WHO: Slight cancer risk after Japan nuke accident


LONDON (AP) — Two years after Japan's nuclear plant disaster, an international team of experts said Thursday that residents of areas hit by the highest doses of radiation face an increased cancer risk so small it probably won't be detectable.


In fact, experts calculated that increase at about 1 extra percentage point added to a Japanese infant's lifetime cancer risk.


"The additional risk is quite small and will probably be hidden by the noise of other (cancer) risks like people's lifestyle choices and statistical fluctuations," said Richard Wakeford of the University of Manchester, one of the authors of the report. "It's more important not to start smoking than having been in Fukushima."


The report was issued by the World Health Organization, which asked scientists to study the health effects of the disaster in Fukushima, a rural farming region.


On March 11, 2011, an earthquake and tsunami knocked out the Fukushima plant's power and cooling systems, causing meltdowns in three reactors and spewing radiation into the surrounding air, soil and water. The most exposed populations were directly under the plumes of radiation in the most affected communities in Fukushima, which is about 150 miles (240 kilometers) north of Tokyo.


In the report, the highest increases in risk are for people exposed as babies to radiation in the most heavily affected areas. Normally in Japan, the lifetime risk of developing cancer of an organ is about 41 percent for men and 29 percent for women. The new report said that for infants in the most heavily exposed areas, the radiation from Fukushima would add about 1 percentage point to those numbers.


Experts had been particularly worried about a spike in thyroid cancer, since radioactive iodine released in nuclear accidents is absorbed by the thyroid, especially in children. After the Chernobyl disaster, about 6,000 children exposed to radiation later developed thyroid cancer because many drank contaminated milk after the accident.


In Japan, dairy radiation levels were closely monitored, but children are not big milk drinkers there.


The WHO report estimated that women exposed as infants to the most radiation after the Fukushima accident would have a 70 percent higher chance of getting thyroid cancer in their lifetimes. But thyroid cancer is extremely rare and one of the most treatable cancers when caught early. A woman's normal lifetime risk of developing it is about 0.75 percent. That number would rise by 0.5 under the calculated increase for women who got the highest radiation doses as infants.


Wakeford said the increase may be so small it will probably not be observable.


For people beyond the most directly affected areas of Fukushima, Wakeford said the projected cancer risk from the radiation dropped dramatically. "The risks to everyone else were just infinitesimal."


David Brenner of Columbia University in New York, an expert on radiation-induced cancers, said that although the risk to individuals is tiny outside the most contaminated areas, some cancers might still result, at least in theory. But they'd be too rare to be detectable in overall cancer rates, he said.


Brenner said the numerical risk estimates in the WHO report were not surprising. He also said they should be considered imprecise because of the difficulty in determining risk from low doses of radiation. He was not connected with the WHO report.


Some experts said it was surprising that any increase in cancer was even predicted.


"On the basis of the radiation doses people have received, there is no reason to think there would be an increase in cancer in the next 50 years," said Wade Allison, an emeritus professor of physics at Oxford University, who also had no role in developing the new report. "The very small increase in cancers means that it's even less than the risk of crossing the road," he said.


WHO acknowledged in its report that it relied on some assumptions that may have resulted in an overestimate of the radiation dose in the general population.


Gerry Thomas, a professor of molecular pathology at Imperial College London, accused the United Nations health agency of hyping the cancer risk.


"It's understandable that WHO wants to err on the side of caution, but telling the Japanese about a barely significant personal risk may not be helpful," she said.


Thomas said the WHO report used inflated estimates of radiation doses and didn't properly take into account Japan's quick evacuation of people from Fukushima.


"This will fuel fears in Japan that could be more dangerous than the physical effects of radiation," she said, noting that people living under stress have higher rates of heart problems, suicide and mental illness.


In Japan, Norio Kanno, the chief of Iitate village, in one of the regions hardest hit by the disaster, harshly criticized the WHO report on Japanese public television channel NHK, describing it as "totally hypothetical."


Many people who remain in Fukushima still fear long-term health risks from the radiation, and some refuse to let their children play outside or eat locally grown food.


Some restrictions have been lifted on a 12-mile (20-kilometer) zone around the nuclear plant. But large sections of land in the area remain off-limits. Many residents aren't expected to be able to return to their homes for years.


Kanno accused the report's authors of exaggerating the cancer risk and stoking fear among residents.


"I'm enraged," he said.


___


Mari Yamaguchi in Tokyo and AP Science Writer Malcolm Ritter in New York contributed to this report.


__


Online:


WHO report: http://bit.ly/YDCXcb


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W.H.O. Sees Low Health Risks From Fukushima Accident





TOKYO — A study published on Thursday by the World Health Organization on the health risks associated with the disaster at the Fukushima Daiichi Nuclear Power Plant suggested that the risk for certain types of cancers had increased slightly among children exposed to the highest doses of radioactivity, but that there would most likely be no observable increase in cancer rates in the wider Japanese population.




The study, which capped off a comprehensive, two-year analysis of the estimated doses of radioactivity from the 2011 Fukushima accident and their potential risks, also warned that the disaster’s psychological impact could have a consequence on health, and called for continued monitoring and health screenings for populations most exposed to the radiological fallout.


The study’s authors warned, however, that their assessment was based on limited scientific knowledge; much of the scientific data on health effects from radiation is based on acute exposures like those that followed the bombing of Hiroshima and Nagasaki and not chronic, low-level exposure. In Japan, some densely populated areas are expected to remain contaminated with relatively low levels of radioactive materials for decades.


“Because scientific understanding of the radiation effects, particularly at low doses, may increase in the future, it is possible that further investigation may change our understanding of the risks of this radiation accident,” the report said.


The Japanese government called the report overly cautious. “It overestimates the risks, and could lead to misunderstandings of the likelihoods of developing cancer,” Japan’s Environment Ministry said in a statement made to the public broadcaster, N.H.K. In particular, the ministry said the study failed to fully take into account government evacuations of residents closest to the plant, assuming many people were exposed for longer than they were.


According to the W.H.O. study, girls exposed as infants to radioactivity in the most contaminated regions of Fukushima Prefecture, where estimated doses ranged from 12 to 25 millisieverts for the first year, faced a 70 percent higher risk of developing thyroid cancer than what would normally be expected. The report pointed out, however, that the normal expected risk of thyroid cancer was just 0.75 percent, and that the additional lifetime risk would raise that to 1.25 percent.


Girls exposed to radioactivity as infants in the most heavily contaminated areas also had a 6 percent higher risk of developing breast cancer, and a 4 percent higher risk of developing cancers that cause tumors. Meanwhile, boys exposed as infants had a 7 percent higher chance of developing leukemia.


The study also said that about a third of the emergency workers who remained to try to stabilize the Fukushima Daiichi plant were estimated to have a slightly increased risk of developing leukemia, thyroid cancer and other types of cancer.


There would most likely be no observable increase in cancer rates for the general population in Fukushima Prefecture outside the most contaminated zones, in the rest of Japan and the world, the report said. It also said that the radiological fallout from the disaster was not expected to cause increases in miscarriages, stillbirths and other physical or mental disabilities.


Still, the study said that the psychological toll of the disaster, including the stresses of evacuation, were harmful to health and should color the Japanese government’s response.


The W.H.O. report “underlines the need for long-term health monitoring of those who are at high risk, along with the provision of necessary medical follow-up and support services,” Dr. Maria P. Neira, the Geneva-based organization’s director for public health and environment, said in a news release. “This will remain an important element in the public health response to the disaster for decades,” she said.


Dr. Angelika Tritscher, acting director for the food safety and zoonoses department at the health agency, said, “In addition to strengthening medical support and services, continued environmental monitoring, in particular of food and water supplies, backed by the enforcement of existing regulations, is required to reduce potential radiation exposure in the future.” .


Matthew L. Wald contributed reporting from Washington.



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HP sells webOS operating system to LG Electronics






SAN FRANCISCO (Reuters) – Hewlett-Packard Co said on Monday it will sell the webOS operating system to South Korea’s LG Electronics Inc, unloading the smartphone software it acquired through a $ 1.2 billion acquisition of Palm in 2010.


LG will use the operating software, used in now-defunct Palm smartphones years ago, for its “smart” or Internet-connected TVs. The Asian electronics company had worked with HP on WebOS before offering to buy it outright.






Under the terms of their agreement, LG acquires the operating software’s source code, associated documentation, engineering talent, various associated websites, and licenses under HP’s intellectual property including patents covering fundamental operating system and user interface technology.


HP will retain the patents and all the technology relating to the cloud service of webOS, HP Chief Operating Officer Bill Veghte said in an interview.


“As we looked at it, we saw a very compelling IP that was very unique in the marketplace,” he said, adding that HP has already had a partnership with LG on webOS before the deal was announced.


“As a result of this collaboration, LG offered to acquire the webOS operating system technology,” Veghte said.


Skott Ahn, President and CTO, LG Electronics, said the company will incorporate the operating system in the Smart TV line-up first “and then hopefully all the other devices in the future.”


Both companies declined to reveal the terms of the deal.


LG will keep the WebOS team in Silicon Valley and, for now, will continue to be based out of HP offices, Ahn said.


HP opened its webOS mobile operating system to developers and companies in 2012 after trying to figure out how to recoup its investment in Palm, one of the pioneers of the smartphone industry.


The company had tried to build products based on webOS with the now-defunct TouchPad tablet its flagship product.


HP launched and discontinued the TouchPad in 2010, a little over a month after it hit store shelves with costly fanfare after it saw poor demand for a tablet priced on par with Apple’s dominant iPad.


WebOS is widely viewed as a strong mobile platform, but has been assailed for its paucity of applications, an important consideration while choosing a mobile device.


(Additional reporting By Paul Sandle and Alistair Barr; Editing by Gerald E. McCormick, Tim Dobbyn and M.D. Golan)


Tech News Headlines – Yahoo! News





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The Jennifer Lawrence Guide to Being Awesome





Wish you were J.Law? Join the club. Here, the rules for living a fabulous life like hers (Disclosure: killer body and Oscar statue not included)








Credit: Sebastian Mlynarski



Updated: Wednesday Feb 27, 2013 | 03:00 PM EST
By: Zoë Ruderman




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Huge study: 5 mental disorders share genetic links


WASHINGTON (AP) — The largest genetic study of mental illnesses to date finds five major disorders may not look much alike but they share some gene-based risks. The surprising discovery comes in the quest to unravel what causes psychiatric disorders and how to better diagnose and treat them.


The disorders — autism, attention deficit-hyperactivity disorder or ADHD, bipolar disorder, major depressive disorder and schizophrenia — are considered distinct problems. But findings published online Wednesday suggest they're related in some way.


"These disorders that we thought of as quite different may not have such sharp boundaries," said Dr. Jordan Smoller of Massachusetts General Hospital, one of the lead researchers for the international study appearing in The Lancet.


That has implications for learning how to diagnose mental illnesses with the same precision that physical illnesses are diagnosed, said Dr. Bruce Cuthbert of the National Institute on Mental Health, which funded the research.


Consider: Just because someone has chest pain doesn't mean it's a heart attack; doctors have a variety of tests to find out. But there's no blood test for schizophrenia or other mental illnesses. Instead, doctors rely on symptoms agreed upon by experts. Learning the genetic underpinnings of mental illnesses is part of one day knowing if someone's symptoms really are schizophrenia and not something a bit different.


"If we really want to diagnose and treat people effectively, we have to get to these more fine-grained understandings of what's actually going wrong biologically," Cuthbert explained.


Added Mass General's Smoller: "We are still in the early stages of understanding what are the causes of mental illnesses, so these are clues."


The Psychiatric Genomics Consortium, a collaboration of researchers in 19 countries, analyzed the genomes of more than 61,000 people, some with one of the five disorders and some without. They found four regions of the genetic code where variation was linked to all five disorders.


Of particular interest are disruptions in two specific genes that regulate the flow of calcium in brain cells, key to how neurons signal each other. That suggests that this change in a basic brain function could be one early pathway that leaves someone vulnerable to developing these disorders, depending on what else goes wrong.


For patients and their families, the research offers no immediate benefit. These disorders are thought to be caused by a complex mix of numerous genes and other risk factors that range from exposures in the womb to the experiences of daily life.


"There may be many paths to each of these illnesses," Smoller cautioned.


But the study offers a lead in the hunt for psychiatric treatments, said NIMH's Cuthbert. Drugs that affect calcium channels in other parts of the body are used for such conditions as high blood pressure, and scientists could explore whether they'd be useful for psychiatric disorders as well.


The findings make sense, as there is some overlap in the symptoms of the different disorders, he said. People with schizophrenia can have some of the same social withdrawal that's so characteristic of autism, for example. Nor is it uncommon for people to be affected by more than one psychiatric disorder.


___


Online:


http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60223-8/abstract


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Wall Street gains on Bernanke comments, S&P above 1,500

NEW YORK (Reuters) - Stocks rose on Wednesday, with major indexes posting their best daily gains since early January, as Federal Reserve Chairman Ben Bernanke remained steadfast in supporting the Fed's stimulus policy and data pointed to economic improvement.


In a second day before a congressional committee, Bernanke defended the Fed's buying of bonds to keep interest rates low to boost growth. The market's jump of more than 1 percent also came on better-than-expected data on business spending plans and the housing market.


Bernanke's remarks helped the market rebound from its worst decline since November and put the S&P 500 index back above 1,500, a closely watched level that has been technical support until recently. The Dow Jones industrial average <.dji> closed at a level not seen since 2007 as it again pulled within striking distance of an all-time high.


Speaking before the House Financial Services Committee, Bernanke downplayed signs of internal divisions at the Fed, saying the policy of quantitative easing, or QE, has the support of a "significant majority" of top central bank officials.


Bernanke removed a headwind from markets arising from concerns the Fed's quantitative easing might end earlier than anticipated. Doubts about the Fed's intentions had broken a seven-week streak of gains by stocks.


"The Fed continues to encourage risk-taking in markets, which is a powerful tool that makes the danger not being long stocks, not in being too long," said Tom Mangan, a money manager at James Investment Research Inc in Xenia, Ohio.


The Dow Jones industrial average <.dji> was up 176.32 points, or 1.27 percent, at 14,076.45. The Standard & Poor's 500 Index <.spx> was up 19.07 points, or 1.27 percent, at 1,516.01. The Nasdaq Composite Index <.ixic> was up 32.61 points, or 1.04 percent, at 3,162.26.


Pending home sales jumped 4.5 percent in January, three times the rate of growth that had been expected. While orders for durable goods fell more than expected in January, non-defense capital goods orders excluding aircraft - a closely watched proxy for business spending plans - showed the biggest gain since December 2011.


About 74 percent of stocks traded on the New York Stock Exchange closed higher while 64 percent of Nasdaq-listed shares closed up.


The S&P turned very slightly higher on the week, recovering from the index's biggest daily drop since November on Monday. That drop came on concerns over Italy's election, as well as over sequestration - U.S. government budget cuts that will take effect starting on Friday if lawmakers fail to reach an agreement on spending and taxes.


The index had climbed 6.3 percent for the year before pulling back on concerns about Fed policy and inconclusive elections in Italy, which rekindled fears of a new euro zone debt crisis.


"While the rally remains intact and there are reasons to be long-term bullish here, there are also reasons to not be surprised if we get a correction," said Mangan, who helps oversee $3.7 billion.


In earnings news, Priceline.com gained 2.6 percent to $695.91 after reporting adjusted earnings that beat expectations. TJX Cos Inc jumped 2.5 percent to $44.75 after the retail chain operator posted higher fourth-quarter results.


The S&P retail index <.spxrt> climbed 1.6 percent.


Target Corp offered a cautious outlook for consumer spending in 2013 following a weak holiday quarter. The stock dipped 1.1 percent to $63.32.


First Solar Inc plunged 14 percent to $27.04 after failing to give a full-year earnings and sales outlook, though it also swung to a quarterly profit.


Groupon Inc plunged 21 percent to $4.70 after the bell after reporting its fourth-quarter results.


With 93 percent of the S&P 500 companies having reported results so far, 69.5 percent beat profit expectations, compared with a 62 percent average since 1994 and 65 percent over the past four quarters, according to Thomson Reuters data.


Fourth-quarter earnings for S&P 500 companies are estimated to have risen 6.2 percent, according to the data, above a 1.9 percent forecast at the start of the earnings season.


About 6.23 billion shares changed hands on the New York Stock Exchange, the Nasdaq and NYSE MKT, slightly below the daily average so far this year of about 6.48 billion shares.


(Editing by Nick Zieminski and Kenneth Barry)



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IHT Rendezvous: Eve Best Returns to the Globe, This Time as a Director

LONDON — The recent press conference announcing the 2013 season at Shakespeare’s Globe on one level seemed like variations on an ongoing theme.

A onetime Falstaff at this address, Roger Allam, is returning to open the season as Prospero in “The Tempest,” directed by Jeremy Herrin, while the perennial favorite, “A Midsummer Night’s Dream,” will be seen in May in a new staging, this time from the Globe’s artistic director, Dominic Dromgoole. The 2011 Olivier winner Michelle Terry (“Tribes”) will play Titania.

The international season that so galvanized the space for six weeks last spring will return in a greatly pared-down form, and there will be three new plays, including one, “Blue Stockings” by Jessica Swale, that tells of the first female students at Cambridge University.

But it’s the last in the trio of supernaturally charged Shakespeares that promises to break fresh theatrical ground. In what represents her first-ever stab (you’ll forgive the word in context) at directing, the much-laureled actress Eve Best will stage a new production in June of “Macbeth.” Joseph Millson and Samantha Spiro have signed on as the murderous couple at the play’s black, bleak heart.

What prompted one of the most accomplished stage performers of her generation (an actress with an Olivier Award and two Tony nominations) to make the shift? The answer was arrived at via a lengthy phone call to a remote island in Denmark, where Ms. Best, 41, is currently filming “Someone You Love” for the director Lars von Trier’s Zentropa production group. This film’s specific director is Pernille Fischer Christensen.

To hear Ms. Best describe it, she thought her time at the Globe was finished, at least for a while, following a triumphant 2011 production of “Much Ado About Nothing” in which she played Beatrice opposite Charles Edwards’s no less witty and scintillating Benedick. (That staging opened within days of a contrasting commercial production of the same play, with David Tennant and Catherine Tate, and trumped its starrier competitor hands down.)

“I love the Globe so much,” Ms. Best recalled, “and wanted any excuse to spend some time there, having played Beatrice which was just my most favorite part ever. But I did think I was sort of running out of parts to play for a little while until I get into the world of Cleopatra and those kinds of parts” — that’s to say, Shakespeare’s more senior women.

But all that was before Mr. Dromgoole surprised Ms. Best with an offer to take on the directing of the Shakespeare tragedy in which she had made her Globe debut in 2001, opposite Jasper Britton.

“I put myself forward to direct something thinking that they might say yes in a couple of years and that if they did say yes they might start me off with something light or something simpler or more obscure,” she said.

“I was not prepared for them to turn around and say, ‘Yes, all right, and what about “Macbeth?”’ Ms. Best continued, delight evident in her voice. “It took me back. My first response was: ‘Absolutely no way; you must be kidding!’”

The play is particularly challenging at the Globe. Open to the elements, the theater is a tricky fit for a text suffused with darkness, and it can be hard to focus the gathering intensity of the Macbeths’ toxic rise and fall.

“We are in the broad daylight and the open air,” Ms. Best acknowledged, “and that particular circular shape is certainly going to have a significant effect on the kind of production ours is. We can’t set it in the dark with candles, so we just have to embrace what it is that the Globe will give us: I’m very interested in just seeing the play as clearly as we possibly can and focusing on the human relationships within it.”

Mr. Dromgoole for his part said he thought Ms. Best would be able to meet the play head-on without lots of additional mumbo jumbo. “I wanted someone who I thought could just let [“Macbeth”] play itself rather than forcing it down a tunnel of darkness.”

As it happens, Ms. Best has firsthand knowledge of both central roles. In addition to acting Lady Macbeth at the Globe, she participated in workshops of the play in New York with the Scottish actor Alan Cumming in which she played the title role opposite Mr. Cumming’s Lady. Mr. Cumming is soon to open his own solo take on the play on Broadway.

(For those collecting “Macbeths,” the West End is now hosting the film actor James McAvoy in a modern-dress, gory, commendably visceral version. That one, at the Trafalgar Studios, will have finished roughly two months before Ms. Best’s begins.)

“What’s really lovely about this play — and all Shakespeare plays obviously — is that they are so magnificently and eminently flexible,” said Ms. Best, who was sounding in no way deterred by other productions arriving before hers. “They can encompass 6 or 8 or 10 productions all going on at the same time, all equally fascinating, all equally interesting, with all kinds of different approaches.”

Nor was she sounding spooked by a famously hexed play that has on occasion brought disaster in its wake. Whereas theater lore, for instance, often insists that those involved with this text refer to it as “the Scottish play,” Ms. Best was having none of that.

“I’ve been saying it like mad,” she said. “If we’re going to be working on it for two months, life’s too short to be worried.”

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Blake Lively and Ryan Reynolds Visit Pediatric Patients















02/26/2013 at 07:00 PM EST







Reynolds and Lively visit with patients


Courtesy Health Sciences North


Why cradle an Oscar when you can cuddle a baby?

While most of Hollywood's A-list stars celebrated at the Academy Awards on Sunday, newlyweds Ryan Reynolds and Blake Lively ditched the glamorous affair and spent time cheering up sick patients at a local hospital in Canada.

Reynolds, 36, and Lively, 25, made a visit to the Health Sciences North's pediatric unit in Sudbury, Ontario. Lively is visiting Reynolds while he is in town filming the drama Queen of The Night.

"I can tell you the visit was really appreciated by the kids, their parents and the staff on the unit," hospital spokesperson Dan Lessard tells Sudbury Northern Life. "Mr. Reynolds and Ms. Lively were wonderful with the children."

Sudbury resident Sarah Lavallee, who is watching over her 3-month-old son at the hospital, was grateful for the stars' visit.

"Ryan and Blake were both very kind to us. They introduced themselves right away and asked how my son was doing," Lavallee tells the paper. "I really appreciated both Ryan and Blake giving me something to smile about at such a difficult time."

The couple, who tied the knot last September, made their rounds chatting with multiple families and even took turns holding an infant.

Blake Lively and Ryan Reynolds Visit Pediatric Patients| Good Deeds, Blake Lively, Ryan Reynolds

Ryan Reynolds and Blake Lively

Courtesy Health Sciences North

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C. Everett Koop, 'rock star' surgeon general, dies


NEW YORK (AP) — Dr. C. Everett Koop has long been regarded as the nation's doctor— even though it has been nearly a quarter-century since he was surgeon general.


Koop, who died Monday at his home in Hanover, N.H., at age 96, was by far the best known and most influential person to carry that title. Koop, a 6-foot-1 evangelical Presbyterian with a biblical prophet's beard, donned a public health uniform in the early 1980s and became an enduring, science-based national spokesman on health issues.


He served for eight years during the Reagan administration and was a breed apart from his political bosses. He thundered about the evils of tobacco companies during a multiyear campaign to drive down smoking rates, and he became the government's spokesman on AIDS when it was still considered a "gay disease" by much of the public.


"He really changed the national conversation, and he showed real courage in pursuing the duties of his job," said Chris Collins, a vice president of amfAR, the Foundation for AIDS Research.


Even before that, he had been a leading figure in medicine. He was one of the first U.S. doctors to specialize in pediatric surgery at a time when children with complicated conditions were often simply written off as untreatable. In the 1950s, he drew national headlines for innovative surgeries such as separating conjoined twins.


His medical heroics are well noted, but he may be better remembered for transforming from a pariah in the eyes of the public health community into a remarkable servant who elevated the influence of the surgeon general — if only temporarily.


"He set the bar high for all who followed in his footsteps," said Dr. Richard Carmona, who served as surgeon general a decade later under President George W. Bush.


Koop's religious beliefs grew after the 1968 death of his son David in a mountain-climbing accident, and he became an outspoken opponent of abortion. His activism is what brought him to the attention of the administration of President Ronald Reagan, who decided to nominate him for surgeon general in 1981. Though once a position with real power, surgeon generals had been stripped of most of their responsibilities in the 1960s.


By the time Koop got the job, the position was kind of a glorified health educator.


But Koop ran with it. One of his early steps involved the admiral's uniform that is bestowed to the surgeon general but that Koop's predecessors had worn only on ceremonial occasions. In his first year in the post, Koop stopped wearing his trademark bowties and suit jackets and instead began wearing the uniform, seeing it as a way to raise the visual prestige of the office.


In those military suits, he surprised the officials who had appointed him by setting aside his religious beliefs and feelings about abortion and instead waging a series of science-based public health crusades.


He was arguably most effective on smoking. He issued a series of reports that detailed the dangers of tobacco smoke, and in speeches began calling for a smoke-free society by the year 2000. He didn't get his wish, but smoking rates did drop from 38 percent to 27 percent while he was in office — a huge decline.


Koop led other groundbreaking initiatives, but perhaps none is better remembered than his work on AIDS.


The disease was first identified in 1981, before Koop was officially in office, and it changed U.S. society. It destroyed the body's immune system and led to ghastly death, but initially was identified in gay men, and many people thought of it as something most heterosexuals didn't have to worry about.


U.S. scientists worked hard to identify the virus and work on ways to fight it, but the government's health education and policy efforts moved far more slowly. Reagan for years was silent on the issue. Following mounting criticism, Reagan in 1986 asked Koop to prepare a report on AIDS for the American public.


His report, released later that year, stressed that AIDS was a threat to all Americans and called for wider use of condoms and more comprehensive sex education, as early as the third grade. He went on to speak frankly about AIDS in an HBO special and engineered the mailing of an educational pamphlet on AIDS to more than 100 million U.S. households in 1988.


Koop personally opposed homosexuality and believed sex should be saved for marriage. But he insisted that Americans, especially young people, must not die because they were deprived of explicit information about how HIV was transmitted.


Koop's speeches and empathetic approach made him a hero to a wide swath of America, including public health workers, gay activists and journalists. Some called him a "scientific Bruce Springsteen." AIDS activists chanted "Koop, Koop" at his appearances and booed other officials.


"I was walking down the street with him one time" about five years ago, recalled Dr. George Wohlreich, director of the College of Physicians of Philadelphia, a medical society with which Koop had longstanding ties. "People were yelling out, 'There goes Dr. Koop!' You'd have thought he was a rock star."


Koop angered conservatives by refusing to issue a report requested by the Reagan White House, saying he could not find enough scientific evidence to determine whether abortion has harmful psychological effects on women.


He got static from some staff at the White House for his actions, but Reagan himself never tried to silence Koop. At a congressional hearing in 2007, Koop spoke about political pressure on the surgeon general post. He said Reagan was pressed to fire him every day.


After his death was reported Monday, the tributes poured forth, including a statement from New York Mayor Michael Bloomberg, who has made smoking restrictions a hallmark of his tenure.


"The nation has lost a visionary public health leader today with the passing of former Surgeon General C. Everett Koop, who was born and raised in Brooklyn," Bloomberg said. "Outspoken on the dangers of smoking, his leadership led to stronger warning labels on cigarettes and increased awareness about second-hand smoke, creating an environment that helped millions of Americans to stop smoking — and setting the stage for the dramatic changes in smoking laws that have occurred over the past decade."


Dr. Anthony Fauci of the National Institutes of Health taught Koop what was known about AIDS during quiet after-hours talks in the early 1980s and became a close friend.


"A less strong person would have bent under the pressure," Fauci said. "He was driven by what's the right thing to do."


Carmona, a surgeon general years later, said Koop was a mentor who preached the importance of staying true to the science in speeches and reports — even when it made certain politicians uncomfortable.


"We remember him for the example he set for all of us," Carmona said.


Koop's nomination originally was met with staunch opposition. Women's groups and liberal politicians complained Reagan had selected him only because of his conservative views, especially his staunch opposition to abortion.


Foes noted that Koop traveled the country in 1979 and 1980 giving speeches that predicted a progression "from liberalized abortion to infanticide to passive euthanasia to active euthanasia, indeed to the very beginnings of the political climate that led to Auschwitz, Dachau and Belsen."


But Koop, a devout Presbyterian, was confirmed as surgeon general after he told a Senate panel he would not use the post to promote his religious ideology. He kept his word and eventually won wide respect with his blend of old-fashioned values, pragmatism and empathy.


Koop was modest about his accomplishments, saying before leaving office in 1989, "My only influence was through moral suasion."


The office declined after that. Few of his successors had his speaking ability or stage presence. Fewer still were able to secure the support of key political bosses and overcome the meddling of everyone else. The office gradually lost prestige and visibility, and now has come to a point where most people can't name the current surgeon general. (It's Dr. Regina Benjamin.)


Even after leaving office, Koop continued to promote public health causes, from preventing childhood accidents to better training for doctors.


"I will use the written word, the spoken word and whatever I can in the electronic media to deliver health messages to this country as long as people will listen," he promised.


In 1996, he rapped Republican presidential hopeful Bob Dole for suggesting that tobacco was not invariably addictive, saying Dole's comments "either exposed his abysmal lack of knowledge of nicotine addiction or his blind support of the tobacco industry."


He maintained his personal opposition to abortion. After he left office, he told medical students it violated their Hippocratic oath. In 2009, he wrote to Senate Majority Leader Harry Reid, urging that health care legislation include a provision to ensure doctors and medical students would not be forced to perform abortions. The letter briefly set off a security scare because it was hand delivered.


Koop served as chairman of the National Safe Kids Campaign and as an adviser to President Bill Clinton's health care reform plan.


Worried that medicine had lost old-fashioned caring and personal relationships between doctors and patients, Koop opened an institute at Dartmouth College in New Hampshire to teach medical students basic values and ethics. He also was a part-owner of a short-lived venture, drkoop.com, to provide consumer health care information via the Internet.


Koop was the only son of a Manhattan banker and the nephew of a doctor. He said by age 5 he knew he wanted to be a surgeon and at age 13 he practiced his skills on neighborhood cats. He attended Dartmouth, where he received the nickname Chick, short for "chicken Koop." It stuck for life.


He received his medical degree at Cornell Medical College, choosing pediatric surgery because so few surgeons practiced it. In 1938, he married Elizabeth Flanagan, the daughter of a Connecticut doctor. They had four children. Koop's wife died in 2007, and he married Cora Hogue in 2010.


He was appointed surgeon-in-chief at Children's Hospital in Philadelphia and served as a professor at the University of Pennsylvania School of Medicine. He pioneered surgery on newborns and successfully separated three sets of conjoined twins. He won national acclaim by reconstructing the chest of a baby born with the heart outside the body.


Although raised as a Baptist, he was drawn to a Presbyterian church near the hospital, where he developed an abiding faith. He began praying at the bedside of his young patients — ignoring the snickers of some of his colleagues.


___


Contributing to this report were Associated Press writers Wilson Ring in Montpelier, Vt.; Jeff McMillan in Philadelphia; and AP Medical Writer Lauran Neergaard in Washington.


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