Mediterranean Diet Can Cut Heart Disease, Study Finds

About 30 percent of heart attacks, strokes and deaths from heart disease can be prevented in people at high risk if they switch to a Mediterranean diet rich in olive oil, nuts, beans, fish, fruits and vegetables, and even drink wine with meals, a large and rigorous new study found.

The findings, published on the New England Journal of Medicine’s Web site on Monday, were based on the first major clinical trial to measure the diet’s effect on heart risks. The magnitude of the diet’s benefits startled experts. The study ended early, after almost five years, because the results were so clear it was considered unethical to continue.

The diet helped those following it even though they did not lose weight and most of them were already taking statins, or blood pressure or diabetes drugs to lower their heart disease risk.

“Really impressive,” said Rachel Johnson, a professor of nutrition at the University of Vermont and a spokeswoman for the American Heart Association. “And the really important thing — the coolest thing — is that they used very meaningful end points. They did not look at risk factors like cholesterol of hypertension or weight. They looked at heart attacks and strokes and death. At the end of the day, that is what really matters.”

Until now, evidence that the Mediterranean diet reduced the risk of heart disease was weak, based mostly on studies showing that people from Mediterranean countries seemed to have lower rates of heart disease — a pattern that could have been attributed to factors other than diet.

And some experts had been skeptical that the effect of diet could be detected, if it existed at all, because so many people are already taking powerful drugs to reduce heart disease risk, while other experts hesitated to recommend the diet to people who already had weight problems, since oils and nuts have a lot of calories.

Heart disease experts said the study was a triumph because it showed that a diet is powerful in reducing heart disease risk, and it did so using the most rigorous methods. Scientists randomly assigned 7,447 people in Spain who were overweight, were smokers, had diabetes or other risk factors for heart disease to follow the Mediterranean diet or a low-fat one.

Low-fat diets have not been shown in any rigorous way to be helpful, and they are also very hard for patients to maintain — a reality born out in the new study, said Dr. Steven E. Nissen, chairman of the department of cardiovascular medicine at the Cleveland Clinic Foundation.

“Now along comes this group and does a gigantic study in Spain that says you can eat a nicely balanced diet with fruits and vegetables and olive oil and lower heart disease by 30 percent,” he said. “And you can actually enjoy life.”

The study, by Dr. Ramon Estruch, a professor of medicine at the University of Barcelona, and his colleagues, was long in the planning. The investigators traveled the world, seeking advice on how best to answer the question of whether a diet alone could make a big difference in heart disease risk. They visited the Harvard School of Public Health several times to consult Dr. Frank M. Sacks, a professor of cardiovascular disease prevention there.

In the end, they decided to randomly assign subjects at high risk of heart disease to three groups. One would be given a low-fat diet and counseled on how to follow it. The other two groups would be counseled to follow a Mediterranean diet. At first the Mediterranean dieters got more intense support. They met regularly with dietitians while the low-fat group just got an initial visit to train them in how to adhere to the diet followed by a leaflet each year on the diet. Then the researchers decided to add more intensive counseling for them, too, but they still had difficulty staying with the diet.

One group assigned to a Mediterranean diet was given extra virgin olive oil each week and was instructed to use at least 4 tablespoons a day. The other group got a combination of walnuts, almonds and hazelnuts and was instructed to eat about an ounce of them each day. An ounce of walnuts, for example, is about a quarter cup — a generous handful. The mainstays of the diet consisted of at least 3 servings a day of fruits and at least two servings of vegetables. Participants were to eat fish at least three times a week and legumes, which include beans, peas and lentils, at least three times a week. They were to eat white meat instead of red, and, for those accustomed to drinking, to have at least 7 glasses of wine a week with meals.

They were encouraged to avoid commercially made cookies, cakes and pastries and to limit their consumption of dairy products and processed meats.

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Horsemeat found in IKEA meatballs

Sweden's IKEA halted sales of its trademark Swedish meatballs in 13 European countries after tests in the Czech Republic on Monday showed the product contained horsemeat.

IKEA, the world's No. 1 furniture retailer and known also for its signature cafeterias in its huge out-of-town stores, said it had stopped sales of all meatballs from a batch implicated in the Czech tests.

The checks were carried out in response to a Europe-wide scandal that erupted last month when tests carried out in Ireland revealed some beef products contained horsemeat. This has triggered recalls of ready-made meals and damaged confidence in Europe's vast and complex food industry.

"We take this very seriously," said IKEA spokeswoman Ylva Magnusson at the company's headquarters in Helsingborg, southern Sweden. "We have stopped selling that specific batch of meatballs in all markets where they may have been sold."

The meatballs, pulled from shelves at IKEA's stores after Czech inspectors discovered they contained horsemeat, had been available in stores in several European countries, the company's Czech spokesman said on Monday.

Besides the Czech Republic, they had also been on sale in Britain, Portugal, Netherlands, Belgium, Slovakia, Hungary, France, Italy, Spain, Greece, Cyprus and Ireland, Magnusson said.

All IKEA's meatballs are produced in Sweden by supplier Familjen Dafgard, which said on its website it was investigating the situation and would receive further test results in the coming days.

IKEA's Magnusson said hopes were that test results would determine the percentage of horsemeat in the meatballs, and that there was is no indication any other batch had been affected.

In Italy, one of the countries where meatballs from the batch were withdrawn from sale, consumer rights group Codacons called for checks on all meat products sold by IKEA in Italy.

"We are ready to launch legal action and seek compensation not only against the companies who are responsible but also those whose duty it was to protect citizens," Codacons President Carlo Rienzi said in a statement.

The Czech State Veterinary Administration reported its findings to the EU's Rapid Alert System for Food and Feed, it said in a statement.

The inspectors took samples for DNA tests in IKEA's unit in the city of Brno from a product labelled as "beef and pork meatballs", the statement said.

Meatballs, a famous Swedish dish, have become a trademark for IKEA across its markets.

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Daytona 500 still a go despite accident that injured fans

DAYTONA BEACH, Fla. —

The Daytona 500 NASCAR race will go ahead on Sunday despite a crash on Saturday that injured more than 20 fans, questions over the safety of the famous speedway and the possibility of lawsuits.

Officials said they had repaired the fencing that was damaged after the pile-up which sent debris flying into the crowd and injuring fans on the final lap of Saturday's second-tier Nationwide race.

Halifax Health spokesman Byron Cogdell said that seven people were treated for injuries at their facility but two who had initially been listed as critical were now in a stable condition.

Another injured spectator was being treated at Florida Hospital Memorial Medical Center in Daytona Beach, but their condition was not available.

Fourteen other fans had been treated on site at the track before being released, said Daytona International Speedway president Joei Chitwood.

Chitwood said any fans in the affected area who were concerned about the safety of their seat position would be relocated.

"If fans are unhappy with...their seating location or if they have any incidents, we would relocate them. We will treat that area like we do every other of the grandstand.

"If a fan is not comfortable where they are sitting, we make every accommodation we can," he said.

NASCAR and the speedway could face millions of dollars' worth of claims from the injured, litigation that would likely center on the sturdiness of the safety fence that was supposed to keep fans from danger, according to several plaintiffs' lawyers.

"Maybe the fence should have been higher; maybe there should have been more spacing between the track and spectators," said Adam Levitt, a lawyer with Grant & Eisenhofer.

However, lawyers also said the auto-racing business would likely point to the disclaimers that it typically displays on tickets, which are designed to exempt NASCAR from any potential injury liability. They expected NASCAR would argue that fans knew what they were getting into when signing up for the race.

NEW FENCING

Both the speedway and NASCAR have said they will closely review the incident in search of any ways they could improve safety.

Chitwood said new, 22-feet-high (6.7 metres) fencing had been put in place three years ago following a review of a crash involving Colin Edwards at Talladega in 2009.

"If you look at our 55 years in the business, we have a pretty good safety track record. I think we are prepared today," said Chitwood.

However, three-times Indianapolis 500 winner Johnny Rutherford said a change might be needed.

"Maybe a double fence, one behind the other with some space in between to stop something like this," he told reporters.

"But there are a lot of things and NASCAR and Indy Car racing are looking at everything they can to make it safer.

"What happened yesterday was a terrible thing because we expect (danger) that is part of it, we have to roll the dice and move on but you don't want to involve the fans," he said.

NASCAR's senior vice-president of racing operations Steve O'Donnell said he would tell any nervous fans that organisers were confident of their safety.

"I would tell them that the fans are our first priority. Obviously we want everyone to be safe at an event," he told reporters.

"We've talked to the speedway. We are confident in what's in place at today's event. Certainly still thinking about those affected but we are confident to move forward for this race," he added.

Fans streamed into the 167,000-capacity venue on Sunday and there was little indication of concern over safety.

"I feel safe. I think anywhere you go you run the risk of being injured but NASCAR does everything they can to protect the fans. They treat the fans like royalty here, it is amazing," said Vinny Nigro of New York City.

Another fan, Brad Stefka from Springfield, Missouri, said that while not particularly worried he would avoid the seating closest to the track.

"I just won't get down low. I would imagine that everyone who comes knows there is some element of danger if the cars are going that fast, if there is going to be a serious impact," he said.

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The Texas Tribune: Advocates Seek Mental Health Changes, Including Power to Detain

Matt Rainwaters for Texas Monthly

The Sherman grave of Andre Thomas’s victims.

SHERMAN — A worried call from his daughter’s boyfriend sent Paul Boren rushing to her apartment on the morning of March 27, 2004. He drove the eight blocks to her apartment, peering into his neighbors’ yards, searching for Andre Thomas, Laura Boren’s estranged husband.

Expanded coverage of Texas is produced by The Texas Tribune, a nonprofit news organization. To join the conversation about this article, go to texastribune.org.

For more articles on mental health and criminal justice in Texas, as well as a timeline of the Andre Thomas case: texastribune.org

Matt Rainwaters for Texas Monthly

Laura Boren

He drove past the brightly colored slides, swings and bouncy plastic animals in Fairview Park across the street from the apartment where Ms. Boren, 20, and her two children lived. He pulled into a parking spot below and immediately saw that her door was broken. As his heart raced, Mr. Boren, a white-haired giant of a man, bounded up the stairwell, calling out for his daughter.

He found her on the white carpet, smeared with blood, a gaping hole in her chest. Beside her left leg, a one-dollar bill was folded lengthwise, the radiating eye of the pyramid facing up. Mr. Boren knew she was gone.

In a panic, he rushed past the stuffed animals, dolls and plastic toys strewn along the hallway to the bedroom shared by his two grandchildren. The body of 13-month-old Leyha Hughes lay on the floor next to a blood-spattered doll nearly as big as she was.

Andre Boren, 4, lay on his back in his white children’s bed just above Leyha. He looked as if he could have been sleeping — a moment away from revealing the toothy grin that typically spread from one of his round cheeks to the other — except for the massive chest wound that matched the ones his father, Andre Thomas (the boy was also known as Andre Jr.), had inflicted on his mother and his half-sister as he tried to remove their hearts.

“You just can’t believe that it’s real,” said Sherry Boren, Laura Boren’s mother. “You’re hoping that it’s not, that it’s a dream or something, that you’re going to wake up at any minute.”

Mr. Thomas, who confessed to the murders of his wife, their son and her daughter by another man, was convicted in 2005 and sentenced to death at age 21. While awaiting trial in 2004, he gouged out one of his eyes, and in 2008 on death row, he removed the other and ate it.

At least twice in the three weeks before the crime, Mr. Thomas had sought mental health treatment, babbling illogically and threatening to commit suicide. On two occasions, staff members at the medical facilities were so worried that his psychosis made him a threat to himself or others that they sought emergency detention warrants for him.

Despite talk of suicide and bizarre biblical delusions, he was not detained for treatment. Mr. Thomas later told the police that he was convinced that Ms. Boren was the wicked Jezebel from the Bible, that his own son was the Antichrist and that Leyha was involved in an evil conspiracy with them.

He was on a mission from God, he said, to free their hearts of demons.

Hospitals do not have legal authority to detain people who voluntarily enter their facilities in search of mental health care but then decide to leave. It is one of many holes in the state’s nearly 30-year-old mental health code that advocates, police officers and judges say lawmakers need to fix. In a report last year, Texas Appleseed, a nonprofit advocacy organization, called on lawmakers to replace the existing code with one that reflects contemporary mental health needs.

“It was last fully revised in 1985, and clearly the mental health system has changed drastically since then,” said Susan Stone, a lawyer and psychiatrist who led the two-year Texas Appleseed project to study and recommend reforms to the code. Lawmakers have said that although the code may need to be revamped, it will not happen in this year’s legislative session. Such an undertaking requires legislative studies that have not been conducted. But advocates are urging legislators to make a few critical changes that they say could prevent tragedies, including giving hospitals the right to detain someone who is having a mental health crisis.

From the time Mr. Thomas was 10, he had told friends he heard demons in his head instructing him to do bad things. The cacophony drove him to attempt suicide repeatedly as an adolescent, according to court records. He drank and abused drugs to try to quiet the noise.

bgrissom@texastribune.org

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Promise, peril seen for crowd-funding investors

Crowd funding is widely seen as a revolutionary idea.

A 2012 federal law known as the JOBS Act opens the door to allowing small, privately owned businesses to market ownership stakes in their ventures to people over the Internet.

Companies will be able to sell up to $1 million in equity a year to ordinary investors without having to register the offering with the Securities and Exchange Commission or state regulators.

Before the average person can use crowd funding to stake a claim in a startup, the SEC still must draft rules that the Obama administration hopes will result in U.S. businesses growing and adding jobs. At the same time, the securities cop needs to include safeguards that protect less sophisticated individual investors drawn to inherently risky startups.

That's why equity crowd funding under JOBS, or Jumpstart our Business Startups, has some longtime regulators and securities lawyers squirming.

"It can be an invitation for fraudsters to steal money," Matthew Brown, a Katten Muchin Rosenman lawyer, said last month at a CFA Society of Chicago event at 1871, a center for digital startups in Chicago.

But Brown also noted that equity crowd funding also democratizes small-business financing, a process that historically has given access mostly to wealthier — or, as they're known in high-finance circles, "accredited" — investors.

"The world has changed dramatically, and who's to say who is smarter than anyone else?" Brown added.

Many existing crowd-funding platforms such as Kickstarter don't sell equity stakes in businesses to average investors. Rather, they give consumers the chance to donate money to an enterprise or to get an early or discounted crack at a new product. Since Kickstarter's launch in April 2009, more than $450 million has been pledged by more than 3 million people funding more than 35,000 projects, the New York-based company's website says.

Their acceptance suggests that consumers are willing to engage with companies on a deeper level. As such, enabling unaccredited consumers to invest in companies in small increments online has promise and could become part of the fundraising "ecosystem," says one Chicago entrepreneur.

Abe's Market, a Chicago-based e-commerce site selling natural and organic products from more than 1,000 suppliers, said it would consider crowd funding under the JOBS Act, saying it and its vendors have "die-hard fans" and "a core group of customers" who might like to invest in their vision.

Last month, Abe's raised $5 million from Carmel Ventures, Index Ventures, Beringea and Accel Partners, a Groupon backer. New backers include OurCrowd, a crowd-funding site for accredited investors.

"If you can get passionate people to invest in your business, you're not just gaining investors, you're gaining evangelists," Abe's Chief Executive Richard Demb said. "The challenge for any consumer brand is: How do you find not just customers, but the right customers who are going to tell their friends?"

But there would also be potential headaches for companies raising equity financing through crowd funding, he said.

"You have to make sure that expectations would be set fairly, that no one is putting their life savings into the investment, and that they don't also come back and become a challenge to manage as the business grows," Demb said. "You don't want someone who invested $250 to come back and say, 'I don't think we should expand to the West Coast.'"

Safeguards for average investors exist in the JOBS Act. They include capping nonaccredited individuals' crowd-funding investments at $2,000, or 5 percent of annual income or net worth of less than $100,000, whichever is greater.

Snapclass, launched a few weeks ago at 1871, provides software enabling businesses to provide training online. Co-founder Scott Mandel, who has financed the company himself, doesn't expect to take advantage of equity crowd funding in the future and instead would seek, say, venture capital funding.

"Not all checks are the same," said Mandel, previously a trader and professional poker player. "I'd want someone who could add more than just the cash, such as connections and experience and help with things that I'm not an expert in."

One of 1871's fastest-growing startups is MarkITx. It recently raised $1.2 million from wealthy individuals in its first fundraising round, has seven employees and is looking to add sales jobs. It's an online exchange for businesses wanting to buy and sell used information technology equipment, from iPads to Oracle servers.

"For us, it wouldn't be the sole way to raise money, but it definitely is a viable vehicle to look at raising money," MarkITx partner Marc Brooks said of equity crowd funding under the JOBS Act.

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Charges filed in slaying of Clemente High School student

Authorities filed charges against a 34-year-old man in connection with the shooting death of an 18-year-old Clemente High School student killed on the West Side last week.

Larry Luellen Jr., 34, was charged with first degree murder in the death of Frances Colon. Luellen is due in court today.

Luellen lives in the 3900 block of West Division Street in West Humboldt Park, around the corner from where Colon was shot. Police don't believe she was the target.

Colon is the third student at Roberto Clemente to be killed this school year, according to the school's principal Marcey Sorensen.

Rey Dorantes, 14, of the 2400 block of West Augusta Boulevard, was shot and killed on Jan. 11. His death came about a month after another Clemente student, 16-year-old Jeffrey Stewart, of the 5200 block of West Race Avenue, was shot and killed on Dec. 9.

Colon was a senior who was preparing to attend college. Hours before the shooting, she had watched President Barack Obama speak at Hyde Park Academy on the South Side about gun violence, according to her father.

Check back for more information.

pnickeas@tribune.com
Twitter: @peternickeas

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Drone Pilots Found to Get Stress Disorders Much as Those in Combat Do

U.S. Air Force/Master Sgt. Steve Horton

Capt. Richard Koll, left, and Airman First Class Mike Eulo monitored a drone aircraft after launching it in Iraq.

The study affirms a growing body of research finding health hazards even for those piloting machines from bases far from actual combat zones.

“Though it might be thousands of miles from the battlefield, this work still involves tough stressors and has tough consequences for those crews,” said Peter W. Singer, a scholar at the Brookings Institution who has written extensively about drones. He was not involved in the new research.

That study, by the Armed Forces Health Surveillance Center, which analyzes health trends among military personnel, did not try to explain the sources of mental health problems among drone pilots.

But Air Force officials and independent experts have suggested several potential causes, among them witnessing combat violence on live video feeds, working in isolation or under inflexible shift hours, juggling the simultaneous demands of home life with combat operations and dealing with intense stress because of crew shortages.

“Remotely piloted aircraft pilots may stare at the same piece of ground for days,” said Jean Lin Otto, an epidemiologist who was a co-author of the study. “They witness the carnage. Manned aircraft pilots don’t do that. They get out of there as soon as possible.”

Dr. Otto said she had begun the study expecting that drone pilots would actually have a higher rate of mental health problems because of the unique pressures of their job.

Since 2008, the number of pilots of remotely piloted aircraft — the Air Force’s preferred term for drones — has grown fourfold, to nearly 1,300. The Air Force is now training more pilots for its drones than for its fighter jets and bombers combined. And by 2015, it expects to have more drone pilots than bomber pilots, although fighter pilots will remain a larger group.

Those figures do not include drones operated by the C.I.A. in counterterrorism operations over Pakistan, Yemen and other countries.

The Pentagon has begun taking steps to keep pace with the rapid expansion of drone operations. It recently created a new medal to honor troops involved in both drone warfare and cyberwarfare. And the Air Force has expanded access to chaplains and therapists for drone operators, said Col. William M. Tart, who commanded remotely piloted aircraft crews at Creech Air Force Base in Nevada.

The Air Force has also conducted research into the health issues of drone crew members. In a 2011 survey of nearly 840 drone operators, it found that 46 percent of Reaper and Predator pilots, and 48 percent of Global Hawk sensor operators, reported “high operational stress.” Those crews cited long hours and frequent shift changes as major causes.

That study found the stress among drone operators to be much higher than that reported by Air Force members in logistics or support jobs. But it did not compare the stress levels of the drone operators with those of traditional pilots.

The new study looked at the electronic health records of 709 drone pilots and 5,256 manned aircraft pilots between October 2003 and December 2011. Those records included information about clinical diagnoses by medical professionals and not just self-reported symptoms.

After analyzing diagnosis and treatment records, the researchers initially found that the drone pilots had higher incidence rates for 12 conditions, including anxiety disorder, depressive disorder, post-traumatic stress disorder, substance abuse and suicidal ideation.

But after the data were adjusted for age, number of deployments, time in service and history of previous mental health problems, the rates were similar, said Dr. Otto, who was scheduled to present her findings in Arizona on Saturday at a conference of the American College of Preventive Medicine.

The study also found that the incidence rates of mental heath problems among drone pilots spiked in 2009. Dr. Otto speculated that the increase might have been the result of intense pressure on pilots during the Iraq surge in the preceding years.

The study found that pilots of both manned and unmanned aircraft had lower rates of mental health problems than other Air Force personnel. But Dr. Otto conceded that her study might underestimate problems among both manned and unmanned aircraft pilots, who may feel pressure not to report mental health symptoms to doctors out of fears that they will be grounded.

She said she planned to conduct two follow-up studies: one that tries to compensate for possible underreporting of mental health problems by pilots and another that analyzes mental health issues among sensor operators, who control drone cameras while sitting next to the pilots.

“The increasing use of remotely piloted aircraft for war fighting as well as humanitarian relief should prompt increased surveillance,” she said.

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16 airport investors show interest in Midway

An international array of airport investors and operators have shown interest in developing bids to privatize Midway Airport, the city announced Friday evening.

Sixteen parties responded to the city's "request for qualifications" by a 4 p.m. deadline, indicating they had interest in leasing, operating and improving the Southwest Side airport, the nation's 26th busiest, with about 9 million passengers passing through annually.

"The response generated from the  ... process is encouraging and provides the city with a sense of the strong level of interest in a potential lease," said Lois Scott, the city's chief financial officer. "We must evaluate fully if this could be a win for Chicagoans."

The city and its advisers will review the responses to identify qualified potential bidders.

Of the 16, seven had both the operational and financial capabilities sought in the RFQ. The city identified them as:

-- ACO Investment Group, an investor and operator with global airport experience.

-- AMP Capital Investors Limited, a manager and investor in airports, including Melbourne Airport in Australia and Newcastle Airport, in Britain.

--  Corporacion America Group, an Argentina-based airport operator with 49 airports in seven countries.

-- Global Infrastructure Partners (GIP), which is the controlling investor and active manager of London City Airport, London Gatwick Airport and Edinburgh Airport.

--Great Lakes Airport Alliance, which is a partnership of Macquarie Infrastructure and Real Assets and Ferrovial. Its airport operations include London's Heathrow, Brussels Airport and Copenhagen Airport.

-- Incheon International Airport and Hastings Funds Management, which is the sole owner and operator of Incheon International Airport in South Korea and an investor with 16 airport-related investments.

--  Industry Funds Management and Manchester Airport Group, an investor with interests in 13 airports, including Melbourne Airport and Brisbane Airport, both in Australia, and operator of Manchester Airport and East Midlands Airport, in Britain.

If the city moves forward and seeks proposals, a privatization plan could be submitted to the City Council this summer.

This is the second time Chicago has looked at privatizing Midway. A 99-year lease that would have brought in $2.5 billion died in 2009 when the financial markets froze. That deal had drawn six serious bidders.

Mayor Rahm Emanuel has said any second attempt would have to provide city taxpayers with a better deal than the widely criticized 75-year agreement to privatize parking meter operations, carried out during former Mayor Richard Daley's administration. Proceeds from the earlier deal were used to plug operating deficits, and meter rates rose sharply.

This time, proposed leases must be less than 40 years, which locks in the city for a shorter period.

Rather than making only an upfront payment, the private operator also must share revenue with the city on an ongoing basis. Initial proceeds would be used to pay down debt issued since 1996 to rebuild the airport, the mayor's office said. There is about $1.4 billion in outstanding debt.

Longer term, cash flow would be directed to city infrastructure needs. The mayor has pledged proceeds would not be used to pay for city operations.

kbergen@tribune.com

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Storm loses punch, but still socks morning commute

A winter storm that buried the Great Plains in more than a foot of snow lost some of its punch as it blew through Chicago overnight, but it still managed to slow the morning commute with slick roads and dozens of spinouts on expressways.

Snow began tapering off around 5:30 a.m., but the National Weather Service was warning of freezing drizzle through the morning and light snow in the afternoon. A winter weather advisory remains in effect until 6 p.m.

At 6 a.m., 2.7 inches had fallen at O'Hare International Airport, tying the highest total recorded there this winter, according to the National Weather Service. Accumulation ranged from 2 to 5 inches throughout the area, according to the Chicago Weather Center.

About 5 inches were reported in Woodstock, 4 inches in Crown Point, Ind., 3.8 inches in Huntley, 3.8 in Milwaukee, 3.5 inches in Lake Villa, 3.4 inches at Wrigley Field, 3.2 inches in Plainfield, 3.1 inches at Midway Airport, 3 inches in Oak Park, 2.7 inches in Mokena, 2.5 inches in Schaumburg, 2.4 inches in Orland Hills, 2.4 inches in Batavia, 2.4 inches in Joliet, and 2 inches in Chesterton, Ind.

At the height of the storm shortly after midnight, state police described road conditions as "horrible." But conditions had improved by the time the morning rush hour began. Still, state police said they had responded to 22 accidents as of 7 a.m. but there were many other spinouts that didn't require their assistance.

The city of Chicago sent 284 plows to work clearing main thoroughfares, according to the Streets and Sanitation Department.

Dozens of schools closed because of the storm, or delayed start times.

As of late Friday morning delays at O’Hare International Airport are averaging 30 minutes for inbound and outbound flights, according to the city’s Department of Aviation.

Airlines there have canceled more than 300 flights primary because of weather, according to the department.  

At Midway, airlines have delays of about 15 minutes while there were more than 30 cancellations, the department said.

Flurries could linger into the weekend, with a chance for light snow on Saturday.  High temperatures both days should be around 30, with lows in the low 20s and high teens both mornings.

Kansas bore the brunt of the storm, with up to 15 inches of snow in some parts of the state, according to the National Weather Service. A 200-mile stretch of Interstate 70 in central Kansas was closed and strewn with cars stuck in snow.

National Guard troops riding in Humvees were dispatched to look for stranded motorists along the interstate and other highways, said Sharon Watson, a spokeswoman for Kansas emergency management services.

The fierce storm triggered severe thunderstorms from eastern Texas to Georgia. Thunder accompanied snow in Kansas City, hit by 2 to 3 inches of snow per hour on Thursday morning.

"When there is thunder and lightning, it's a pretty screaming clue that you are going to have massive snowfall," said Andy Bailey, a meteorologist with the National Weather Service in Pleasant Hill, Missouri.

Missouri Gov. Jay Nixon and Kansas Gov. Sam Brownback declared states of emergency because of hazardous travel and possible power outages. Brownback ordered state offices closed because of the storm.

Kansas City International Airport was closed on Thursday while crews cleared runways. It was unclear when the airport would reopen, spokesman Joe McBride said.

At the Denver International Airport, some 55 commuter flights were canceled overnight, spokeswoman Laura Coale said. More than 320 flights in and out of Lambert-St. Louis International Airport were scrapped and nearly 50 flights in and out of Omaha's Eppley Airfield were listed as canceled by midday.

In Nebraska, a 19-year-old woman was killed in a two-car accident on Wednesday on Interstate 80 near Giltner. The Nebraska State Patrol said weather was a factor.

An 18-year-old man died in Oklahoma when his vehicle slid into a semi-truck on a slushy state highway, the state's highway patrol said.

The storm is expected to reach the East Coast this weekend, delivering heavy snow to parts of New England for a third straight weekend, from northern Connecticut to southern Maine.

Reuters contributed

chicagobreaking@tribune.com

Twitter: @ChicagoBreaking

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Well: Depression May Stifle Shingles Vaccine Response

Depression may lower the effectiveness of the shingles vaccine, a new study found.

The research showed that adults with untreated depression who received the vaccine mounted a relatively weak immune response. But those who were taking antidepressants showed a normal response to the vaccine, even when symptoms of depression persist.

Shingles, an acute and painful rash, strikes a million Americans each year, mostly older adults. Health officials recommend that those over 60 get vaccinated against the condition, which is caused by reactivation of the same virus that causes chickenpox, varicella-zoster.

In the new study, published in the journal Clinical Infectious Diseases, researchers followed a group of 92 older men and women for two years. Forty of the subjects had a major depressive disorder; they were matched with 52 control subjects of similar age. The researchers measured their immune responses to the shingles vaccine and a placebo shot.

Compared with the control patients, those with depression were poorly protected by the vaccine. But the patients who were being treated for their depression showed a boost in immunity — what the researchers called a “normalization” of the immune response. It is unclear why that was the case.

The authors of the study speculated that treatment of older people with depression might increase the effectiveness of the flu shot and other vaccines as well.

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