Study Bolsters Link Between Routine Hits to Head and Long-Term Brain Disease

The growing evidence of a link between head trauma and long-term, degenerative brain disease was amplified in an extensive study of athletes, military veterans and others who absorbed repeated hits to the head, according to new findings published in the scientific journal Brain.

The study, which included brain samples taken posthumously from 85 people who had histories of repeated mild traumatic brain injury, added to the mounting body of research revealing the possible consequences of routine hits to the head in sports like football and hockey. The possibility that such mild head trauma could result in long-term cognitive impairment has come to vex sports officials, team doctors, athletes and parents in recent years.

Of the group of 85 people, 80 percent (68 men) — nearly all of whom played sports — showed evidence of chronic traumatic encephalopathy, or C.T.E., a degenerative and incurable disease whose symptoms can include memory loss, depression and dementia.

Among the group found to have C.T.E., 50 were football players, including 33 who played in the N.F.L. Among them were stars like Dave Duerson, Cookie Gilchrist and John Mackey. Many of the players were linemen and running backs, positions that tend to have more contact with opponents.

Six high school football players, nine college football players, seven pro boxers and four N.H.L. players, including Derek Boogaard, the former hockey enforcer who died from an accidental overdose of alcohol and painkillers, also showed signs of C.T.E. The study also included 21 veterans, most of whom were also athletes, who showed signs of C.T.E.

The study was conducted by investigators at the Boston University Center for the Study of Traumatic Encephalopathy and the Veterans Affairs Boston Healthcare System, in collaboration with the Sports Legacy Institute. It took four years to complete, included subjects 17 to 98 years old, and more than doubled the number of documented cases of C.T.E. The investigators also created a four-tiered system to classify degrees of C.T.E., hoping it would help doctors treat patients.

The volume of cases in the study “allows us to see the disease at all stages of severity and how it starts and spreads in the brain, which gives us an idea of the mechanism of the injury,” said Ann McKee, the main author of the study, who is a professor of neurology and pathology at Boston University School of Medicine and works at the V.A. Boston.

Those categorized as having Stage 1 of the disease had headaches and loss of attention and concentration, while those with Stage 2 also had depression, explosive behavior and short-term memory loss. Those with Stage 3 of C.T.E., including Duerson, a former All-Pro defensive back for the Chicago Bears who killed himself last year, had cognitive impairment and trouble with executive functions like planning and organizing. Those with Stage 4 had dementia, difficulty finding words and aggression.

Despite the breadth of the findings, the study, like others before it, did not prove definitively that head injuries sustained on the field caused C.T.E. To do that, doctors would need to identify the disease in living patients by using imaging equipment, blood tests or other techniques. Researchers have not been able to determine why some athletes who performed in the same conditions did not develop C.T.E.

The study also did not demonstrate what percentage of professional football players were likely to develop C.T.E. To do that, investigators would need to study the brains of players who do not develop C.T.E., and those are difficult to acquire because families of former players who do not exhibit symptoms are less likely to donate their brains to science.

“It’s a gambler’s game to try to predict what percentage of the population has this,” said Chris Nowinski, a co-author of the study and a co-director of the Center for the Study of Traumatic Encephalopathy at Boston University School of Medicine. “Many of the families donated the brains of their loved ones because they were symptomatic. Still, this is probably more widespread than we think.”

Researchers expected the details in the study to dispel doubts about the likelihood that many years of head trauma can lead to C.T.E. The growing connections between head trauma and contact sports, though, have led some nervous parents and coaches to assume that any concussion could lead to long-term impairment. Some doctors say that oversimplifies matters. Rather, the total amount of head trauma, including smaller subconcussive hits, as well as how they were treated, must be considered when evaluating whether an athlete is more at risk of developing a disease like C.T.E.

“All concussions are not created equal,” said Robert Cantu, a co-author of the study and a co-director of the encephalopathy center. “Parents have become paranoid about concussions and connecting the dots with C.T.E., and that’s wrong. The dots are really about total head trauma.”

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Heat is on Groupon's Andrew Mason

In June 2011, Groupon Inc. Chief Executive Andrew Mason took the stage at a conference hosted by influential technology blog AllThingsD.

When co-executive editor Kara Swisher asked him whether an initial public offering was coming soon, he shot her what she later dubbed his "death stare."

The audience laughed and broke into applause.

The tone was decidedly more subdued last week, when Mason found himself at another tech industry confab, fielding questions from Business Insider's Henry Blodget, this time about whether Groupon's directors were going to fire him at their meeting the next day. AllThingsD had reported a day earlier, citing anonymous sources, that Groupon's board of directors was considering replacing Mason with a more experienced CEO to lead the Chicago-based daily deal company's turnaround.

The contrast between those two appearances underscores the swift and dramatic tumble of Mason's standing in tech and business circles within a few years. The young founder and CEO graced the cover of Forbes in 2010 and was named Ernst & Young's National Entrepreneur of the Year in the "emerging" category a year later.

Those accolades are a far cry from the cloud hanging over Mason, 32, and the company he launched four years ago. The leak to AllThingsD appeared to be deliberately timed to embarrass the executive, forcing him to field questions about his own competence at a scheduled appearance. This public hint of internal strife has fueled speculation around Mason's fate even as other public tech companies, such as Facebook and social game-maker Zynga, have also seen their stock prices drop since their IPOs.

Groupon's board met Thursday and took no action on the CEO's job, with company spokesman Paul Taaffe saying the board and management were "working together with their heads down to achieve Groupon's objectives."

Markets, however, seemed unconvinced. Groupon's beleaguered stock closed slightly higher Thursday but dropped 8.7 percent to $4.14 Friday. Shares debuted at $20 in November 2011.

Investors "want experience in leadership," said Raman Chadha, a clinical professor at DePaul University and co-founder of the Junto Institute for Entrepreneurial Leadership, a training program for startup founders. "And as a result, where Andrew's background was cool and sexy — and maybe even bordering on amusing — when Groupon was a pure startup, that's in the mindset of those of us who are observers and supporters … and fellow entrepreneurs. I think in the minds of the investor community and Wall Street, (it's different) because now the company has a lot more to lose. And if it's going to fall, it's going to fall really hard and really far."

For Chadha, Mason's unconventional pedigree as a music major-turned-startup-founder was part of the appealing, media-friendly story of Groupon's origin. The company was launched as recession-weary consumers were eager for deals, and it achieved rapid growth while earning a reputation for antics like decorating a conference room in the style of a fictional, possibly deranged tenant of Groupon's headquarters who had lived there before the startup moved into the offices.

The scrutiny of Groupon was tremendous given the "high-flying" nature of the company, said David Larcker, a corporate governance expert at the Stanford Graduate School of Business.

"You have a founder as CEO," he said. "He's the public face of the company. He has set the culture. All of that stuff."

That culture, driven in large part by Mason, turned from a lovable quirk to a major liability as the company ran into controversy over its poorly received Super Bowl ads in February 2011 and a series of missteps in the run-up to its IPO. Then, within months of its public debut, it disclosed an accounting flaw that forced it to restate financial results.

The larger question surrounding Groupon is the long-term viability of its basic business model. The company has been expanding offerings beyond its core daily deals, which have seen growth rates tail off. It's also dealing with a recession in the key European market as well as continued competition in the U.S.

But the biggest challenge facing Mason now is probably his own performance, or rather the perception that he isn't up to the task of running the global, publicly traded business worth billions that he founded but that now needs a turnaround. The stock is down 80 percent from its IPO price.

"It's an oft-told, oft-expected story that the genius entrepreneur steps aside when he or she succeeds at building a company big enough to need an experienced CEO," said Erik Gordon, a business professor at the University of Michigan.

The example Gordon and others cite is Google, which flourished after its co-founders Larry Page and Sergey Brin made way for a more seasoned executive in Eric Schmidt.

"The Google guys did it, and the results were spectacular," Gordon said.

Chadha said many startups tend to become more corporate in outlook, and less quirky, as they grow, because they bring in experienced executives from large companies that may have difficulty adapting to an entrepreneurial culture or reject it outright as not professional enough.

"I think that's where Google is very different," Chadha said. "(The company) sought out entrepreneurial, startup types — people that became part of their management team." That free-form element of Google's culture comes out in such things as the Google doodles — the offbeat tributes to notable anniversaries or famous people that pop up on the main search page.

Mason has acknowledged areas where Groupon needs to improve and has hired senior executives with experience at more mature tech companies. That hasn't always worked either. Margo Georgiadis, who came from Google as chief operating officer, returned to that company after five months.

Whether there's still room for Mason on the top management team remains to be seen. He was direct in his interview last week with Blodget, offering a minimum of jokes as he focused on discussing the job he and others at Groupon must accomplish.

"I care far more about the success of the business than I care about my role as CEO," he said.

A year ago, when he spoke to author Frank Sennett for his book "Groupon's Biggest Deal Ever," Mason was unapologetic about his management style.

"You only live once, and all I'm doing is being myself," he told Sennett. "I think a normal CEO is trying to appear in some way that's not actually them. That's probably not what they're like."

In the same book, former President and Chief Operating Officer Rob Solomon offered this blunt assessment of his ex-boss: "Andrew at thirty-five and forty is going to hate Andrew at twenty-nine and thirty; I guarantee it."

Melissa Harris and Bloomberg News contributed.

wawong@tribune.com

Twitter @VelocityWong

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German producers plan Pope Benedict biopic

MUNICH, Germany (Reuters) – Two German producers have bought the film rights to an upcoming biography of Pope Benedict by the Bavarian author of three best-selling interview books with the pontiff.

The Odeon Film company said producers Marcus Mende and Peter Weckert planned a film for international release based on a biography by journalist Peter Seewald due to be published in early 2014.

Seewald’s book-length interviews with Benedict – two as Cardinal Joseph Ratzinger and one as pope – have given readers many insights into the life and thoughts of the shy theologian who now heads the Roman Catholic Church.

Seewald has signed on as a consultant to the scriptwriter, Odeon Film said in a statement on Thursday. It gave no information about the schedule for the film or who might play the main role.

“The producers plan an international film that illustrates all aspects of the extraordinary life and work of Joseph Ratzinger from his birth on Easter night in 1927 in Marktl am Inn in Bavaria to his pontificate today,” it said.

Benedict’s predecessor Pope John Paul was the subject of a dozen documentary films around the world and two major television movies in the United States.

(Reporting by Tom Heneghan; editing by Andrew Roche)

Movies News Headlines – Yahoo! News

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Opinion: A Health Insurance Detective Story

I’VE had a long career as a business journalist, beginning at Forbes and including eight years as the editor of Money, a personal finance magazine. But I’ve never faced a more confounding reporting challenge than the one I’m engaged in now: What will I pay next year for the pill that controls my blood cancer?

After making more than 70 phone calls to 16 organizations over the past few weeks, I’m still not totally sure what I will owe for my Revlimid, a derivative of thalidomide that is keeping my multiple myeloma in check. The drug is extremely expensive — about $11,000 retail for a four-week supply, $132,000 a year, $524 a pill. Time Warner, my former employer, has covered me for years under its Supplementary Medicare Program, a plan for retirees that included a special Writers Guild benefit capping my out-of-pocket prescription costs at $1,000 a year. That out-of-pocket limit is scheduled to expire on Jan. 1. So what will my Revlimid cost me next year?

The answers I got ranged from $20 a month to $17,000 a year. One of the first people I phoned said that no matter what I heard, I wouldn’t know the cost until I filed a claim in January. Seventy phone calls later, that may still be the most reliable thing anyone has told me.

Like around 47 million other Medicare beneficiaries, I have until this Friday, Dec. 7, when open enrollment ends, to choose my 2013 Medicare coverage, either through traditional Medicare or a private insurer, as well as my drug coverage — or I will risk all sorts of complications and potential late penalties.

But if a seasoned personal-finance journalist can’t get a straight answer to a simple question, what chance do most people have of picking the right health insurance option?

A study published in the journal Health Affairs in October estimated that a mere 5.2 percent of Medicare Part D beneficiaries chose the cheapest coverage that met their needs. All in all, consumers appear to be wasting roughly $11 billion a year on their Part D coverage, partly, I think, because they don’t get reliable answers to straightforward questions.

Here’s a snapshot of my surreal experience:

NOV. 7 A packet from Time Warner informs me that the company’s new 2013 Retiree Health Care Plan has “no out-of-pocket limit on your expenses.” But Erin, the person who answers at the company’s Benefits Service Center, tells me that the new plan will have “no practical effect” on me. What about the $1,000-a-year cap on drug costs? Is that really being eliminated? “Yes,” she says, “there’s no limit on out-of-pocket expenses in 2013.” I tell her I think that could have a major effect on me.

Next I talk to David at CVS/Caremark, Time Warner’s new drug insurance provider. He thinks my out-of-pocket cost for Revlimid next year will be $6,900. He says, “I know I’m scaring you.”

I call back Erin at Time Warner. She mentions something about $10,000 and says she’ll get an estimate for me in two business days.

NOV. 8 I phone Medicare. Jay says that if I switch to Medicare’s Part D prescription coverage, with a new provider, Revlimid’s cost will drive me into Medicare’s “catastrophic coverage.” I’d pay $2,819 the first month, and 5 percent of the cost of the drug thereafter — $563 a month or maybe $561. Anyway, roughly $9,000 for the year. Jay says AARP’s Part D plan may be a good option.

NOV. 9 Erin at Time Warner tells me that the company’s policy bundles United Healthcare medical coverage with CVS/Caremark’s drug coverage. I can’t accept the medical plan and cherry-pick prescription coverage elsewhere. It’s take it or leave it. Then she puts CVS’s Michele on the line to get me a Revlimid quote. Michele says Time Warner hasn’t transferred my insurance information. She can’t give me a quote without it. Erin says she will not call me with an update. I’ll have to call her.

My oncologist’s assistant steers me to Celgene, Revlimid’s manufacturer. Jennifer in “patient support” says premium assistance grants can cut the cost of Revlimid to $20 or $30 a month. She says, “You’re going to be O.K.” If my income is low enough to qualify for assistance.

NOV. 12 I try CVS again. Christine says my insurance records still have not been transferred, but she thinks my Revlimid might cost $17,000 a year.

Adriana at Medicare warns me that AARP and other Part D providers will require “prior authorization” to cover my Revlimid, so it’s probably best to stick with Time Warner no matter what the cost.

But Brooke at AARP insists that I don’t need prior authorization for my Revlimid, and so does her supervisor Brian — until he spots a footnote. Then he assures me that it will be easy to get prior authorization. All I need is a doctor’s note. My out-of-pocket cost for 2013: roughly $7,000.

NOV. 13 Linda at CVS says her company still doesn’t have my file, but from what she can see about Time Warner’s insurance plans my cost will be $60 a month — $720 for the year.

CVS assigns my case to Rebecca. She says she’s “sure all will be fine.” Well, “pretty sure.” She’s excited. She’s been with the company only a few months. This will be her first quote.

NOV. 14 Giddens at Time Warner puts in an “emergency update request” to get my files transferred to CVS.

Frank Lalli is an editorial consultant on retirement issues and a former senior executive editor at Time Warner’s Time Inc.

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Designer made herself into a manufacturer

Shoemaker Annie Mohaupt nearly closed down a year ago after her move to make sandals in China proved a bust. The sandals could easily be pulled apart.

She looked into what it would cost to make her sandals in another country but returned production to Chicago. The decision, she said, allows her to tap into growing demand for U.S.-made products and to utilize manufacturing technology that makes her company, Mohop Inc., a global competitor.

"I have a factory," Mohaupt said, her statement reflecting her evolution from thinking of herself solely as a designer. As a manufacturer she understands she has control over the quality of her products — a key to sales and growth. "I'm happy but it's also intimidating. There is a lot to manage and wrap my head around."

Mohaupt's tale is illustrative of what manufacturing experts and politicians have been saying for quite some time: American manufacturers can be successful and create jobs by using the latest technology in producing and developing products.

So far this year, Mohaupt has sold about 1,500 pairs of sandals for about $158,000, she said. Mohaupt credits Facebook fans and word-of-mouth recommendations for a 500 percent increase in sales this fall over a year ago, and she expects to sell about 5,000 pairs of sandals in 2013. When she reaches annual sales of 10,000 pairs, Mohaupt said she'll need to invest in more equipment, like a new wood-cutting machine.

"I want for her to be making her shoes in the U.S.," said Greg Kaleel, owner of American Male & Co. a family-owned retail shop in Oswego, adding that his customers will pay more for shoes made here. "That's how important the 'made in America' is."

On a recent evening, the sweet smell of burned walnut filled Mohaupt's basement shop in a three-story building in Chicago's River West neighborhood. The smell emanated from a computerized machine about the size of a pingpong table cutting walnut blocks into triangles with concave curves and arches. Those curves support the heel and arch of a woman's foot and create a sleek, sophisticated look.

An architect by training, Mohaupt, 37, feeds her three-dimensional designs into a program that converts it into letters and numbers and tells the machine where to cut. That was the easy part for her to learn. To operate the machine, Mohaupt relied on a tutorial from the machine-maker and learned the rest via the Internet.

The soft-spoken woman employs three people, including an office manager and a young designer. If sandals sell as planned, she would hire four to six temporary workers in the spring. That's when sales typically ramp up after the winter lull. Mohaupt wants to expand her product line to lessen her dependence on sandal sales. One idea is a moccasin she can sell in the cold months.

Mohaupt has come a long way since 2005, when she cut and glued layers of plywood by hand to make her sandals. Her early versions featured a cylindrical wooden heel and elastic loops on each side of the sole that acted as guides for ties or ribbons that customers could change at will — her signature design.

She sold her first sandals for $70 at a craft fair and appeared to be off and running. The bliss of her success crumbled the following morning when customers complained that the shoes easily came apart. The heels broke off and the loops snapped. In effect, the stumble marked the beginning of her apprenticeship as a manufacturer.

Mohaupt spent the next year quizzing seasoned shoemakers and shoe repairers about how she could improve the quality of her shoes. Ultimately, she decided that her sandals should be able to withstand 100 miles of use. To test her designs, she wore her sandals while taking her dog on five-mile treks.

"I lost some weight," she said. She also test-marketed the evolving sandals by mailing samples to her first customers. Some got up to five pairs as Mohaupt developed — and later patented — a system to keep the elastic loops in place. One problem licked, she then focused on the labor involved.

Cutting the plywood by hand was grueling work in its own right. And then she had to glue together the layers. "I would end up covered in glue," she said.

So Mohaupt began experimenting with wooden blocks, which she'd sculpt with a saw into wedges. That eliminated having to glue together layers of plywood but still was physically draining.

That's when she made a decision that would forever change her business. In 2009 she bought on credit a $70,000 computer-driven machine that could read her 3-D designs and cut heels in minutes, saving hours of labor. The machine also allowed Mohaupt to experiment with new designs. For example, she could for the first time produce curved heel bases and make shoes with added arch support.

Demand grew steadily, which should have been a good problem. But even with the machine she couldn't keep pace with orders. Mohaupt tried training people to make the sandals but found that she couldn't train them and make shoes at the same time.

That's when she first considered outsourcing production. She tested a Canadian shoemaker but severed the relationship after it sent her a shipment of poorly made shoes. Mohaupt also was unsuccessful in lining up production in Argentina.

Then, suddenly, a competitor emerged that jolted her into making a decision that ultimately would nearly bring down her company. The competitor was selling sandals almost identical to hers and nudging her sandals out of local shops she had supplied for years. Its prices also were lower because it was producing its sandals in China. She faced being driven out of business, she said.

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Kansas City police: Chiefs player involved in shootings

A file photo of the Kansas City Chiefs football facility. (Getty Photo / December 1, 2012)

Tribune wire services

10:37 a.m. CST, December 1, 2012

A 25-year-old Kansas City Chiefs player shot his girlfriend early Saturday, then drove to Arrowhead Stadium and turned the gun on himself as two team officials were confronting him, police said.

Kansas City police Supervisor Andrea Khan would not release the name of the player involved and the condition of the two parties was not immediately known. A team source told CBSSports.com that linebacker Jovan Belcher was involved in a shooting. 

Police spokesman Darin Snapp said authorities received a call Saturday morning from a woman who said her daughter had been shot multiple times at a residence about five miles away from the Arrowhead complex. Snapp said a call was then received from the Chiefs' practice facility.

Upon arriving, Snapp said that police witnessed a black male in a car with a handgun to his head talking to two Chiefs officials. That's when police heard a gunshot.

Arrowhead Stadium has been lockdown since about 8 a.m.

"We can confirm that there was an incident at Arrowhead earlier this morning," the Chiefs said in a statement. "We are cooperating with authorities in their investigation."

Kansas City is scheduled to host the Carolina Panthers on Sunday.

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New job posting suggests Nokia may still be considering Android after all

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Glen Campbell considering more live shows in 2013

NASHVILLE, Tenn. (AP) — Glen Campbell may be wrapping up a goodbye tour but that doesn’t mean he’s done with the stage.

Campbell is considering scheduling more shows next year after playing more than 120 dates in 2012.

The 76-year-old singer has Alzheimer’s disease and has begun to lose his memory. He put out his final studio album, “Ghost on the Canvas,” in 2011 and embarked on the tour with family members and close friends serving in his band and staffing the tour.

Campbell’s longtime manager Stan Schneider said in a phone interview from Napa, Calif., where the tour wrapped for the year Friday night, that recent West Coast shows have been some of the singer’s strongest. Campbell will break for the holidays and if he still feels strong he’ll begin scheduling more shows.

___

Online:

http://glencampbellmusic.com

Entertainment News Headlines – Yahoo! News

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Jewel parent says sale talks proceeding

Exterior of Jewel-Osco's first "Green Store" located at 370 N. Desplaines in Chicago. (Antonio Perez / November 29, 2012)

By Emily Bryson York




Chicago Tribune reporter

6:51 a.m. CST, November 30, 2012

Supervalu, the Minneapolis-based parent of Jewel-Osco said sale talks are proceeding after stock closed down more than 18 percent Thursday, to $2.28.

The beleaguered grocery chain was likely moving to combat reports that sale talks with suitor Cerberus Capital Management had stalled over funding.

"The company continues to be in active discussion with several parties," according to the statement. "There can be no assurance that this process will result in any transaction or any change in the Company's overall structure or its business model."

Supervalu, the third-largest U.S. grocery chain, has acknowledged sale talks since the spring. The company has been closing stores and cutting jobs as it has underperformed competitors like Dominick's parent Safeway and Kroger.

If Supervalu does not sell to Cerberus, it may have to restructure on its own or sell off individual assets, which could have big tax consequences, Bloomberg said.

Reuters reported last month that buyout firm Cerberus was preparing a takeover bid for Supervalu, the third-largest U.S. supermarket chain.

Cerberus officials could not be reached immediately for comment.

-- Reuters contributed to this report

In addition to Jewel, Supervalu owns Albertsons, Cub and other regional grocery chains.

SVU data by YCharts

SVU data by YCharts

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Missouri Powerball winner identified as mechanic

A 52-year-old Missouri mechanic and his wife claimed their share Friday of the record $588 million Powerball jackpot.

Lottery officials sent a statement Friday announcing that Mark and Cindy Hill, of Dearborn, held one of two winning tickets for the nation's biggest Powerball jackpot.

The Hills will split the $588 million prize with whoever holds a winning ticket sold at a convenience store in suburban Phoenix. No one has come forward yet with the Arizona ticket, lottery officials said.

The $587.5 million payout, which represents the second-largest jackpot in U.S. history, set off a nationwide buying frenzy, with tickets at one point selling at nearly 130,000 per minute. Before Wednesday's winners, the jackpot had rolled over 16 consecutive times without someone hitting the jackpot.

Lottery officials' announcement that the Hills had won only confirmed what many residents in Dearborn, a town of about 500 about 40 miles north of Kansas City, already knew. Lottery officials said Thursday that one winning ticket had been sold at a Trex Mart gas station and convenience store on the edge of town, and Mark Hill's name circulated quickly. While he and his wife did not speak to reporters, friends and relatives identified Mark Hill as the winner.

Myron Anderson, pastor of the Baptist Church in nearby Camden Point, said he heard Thursday that the Hills had won the huge lottery prize. Anderson said he has known Mark Hill since they attended high school together and that the couple have older children and a younger elementary school-age daughter.

"He's a really nice guy, and I know his wife, and they have this nice little adopted daughter that they went out of their way to adopt," Anderson said. Funeral services for Hill's father were at the Baptist church, but the family attends church elsewhere, he said.

"I hope it's good news for them," Anderson said. "I've heard awful horror stories about people who get all that money in their lap and how everybody treats them, and if you don't mind me saying, I mean just the fact that the press is going to be after them."

Kevin Bryan, a lifelong Dearborn resident, said the only other local lottery winner he could remember was a farmer who won about $100,000 in scratch-off game years ago "and bought himself a combine."

The winning ticket sold in Arizona was purchased at a 4 Sons Food Store in Fountain Hills near Phoenix, state lottery officials said.

In a Mega Millions drawing in March, three ticket buyers shared a $656 million jackpot, the largest lottery payout of all time.

Hill and the holder of the Arizona winning ticket have numerous decisions ahead, including how to accept their new wealth. The cash payout from the overall jackpot has been estimated at about $385 million, or about $192.5 million for each ticket. The winners can take their jackpots in lump sums or annual payments.

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