go to them and say, ‘The C.I.A. isn’t involved.’ ”

Dr. Pate said the attack would not stop the newly reinvigorated eradication drive, adding, “This isn’t going to deter us from getting everyone vaccinated to save the lives of our children.”

Aminu Abubakar contributed reported from Kano, Nigeria.

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IHT Rendezvous: IHT Quick Read: Feb. 9

After a failed attempt to set spending targets at a summit meeting in November and in a 24-hour marathon of talks this week, European leaders finally agreed late Friday to a common budget for the next seven years. The new budget, which is slightly smaller than its predecessor — the first decrease in the European Union’s history — reflects the climate of austerity across a Continent still struggling to emerge from a crippling debt crisis. James Kanter and Andrew Higgins report from Brussels.

Few things divide British eating habits from those of Continental Europe as clearly as a distaste for consuming horse meat, so news that many Britons have unknowingly done so has prompted alarm among shoppers and plunged the country’s food industry into crisis. A trickle of discoveries of horse meat in hamburgers, starting in Ireland last month, has turned into a steady stream of revelations, including, on Friday, that lasagna labeled beef from one international distributor of frozen food, Findus, contained in some cases 100 percent horse meat. Stephen Castle reports from London.

The coaches of England’s Premier League are an aggressively unstylish bunch, stalking the sideline in the most scrutinized sport in the world with wardrobes that speak less of Savile Row than of the remainder rack on the Island of Misfit Clothes. The way the coaches dress, there’s no mistaking the English Premier League sideline for a fashion runway. Sarah Lyall reports from London.

With only two weeks to go before national elections, the Italian campaign has become a surreal spectacle in which a candidate many had given up for dead, former Prime Minister Silvio Berlusconi, has surged. Although he is not expected ever to govern again, with his media savvy and pie-in-the-sky offers of tax refunds, Mr. Berlusconi now trails the front-runner, Pierluigi Bersani, the leader of the Democratic Party, by about five or six points, according to a range of opinion polls published on Friday. Rachel Donadio reports from Rome.

ARTS The auction of Impressionist and Modern art followed by Surrealist works that took place at Sotheby’s on Tuesday evening ended with 52 lots fetching £121 million. It will be remembered by auction house professionals as the second most successful sale in the field held at Sotheby’s London and, by some of those attending, as the strangest session in living memory. Souren Melikian reports from New York.

SPORTS If size or the weight of history were the sole determining factors in a soccer match, then you might wonder why Burkina Faso would even bother to turn up against Nigeria in the Africa Cup final. Rob Hughes reports from London.

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Bryant leads Lakers over Bobcats 100-93

CHARLOTTE, N.C. (AP) — Even though Kobe Bryant and the Lakers were able to escape with a 100-93 win Friday night over the Charlotte Bobcats, the Los Angeles star was left feeling "irritated" after the game.

Irritated at his team's shot selection.

Irritated at his team's selfishness.

And especially irritated that the Lakers needed to overcome a 20-point deficit to beat the NBA's worst team.

"We have to play the right way," Bryant said. "When we have shots available, we take them. If we don't, move the ball on. It can't be about individual touches. It can't be about that."

Still, the Lakers won.

Bryant shrugged off a scoreless first half — he attempted only two shots — to finish with 20 points, eight assists and seven rebounds and the Lakers improved to 4-2 on their road trip heading into Sunday's game in Miami against the Heat.

Bryant didn't come out for warm-ups to start the second half.

But he was there to provide the spark the lackluster Lakers needed in the third quarter. He scored 14 of his points in the final period, including a driving layup with 40 seconds left to push the lead to five and help seal the win.

"In the second half I got in position where I could catch it and turn and shoot it a little bit," Bryant said. "They were reluctant to double team because we started knocking down some shots. I think that makes the game a lot easier."

Steve Nash and Earl Clark each had 17 points and Dwight Howard had 12 points, all in the first half, and 11 rebounds for the Lakers (24-27).

Howard played his second straight game despite nursing an injured right shoulder.

"Continuity," Howard said when asked of the Lakers offensive woes. "We have to do a better job of spreading everything out and moving and getting everybody involved. When we do that, we are pretty good."

Byron Mullens and Gerald Henderson each had 20 points for the Bobcats, who have lost six straight.

Charlotte led 71-51 in the third quarter, but the Lakers stormed back behind a 9-0 run. They cut the lead to one on a driving layup by Bryant with 6:06 left in the game and Antawn Jamison gave the Lakers their first lead with 4:46 remaining on a left-handed finger roll in the lane.

The Lakers took the lead for good at 92-91 when Jodie Meeks made a 3-pointer with 3:02 left in the game.

Lakers coach Mike D'Antoni wasn't pleased with the overall effort, but liked that his team bounced back after a 116-95 loss to the Boston Celtics the night before.

"We just got to be able to put our earplugs in, or mufflers on, or blinders on," D'Antoni said. "It's like the Kentucky Derby with horses, just get those blinders on and just get out there and run.

"We have so much stuff going on out here that every little thing is blown to bits and whether it is right or wrong or blown out of proportion it is. But, it affects us. It is a distraction. It saps energy. We got to be able to just close that out somehow."

The Lakers have been unpredictable this season, particularly on the road where they were 8-17 coming into this game.

Before Friday night's game against Charlotte, D'Antoni was asked if the Bobcats were a dangerous opponent for his team.

"We're playing, aren't we? (Then) there's a danger," D'Antoni said with a laugh. "If they play the national anthem, we're in danger."

He was right.

The Lakers started slow, looking out of sync just as they have for a good portion of the season as pick and rolls turned into turnovers and layups on the other end.

Nash had four early turnovers and Howard threw a pass across court that hit the side of the backboard.

The Lakers turned the ball over five times in the game's first eight minutes and fell behind 20-9.

Bryant missed his only two shots in the first half, his slowest start since March 31, 2012, when he went three quarters without scoring a point before beating the New Orleans Hornets on a game-winning shot.

The game was similar to earlier this season when the Bobcats led by 18 in Los Angeles only to squander the lead.

"We had them down pretty much the whole game," Bobcats guard Kemba Walker said. "You know, they made a really good run. Kobe made a lot of good plays, made the right passes and guys just made shots."

NOTES: Bobcats rookie Michael Kidd-Gilchrist returned to action Friday after missing two games with a concussion. ... At halftime Bryant had five rebounds, two assists and no points. ... The Bobcats had been one of three teams with a .500 or better record all-time against the Lakers, but fell to 8-9 with Friday night's loss.

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John E. Karlin, 1918-2013: John E. Karlin, Who Led the Way to All-Digit Dialing, Dies at 94

Courtesy of Alcatel-Lucent USA

John E. Karlin, a researcher at Bell Labs, studied ways to make the telephone easier to use.

A generation ago, when the poetry of PEnnsylvania and BUtterfield was about to give way to telephone numbers in unpoetic strings, a critical question arose: Would people be able to remember all seven digits long enough to dial them?

And when, not long afterward, the dial gave way to push buttons, new questions arose: round buttons, or square? How big should they be? Most crucially, how should they be arrayed? In a circle? A rectangle? An arc?

For decades after World War II, these questions were studied by a group of social scientists and engineers in New Jersey led by one man, a Bell Labs industrial psychologist named John E. Karlin.

By all accounts a modest man despite his variegated accomplishments (he had a doctorate in mathematical psychology, was trained in electrical engineering and had been a professional violinist), Mr. Karlin, who died on Jan. 28, at 94, was virtually unknown to the general public.

But his research, along with that of his subordinates, quietly yet emphatically defined the experience of using the telephone in the mid-20th century and afterward, from ushering in all-digit dialing to casting the shape of the keypad on touch-tone phones. And that keypad, in turn, would inform the design of a spate of other everyday objects.

It is not so much that Mr. Karlin trained midcentury Americans how to use the telephone. It is, rather, that by studying the psychological capabilities and limitations of ordinary people, he trained the telephone, then a rapidly proliferating but still fairly novel technology, to assume optimal form for use by midcentury Americans.

“He was the one who introduced the notion that behavioral sciences could answer some questions about telephone design,” Ed Israelski, an engineer who worked under Mr. Karlin at Bell Labs in the 1970s, said in a telephone interview on Wednesday.

In 2013, the 50th anniversary of the introduction of the touch-tone phone, the answers to those questions remain palpable at the press of a button. The rectangular design of the keypad, the shape of its buttons and the position of the numbers — with “1-2-3” on the top row instead of the bottom, as on a calculator — all sprang from empirical research conducted or overseen by Mr. Karlin.

The legacy of that research now extends far beyond the telephone: the keypad design Mr. Karlin shepherded into being has become the international standard on objects as diverse as A.T.M.’s, gas pumps, door locks, vending machines and medical equipment.

Mr. Karlin, associated from 1945 until his retirement in 1977 with Bell Labs, headquartered in Murray Hill, N.J., was widely considered the father of human-factors engineering in American industry.

A branch of industrial psychology that combines experimentation, engineering and product design, human-factors engineering is concerned with easing the awkward, often ill-considered marriage between man and machine. In seeking to design and improve technology based on what its users are mentally capable of, the discipline is the cognitive counterpart of ergonomics.

“Human-factors studies are different from market research and other kinds of studies in that we observe people’s behavior and record it, systematically and without bias,” Mr. Israelski said. “The hallmark of human-factors studies is they involve the actual observation of people doing things.”

Among the issues Mr. Karlin examined as the head of Bell Labs’ Human Factors Engineering department — the first department of its kind at an American company — were the optimal length for a phone cord (a study that involved gentle, successful sabotage) and the means by which rotary calls could be made efficiently after the numbers were moved from inside the finger holes, where they had nestled companionably for years, to the rim outside the dial.

John Elias Karlin was born in Johannesburg on Feb. 28, 1918, and reared nearby in Germiston, where his parents owned a grocery store and tearoom.

He earned a bachelor’s degree in philosophy, psychology and music, and a master’s degree in psychology, both from the University of Cape Town. Throughout his studies he was a violinist in the Cape Town Symphony Orchestra and the Cape Town String Quartet.

Moving to the United States, Mr. Karlin earned a Ph.D. from the University of Chicago in 1942. Afterward, he became a research associate at Harvard; he also studied electrical engineering there and at the Massachusetts Institute of Technology.

At Harvard, Mr. Karlin did research for the United States military on problems in psychoacoustics that were vital to the war effort — studying the ways, for instance, in which a bomber’s engine noise might distract its crew from their duties.

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Well: Old Age and Motorcycles Are a Dangerous Mix

If you’re over 40 and planning to hop on a motorcycle, take care. Compared with younger riders, the odds of being seriously injured are high.

That is the message of a new study, published this week in the journal Injury Prevention, which found that older bikers are three times as likely to be severely injured in a crash as younger riders.

The percentage of older bikers on the road is quickly rising, and their involvement in accidents is a growing concern. Nationwide, from 1990 to 2003, the percentage of motorcyclists over age 50 soared from roughly 1 in 10 to about 1 in 4. At the same time, the average age of riders involved in motorcycle crashes has also been climbing. Injury rates among those 65 and older jumped 145 percent from 2000 to 2006 alone.

Because of the increase in motorcycle ridership among older Americans, the researchers, led by Tracy Jackson, a graduate student in the epidemiology department at Brown University, wanted a closer look at their injury patterns. So she and her colleagues combed through a federal database of motorcycle crashes that were serious enough to require emergency medical care. That yielded about 1.5 million incidents involving motorcyclists 20 or older from 2001 to 2008.

The researchers then split them into groups: those in their 20s and 30s, another group between 40 and 59, and those 60 and older.

Over all, the study showed that injury rates for all three groups were on the rise. But the rise was steepest for the oldest riders. Compared with the youngest motorcyclists, those who were 60 and older were two and a half times as likely to end up with serious injuries, and three times as likely to be admitted to a hospital. The riders who were middle age were twice as likely as their younger counterparts to be hospitalized.

For older riders, the consequences of a collision were also especially alarming. Older and middle-aged bikers were more likely to sustain fractures and dislocations, and they had a far greater chance of ending up with injuries to internal organs, including brain damage.

The researchers speculated that it was very likely that a number of factors played a role in older riders’ higher injury rates. For one, declines in vision and reaction time may make older riders more prone to mistakes that end up in collisions. Another theory is that older riders tend to ride bigger bikes, “which may be more likely to roll or turn over,” Ms. Jackson said.

Then there is the greater fragility that comes with age. Older riders may be involved in the same types of accidents as younger riders, Ms. Jackson said, but in some cases, a collision that a 20-year-old would walk away from might send a 65-year-old to the hospital.

“Your bones become more brittle, and you lose muscle mass as you get older,” she said. “It could just be a matter of aging and the body being less durable.”

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Lens Blog: Sirkka-Liisa Konttinen's Photos of Her Newcastle Neighborhood

On clear days in Newcastle-Upon-Tyne, a small yet bustling working-class city in northeast England, the view from the hills of Byker can be spectacular. That shabby neighborhood’s rows of brick houses and terraced streets overlook a historic city center, the river and sometimes far beyond.

Those vistas were rare in 1969, when Sirkka-Liisa Konttinen, a 21-year-old Finnish photographer, arrived. The landscape was cloaked in an industrial fog belched from the coal and shipbuilding industries.

Despite the grayness, the laughter and vivacity that radiated from this close-knit community appealed to Ms. Konttinen. It welcomed a young foreigner whose presence stoked curiosity, but also generosity. They joked with her in pubs. Some of the older women took her under their wing — she kindled a protective instinct in them.

“People were baffled by my choice to live there,” Ms. Konttinen recalled. “Not that many people had any idea where Finland was, but if they did, they thought it such a beautiful clean country, and why would I choose to come to Byker?”

She had ventured there because of Amber Collective, a progressive documentary project that she helped found, which chronicled the lives of working people in northeast England. The group was formed in London by a handful of students who made a film following Vietnam War demonstrations at Grosvenor Square that turned violent. Titled “All You Need Is Dynamite,” it was just a student effort, but its makers found they shared a philosophy.

Before long, they had relocated to Newcastle.

The city was in decline. Urban planners sought flashy new development projects, and some sections, like Byker, were scheduled for demolition. Ms. Konttinen was unaware that she was documenting a place that was about to disappear. Not drawn to gloomy topics, she found the place spirited and interesting.

“Initially, I don’t think we ever thought that we need to document it because it will be the only thing left for people to remember the place and what the area was like,” she said. “I personally have never felt that that was my mission.”

The Amber Collective has produced an enormous amount of material, dating back decades, that is focused on the communities of northeast England, although Ms. Konttinen’s Byker pictures are probably the collective’s best-known project. That work was published as a book in 1983; Amber also released a film companion of the same name, and in 2011 her documentation was registered with the Unesco U.K. Memory of the World. For the first time in a commercial art space, photographs from the series will be shown in the United States, on view at the L. Parker Stephenson Gallery from Feb. 15 through May 11. Ms. Konttinen will also deliver a lecture at the International Center for Photography on Feb. 13.

In recent years, she returned to Byker. The new Byker is changed — more on that Friday — and the changes required her to reconsider her approach when she decided to photograph it. The newer project, “Byker Revisited,” is a result of a far more collaborative endeavor. Not that she hadn’t collaborated in other ways with a subject before. Her 1971 photo of Heather (Slide 3) brought about one such relationship.

“I heard music coming from a derelict house,” she said. “This was one of the last terraces before the final demolition, and there were no steps left to the house, but upstairs I heard music, piano, coming out the windows.”

She entered the house, climbing a rickety staircase to where the music was coming from. She found a girl, Heather, “playing the piano, banging the notes that were kind of stuck and unstuck.”

Ms. Konttinen and Heather started talking, and Ms. Konttinen taught her a simple tune.

“I told her if she ever wanted to come and play, she could come and play it again on my piano,” Ms. Konttinen said. Heather showed up a few days later, with her little brother. On Ms. Konttinen’s piano, they played the tune together.

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Friday: Returning to Byker, in color.

Photographs from “Byker” will be on view at the L. Parker Stephenson Gallery from Feb. 15 through May 11. Ms. Konttinen will also deliver a lecture at the International Center for Photography on Feb. 13.

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Illini buzzer-beater upsets No. 1 Hoosiers, 74-72

CHAMPAIGN, Ill. (AP) — Tyler Griffey made the easiest and biggest shot of his career.

The senior forward took an inbounds pass and made a wide-open layup with 0.9 seconds to play to give Illinois a 74-72 victory over No. 1 Indiana on Thursday night, the fifth straight week the nation's top-ranked team lost.

Hoosiers coach Tom Crean, whose team has been No. 1 for a total of seven weeks this season, doesn't have a reason for the recent weekly changes on top of the poll.

"I can't answer that. I'm not sure," Crean said. "I just know that these games are 40-minute games. We played at a high level for most of the game."

The Hoosiers were in charge until the final 3 1-2 minutes when the Illini (16-8, 3-7 Big Ten) finally put together a run to take and then retake the lead.

"I know this, when we turn the ball over we're not very good," Crean said. "And the biggest difference tonight was 28 points off turnovers to our 16."

And nothing could have been worse for the Hoosiers (20-3, 8-2) than the way the game ended.

With 0.9 seconds left Griffey left defenders Cody Zeller and Christian Watford behind on an inbounds play from the baseline, took the pass from Brandon Paul and delivered the uncontested buzzer-beater for the Illini.

The shot sent hundreds of students onto the court — holding their collective breath as officials checked the replay to make sure the clock hadn't beaten Griffey — and Paul and fellow guard D.J. Richardson hugged and teared up with relief.

Illinois had lost eight of 11 since starting the season 12-0. The Illini had been ranked as high as No. 10 and were now falling to the bottom of the Big Ten.

Griffey, accustomed to struggling in recent weeks, seemed surprised with the ease he was able to make the game-winner.

"I just made a simple curl cut and left two guys behind me, and Brandon got off a heck of a pass," he said. "Zeller and Watford were both right in front of me and just kind of stayed there."

Crean, whose team just moved into the No. 1 spot after knocking off then-No. 1 Michigan on Saturday, said the play was a lot like the other breakdowns in the Hoosiers' game that let Illinois climb back from a 12-point halftime deficit.

"We didn't communicate," Crean said.

"They're very deserving of the win, they never gave in," he added, but he qualified that with, "We didn't put them away when we had the opportunities."

Indiana's loss drops them into a three-way tie for first in the Big Ten with Michigan and Michigan State. For the Illini, the win means a move out of 10th in the 12-team conference up into a ninth-place tie with Iowa.

More importantly, it's a potential lifeline for an Illini team that still has to face No. 18 Minnesota on the road Sunday and had been watching its season slip away.

"It was good to get back to having that toughness and togetherness and trust that we needed," Illinois coach John Groce said.

Illinois hadn't beaten a No. 1 team since a 2004 win over Wake Forest. But the Illini had won nine of the last 10 against the Hoosiers in Champaign. And this season, whatever else has gone wrong, Illinois has delivered against the big boys. Coming into Thursday night the Illini had already beaten three teams now in the top 15: No. 6 Gonzaga, No. 10 Ohio State and No. 14 Butler.

Richardson had 23 points for Illinois, Paul had 21 and Griffey finished with 14 points and eight rebounds.

Zeller led Indiana with 14 points, while Will Sheehey had 13, Watford 12 and Jordan Hulls 11.

Indiana shot 50 percent from the field (25 of 50), 52.9 percent from 3-point range (9 of 17) and 93 percent from the free throw line (13 of 14). The Hoosiers led by an 8- to 10-point margin for most of the second half.

And when 6-foot-11 Nnanna Egwu fouled out with just under 5 minutes to play, Indiana looked in control. Egwu is the only Illini player with the size to realistically match up with the 7-0 Zeller.

Watford made two free throws after Egwu's fifth foul and, at 69-59, the Illini looked done.

But with the clock under 3 minutes, Richardson went on a run of his own, first burying consecutive 3-pointers and then hitting a midrange jumper on the run to tie the game at 70 with 1:17 to play.

Oladipo's layup put the Hoosiers back on top with 50 seconds left, but Paul answered with two free throws, the first banked in, to tie the score again at 72.

With the clock under 30 seconds, Indiana had the ball for what would have been a last shot but Oladipo fumbled the ball. Richardson picked it up and sprinted down court. Oladipo slapped Richardson's layup out of bounds to set up the final play.

Groce credited Richardson for sparking the comeback.

"I thought he was absolutely terrific on both ends of the floor," Groce said. "He battled, he fought."

Griffey was benched several weeks ago after a blowout loss at Wisconsin. On a team that had lost its shooting touch, the senior forward had grown especially cold. And, though one of Illinois' bigger players at 6-9, he wasn't adding much to the inside presence the Illini desperately needed.

The play that brought him to life Thursday, though, had nothing to do with Illinois' late surge. Griffey hit a 3-pointer less than 4 minutes into the second half. He had missed 20 straight 3-point attempts, dating to the start of the Big Ten season.

"I said to myself, 'Finally,'" said Griffey, who said he has been doing so much extra shooting that he's had to have regular ice treatments on his wrist.

Groce said that, even after he benched Griffey, he never gave up on him.

"I just have told him numerous times here I believe in him," the first-year Illinois coach said. "I do."

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Chinese Imports and Exports Soar in January

HONG KONG — January trade data from China on Friday showed a surge in exports and imports from a year earlier — a phenomenon that was largely due to the timing of the Lunar New Year holiday, but that also supported the view that the Chinese economy is firming.

Economic data from China are often severely distorted by the holiday, the highlight of the Chinese calendar, when many factories shut down for a week or more.

The holiday this year takes place in February — the first day of the Lunar New Year is on Sunday — but last year it fell squarely in January, cutting down on the number of working days during that month.

The trade data released Friday reflected this with a large increase compared with the year before, as analysts had expected. Exports climbed 25 percent from January 2012, according to the General Administration of Customs, and imports soared 28.8 percent.

Both figures beating expectations by a wide margin, however, supported the view that the rise was also caused in part by healthier domestic and overseas demand.

“This strong export number cannot be fully explained by the Chinese New Year effect alone,” Zhiwei Zhang, chief China economist at Nomura in Hong Kong, said in a research note.

“These data suggest that external and domestic demand are both strong, which supports our view that the economy is on track for a cyclical recovery” in the first half of this year, he added.

Dariusz Kowalcyk, an economist at Crédit Agricole in Hong Kong, said “we need to wait for February results to have the full picture of trade at the start of 2013.”

However, he added, “one trend is clear: exports have been doing very well recently. This may be a sign of improved external demand, but is also a testimony to the resilience of Chinese exporters and to their competitiveness.”

The Chinese economy has been accelerating gradually in the past few months, reversing a marked slowdown that had raised fears of a possible “hard landing” in China early last year.

Improved overseas demand, combined with a string of government-mandated stimulus measures, have gradually propped up growth and dispelled those fears.

Data released last month showed the Chinese economy expanded just 7.8 percent last year — down from 9.3 percent in 2011 and 10.4 percent in 2010 — but many analysts expect slightly faster growth again in 2013.

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Well: Think Like a Doctor: A Confused and Terrified Patient

The Challenge: Can you solve the mystery of a middle-aged man recovering from a serious illness who suddenly becomes frightened and confused?

Every month the Diagnosis column of The New York Times Magazine asks Well readers to sift through a difficult case and solve a diagnostic riddle. Below you will find a summary of a case involving a 55-year-old man well on his way to recovering from a series of illnesses when he suddenly becomes confused and paranoid. I will provide you with the main medical notes, labs and imaging results available to the doctor who made the diagnosis.

The first reader to figure out this case will get a signed copy of my book, “Every Patient Tells a Story,” along with the satisfaction of knowing you solved a case of Sherlockian complexity. Good luck.

The Presenting Problem:

A 55-year-old man who is recovering from a devastating injury in a rehabilitation facility suddenly becomes confused, frightened and paranoid.

The Patient’s Story:

The patient, who was recovering from a terrible injury and was too weak to walk, had been found on the floor of his room at the extended care facility, raving that there were people out to get him. He was taken to the emergency room at the Waterbury Hospital in Connecticut, where he was diagnosed with a urinary tract infection and admitted to the hospital for treatment. Doctors thought his delirium was caused by the infection, but after 24 hours, despite receiving the appropriate antibiotics, the patient remained disoriented and frightened.

A Sister’s Visit:

The man’s sister came to visit him on his second day in the hospital. As she walked into the room she was immediately struck by her brother’s distress.

“Get me out of here!” the man shouted from his hospital bed. “They are coming to get me. I gotta get out of here!”

His blue eyes darted from side to side as if searching for his would-be attackers. His arms and legs shook with fear. He looked terrified.

For the past few months, the man had been in and out of the hospital, but he had been getting better — at least he had been improving the last time his sister saw him, the week before. She hurried into the bustling hallway and found a nurse. “What the hell is going on with my brother?” she demanded.

A Long Series of Illnesses:

Three months earlier, the patient had been admitted to that same hospital with delirium tremens. After years of alcohol abuse, he had suddenly stopped drinking a couple of days before, and his body was wracked by the sudden loss of the chemical he had become addicted to. He’d spent an entire week in the hospital but finally recovered. He was sent home, but he didn’t stay there for long.

The following week, when his sister hadn’t heard from him for a couple of days, she forced her way into his home. There she found him, unconscious, in the basement, at the bottom of his staircase. He had fallen, and it looked as if he may have been there for two, possibly three, days. He was close to death. Indeed, in the ambulance on the way to the hospital, his heart had stopped. Rapid action by the E.M.T.’s brought his heart back to life, and he made it to the hospital.

There the extent of the damage became clear. The man’s kidneys had stopped working, and his body chemistry was completely out of whack. He had a severe concussion. And he’d had a heart attack.

He remained in the intensive care unit for nearly three weeks, and in the hospital another two weeks. Even after these weeks of care and recovery, the toll of his injury was terrible. His kidneys were not working, so he required dialysis three times a week. He had needed a machine to help him breathe for so long that he now had to get oxygen through a hole that had been cut into his throat. His arms and legs were so weak that he could not even lift them, and because he was unable even to swallow, he had to be fed through a tube that went directly into his stomach.

Finally, after five weeks in the hospital, he was well enough to be moved to a short-term rehabilitation hospital to complete the long road to recovery. But he was still far from healthy. The laughing, swaggering, Harley-riding man his sister had known until that terrible fall seemed a distant memory, though she saw that he was slowly getting better. He had even started to smile and make jokes. He was confident, he had told her, that with a lot of hard work he could get back to normal. So was she; she knew he was tough.

Back to the Hospital:

The patient had been at the rehab facility for just over two weeks when the staff noticed a sudden change in him. He had stopped smiling and was no longer making jokes. Instead, he talked about people that no one else could see. And he was worried that they wanted to harm him. When he remained confused for a second day, they sent him to the emergency room.

You can see the records from that E.R. visit here.

The man told the E.R. doctor that he knew he was having hallucinations. He thought they had started when he had begun taking a pill to help him sleep a couple of days earlier. It seemed a reasonable explanation, since the medication was known to cause delirium in some people. The hospital psychiatrist took him off that medication and sent him back to rehab that evening with a different sleeping pill.

Back to the Hospital, Again:

Two days later, the patient was back in the emergency room. He was still seeing things that weren’t there, but now he was quite confused as well. He knew his name but couldn’t remember what day or month it was, or even what year. And he had no idea where he was, or where he had just come from.

When the medical team saw the patient after he had been admitted, he was unable to provide any useful medical history. His medical records outlined his earlier hospitalizations, and records from the nursing home filled in additional details. The patient had a history of high blood pressure, depression and alcoholism. He was on a long list of medications. And he had been confused for the past several days.

On examination, he had no fever, although a couple of hours earlier his temperature had been 100.0 degrees. His heart was racing, and his blood pressure was sky high. His arms and legs were weak and swollen. His legs were shaking, and his reflexes were very brisk. Indeed, when his ankle was flexed suddenly, it continued to jerk back and forth on its own three or four times before stopping, a phenomenon known as clonus.

His labs were unchanged from the previous visit except for his urine, which showed signs of a serious infection. A CT scan of the brain was unremarkable, as was a chest X-ray. He was started on an intravenous antibiotic to treat the infection. The thinking was that perhaps the infection was causing the patient’s confusion.

You can see the notes from that second hospital visit here.

His sister had come to visit him the next day, when he was as confused as he had ever been. He was now trembling all over and looked scared to death, terrified. He was certain he was being pursued.

That is when she confronted the nurse, demanding to know what was going on with her brother. The nurse didn’t know. No one did. His urinary tract infection was being treated with antibiotics, but he continued to have a rapid heart rate and elevated blood pressure, along with terrifying hallucinations.

Solving the Mystery:

Can you figure out why this man was so confused and tremulous? I have provided you with all the data available to the doctor who made the diagnosis. The case is not easy — that is why it is here. I’ll post the answer on Friday.

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Rules and Regulations: Post your questions and diagnosis in the comments section below.. The correct answer will appear Friday on Well. The winner will be contacted. Reader comments may also appear in a coming issue of The New York Times Magazine.

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Japan Spends Heavily to Keep Whaling Industry Afloat, Report Says

TOKYO — A wildlife conservation group said in a report on Wednesday that Japan has been propping up its whaling industry with nearly $400 million in tax money in recent years, stepping up subsidies even as consumption of whale meat here has slumped.

The report, compiled by the International Fund for Animal Welfare, in Yarmouth Port, Mass., challenges assertions by the Japanese government that whaling is a tradition with wide support among Japanese consumers.

Instead, government figures tallied in the report paint a picture of a struggling industry employing fewer than 1,000 people and dependent on public handouts, including money meant for reconstruction after the devastating earthquake and tsunami of March 2011.

Most Japanese consumers have turned away from whale meat. The industry shipped just 5,000 tons in 2011, compared with 233,000 tons at the peak in 1962, according to data from the Ministry of Agriculture, Forestry and Fisheries. Demand this year is so low that the industry has cut its planned shipments by half, to 2,400 tons.

“Whaling is unprofitable, and survives only with substantial subsidies, something cultural and nationalist arguments for whaling obscure,” said Patrick Ramage, the director of the animal welfare fund’s whale program. He said the country would be better off economically and ecologically if it promoted whale-watching tourism instead of hunting whales.

Japan’s Fisheries Agency declined to comment on the report, saying it had not yet studied its contents.

But an official, speaking on the condition of anonymity, said there was “nothing wrong with these subsidies, which fund an important program,” though it was “not the government’s responsibility to make whaling economically viable.”

A world moratorium on commercial whaling took effect in 1986, but Japan has taken advantage of an exception allowing whaling for research purposes to continue hunting, though environmental activists who chase whaling boats have made those hunts increasingly difficult. Japan has captured and killed more than 14,000 whales since the moratorium began.

The meat from the whales is sold off as “byproducts” of research, and it makes its way to supermarkets, restaurants and even school lunches. A government Web site says the most popular whale dishes are fried whale, whale sashimi and medium-rare whale steak.

According to figures from the Institute of Cetacean Research, the nonprofit organization set up to run the whaling program, income from whale meat has failed to cover the costs of whaling for the past five years. So subsidies have been increased, and some disaster aid has been diverted to the industry, prompting a public outcry.

The dire financial picture prompted the government to announce a plan last year to cut costs by reducing the annual catch and to sell more whale meat directly to schools for lunches. But experts doubt that those measures will make the whaling industry self-sufficient again. 

“The Japanese government has desperately defended whaling for years, but the question has increasingly become: for what?” said Yusuke Saskata, a professor of environmental economics at Kinki University in Osaka. “Supporting whaling culture is one thing, but maintaining whaling at this scale makes no sense.”

Hisako Ueno contributed research.

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