Wisconsin beats No. 3 Michigan 65-62 in OT

MADISON, Wis. (AP) — When Ben Brust tied the game at the end of regulation with a shot just from just inside midcourt, his teammate Mike Bruesewitz looked over at Wisconsin coach Bo Ryan and saw something unusual.

His coach had both his arms in the air.

"You know when he shows some emotion, you've done something pretty special," Bruesewitz said.

Brust hit a tie-breaking 3-pointer with less than 40 seconds left in overtime as Wisconsin beat No. 3 Michigan 65-62 on Saturday.

"It was awesome, something I'll remember forever, and I'm sure a lot of people will," Brust said of the game, which ended with students storming the court and Bruesewitz taking the public address announcer's microphone to thank the crowd as students celebrated around him.

The Wolverines became the third top three team to lose this week as No. 1 Indiana lost to Illinois and No. 2 Florida was beaten by Arkansas. This should be the sixth straight week with a different No. 1 in The Associated Press' Top 25.

Brust's shot at the end of regulation was a dramatic turn of events for Wisconsin (17-7, 8-3 Big Ten) and a soul crusher for Michigan (21-3, 8-3).

Just moments earlier, Tim Hardaway Jr. hit a contested 3-pointer to put the Wolverines up 65-62 with less than 3 seconds left in regulation.

Following a timeout, Bruesewitz passed up his first option in the inbounds play and hit Brust in stride. The guard took one dribble across halfcourt and launched the shot, which hit nothing but net.

Ryan said the play was drawn up to see how Michigan defended the first cutter, Brust read the defense and reacted.

"The best thing was Mike's pass on the dime on the run, didn't have to reach back for it, able to catch it all in one motion," Ryan said.

Michigan still had fouls to give before the shot, and coach John Beilein said the order coming out of the timeout was to foul. He also put Caris LeVert on Brust to bolster the defense.

"We were definitely fouling, wanted to keep everyone in front of us and (Brust) turned the corner on (LeVert) just enough that he couldn't foul him," Beilein said. "I thought we had them once they couldn't get their initial guy.

"With Caris' quickness, we thought he could get there, but he didn't."

For all the fireworks in the final 3 seconds, the teams only managed seven points in overtime, including Brust's winning 3-pointer.

Following Brust's shot, Hardaway couldn't connect on his drive to the hoop on the next Michigan possession, and Glenn Robinson III fouled Jared Berggren on the rebound.

The Wolverines went to a full-court press with two more fouls to give. But the Badgers broke the press, and Michigan had to foul twice more to finally put Ryan Evans on the free throw line.

Evans, who shoots less than 43 percent from the line, missed the front end of a 1-and-1, and Burke couldn't connect in a rushed final possession for the Wolverines.

It was another grinding win for the Badgers keyed by their defense. Michigan came in as one of the top scoring teams in the country at almost 78 points per game. But Wisconsin held Michigan to less than 40 percent shooting from the field, including 5 of 18 from beyond the 3-point line.

Michigan was 1 for 7 from the field in overtime, and the offensive futility was highlighted by one sequence in which Mitch McGary stole the ball outside the 3-point line and drove the other way only to miss the layup with Berggren defending the rim.

Beilein said the Wolverines missed out on 14 points thanks to missed layups.

"I'm not talking about when they're really contesting," Beilein said. "I'm talking about we had the ball, the basket and us, and it didn't go in."

Brust scored 14 points for the Badgers, while Berggren added 13 and eight rebounds. Sam Dekker scored 12 points, while Evans finished with 11 points and nine rebounds.

Burke scored 19 points to lead Michigan, but needed 21 shots to do it. Hardaway added 18, and McGary had 12 points and eight rebounds.

It was the second straight game for both teams to go past regulation after the Badgers beat Iowa 74-70 in double overtime on Wednesday and Michigan downed Ohio State 76-74 in overtime on Tuesday.

Several Wisconsin players said consecutive overtime games exemplified their will to win even as critics contend they're not talented enough, not fast enough and, as Bruesewitz said he's seen on Twitter, not good-looking enough.

"We have a group of guys in that locker room that believe and is going to fight until the end until you tell us we can't play any more basketball," Berggren said. "We just find a way to get it done."

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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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Business Week in Pictures

Phil Libin, the chief executive of Evernote, during a staff meeting at Evernote’s headquarters in Redwood City, Calif. Evernote is among the privately held Silicon Valley start-ups that are worth more than $1 billion. An unprecedented number of high technology start-ups, easily 25 and possibly exceeding 40, have crossed that threshold. Many employees are quietly growing rich, or at least building a big cushion against a crash, as they sell shares to outside investors. Airbnb, Pinterest, SurveyMonkey and Spotify are among the better-known privately held companies that have reached $1 billion.

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U.S. Use of Mexican Battery Recyclers Is Faulted

United States companies are sending spent lead batteries to recycling plants in Mexico that do not meet American environmental standards, according to an environmental agency created under the North American Free Trade Agreement, putting Mexican communities at risk.

In a blistering report submitted this week, the agency, the Commission for Environmental Cooperation, notes that the United States does not fully follow procedures common among developed nations that treat international battery shipments as hazardous waste. It faults environmental agencies on both sides of the border for lapses in regulation and enforcement. Cross-border trade in lead batteries increased by up to 525 percent from 2004 to 2011, the report said.

The report, which has been circulating in draft form, has been forwarded to the governments of the United States, Canada and Mexico, which have 60 days to object to its publication. An estimated 20 percent of lead acid batteries from the United States now go to Mexico for recycling, according to trade statistics.

“There needs to be better coordination between government agencies and better cross-border tracking,” said Evan Lloyd, who was the agency’s executive director until late last year and oversaw the yearlong study.

The report highlighted a number of shortcomings: Customs data on the number of batteries crossing the border did not mesh with counts by the United States Environmental Protection Agency. Though the E.P.A. requires notice of batteries leaving the United States, there was no effort to make sure that they had arrived at qualified recyclers in Mexico. The data that battery companies sent to the E.P.A. about exports consisted of “piles of paper,” Mr. Lloyd said, and it was never amassed into an electronic database that would be “useful to regulators.”

Almost all lead acid batteries used in the United States are recycled to extract the lead for reuse because lead is a dangerous pollutant and because it is a valuable commodity. Lead batteries are used in vehicles, cellphone towers and wind turbines.

Since 2008, new United States limits on lead pollution have made domestic recycling complicated and costly. That has helped propel the recycling trade to Mexico, both legally and illegally, environmental groups say, because that country has less stringent limits for lead pollution, and far less vigorous enforcement.

“There’s a pretty consistent pattern suggesting that exports are the direct result of U.S. emissions standards,” said Perry Gottesfeld, executive director of Occupational Knowledge International, which has led the campaign against lead poisoning internationally. Mr. Gottesfeld noted that a Mexican plant owned by a major American recycler, Johnson Controls International, puts out more than 30 times as much lead emissions as its newest plant in the United States.

“What Mexico needs to do is to get its recycling up to U.S. standards, and the U.S. needs to do a much better job of tracking batteries overseas,” he said. In an e-mail, Johnson Controls, based in Milwaukee, said it was “modernizing and reinvesting” in the Mexican facility, acquired in 2005, “to reduce its environmental footprint.”

The report was initiated in response to a report by Occupational Knowledge International and Fronteras Comunes, a Mexican environmental group, as well as to an investigative article in The New York Times, Mr. Lloyd said. Soil collected by The Times in a school playground near a recycling plant outside Mexico City were found to have lead levels five times those allowed in the United States.

Lead poisoning causes high blood pressure, kidney damage and abdominal pain in adults, and serious developmental delays and behavioral problems in young children. When batteries are broken for recycling, the lead is released as dust and, during melting, as lead-laced emissions.

In the United States, recyclers operate in highly mechanized, tightly sealed plants, with smokestack scrubbers and extensive monitors to detect lead release. Plants in Mexico vary greatly in safety standards, and in some, the recycling process is little more than men with hammers smashing batteries and melting down their contents in furnaces.

In recent months, there have been new efforts to curb the flow of batteries south of the border, though many battery makers have fought that. In response to a draft of the report released late last year, Battery Council International, an industry group, said it opposed “the creation of additional burdensome certification programs.”

Last year, the United States General Services Administration, which is responsible for federal vehicles, asked ASTM International, an independent standards agency, to explore a voluntary standard for battery recycling.

But that effort came to naught after the proposal was voted down at an open meeting attended by representatives from industry, government and environmental groups in December. Of the 103 people at the meeting, 49 worked for Johnson Controls.

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Super Bowl blackout was caused by electrical relay

NEW ORLEANS (AP) — The company that supplied electricity to the Super Bowl says the blackout that halted the big game was caused by a device it installed specially to prevent a power failure.

But the utility stopped short of taking all the blame and said Friday that it was looking into whether the electrical relay at fault had a design flaw or a manufacturing defect.

The relay had been installed as part of a project begun in 2011 to upgrade the electrical system serving the Superdome in anticipation of the championship game. The equipment was supposed to guard against problems in the cable that links the power grid with lines that go into the stadium.

"The purpose of it was to provide a newer, more advanced type of protection for the Superdome," Dennis Dawsey, an executive with Entergy Corp., told members of the City Council. Entergy is the parent company of Entergy New Orleans, the city's main electric utility.

Entergy officials said the relay functioned with no problems during January's Sugar Bowl and other earlier events. It has been removed and will be replaced.

All systems at the Superdome are now working, and the stadium was to host a major Mardi Gras event Saturday night, said Doug Thornton, an executive with SMG, the company that manages the stadium for the state.

The relay was installed in a building near the stadium known as "the vault," which receives a line directly from a nearby Entergy substation. Once the line reaches the vault, it splits into two cables that go into the Superdome.

Sunday's power failure cut lights to about half of the stadium, halting play between the Baltimore Ravens and San Francisco 49ers and interrupting the nation's most-watched sporting event for 34 minutes.

Not long after the announcement, the manufacturer of the relay, Chicago-based S&C Electric Co., released a statement saying that the blackout occurred because system operators had put the relay's so-called trip setting too low to allow the device to handle the incoming electric load.

The equipment was owned and installed by Entergy New Orleans.

"If higher settings had been applied, the equipment would not have disconnected the power," said Michael J.S. Edmonds, vice president of strategic solutions for S&C.

In a follow-up statement, Entergy said that tests conducted by S&C and Entergy on the two relays at the Superdome showed that one worked as expected, the other did not.

Entergy spokesman Mike Burns said both relays had the same trip setting.

Entergy's announcement came shortly before company officials went before a committee of the City Council, which is the regulatory body for the company.

During the committee hearing, council member Susan Guidry asked Entergy executives whether they were "fairly certain" that the relay was faulty.

"That is correct," Dawsey said.

However, when asked if the outage was caused by the design or a defect in a part of the equipment, Entergy New Orleans CEO Charles Rice said that had not been determined.

"The equipment did not function properly," Rice said. "At this particular time, based upon our analysis, we cannot say definitively that there was a defect in design. What we do know is that the equipment for some unknown reason, at this particular time, did not react the way that it should have."

Asked if Entergy and SMG still plan to hire a third-party investigator to get to the bottom of the cause, Rice said that possibility remains open.

"We'll work closely with SMG, and if there is a need for a third-party investigation, we will do that," Rice said, adding that Entergy was also working with the relay manufacturer.

Shabab Mehraeen, an assistant professor of electrical engineering at Louisiana State University, said relays are common electrical fixtures in businesses and massive facilities such as the Superdome.

"They are designed to keep a problem they sense from becoming something bigger, like a fire or catastrophic event," he said.

The devices vary in size. Mehraeen, who was not familiar with the relay at the Superdome, said he "wouldn't be surprised if it was bigger than a truck."

The reasons the devices fail are the subject of much academic research into the interaction of relays with the complex electrical systems they regulate.

"It's not unusual for them to have problems," Mehraeen said. "They can be unpredictable, despite national testing standards recommended by manufacturers."

Entergy and SMG had both upgraded lines and equipment in the months leading up to the Super Bowl. Rice said the new gear, with the faulty relay, was installed as part of a $4.2 million upgrade by Entergy that included a new power line dedicated solely to the stadium.

In a separate project, SMG replaced lines coming into the stadium after managers expressed concerns the Superdome might be vulnerable to a power failure like the one that struck Candlestick Park during an NFL game in 2011.

Thornton stressed Friday that the dome was drawing only about two-thirds of its power capacity Super Bowl night. He said typical NFL games in late August or September can draw a little more.

Friday's announcement appeared to absolve Superdome officials of any missteps in the blackout.

City officials had worried that the Super Bowl outage might harm New Orleans' chances of getting another NFL championship game.

But NFL Commissioner Roger Goodell downplayed that possibility, saying the league planned to keep New Orleans in its Super Bowl plans. Mayor Mitch Landrieu said the city intends to bid for the game again in 2018.

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Associated Press Writer Michael Kunzelman in New Orleans contributed to this report.

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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 brown 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.

Friday Feb. 8 4:13 p.m. | Updated Thanks for all your responses. You can read about the winner at “Think Like a Doctor: A Confused and Terrified Patient Solved.”

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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.

Correction: The patient’s eyes were brown, not blue.

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DealBook: Southeastern Asset Management to Fight Dell's Takeover

7:44 p.m. | Updated One of the biggest investors in Dell said on Friday that it would oppose the company’s plans to go private, setting up a major potential roadblock for the biggest buyout since the financial crisis.

Southeastern Asset Management, Dell’s largest outside shareholder, argued in a letter to the board that the $24.4 billion takeover bid was too low.

The company’s founder, Michael S. Dell, and the investment firm Silver Lake, are offering $13.65 a share. Southeastern, which has an 8.5 percent stake in Dell, contends that the company is worth closer to $24 a share.

To block the “ill-advised transaction,” Southeastern laid out a range of possible tactics, including a proxy fight and lawsuits. The firm also pushed the board to “aggressively” look for alternative proposals. Dell has 45 days to solicit other bids as part of the so-called go-shop process.

A Dell spokesman said in a statement on Friday that a special committee of the company’s board had considered various options with the help of advisers before accepting the management buyout.

“Based on that work, the board concluded that the proposed all-cash transaction is in the best interests of stockholders,” said the spokesman, David Frink. “The transaction offers an attractive and immediate premium for stockholders and shifts the risks facing the business to the buyer group.”

The opposition highlights the conflict facing Dell and its investors.

Many shareholders bought the company at lofty prices, watching the value of their shares erode. Analysts estimated that Southeastern paid more than $20 a share on average, meaning that the asset management firm would lose over $800 million if the current deal was completed.

Still, the takeover values Dell at price that the company has not touched for months. Its stock has not reached $14 since late May, and it lingered below $10 for two months late last year.

The company also faces continued pressure in its operations. Its core PC business is ceding ground to lower-cost rivals, as well as new entrants like tablets and smartphones.

Additionally, its effort to sell servers to big companies has been hurt by the changing industry dynamics, including the move to cloud computing.

Management buyouts have long been regarded skeptically by investors. The concern is that they enrich executives at the expense of other shareholders. The takeovers of companies like J. Crew and Affiliated Computer Services spurred a number of lawsuits by irate investors.

Southeastern and its founder, O. Mason Hawkins, generally keep a low profile and shun the press. But the money manager, based in Memphis, has been more outspoken of late.

The firm stepped into the spotlight last year when it called on Chesapeake Energy to entertain takeover offers, after the company ran into financial difficulties and faced criticism for the compensation plan of its co-founder, Aubrey McClendon. Southeastern and another activist investor, Carl C. Icahn, eventually won seats on Chesapeake’s board. Last month, Mr. McClendon was forced to retire under pressure from the board.

In its letter to Dell’s board, Southeastern said that it would support a number of alternatives. The investor, for example, outlined a plan to pay out a special dividend to shareholders or a buyout that would allow existing investors to keep a piece of the company.

But Southeastern said the current deal, hashed out over six months, “falls significantly short,” adding that it “appears to be an effort to acquire Dell at a substantial discount to intrinsic value at the expense of public shareholders.”

Dell’s board was mindful of potential conflicts — legal and otherwise — that its founder faced in trying to buy back the company he founded nearly three decades ago. To assess the deal, it formed a special committee of its board, led by Alex J. Mandl, which was advised by two sets of financial advisers.

JPMorgan Chase served as the principal investment bank for the committee, negotiating with Silver Lake.

Evercore Partners is overseeing a 45-day go-shop period intended to flush out rival suitors for the company. The company itself was advised by Goldman Sachs.

To help further minimize conflicts, JPMorgan refrained from providing financing for the deal. And Evercore’s advisory fee is set up in a way that encourages the bank to find a higher bid.

“The go-shop process provides stockholders an opportunity to determine if there are alternatives that are superior to the present offer,” the Dell spokesman said in a statement.

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Russian Performers Support U.S. Adoptions

MOSCOW — A panel of respected figures from Russia’s art world issued an emotional appeal to President Vladimir V. Putin on Thursday to make an exception to a recent ban on adoptions by Americans, and allow children to join American parents they have already come to know.

Chulpan Khamatova, revered here for her charity work as well as her acting, spoke in front of a screen showing blown-up photographs of families whose adoptions have been halted. Beside her sat Beth Hettinger of Westfield, N.J., who flew to Russia to bring back Aleksei, who is 18 months old. Ms. Hettinger was scheduled to leave Russia without Aleksei on Friday.

“A child, even if he is very small, is already waiting for his mama to come and get him, and she does not come,” Ms. Khamatova said. “When he grows up he is told, ‘When you were small, this thing took place.’ This will happen, anyway. I think he will hate his country, and hate his motherland.”

She said she had visited children’s homes in Russia “where children lie in heaps, in huge wards,” and added: “Dear, respected president, dear, respected society, let’s make an exception. Our country is so big, and we always ignore the specific fates of people. Just once, let’s not ignore them.”

Ms. Khamatova, who has a husky voice and an unguarded manner, commands unusual moral authority in Russia, and shocked many in creative circles by agreeing to star in a campaign advertisement for Mr. Putin last year.

Her appeal on Thursday pointed to the passionate social divide over Mr. Putin’s decision to ban American adoptions, a response to American legislation aiming to punish Russian officials accused of corruption. While polling shows that the move met with approval in Russia’s heartland, people in Moscow were far more critical, and tens of thousands joined a protest march in January.

A few dozen children whose adoptive parents had already received a court order have been allowed to leave. Approximately 100 families have petitioned Russia’s government to allow adoptions that were near that stage when Mr. Putin signed the law. At a news conference on Thursday, Lesley Philips, of Croton-on-Hudson, N.Y., described a three-year process to retrieve a girl from a facility for children with special needs in Kaliningrad.

“Imagine that you have been pregnant for three years, and then you see your child, but you only spend a week with him, because someone takes her away,” she said. In an interview, she said she had raced to Russia at the end of the year — delayed because Hurricane Sandy held up a document — and was waiting for a court date when Mr. Putin signed the ban.

Ms. Philips is raising Misha, a child adopted from St. Petersburg, and said she wanted him to have a Russian sibling “so that they would have a bond.”

“When we met her, it just felt like our family was complete,” she said.

Among the Russian cultural figures who joined Ms. Khamatova in her appeal were Andrei Makarevich, lead singer of the rock band Time Machine, and the actors Yevgeny Mironov and Sergei Yursky.

Andrew Roth contributed reporting.

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NCAA wants Pa. gov's Penn State lawsuit dismissed

HARRISBURG, Pa. (AP) — The NCAA said Thursday a judge should throw out the federal antitrust lawsuit the governor filed against it over Penn State's $60 million fine and other penalties resulting from the Jerry Sandusky child molestation scandal.

College sports' governing body said in a filing that it disagrees with just about every allegation in the complaint against it initiated by Gov. Tom Corbett last month.

The NCAA said the penalties imposed under a July consent decree with the university are unrelated to regulation of economic activity, so antitrust law does not apply. It also argued Corbett lacks standing to sue and called his lawsuit "an inappropriate attempt to drag the federal courts into an intra-state political dispute."

"The remedial measures that Penn State agreed to were controversial, and have elicited strong feelings on all sides," the NCAA's lawyers wrote. "Some think they are too harsh, and some think they are too lenient. But none of those feelings have anything to do with the antitrust laws."

Corbett, a Republican, has said the NCAA overstepped its authority in punishing Penn State. His spokesman Nils Frederiksen said Thursday his lawyers will review the NCAA's filing "and respond as appropriate."

Corbett claimed in his lawsuit the NCAA "piled on" when it penalized Penn State over the Sandusky scandal. He asked that a federal judge throw out the sanctions, which include a four-year ban on bowl games, arguing that the measures have harmed students, business owners and others who had nothing to do with Sandusky's crimes.

The NCAA, in its federal court filing, disagreed.

"It is exceptionally unlikely that sanctions temporarily impairing one school's prowess on the football field would render any of these robust nationwide economic markets less competitive, such that Stanford suddenly could raise tuition, Michigan could offer fewer or less valuable football scholarships, or Notre Dame could charge more for branded football jerseys," the NCAA said in the new filing.

The case could define just how far the NCAA's authority extends. Up to now, the federal courts have allowed the organization broad powers to protect the integrity of college athletics.

Even if the factual claims in Corbett's lawsuit are true, the NCAA said, the matter involves Penn State, not the Pennsylvania residents on whose behalf the antitrust action was made.

Penn State said it had no role in the lawsuit. In fact, it agreed not to sue as part of the deal with the NCAA accepting the sanctions, which were imposed in July after an investigation found that football coach Joe Paterno and other top officials hushed up sexual-abuse allegations against Sandusky, a former member of Paterno's staff, for more than a decade for fear of bad publicity.

Sandusky, who's in his late 60s, was convicted in June of sexually abusing 10 boys, some of them on Penn State's campus. He is serving a 30- to 60-year prison sentence but insists he's innocent.

The penalties against Penn State include a cut in the number of football scholarships the university can award and a rewriting of the record books to erase 14 years of victories under Paterno, who was fired when the scandal broke in late 2011 and died of lung cancer shortly after.

The lawsuit represents a reversal by the governor. When Penn State's president consented to the sanctions last summer, Corbett, a member of the Board of Trustees, embraced them as part of the university's effort to repair the damage from the Sandusky scandal.

Corbett said he waited to sue over the penalties because he wanted to thoroughly research the legal issues and did not want to interfere with the football season.

Two Pennsylvania congressmen, Charlie Dent and Glenn Thompson, called for the NCAA to restore football scholarships taken away from Penn State, saying in a letter last month the sanctions unfairly punish innocent student-athletes for the child sex abuse scandal.

Penn State officials and Paterno's family deny there was a cover-up of allegations against Sandusky.

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Well: The 'Monday Morning' Medical Screaming Match

I did not think I would ever see another “morbidity and mortality” conference in which senior doctors publicly attacked their younger colleagues for making medical errors. These types of heated meetings were commonplace when I was a medical student but have largely been abandoned.

Yet here they were again on “Monday Mornings,” a new medical drama on the TNT network, based on a novel by Dr. Sanjay Gupta, CNN’s chief medical correspondent and one of the executive producers of the show. Such screaming matches may make for good television, but it is useful to review why new strategies have emerged for dealing with medical mistakes.

So-called M&M conferences emerged in the early 20th century as a way for physicians to review cases that had either surprising outcomes or had somehow gone wrong. Although the format varied among institutions and departments, surgery M&Ms were especially known for their confrontations, as more experienced surgeons often browbeat younger doctors into admitting their errors and promising to never make them again.

Such conferences were generally closed door — that is, attended only by physicians. Errors were a private matter not to be shared with other hospital staff, let alone patients and families.

But in the late 1970s, a sociology graduate student named Charles L. Bosk gained access to the surgery department at the University of Chicago. His resultant 1979 book, “Forgive and Remember,” was one of the earliest public discussions of how the medical profession addressed its mistakes.

Dr. Bosk developed a helpful terminology. Technical and judgment errors by surgeons could be forgiven, but only if they were remembered and subsequently prevented by those who committed them. Normative errors, which called into question the moral character of the culprit, were unacceptable and potentially jeopardized careers.

Although Dr. Bosk’s book was more observational than proscriptive, his depiction of M&M conferences was disturbing. I remember attending a urology M&M as a medical student in which several senior physicians berated a very well-meaning and competent intern for a perceived mistake. The intern seemed to take it very well, but my fellow students and I were shaken by the event, asking how such hostility could be conducive to learning.

There were lots of angry accusations in the surgical M&Ms in the pilot episode of “Monday Mornings.” In one case, a senior doctor excoriated a colleague who had given Tylenol to a woman with hip pain who turned out to have cancer. “You allowed metastatic cancer to run amok for four months!” he screamed.

If this was what Dr. Bosk would have called a judgment error, the next case raised moral issues. A neurosurgeon had operated on a boy’s brain tumor without doing a complete family history, which would have revealed a disorder of blood clotting. The boy bled to death on the operating table. “The boy died,” announced the head surgeon, “because of a doctor’s arrogance.”

In one respect, it is good to see that the doctors in charge were so concerned. But as the study of medical errors expanded in the 1990s, researchers found that the likelihood of being blamed led physicians to conceal their errors. Meanwhile, although doctors who attended such conferences might indeed not make the exact same mistakes that had been discussed, it was far from clear that M&Ms were the best way to address the larger problem of medical errors, which, according to a 1999 study, killed close to 100,000 Americans annually.

Eventually, experts recommended a “systems approach” to medical errors, similar to what had been developed by the airline industry. The idea was to look at the root causes of errors and to devise systems to prevent them. Was there a way, for example, to ensure that the woman with the hip problem would return to medical care when the Tylenol did not help? Or could operations not be allowed to occur until a complete family history was in the chart? Increasingly, hospitals have put in systems, such as preoperative checklists and computer warnings, that successfully prevent medical errors.

Another key component of the systems approach is to reduce the emphasis on blame. Even the best doctors make mistakes. Impugning them publicly — or even privately — can make them clam up. But if errors are seen as resulting from inadequate systems, physicians and other health professionals should be more willing to speak up.

Of course, the systems approach is not perfect. Studies continue to show that physicians conceal their mistakes. And elaborate systems for preventing errors can at times interfere with getting things done in the hospital.

Finally, it is important not to entirely remove the issue of responsibility. Sad to say, there still are physicians who are careless and others who are arrogant. Even if today’s M&M conferences rarely involve screaming, supervising physicians need to let such colleagues know that these types of behaviors are unacceptable.

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Barron H. Lerner, M.D., professor of medicine at New York University Langone Medical Center, is the author, most recently, of “One for the Road: Drunk Driving Since 1900.”

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