Well: Waiting for Alzheimer's to Begin

My gray matter might be waning. Then again, it might not be. But I swear that I can feel memories — as I’m making them — slide off a neuron and into a tangle of plaque. I steel myself for those moments to come when I won’t remember what just went into my head.

I’m not losing track of my car keys, which is pretty standard in aging minds. Nor have I ever forgotten to turn off the oven after use, common in menopausal women. I can always find my car in the parking lot, although lots of “normal” folk can’t.

Rather, I suddenly can’t remember the name of someone with whom I’ve worked for years. I cover by saying “sir” or “madam” like the Southerner I am, even though I live in Vermont and grown people here don’t use such terms. Better to think I’m quirky than losing my faculties. Sometimes I’ll send myself an e-mail to-do reminder and then, seconds later, find myself thrilled to see a new entry pop into my inbox. Oops, it’s from me. Worse yet, a massage therapist kicked me out of her practice for missing three appointments. I didn’t recall making any of them. There must another Nancy.

Am I losing track of me?

Equally worrisome are the memories increasingly coming to the fore. Magically, these random recollections manage to circumnavigate my imagined build-up of beta-amyloid en route to delivering vivid images of my father’s first steps down his path of forgetting. He was the same age I am now, which is 46.

“How old are you?” I recall him asking me back then. Some years later, he began calling me every Dec. 28 to say, “Happy birthday,” instead of on the correct date, Dec. 27. The 28th had been his grandmother’s birthday.

The chasms were small at first. Explainable. Dismissible. When he crossed the street without looking both ways, we chalked it up to his well-cultivated, absent-minded professor persona. But the chasms grew into sinkholes, and eventually quicksand. When we took him to get new pants one day, he kept trying on the same ones he wore to the store.

“I like these slacks,” he’d say, over and over again, as he repeatedly pulled his pair up and down.

My dad died of Alzheimer’s last April at age 73 — the same age at which his father succumbed to the same disease. My dad ended up choosing neurology as his profession after witnessing the very beginning of his own dad’s forgetting.

Decades later, grandfather’s atrophied brain found its way into a jar on my father’s office desk. Was it meant to be an ever-present reminder of Alzheimer’s effect? Or was it a crystal ball sent to warn of genetic fate? My father the doctor never said, nor did he ever mention, that it was his father’s gray matter floating in that pool of formaldehyde.

Using the jarred brain as a teaching tool, my dad showed my 8-year-old self the difference between frontal and temporal lobes. He also pointed out how brains with Alzheimer’s disease become smaller, and how wide grooves develop in the cerebral cortex. But only after his death — and my mother’s confession about whose brain occupied that jar — did I figure out that my father was quite literally demonstrating how this disease runs through our heads.

Has my forgetting begun?

I called my dad’s neurologist. To find out if I was in the earliest stages of Alzheimer’s, he would have to look for proteins in my blood or spinal fluid and employ expensive neuroimaging tests. If he found any indication of onset, the only option would be experimental trials.

But documented confirmation of a diseased brain would break my still hopeful heart. I’d walk around with the scarlet letter “A” etched on the inside of my forehead — obstructing how I view every situation instead of the intermittent clouding I currently experience.

“You’re still grieving your father,” the doctor said at the end of our call. “Sadness and depression affect the memory, too. Let’s wait and see.”

It certainly didn’t help matters that two people at my father’s funeral made some insensitive remarks.

“Nancy, you must be scared to death.”

“Is it hard knowing the same thing probably will happen to you?”

Maybe the real question is what to do when the forgetting begins. My dad started taking 70 supplements a day in hopes of saving his mind. He begged me to kill him if he wound up like his father. He retired from his practice and spent all day in a chair doing puzzles. He stopped making new memories in an all-out effort to preserve the ones he already had.

Maybe his approach wasn’t the answer.

Just before his death — his brain a fraction of its former self — my father managed to offer up a final lesson. I was visiting him in the memory-care center when he got a strange look on his face. I figured it was gas. But then his eyes lit up and a big grin overtook him, and he looked right at me and said, “Funny how things turn out.”

An unforgettable moment?

I can only hope.



Nancy Stearns Bercaw is a writer in Vermont. Her book, “Brain in a Jar: A Daughter’s Journey Through Her Father’s Memory,” will be published in April 2013 by Broadstone.

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Royal Dutch Shell Posts $5.6 Billion Profit







LONDON — Royal Dutch Shell, Europe’s largest oil company, disappointed the markets Thursday with fourth-quarter earnings of $5.6 billion after one-time items and inventory changes.




The results were 15 percent above the previous year but well below analysts’ expectation of around $6.3 billion.


Stuart Joyner, an analyst at Investec Securities in London, described the results as “a substantial miss.” Shell’s stock price was down about 1 percent in morning trading in London.


The company’s earnings for the year were $25.1 billion, up 2 percent over 2011.


The disappointment was largely due to lower earnings in Shell’s core exploration and production business, mainly because of weak performance in the Americas, where Shell’s multibillion Alaska drilling program has encountered multiple snafus and delays.


Exploration and production earnings were $4.4 billion compared to $5.1 billion the previous year, with the U.S. exploration and production business reporting a $69 million loss, partly due to low natural gas prices.


In another disappointment Shell estimated that it only replaced 44 percent of the reserves of oil and gas that it produced in 2012. That indicated that the company’s exploration effort, despite increased emphasis and spending in recent years, is still not performing well.


The capital investment forecast for 2013 was increased by 10 percent to $33 billion — another worry for the markets, as it suggests that Shell may be having trouble controlling costs.


On the positive side, Shell’s huge Pearl gas-to-liquids plant in Qatar is now fully operational and adding a hefty 235,000 barrels per day of oil equivalent to Shell’s production for the quarter.


Shell said that it was likely to increase its dividend in the first quarter of 2013 to 45 cents a share, a 4.7 percent increase over the first quarter of 2012.


“Shell is competitive and innovative,” the company’s chief executive, Peter Voser, said in a statement. “We are delivering on a strategy that others can’t easily repeat.”


Shell also had cause for relief on Wednesday when a court in The Hague dismissed most aspects of lawsuits brought against it by Nigerian farmers and fishermen seeking damages for pollution from oil spills in the Niger Delta.


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Toyota recalls nearly 1 million Corollas, Lexus IS sedans









Toyota is recalling 907,000 vehicles, mostly Corolla models, around the world for faulty air bags and another 385,000 Lexus IS luxury cars for defective wipers.


Toyota Motor Corp. spokesman Naoto Fuse said Wednesday there have been no accidents or injuries related to either of those defects, but the Japanese automaker received 46 reports of problems involving the air bags from North America, and one from Japan.


There were 25 reports of problems related to the windshield wipers.





Being recalled for air bags that can improperly inflate are 752,000 Corolla and Corolla Matrix cars in the U.S. as well as thousands of similar vehicles in Japan, Mexico and Canada, manufactured between December 2001 and May 2004.


The problem windshield wipers can get stuck if there is heavy snowfall, according to Toyota.





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7 Massive Ideas That Could Change the World








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Lindsay Lohan’s driving case returns to LA court






LOS ANGELES (AP) — A judge who has sentenced Lindsay Lohan to jail before will conduct her first hearing Wednesday on new misdemeanor charges of lying to authorities and reckless driving against the trouble-prone actress.


Lohan has been ordered to appear before Judge Stephanie Sautner for the scheduling hearing, which is the first time the actress has been required to appear in court in nearly a year.






Prosecutors in Santa Monica, Calif., have charged Lohan with lying to police about driving a sports car that crashed into a dump truck in June, reckless driving and obstructing officers from performing their duties.


In March, Sautner released her from supervised probation but warned her to stop partying and grow up.


“You need to live your life in a more mature way, stop the nightclubbing and focus on your work,” Sautner told Lohan at the time. The admonition came after the judge conducted several monthly updates with the actress and required her to perform morgue cleanup duty to complete her sentence in a 2007 drunken driving case.


Lohan has since filmed two movies but has repeatedly gotten into trouble, including a pair of arrests in New York that have not resulted in charges.


She was on probation for theft at the time of the wreck in California, and Sautner had warned the actress she could be sentenced to 245 days in jail if she didn’t behave. She has pleaded not guilty and a Feb. 27 trial date has been set.


The latest hearing may also resolve who will be Lohan’s lawyer for the criminal case. New York attorney Mark Heller has petitioned to join the case, but his involvement must be approved by Sautner.


Heller was traveling on Tuesday and did not return a phone message.


___


Anthony McCartney can be reached at http://twitter.com/mccartneyAP


Entertainment News Headlines – Yahoo! News





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BlackBerry 10’s Debut Is a Critical Day for Research in Motion





OTTAWA — Research in Motion’s introduction on Wednesday of a new BlackBerry phone will be the most important event in the company’s history since 1996, when its founders showed investors a small block of wood and promised that a wireless e-mail device shaped like that would change business forever.




Now with just 4.6 percent of the global market for smartphones in 2012, according to IDC, RIM long ago exchanged dominance for survival mode. On Wednesday, the company will introduce a new line of smartphones called the BlackBerry 10 and an operating system of the same name that Thorsten Heins, the president and chief executive of RIM, says will restore the company to glory.


But Frank Mersch, who became one of RIM’s earliest investors after seeing the block of wood, is far less excited by what he sees this time around.


“You’re in a very, very competitive market and you’re not the leader,” Mr. Mersch, now the chairman and a vice president at Front Street Capital in Toronto, said of RIM. “You have to ask: ‘At the end of the day are we really going to win?’ I personally think the jury’s out on that.”


The main elements of the new phones and their operating system are already well known. Mr. Heins and other executives at RIM have been demonstrating the units for months to a variety of audiences. App developers received prototype versions as far back as last spring.


While analysts and app developers may be divided about the future of RIM, there is a consensus that BlackBerry 10, which arrives more than year behind schedule, was worth the wait.


Initially RIM will release two variations of the BlackBerry 10, one a touch-screen model that resembles many other phones now on the market. The other model is a hybrid with a keyboard similar to those now found on current BlackBerrys as well as a small touch screen.


The real revolution, though, may be in the software that manages a person’s business and personal information. It is clearly designed with an eye toward retaining and, more important, luring back, corporate users.


Corporate and government information technology managers will be able to segregate business-related apps and data on BlackBerry 10 handsets from users’ personal material through a system known as BlackBerry Balance. It will enable an I.T. manager to, among other things, remotely wipe corporate data from fired employees’ phones while leaving the newly jobless workers’ personal photos, e-mails, music and apps untouched. The system can also block users from forwarding or copying information from the work side of the phone.


Messages generated by e-mail, Twitter, Facebook, instant messaging and LinkedIn accounts are automatically consolidated into a single in-box that RIM calls BlackBerry Hub.


Charles Golvin, an analyst with Forrester Research, called the new phones “beautiful” and described the operating system as “a giant leap forward” from RIM’s current operating system. Ray Sharma, who followed RIM’s glory years as a financial analyst but who now runs XMG Studio, a mobile games developer in Toronto, has been similarly impressed.


But both men are among many analysts who question the ability of BlackBerry 10, whatever its merits, to revive RIM’s fallen fortunes.


“If it’s good, it will help inspire the upgrade cycle,” Mr. Sharma said. “But it has to be great in order to inspire touch-screen users to come back. If it’s good, not great, I will be concerned.”


Mr. Golvin was more blunt. “They’ll need to prove themselves in the face of a simultaneous onslaught of marketing from Microsoft, not to mention the continued push from Apple plus Google and its Android partners,” he wrote. “This is a gargantuan challenge for a company of RIM’s size.”


In the year since he took over from the founders, Jim Balsillie and Mike Lazaridis, Mr. Heins has certainly remade RIM. He cut 5,000 jobs in a program to reduce operating costs by about $1 billion a year. Along the way, he also replaced RIM’s senior management and straightened out its balance sheet. While unprofitable, RIM remains debt-free and holds $2.9 billion in cash.


With BlackBerry 10, RIM not only started over with its operating system, it also rebuilt the company through acquisitions. Its core operating system comes from QNX Software Systems, the design of the user interface is largely the work of the Astonishing Tribe in Sweden while other main components, like the touch-screen technology, came from smaller companies that are now part of RIM.


Integrating all of those acquisitions, analysts and former RIM employees say, added to the delays that plagued BlackBerry 10.


Now that the new phones are finally here, Mr. Heins is counting on RIM’s remaining base of 79 million users globally to eagerly upgrade. But where those customers reside may be as important in their numbers in determining the success of that plan.


In the United States, which leads the world in setting smartphone trends, about 11 million BlackBerry users switched to other phones between 2009 and the middle of last year, according to an analysis by Horace Dediu on Asymco, a wireless industry blog he founded.


Until the final months of 2012, RIM continued to increase its subscriber base through sales of low-cost handsets to less developed countries like Nigeria and Indonesia. Although BlackBerry 10 will be made available worldwide, the initial phones will be too expensive for a majority of BlackBerry fans in those regions.


RIM may also have confused its loyalists, particularly in North America and Europe, in the run-up to the BlackBerry 10 debut. Many of those users stuck with BlackBerrys because of their physical keyboards. But public demonstrations for BlackBerry 10 were centered on the touch-screen-only version and its virtual keyboard.


While some corporations have remained loyal to BlackBerry, RIM not only has to sell them on the new handsets, it also must persuade them to upgrade server software to accommodate the new operating system, a costly and time-consuming process. Companies whose employees continue to use older BlackBerrys will have to run two separate BlackBerry servers.


Mr. Heins’s pitch to those corporations is that the BlackBerry 10 server software will also allow them to manage and control data on employees’ Android phones and iPhones. But any corporation or organization that allows those phones to connect with its systems long ago installed mobile device management software from other companies, including Good Technology and SAP. RIM is likely to find that the competition in device management software is as severe as it is in the handset business.


This article has been revised to reflect the following correction:

Correction: January 30, 2013

An earlier version of this story incorrectly stated that Frank Mersh is the chairman and a vice president at First Street Capital in Toronto. Mr. Mersh is the chairman and a vice president at Front Street Capital in Toronto.



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Mayoral debate focuses on city's troubled finances









In the highest-profile debate so far in the Los Angeles mayoral race, three longtime city officials defended their records Monday night as two long-shot challengers accused them of putting the city on a path to insolvency.


The city's chronic budget shortfalls dominated the event at UCLA's Royce Hall, televised live on KNBC-TV Channel 4. Entertainment lawyer Kevin James and technology executive Emanuel Pleitez sought to maximize the free media exposure, portraying themselves as fresh alternatives to business as usual at City Hall.


James, a former radio talk-show host, described himself as an independent and accused rivals Wendy Greuel, Eric Garcetti and Jan Perry — all veteran elected officials — of being cozy with unions representing the city workforce.





"Bankruptcy doesn't happen overnight," said James, the only Republican in the race. "This happened over a period of time and it happened because of a series of bad decisions."


Pleitez struck a similar note.


"Our politicians in the last decade made decisions on numbers they didn't understand," he said.


"I'm the only one that has worked in the private sector and on fiscal and economic policies at the highest levels," Pleitez said, citing his experience as a special assistant to economist Paul Volcker on President Obama's Economic Recovery Advisory Board.


Greuel, Garcetti and Perry, in turn, pledged to show fiscal restraint as the city grapples with projected budget shortfalls totaling more than $1 billion over the next four years.


City Controller Greuel cited the "waste, fraud and abuse" her office's audits have identified at City Hall, saying they demonstrate her independence.


"As mayor of Los Angeles, I get not only being the fiscal watchdog, and showing where we can find this money, and knowing where the bodies are buried," said Greuel, who served on the City Council for seven years. "I've learned as city controller, you don't always make friends when you highlight what can be done better."


Garcetti, a councilman for more than a decade, said he had a record of "not just talking about pension reform, but delivering on it." When tax collections dried up in the recession, he said, the council and mayor eliminated 5,000 jobs and negotiated a deal with unions requiring some city workers to contribute to their health and pension benefits.


"Those are the things that kept us away from our own fiscal cliff," he said.


Perry also stressed her support for increasing worker contributions to health and retirement benefits.


"This is about long-term survival," she said.


By the normal standards of election campaigns, it was a remarkably genteel debate, at least among the three city officials.


Only Perry attacked her rivals, and even then, not by name.


Recalling her work with Garcetti and Greuel in talks with city unions, she faulted them for engaging in "side meetings and side negotiations," saying she was more transparent.


"As mayor, I will make sure that practice stops, that everything is done on the record — that all employees are treated fairly and all employees are given the same information," Perry said.


Neither Greuel nor Garcetti answered the attack.


As in previous forums, the most obvious contrasts among the candidates Monday night were in biography and style — rather than policy positions.





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Supernova Remnants: Dazzling Entrails of Violent Stellar Death

Even in death, there can be great beauty. Consider supernova remnants, the results of massive stars dying in great explosions, creating some of the most spectacular cosmic objects around.


Every 50 years or so, a star in our galaxy with more than 10 times the mass of our sun will expire. When such stars die, they go supernova, one of the most violent events in our universe. These explosions shoot off tons of material from the central star at up to 10 percent the speed of light.


Though the area surrounding stars seems empty, it is usually home to vast amounts of interstellar gas and dust. The supernova’s outburst runs into this surrounding material, creating a shockwave and heating it to temperatures greater than 10,000 Celsius. Over thousands of years, the local structure of the gas and dust shapes the stellar outpouring into shells, filaments, and other diffuse forms. Astronomers call these objects supernova remnants.


Supernova explosions and the remnants they leave behind have wide-ranging effects. They heat up the interstellar medium, creating complex chemistry out in space, and are responsible for accelerating protons and other atomic nuclei, which go zipping around the universe as cosmic rays. Perhaps most importantly, supernova explosions generate and liberate heavy elements, such as oxygen, carbon, and all metals, distributing them out into the wider cosmos. These elements eventually find their way into planetary systems, making life possible on at least one world that we know of.


Here, we take a look at some of the most famous and beautiful supernova remnants, giving you a chance to contemplate life, death, and cycles of renewal in the universe.


Above:



The supernova remnant N186 D appears as a bright pink spot at the top of this new image released by NASA on Jan. 28, spewing off tremendous amounts of X-rays. Located in the Large Magellanic Cloud about 160,000 light-years away, the remnant is blowing a huge bubble (the giant structure below the bright spot) as hot wind carves out a shock wave in the surrounding material.


Image: X-ray: NASA/CXC/Univ of Michigan/A.E.Jaskot, Optical: NOAO/CTIO/MCELS

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How Fox Searchlight made the biggest deal at Sundance $9.75 million on an egg sandwich






NEW YORK (TheWrap.com) – The biggest sale at Sundance this year – “The Way, Way Back” – began with a promise and ended with a fried egg sandwich.


Producer Kevin J. Walsh, a former assistant to Scott Rudin, told the agents selling his movie that he’d make everyone food if they closed a big deal. But before he could cook, a bidding war broke out that would pit the favored Fox Searchlight against a half-dozen other studios, including Lionsgate, Paramount, Magnolia, FilmDistrict and Open Road.






Fox Searchlight won out and paid one of the highest prices for a Sundance movie in recent years – $ 9.75 million – for the story of an alienated 14-year-old (“The Killing’s” Liam James) on summer vacation.


The one big thing in their favor: Once “The Way, Way Back” premiered on Monday, everyone knew it would sell. The film not only drew a standing ovation, but almost every distributor stayed through the Q&A session with the filmmakers – a “rare” occasion, as one person close to the deal told TheWrap.


Fox Searchlight was an early starter out of the gate. It had already won an Oscar with Rash and Faxon, who co-wrote Alexander Payne’s “The Descendants.”


And at one point it was going to produce the film, back when Shawn Levy was going to direct and it was called “The Way Back.” Rash and Faxon’s script had charted on the 2007 Black List, which ranks the industry’s favorite unproduced screenplays.


The project stalled. Levy moved on to other films, and the script bounced around until Walsh came aboard as producer and decided Faxon and Rash should direct.


In hopes of sealing the deal, Searchlight sent more than a dozen of its executives to the Sundance debut, many of whom began firing off ardent emails to the filmmakers after they had seen it.


“They came wanting to love that movie, and they were going overboard in an impressive way,” a person with knowledge of the deal told TheWrap. “Multiple people at the company talked about how much they loved the film. It still didn’t mean they’d get it. Sometimes you have a distributor who does all that to justify lowballing.”


But Searchlight didn’t have a clear field. As the filmmakers attended an after party at the Grey Goose Blue Door on Main Street, several other distributors circled. These ranged from the massive, Paramount and Warner Bros., to the very large Lionsgate, to the medium-sized FilmDistrict, Open Road and Magnolia.


Another factor was that rival agencies CAA and WME had to play nice. The movie was written and directed by CAA‘s Faxon and Rash and stars WME clients Steve Carell and Toni Collette.


Around 7 p.m., the dealmakers retired to the WME house, where the discussions began. Alexis Garcia, Deb McIntosh and Graham Taylor from WME would handle the deal with Laura Lewis and Dina Kuperstock from CAA.


“We had some in-person meetings, some phone calls and a lot of the offers were apples and oranges,” Tom Rice of Sycamore Pictures, which produced and co-financed the movie with OddLot Entertainment, told TheWrap.


Fox Searchlight was an early starter out of the gate. It had already won an Oscar with Rash and Faxon, who co-wrote Alexander Payne’s “The Descendants.”


And at one point it was going to produce the film, back when Shawn Levy was going to direct and it was called “The Way Back.” Rash and Faxon’s script had charted on the 2007 Black List, which ranks the industry’s favorite unproduced screenplays.


The project stalled. Levy moved on to other films, and the script bounced around until Walsh came aboard as producer and decided Faxon and Rash should direct.


In hopes of sealing the deal, Searchlight sent more than a dozen of its executives to the Sundance debut, many of whom began firing off ardent emails to the filmmakers after they had seen it.


“They came wanting to love that movie, and they were going overboard in an impressive way,” a person with knowledge of the deal told TheWrap. “Multiple people at the company talked about how much they loved the film. It still didn’t mean they’d get it. Sometimes you have a distributor who does all that to justify lowballing.”


But Searchlight didn’t have a clear field. As the filmmakers attended an after party at the Grey Goose Blue Door on Main Street, several other distributors circled. These ranged from the massive, Paramount and Warner Bros., to the very large Lionsgate, to the medium-sized FilmDistrict, Open Road and Magnolia.


Another factor was that rival agencies CAA and WME had to play nice. The movie was written and directed by CAA‘s Faxon and Rash and stars WME clients Steve Carell and Toni Collette.


Around 7 p.m., the dealmakers retired to the WME house, where the discussions began. Alexis Garcia, Deb McIntosh and Graham Taylor from WME would handle the deal with Laura Lewis and Dina Kuperstock from CAA.


“We had some in-person meetings, some phone calls and a lot of the offers were apples and oranges,” Tom Rice of Sycamore Pictures, which produced and co-financed the movie with OddLot Entertainment, told TheWrap.


“When we went over there, we didn’t tell them it was exclusive. But quickly getting there, it was clear they were intending to make it work as quickly as possible,” an individual close to the deal said. “And it still dragged out for several hours.”


As they haggled over numbers, the two sides moved in and out of the condo. The agents would move while Fox talked about it. The Fox team had to move when the agents wanted to call people back at the WME house.


Meanwhile, over the night, Searchlight increased its offer significantly. Making a big bet on the first-time directors, $ 9.75 million, at 4:30 a.m. it finally closed one of the richest deals in Sundance history.


Fox Searchlight considers Jim and Nat a real part of their family,” Rice said. “They made their interest known for a long time.”


The deal done, the negotiating team headed back to the WME house to play pool, listen to music, drink champagne and down vodka. Whiskey would have been ideal given the frigid weather, but Utah’s Byzantine liquor laws had dashed the hopes of a late-night liquor run. The local whiskey from High West Distillery would have to wait.


“We didn’t plan ahead for celebrations, and it isn’t too easy to improvise in Park City,” one person there recalled.


With a couple hours until the papers would be signed, pre-planned improvisation would have to do.


And Walsh made good on his promise: Fried egg sandwiches with asparagus.


“We cracked a bottle of champagne at about 6 a.m.,” he said. Good morning.


Movies News Headlines – Yahoo! News




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Rescuer Appears for New York Downtown Hospital





Manhattan’s only remaining hospital south of 14th Street, New York Downtown, has found a white knight willing to take over its debt and return it to good health, hospital officials said Monday.




NewYork-Presbyterian Hospital, one of New York City’s largest academic medical centers, has proposed to take over New York Downtown in a “certificate of need” filed with the State Health Department. The three-page proposal argues that though New York Downtown is projected to have a significant operating loss in 2013, it is vital to Lower Manhattan, including Wall Street, Chinatown and the Lower East Side, especially since the closing of St. Vincent’s Hospital after it declared bankruptcy in 2010.


The rescue proposal, which would need the Health Department’s approval, comes at a precarious time for hospitals in the city. Long Island College Hospital, just across the river in Cobble Hill, Brooklyn, has been threatened with closing after a failed merger with SUNY Downstate Medical Center, and several other Brooklyn hospitals are considering mergers to stem losses.


New York Downtown has been affiliated with the NewYork-Presbyterian health care system while maintaining separate operations.


“We are looking forward to having them become a sixth campus so the people in that community can continue to have a community hospital that continues to serve them,” Myrna Manners, a spokeswoman for NewYork-Presbyterian, said.


Fred Winters, a spokesman for New York Downtown, declined to comment.


Presbyterian’s proposal emphasized that it would acquire New York Downtown’s debt at no cost to the state, a critical point at a time when the state has shown little interest in bailing out failing hospitals.


The proposal said that if New York Downtown were to close, it would leave more than 300,000 residents of Lower Manhattan, including the financial district, Greenwich Village, SoHo, the Lower East Side and Chinatown, without a community hospital. In addition, it said, 750,000 people work and visit in the area every day, a number that is expected to grow with the construction of 1 World Trade Center and related buildings.


The proposal argues that New York Downtown is essential partly because of its long history of responding to disasters in the city. One of its predecessors was founded as a direct result of the 1920 terrorist bombing outside the J. P. Morgan Building, and the hospital has responded to the 1975 bombing of Fraunces Tavern, the 1993 and 2001 attacks on the World Trade Center, and, this month, the crash of a commuter ferry from New Jersey.


Like other fragile hospitals in the city, New York Downtown has shrunk, going to 180 beds, down from the 254 beds it was certified for in 2006, partly because the more affluent residents of Lower Manhattan often go to bigger hospitals for elective care.


The proposal says that half of the emergency department patients at New York Downtown either are on Medicaid, the program for the poor, or are uninsured.


NewYork-Presbyterian would absorb the cost of the hospital’s maternity and neonatal intensive care units, which have been expanding because of demand, but have been operating at a deficit of more than $1 million a year, the proposal said.


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