House Democrats approve gun bans in votes GOP calls 'stunt'

SPRINGFIELD — The Democratic-led majority in the Illinois House voted Tuesday in favor of banning guns in schools, casinos and on public transit during an unusual debate allowing lawmakers to vote piece by piece on where people should be allowed to carry concealed weapons.

Democrats said the hourslong action on the House floor was a way to test support for the various elements of a bill that lawmakers are expected to pass this spring to comply with a federal appeals court ruling against Illinois — the only state that hasn't legalized some form of concealed carry for citizens.

Republicans accused the Chicago-led majority of forcing GOP lawmakers to take controversial positions that could be used against them in their next campaign.

"This is a political stunt," said Rep. Dennis Reboletti, R-Elmhurst, a former prosecutor. "It demeans this process."

The perpetual fight over gun control in Springfield took on new meaning following a December federal appeals court order that calls for Illinois to legalize concealed carry by early June. At the same time, Democrats who run City Hall and the Statehouse are pushing for new gun penalties amid an unrelenting stream of Chicago shootings punctuated in January by the death of a South Side teen who had traveled to Washington with her school to participate in President Barack Obama's inauguration festivities.

House Speaker Michael Madigan, D-Chicago, set aside a special order of business to allow debate and votes on more than a dozen concealed carry proposals. Madigan's action forced up-or-down votes on the long lineup of amendments to a Democratic bill rather than the typical approach of weeding them out in committee or behind closed doors, then tacking on a few changes in the full House.

The legislation that carries all the amendments was not called for a vote, leaving potential conflicts between the proposals that lawmakers may seek to reconcile before any House vote to send the bill to the Senate.

With Madigan, the state Democratic Party chairman, already picking up suburban seats in the last election, Republicans feared he was setting his sights on gaining even more ground rather than actually trying to address the concealed carry issue. Republicans questioned why Democrats were focusing on the gun issue now, in this fashion, rather than on Illinois' budget problems and $96.8 billion pension debt.

Republican Minority Leader Tom Cross asked state Rep. Sara Feigenholtz, D-Chicago, whether her gun amendment does anything to address the state's pension crisis. Feigenholtz said the proposal was an "attempt to save lives."

"This bill can't pass out of the House like it is, nor can it go to the Senate, so how does that save a life?" Cross said.

Democratic lawmakers voted in favor of prohibiting concealed weapons in places like casinos, libraries, hospitals, mental health centers, child care facilities, stadiums and amusement parks.

"When they get done with this, you won't be able to carry anywhere," said Rep. David Reis, R-Willow Hill, expressing a frustration among many gun rights advocates as they watched restrictions get piled on.

At the end of the long string of amendment votes, lawmakers late Tuesday also approved an amendment sponsored by Rep. Brandon Phelps, the Harrisburg Democrat who has long sought to legalize concealed weapons. Phelps' proposal was drawn as a full bill that includes bans for stadiums, bars, churches, gymnasiums, sporting events and some businesses.

The gun debate in Illinois has always been more regional than partisan, with Downstate and suburban lawmakers of both parties more interested in gun rights for hunters and sportsmen. Chicagoans and lawmakers from nearby suburbs have been more interested in gun control.

raguerrero2@tribune.com

rlong@tribune.com

Twitter @RayLong

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Advanced Breast Cancer May Be Rising Among Young Women, Study Finds

The incidence of advanced breast cancer among younger women, ages 25 to 39, may have increased slightly over the last three decades, according to a study released Tuesday.

But more research is needed to verify the finding, which was based on an analysis of statistics, the study’s authors said. They do not know what may have caused the apparent increase.

Some outside experts questioned whether the increase was real, and expressed concerns that the report would frighten women needlessly.

The study, published in The Journal of the American Medical Association, found that advanced cases climbed to 2.9 per 100,000 younger women in 2009, from 1.53 per 100,000 women in 1976 — an increase of 1.37 cases per 100,000 women in 34 years. The totals were about 250 such cases per year in the mid-1970s, and more than 800 per year in 2009.

Though small, the increase was statistically significant, and the researchers said it was worrisome because it involved cancer that had already spread to organs like the liver or lungs by the time it was diagnosed, which greatly diminishes the odds of survival.

For now, the only advice the researchers can offer to young women is to see a doctor quickly if they notice lumps, pain or other changes in the breast, and not to assume that they cannot have breast cancer because they are young and healthy, or have no family history of the disease.

“Breast cancer can and does occur in younger women,” said Dr. Rebecca H. Johnson, the first author of the study and medical director of the adolescent and young adult oncology program at Seattle Children’s Hospital.

But Dr. Johnson noted that there is no evidence that screening helps younger women who have an average risk for the disease and no symptoms. “We’re certainly not advocating that young women get mammography at an earlier age than is generally specified,” she said.

Expert groups differ about when screening should begin; some say at age 40, others 50.

Breast cancer is not common in younger women; only 1.8 percent of all cases are diagnosed in women from 20 to 34, and 10 percent in women from 35 to 44. However, when it does occur, the disease tends to be more deadly in younger women than in older ones. Researchers are not sure why.

The researchers analyzed data from SEER, a program run by the National Cancer Institute to collect cancer statistics on 28 percent of the population of the United States. The study also used data from the past when SEER was smaller.

The study is based on information from 936,497 women who had breast cancer from 1976 to 2009. Of those, 53,502 were 25 to 39 years old, including 3,438 who had advanced breast cancer, also called metastatic or distant disease.

Younger women were the only ones in whom metastatic disease seemed to have increased, the researchers found.

Dr. Archie Bleyer, a clinical research professor in radiation medicine at the Knight Cancer Institute at the Oregon Health and Science University in Portland who helped write the study, said scientists needed to verify the increase in advanced breast cancer in young women in the United States and find out whether it is occurring in other developed Western countries. “This is the first report of this kind,” he said, adding that researchers had already asked colleagues in Canada to analyze data there.

“We need this to be sure ourselves about this potentially concerning, almost alarming trend,” Dr. Bleyer said. “Then and only then are we really worried about what is the cause, because we’ve got to be sure it’s real.”

Dr. Johnson said her own experience led her to look into the statistics on the disease in young women. She had breast cancer when she was 27; she is now 44. Over the years, friends and colleagues often referred young women with the disease to her for advice.

“It just struck me how many of those people there were,” she said.

Dr. Donald A. Berry, an expert on breast cancer data and a professor of biostatistics at the University of Texas’ M. D. Anderson Cancer Center in Houston, said he was dubious about the finding, even though it was statistically significant, because the size of the apparent increase was so small — 1.37 cases per 100,000 women, over the course of 30 years.

More screening and more precise tests to identify the stage of cancer at the time of diagnosis might account for the increase, he said.

“Not many women aged 25 to 39 get screened, but some do, but it only takes a few to account for a notable increase from one in 100,000,” Dr. Berry said.

Dr. Silvia C. Formenti, a breast cancer expert and the chairwoman of radiation oncology at New York University Langone Medical Center, questioned the study in part because although it found an increased incidence of advanced disease, it did not find the accompanying increase in deaths that would be expected.

A spokeswoman for an advocacy group for young women with breast cancer, Young Survival Coalition, said the organization also wondered whether improved diagnostic and staging tests might explain all or part of the increase.

“We’re looking at this data with caution,” said the spokeswoman, Michelle Esser. “We don’t want to invite panic or alarm.”

She said it was important to note that the findings applied only to women who had metastatic disease at the time of diagnosis, and did not imply that women who already had early-stage cancer faced an increased risk of advanced disease.

Dr. J. Leonard Lichtenfeld
, deputy chief medical officer of the American Cancer Society, said he and an epidemiologist for the society thought the increase was real.

“We want to make sure this is not oversold or that people suddenly get very frightened that we have a huge problem,” Dr. Lichtenfeld said. “We don’t. But we are concerned that over time, we might have a more serious problem than we have today.”

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What's next for revitalized Chicago Loop?

Michael Edwards has only been in town for a few months, but the new executive director of the Chicago Loop Alliance says the warm reception he's getting makes him feel part of something distinctly Chicago.

There's the strong handshake upon meeting. Direct eye contact. A hearty "Welcome to Chicago," he notes. "It's really a dynamic thing," Edwards says with a laugh. "I get it all the time."

A Buffalo, N.Y., native who took the role in November, Edwards arrived at a crucial time for the alliance, which is charged with representing downtown businesses and promoting the area as a destination to live, work and play. On the rebound from the Great Recession, the Loop is aiming to solidify its place as a hub for businesses, retail and residents — from college students to urban professionals to empty nesters who seek easy access to transportation, Millennium Park and museums.

But the return hasn't been easy. During the economic downturn, vacancies shot up, but a rash of new apartments are under construction in downtown Chicago. Target Corp. filled the long-empty Carson Pirie Scott & Co. storefront with its new urban format on State Street in July, and a few blocks up The Gap will open a new store in the spring. State Street's crown jewel, Block 37, is still trying to land a big tenant to drive more foot traffic to the mall.

Now that vacancies are declining and rents are climbing, Edwards and other civic leaders are aiming to figure out what's next for the business district and State Street retail corridor.

At its annual meeting Tuesday, Edwards and the Chicago Loop Alliance announced development of a five-year strategic plan aimed at clarifying the organization's role in economic development, housing, transportation, tourism, culture and services in the Loop. It's the first ever in the organization's history.

The process will tap input from business owners, elected officials, civic leaders and alliance board members, said Edwards, who held similar positions in Pittsburgh and Spokane, Wash. He replaced executive director Ty Tabing, who left in the summer to head up an economic development organization in Singapore.

The strategic planning process is under way, and a draft is due in June. Oakland, Calif.- based MIG Inc. was hired to assist in developing the new strategy.

With the Loop moving in the right direction, it's time to shift gears and ask residents and business owners what they think of its opportunities and challenges, as well as the role of the alliance, Edwards says.

The need for a new plan is driven in part by Edwards' arrival, but also by the fact that the State Street special service area, one of 44 local tax districts that fund expanded services and programs with a property tax levy, is up for renewal in 2016. The State Street SSA collects about $2.5 million annually.

Part of the planning process will include determining whether the SSA, which is administered by the Chicago Loop Alliance and pays for such services as public way maintenance and district marketing, security and economic development, should be expanded to encompass all of the Loop's business and retail districts, including Dearborn Street and Wabash Avenue as well as North Michigan Avenue, he said.

No decisions have been yet, Edwards said. "We're pretty focused on State Street, but can we provide that level of service to other areas?" he said.

Edwards said the new strategy will also determine whether the alliance, which has an annual budget of about $3.4 million, should take on a larger role as an advocate for the Loop.

"We have a website that's all about our members that gets about 10,000 hits a year, and we need about 2 million hits a year. And we need to control the narrative about what's going on downtown," he said.

With other local organizations such as Choose Chicago and World Business Chicago tasked with touting the region, "Is there a role for us to amplify this notion that we're an authentic American city that's an economic engine for the region?" asked Edwards. "Is there a role for the CLA to help promote that or not?"

If the new focus of the alliance has yet to be determined, Edwards has few opinions. Any new partnerships with other local groups, he said, will have to be formed "organically."

And he predicts the alliance's focus will likely shift to "typical downtown management duties — keeping the area safe and clean," coupled with "a little more economic development sensibility as opposed to an arts sensibility," he said.

For years, the Chicago Loop Alliance has run the PopUp Art Loop program in which public art was showcased in vacant storefronts. But the number of empty retail spaces along State Street has been cut in half, to about six, Edwards said.

Now that State Street has evolved, it's time the alliance's role evolved too, according to officials.

"We're seeing a lot of tremendous opportunities for growth in the Loop, whether it's in retail, new companies coming downtown, new residents or tourism," said Martin Stern, executive vice president and managing director at US Equities Realty and board chairman of the Chicago Loop Alliance.

Added Edwards: "There's a sort of feeling that we need to be more focused, provide more value, provide more leadership."

crshropshire@tribune.com

Twitter @corilyns

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Cardinal George: New pope must 'govern ... as a pastor'

Cardinal Francis George tells the Tribune's Manya Brachear about the qualities that a new pope should have, one day before the cardinal heads to Rome to elect a new leader of the Catholic Church. (Chris Walker/Chicago Tribune)

As he prepared to rush to Rome ahead of a snowstorm at home, Chicago's Cardinal Francis George said Monday that the next pope should have insight about how the Vatican operates and the ability to lead a global church.

"You're talking about governance here," George said. "People say sanctity. Well, sanctity is nice, but there have been popes who have governed fairly well who have not been holy. … What's important here is governance. Can the man govern the church as a pastor? He has to be a man who knows the Lord because he's governing in his name. But it doesn't mean he's going to be a great saint."

George's interview with the Tribune was cut short as his staff scrambled to move up his travel plans to avoid a snowstorm in Tuesday's forecast. He will land at Leonardo da Vinci-Fiumicino Airport in Rome on Tuesday morning, two days ahead of Pope Benedict XVI's departure to the Vatican holiday retreat of Castel Gandolfo on Thursday.

The cardinals will meet Friday to begin preparing for the conclave where they will select the next pontiff. George also voted in the 2005 papal election that chose Pope Benedict.

While George initially will stay at the Pontifical North American College on the Janiculum Hill overlooking Rome, he will join other cardinals at the Domus Sanctae Marthae, a secluded residence on the edge of Vatican City, when the conclave begins.

In many respects, the Eternal City has become George's second home. He spent 13 years there as the vicar general for his religious order, the Missionary Oblates of Mary Immaculate. During his time as a cardinal, he has served on at least eight congregations, or Vatican committees, advising the pope on everything from financial management and evangelization to charity and liturgy.

Like cardinals from Germany, France and Italy, George also has served as president of his national bishops conference. For three years, the job took George back and forth as a liaison between the Vatican and the American Catholic Church. It's those kinds of responsibilities that leave an impression on other cardinals enough to earn their consideration, George said.

"Those are all relationships that enable you to have some insight into how they operate, a little bit about what they do and how they think," George said.

George considers the mileage accrued between a cardinal's diocese and Rome an important credential for the papacy.

Time spent in Rome enables a cardinal to learn how the church traditionally operates. It creates opportunities for cardinals who are not posted at the Vatican to learn the leadership styles of others outside their dioceses. It also exposes them to a different set of pressures and gives cardinals a chance to witness how they would respond.

A cardinal does not have to serve in the Roman Curia, he said. In fact, Pope John Paul II did not.

"But he knew what was going on," George said.

"Because the administration of the church is in the hands of the Roman Curia, at that level, does he have some curial experience?" George added. "Does he know a little bit about what's going on? Can he handle it? Can he appoint people who are in charge?"

The informal conversations leading up to the conclave, George said, provide opportunities to share observations and ask questions. Those questions often revolve around a man's style of public ministry, his administrative abilities and "his freedom from his own cultural background if he's got to be universal."

"You assume the man is prayerful and that he understands and lives out of the apostolic faith," George said. "However, you might create a question about that depending on what he might have said (publicly)."

Kurt Martens, an associate professor of canon law at the Catholic University of America and an expert on the Roman Curia, wholeheartedly agreed.

"Comparable to government agencies, the Roman Curia will help the Roman pontiff when he's planning out his ministries as shepherd of the flock," Martens said. "That means the Roman Curia is at his service. If you don't know the administration and how it works, it's not going to be at your service. You might be at the service of it.

"I might even go a little further than his eminence. It's key for the new supreme pontiff to not only be familiar with the Roman Curia, but also to be willing to control the Roman Curia to make sure they do what he wants, not the other way around."

Last year, confidential memos leaked to the news media — a scandal dubbed Vatileaks — revealed allegations of corruption within the Roman Curia.

Indeed, in his new book "Evangelical Catholicism," papal biographer and conservative Catholic scholar George Weigel said reforming the Roman Curia will be one of many priorities for the next pope.

"The Curia not infrequently caused acute embarrassment to Benedict XVI, putting obstacles in the way of his evangelical, catechetical, and pastoral efforts, and ill-serving the Pope's attempts to reframe the global agenda of debate on the crucial issues facing humanity," Weigel wrote.

Martens agreed with the cardinal's point that experience in Rome outside a cardinal's local diocese also helps demonstrate how well he can shake off cultural habits or constraints.

"You have to almost distance yourself from where you come from and think for the whole church," he said.

Everyone is speculating whether the cardinals will choose a pope from the developing world, he said.

"Perhaps we are ready for an African or Latin American pope," Martens added. But when he's elected pope, "he becomes a Roman."

mbrachear@tribune.com

Twitter @tribseeker

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Oscars telecast review: Guys, it’s not about you

NEW YORK (TheWrap.com) – Would it shock you to learn that this year’s Oscars producers also produced “Chicago“? Not at all? OK.

Self-referencing was the order of the evening Sunday at an overstuffed Oscars telecast where host Seth MacFarlane and producers Craig Zadan and Neil Meron decided the ceremony was All About Them.

That was the only explanation for a lengthy opening sequence centered on how MacFarlane would fare as host, and numerous reminders throughout the show of how much we all enjoyed “Chicago.”

Thanks, guys, but we kind of took care of praising “Chicago” when it won Best Picture in 2002.

The Oscars are always a treasure trove of hilarious narcissism – it’s inherently obnoxious to hear some of the richest and best-looking people alive praise one another and themselves.

This year had plenty of the usual silliness – as when best supporting actor Christoph Waltz praised Quentin Tarantino for going on a “hero’s journey” to make films. And it won’t exactly reduce Hollywood’s sense of self-importance that no less than Michelle Obama handed out the Best Picture. (“Argo” won.)

Inflated egos are to be expected. But we can usually count on the producers and host to share the spotlight. Not so this year.

You can’t really blame MacFarlane for turning the opening into a “Family Guy” episode, with all of his show’s requisite pop culture references, parody songs and gay panic jokes. MacFarlane brought in William Shatner to play Captain Kirk critiquing the show from the future.

The “Ted” director and star made it all of eight minutes before his first gay joke. He sang a song about actresses’ “boobs” with the Gay Men’s Chorus of Los Angeles, then clarified that he isn’t a member.

“Oh, trust me,” Captain Kirk said from the future. “In July 2015, you join the chorus.”

The theme of the night was celebrating musicals, but it was hard to find anything else consistent about the ceremony. Like many an overstuffed blockbuster, the three-and-a-half-hour show refused to leave anything out.

Studio slates are so dominated by CGI monstrosities that Oscar voters now nominate pretty much every grown-up movie they see for Best Picture. Rather than make hard decisions, they give us a grab bag.

And so we get extended ceremonies like this one, which somehow always manage to cull names from the “In Memoriam” segment, but not boring parts of the show. Key figures like the host and producers are allowed to protect their vanity pieces, and viewers just have to deal.

We were occasionally rewarded for our patience. Shirley Bassey and Adele gave spectacular performances of Bond songs from five decades apart. Jennifer Hudson delivered another excellent rendition of “And I Am Telling You I Am Not Going” from “Dreamgirls.” And we learned that Channing Tatum and Charlize Theron are good dancers.

But of course they are.

Catherine Zeta Jones did a commendable job on “All That Jazz” from “Chicago” – but couldn’t we have left it at that? The producers also reunited their cast as presenters – to remind us once again how much we apparently still cherish their decade-old film.

Near the end of the ceremony, Tarantino made his hero’s journey to the stage to accept his well-deserved award for Best Original Screenplay and remind us of the importance of writers.

One thing the best writers do is keep it short. Maybe next year should be a tribute to writers.

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Global Health: After Measles Success, Rwanda to Get Rubella Vaccine

Rwanda has been so successful at fighting measles that next month it will be the first country to get donor support to move to the next stage — fighting rubella too.

On March 11, it will hold a nationwide three-day vaccination campaign with a combined measles-rubella vaccine, hoping to reach nearly five million children up to age 14. It will then integrate the dual vaccine into its national health service.

Rwanda can do so “because they’ve done such a good job on measles,” said Christine McNab, a spokeswoman for the Measles and Rubella Initiative, which will provide the vaccine and help pay for the campaign.

Rubella, also called German measles, causes a rash that is very similar to the measles rash, making it hard for health workers to tell the difference.

Rubella is generally mild, even in children, but in pregnant women, it can kill the fetus or cause serious birth defects, including blindness, deafness, mental retardation and chronic heart damage.

Ms. McNab said that Rwanda had proved that it can suppress measles and identify rubella, and it would benefit from the newer, more expensive vaccine.

The dual vaccine costs twice as much — 52 cents a dose at Unicef prices, compared with 24 cents for measles alone. (The MMR vaccine that American children get, which also contains a vaccine against mumps, costs Unicef $1.)

More than 90 percent of Rwandan children now are vaccinated twice against measles, and cases have been near zero since 2007.

The tiny country, which was convulsed by Hutu-Tutsi genocide in 1994, is now leading the way in Africa in delivering medical care to its citizens, Ms. McNab said. Three years ago, it was the first African country to introduce shots against human papilloma virus, or HPV, which causes cervical cancer.

In wealthy countries, measles kills a small number of children — usually those whose parents decline vaccination. But in poor countries, measles is a major killer of malnourished infants. Around the world, the initiative estimates, about 158,000 children die of it each year, or about 430 a day.

Every year, an estimated 112,000 children, mostly in Africa, South Asia and the Pacific islands, are born with handicaps caused by their mothers’ rubella infection.

Thanks in part to the initiative — which until last year was known just as the Measles Initiative — measles deaths among children have declined 71 percent since 2000. The initiative is a partnership of many health agencies, vaccine companies, donors and others, but is led by the American Red Cross, the United Nations Foundation, the Centers for Disease Control and Prevention, Unicef and the World Health Organization.

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5 of top 15 teaching hospitals in Chicago area

By Peter Frost




Tribune reporter

11:27 a.m. CST, February 25, 2013

Five of the country's top 15 major teaching hospitals are in the Chicago area, according to an annual study released Monday that evaluates performance in 10 categories of publicly available data.

The study, conducted by Truven Health Analytics, the former health care business of Thomson Reuters, listed seven Chicagoland hospitals among the nation's top 100, including four owned by Advocate Health Care.

Researchers evaluated 2,922 acute-care hospitals using information from the federal Centers for Medicare and Medicaid Services, including cost, patient satisfaction and quality measures, such as re-admission rates, patient safety, mortality and medical complications.  Hospitals do not apply or pay for inclusion on the list, which has been produced since 1993.

The seven Illinois hospitals that made the Top 100

• Advocate Christ Medical Center in Oak Lawn


• Advocate Illinois Masonic Medical Center in Chicago


• Advocate Lutheran General Hospital in Park Ridge


• Advocate Good Samaritan Hospital in Downers Grove


• Central DuPage Hospital in Winfield


• NorthShore University HealthSystem in Evanston


• Northwestern Memorial Hospital in Chicago

pfrost@tribune.com | Twitter: @peterfrost

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Oscars live: Hathaway wins best supporting actress

9:59: George Clooney introduces the "In Memoriam" segment of the show. Ernest Borgnine is the first actor honored. Barbra Streisand gives a tribute to Marvin Hamlisch, singing "The Way We Were."

9:48 p.m.: Daniel Radcliffe and Kristin Stewart presented the award for best production design to "Lincoln."

MORE OSCARS: Red carpet pics | Winners | Red carpet highlights

9:35 p.m.: Adele performs her song from the Bond film "Skyfall."

9:31 p.m.: The Oscar for film editing, presented by Sandra Bullock, is given to William Goldenberg of "Argo." It's the first win for the movie.

9:23 p.m.: Anne Hathaway wins best supporting actress for her role in "Les Miserables." The award is presented by Christopher Plummer.

9:14 p.m.: Mark Wahlberg and Ted from "Ted" present the award for best sound mixing to "Les Miserables." There was a tie for best sound editing, as "Zero Dark Thirty" and "Skyfall." It is the first tie for an Oscar since 1995.

9:03 p.m.: John Travolta presents a montage to movie musicals, featuring Catherine Zeta-Jones and Chicagoan Jennifer Hudson, who gets a standing ovation for singing "And I Am Telling You I'm Not Going," from "Dreamgirls."

The entire cast of "Les Miserables," including Anne Hathaway, Hugh Jackman and Russell Crowe, sings "Suddenly" from the movie.

8:51 p.m.: Jennifer Garner and Jessica Chastain present the best foreign language film to "Amour."

8:43 p.m.: "Argo" director and star Ben Afflek gives the award for best documentary feature to "Searching For Sugar Man."

8:35 p.m.: Shawn Christensen wins best live action short film for "Curfew." The award for best documentary short subject goes to "Inocente."

8:25 p.m.: Halle Berry, a Bond girl herself in "Golden Eye," presents a montage celebrating the music of James Bond films. Shirley Bassey sings "Goldfinger" live.

8:19 p.m.: Jennifer Aniston and Channing Tatum give the award for best costume design to Jacqueline Durran for "Anna Karenina." The award for best makeup goes to Lisa Westcott and Julie Dartnell for "Les Miserables."

8:10 p.m.: Claudio Miranda wins best cinemtography for "Life of Pi." The movie also wins for best visual effects.

7:59 p.m.: Paul Rudd and Melissa McCarthy present the best animated feature film award, which goes to "Brave." Director Mark Andrews accepts the award wearing a kilt. John Kahrs wins best animated short film for "Paperman."

7:50 p.m.: Christoph Waltz wins the first award of the night, as best supporting actor for his role in "Django Unchained." The award is given by Octavia Spencer.

7:35 p.m.: The 85th Academy Awards are under way, with Seth MacFarlane as host. He announces that this year's Oscars will have a musical theme.

The show's first surprise is William Shatner as Captain Kirk from "Star Trek," telling MacFarlane he is doing a terrible job as host.

The first song of the night is MacFarlane singing a song called "We Saw Your Boobs."

MacFarlane then sings a rendition of the Frank Sinatra hit "The Way You Look Tonight" with Channing Tatum and Charlize Theron dancing.

He then sings "High Hopes" with Daniel Radcliffe and Joseph Gordon-Levitt.

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‘Bloodless’ Lung Transplants for Jehovah’s Witnesses

Eric Kayne for The New York Times

SHARING HOME AND FAITH A Houston couple hosted Gene and Rebecca Tomczak, center, in October so she could get care nearby.

HOUSTON — Last April, after being told that only a transplant could save her from a fatal lung condition, Rebecca S. Tomczak began calling some of the top-ranked hospitals in the country.

She started with Emory University Hospital in Atlanta, just hours from her home near Augusta, Ga. Then she tried Duke and the University of Arkansas and Johns Hopkins. Each advised Ms. Tomczak, then 69, to look somewhere else.

The reason: Ms. Tomczak, who was baptized at age 12 as a Jehovah’s Witness, insisted for religious reasons that her transplant be performed without a blood transfusion. The Witnesses believe that Scripture prohibits the transfusion of blood, even one’s own, at the risk of forfeiting eternal life.

Given the complexities of lung transplantation, in which transfusions are routine, some doctors felt the procedure posed unacceptable dangers. Others could not get past the ethics of it all. With more than 1,600 desperately ill people waiting for a donated lung, was it appropriate to give one to a woman who might needlessly sacrifice her life and the organ along with it?

By the time Ms. Tomczak found Dr. Scott A. Scheinin at The Methodist Hospital in Houston last spring, he had long since made peace with such quandaries. Like a number of physicians, he had become persuaded by a growing body of research that transfusions often pose unnecessary risks and should be avoided when possible, even in complicated cases.

By cherry-picking patients with low odds of complications, Dr. Scheinin felt he could operate almost as safely without blood as with it. The way he saw it, patients declined lifesaving therapies all the time, for all manner of reasons, and it was not his place to deny care just because those reasons were sometimes religious or unconventional.

“At the end of the day,” he had resolved, “if you agree to take care of these patients, you agree to do it on their terms.”

Ms. Tomczak’s case — the 11th so-called bloodless lung transplant attempted at Methodist over three years — would become the latest test of an innovative approach that was developed to accommodate the unique beliefs of the world’s eight million Jehovah’s Witnesses but may soon become standard practice for all surgical patients.

Unlike other patients, Ms. Tomczak would have no backstop. Explicit in her understanding with Dr. Scheinin was that if something went terribly wrong, he would allow her to bleed to death. He had watched Witness patients die before, with a lifesaving elixir at hand.

Ms. Tomczak had dismissed the prospect of a transplant for most of the two years she had struggled with sarcoidosis, a progressive condition of unknown cause that leads to scarring in the lungs. The illness forced her to quit a part-time job with Nielsen, the market research firm.

Then in April, on a trip to the South Carolina coast, she found that she was too breathless to join her frolicking grandchildren on the beach. Tethered to an oxygen tank, she watched from the boardwalk, growing sad and angry and then determined to reclaim her health.

“I wanted to be around and be a part of their lives,” Ms. Tomczak recalled, dabbing at tears.

She knew there was danger in refusing to take blood. But she thought the greater peril would come from offending God.

“I know,” she said, “that if I did anything that violates Jehovah’s law, I would not make it into the new system, where he’s going to make earth into a paradise. I know there are risks. But I think I am covered.”

Cutting Risks, and Costs

The approach Dr. Scheinin would use — originally called “bloodless medicine” but later re-branded as “patient blood management” — has been around for decades. His mentor at Methodist, Dr. Denton A. Cooley, the renowned cardiac pioneer, performed heart surgery on hundreds of Witnesses starting in the late 1950s. The first bloodless lung transplant, at Johns Hopkins, was in 1996.

But nearly 17 years later, the degree of difficulty for such procedures remains so high that Dr. Scheinin and his team are among the very few willing to attempt them.

In 2009, after analyzing Methodist’s own data, Dr. Scheinin became convinced that if he selected patients carefully, he could perform lung transplants without transfusions. Hospital administrators resisted at first, knowing that even small numbers of deaths could bring scrutiny from federal regulators.

“My job is to push risk away,” said Dr. A. Osama Gaber, the hospital’s director of transplantation, “so I wasn’t really excited about it. But the numbers were very convincing.”

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ComEd chief hopes to spark positive change

Every organization has its low point. For Commonwealth Edison, it was in summer 2011 when a storm left more than 850,000 people without power, some for days.

Customers flocked to the phones for information and were shocked to find that they were not only in the dark, but in the dark ages. They waited on hold for hours, only to hear the same message every 45 minutes. They couldn't find out when their power would be restored, what had caused the outage or how many other people were affected.

Residents raged about ComEd on Facebook and Twitter and to mayors, state representatives, and fire and police departments. Dealing with wires that blocked roadways, nursing homes without power and angry residents with spoiled groceries, these public officials turned back to ComEd — only to receive misinformation or no information at all.

For soon-to-be-instated CEO Anne Pramaggiore, it was a blaring wake-up call: Customers hated the utility.

"We heard our customers loud and clear that summer," Pramaggiore said. "Everything else in the world is instantaneous, and they don't understand why they have to sit and wait without power or information."

Fast-forward to today, and customers can text, call, look online, use an iPhone or Android app or communicate with a ComEd representative on Twitter or Facebook. In less than a year, the company's smartphone app has generated more than 1 million transactions and 59,000 downloads.

"We're on a mission to improve service to our customers," said Pramaggiore, 54.

The good news is that the company has nowhere to go but up. Since 1999, ComEd has consistently ranked among the worst utilities in the Midwest for customer satisfaction in surveys conducted by The American Customer Satisfaction Index and J.D. Power and Associates.

Two months ago, the company had zero pending complaints for the first time in its history after working its way out of backlog in "the thousands," according to Miguel Ortega, director of customer technology and support for ComEd.

"Anne gets it," he said. "I've been around for quite a while. I've been through a lot of CEOs. She has made it a priority to put the customer in every aspect of our business, which is a huge cultural change."

The shift comes at a time when ComEd's parent company, Exelon Corp., is squeezing its three regulated utilities for revenue. The money Exelon receives for producing its mostly nuclear-powered electricity is not what it once was because of increased competition from natural gas and wind.

As a regulated utility that is paid by customers to deliver electricity regardless of which supplier they choose, ComEd is in a position to provide a steady, predictable stream of income to its parent if it can garner support from the General Assembly to pass legislation that will benefit its bottom line. But to get there, Pramaggiore must convince legislators — the same ones who have spent years fielding complaints from constituents about ComEd's abysmal service — that the company can change.

Legislation related to funding the so-called smart grid, passed into law in 2011 as part of the Energy Infrastructure Modernization Act, is making its way through Springfield and is worth about $1 billion to ComEd.

Within four years, Pramaggiore wants the utility that customers love to hate to be the utility that customers actually like, a plan she has spent countless hours communicating to every employee in the company.

"Whether you'll love your utility, I don't know. It's not the kind of business you ultimately love," said David Kolata, executive director of the Citizens Utility Board consumer advocacy group, a frequent opponent of ComEd. "We are encouraged and do think generally that her heart is in the right place. She does want to transform the company. Will that play out? It's too early to tell."

Inspires trust

While Pramaggiore's lawyerlike ability to boil down complex regulatory issues is impressive, her power lies in her charm. Gracious and savvy, she laughs easily and often, winning over opponents with humility and a down-to-earth speaking style that inspires trust.

Gloria Castillo, a personal friend of Pramaggiore and president of Chicago United, said her ability to listen is one of her greatest assets.

"Anne is really one of the highest-ranking women in energy anywhere in the country, but you never get the feeling that she thinks about herself in a way that's different," she said. "She's so striking. She has a unique ability to be so present in a conversation."

Indeed, Pramaggiore, a soccer mom who fits in at a Paul McCartney concert as easily as in a contentious hearing in Springfield, is disarming in her remarkable ability to appear unremarkable. She described her childhood in Dayton, Ohio, as a "quiet, suburban upbringing with good schools," with a father who was a civil engineer and a mom who was president of the local PTO.

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