So a year later, has the bet paid off?

Consensus is largely favorable for the Horseshoe Cleveland.

In its first year, after subtracting winnings paid out to lucky players, it’s generated 243 million dollars in profits.

“We are right at internal projections,” says Marcus Glover, Senior Vice President of Northeast Ohio Caesar’s Entertainment.

He considers the casino’s first year to be a pretty great start.

At the same time, he says there is no year to year comparison to be had until 2014.

Glover also says there have been issues with construction.

There’s a lot of work being down on the roadways in downtown Cleveland that lead to some very, very, congestive times of traffic.

Helping City Coffers

Cleveland City Controller Jim Gentile says the Horseshoe has had a largely positive impact.

He says through April 30th, the city’s received just under 9 million from casino tax in total.

Gentile adds that the downtown area is more vibrant, with hotel bookings up and local restaurants enjoying more business.

And Cleveland’s parking tax collections are up $2 million more than last year.

Gentile says it all adds up to a much needed boost to the city coffers.

“Fifteen percent of casino revenues are allocated towards council, and they have capital projects in their wards. The 85 percent goes to general fund. Part of that being used to increase police presence around casino, and public works to keep that area clean and safe.”

The county sees a gain from the casinos too, about $4.5 million so far, and another $8 million expected by year’s end.

Cuyahoga County Executive Ed Fitzgerald announced plans to put some of that money toward economic development projects, including the Flats East Bank and Playhouse Square.

There are shovels in the ground, there are cranes in the air, and things are getting done. What you’re seeing is, an optimistic period in Cleveland’s development future, that we have really just not seen for decades, and decades, and decades.

Fitzgerald says it’s worked out well, even if casino revenues are about 10 percent less than his office originally projected.

“It’s a little off what it was, but every little bit helps. And I think we’ve set a good pattern that I hope other communities will emulate,” Fitzgerald says.

“Because we’re putting all of it to try to keep the job creation engine humming along.”

Not Without Problems

In addition to tax money for the city and county, Ohio’s casinos have also generated something they’re less apt to publicize: problem gamblers.

The Ohio Casino Control Commission reports that calls to their HelpLine topped 500 in March.

And as of yesterday, 365 people have joined the Voluntary Exclusion Program, which bars them from entering the Horseshoe and other gaming establishments.

That’s an average of one person a day since the Horseshoe opened its doors.

And both she and her husband, Felix DeJesus, had talked about the need for poor, working-class neighborhoods like theirs to band together to raise and protect children.

The Spanish-language Mass at St. Michael the Archangel was packed on Sunday. Weary after a week of media scrutiny, parishioners prayed for the freed women, and for their neighborhood to protect its own.

The church on Scranton Avenue is just three blocks from the house where Ariel Castro allegedly held three women hostage for a decade. The young women – Gina DeJesus, Amanda Berry and Michelle Knight—have all returned home since their rescue a week ago.

Time to heal

On Sunday morning – Mother’s Day—attorneys for the three asked well-wishers and the media to give them time to heal and reconnect with their families.

“There may be a time in the future when Ms. DeJesus, Ms. Berry and Ms. Knight are ready to tell their story. Let me make this very clear: that will not be while the criminal proceeding is pending, and it will not be until they tell us they are ready to do so,” said attorney Jim Wooley.

And overall, the media and crowds seem to be starting to give them that room.

A Return to Normalcy

Just a few cameramen remain perched on Seymour Avenue as police cars allow access to the block for residents. William Johnson used to live nearby, and was attending St. Michael’s with his wife, who grew up in the largely Hispanic neighborhood. Like many in the past week, he’s asking himself how three young women could go undetected for a decade.

“Nowadays, I just notice people are more into themselves and minding their own business,” he says. “They’re not as neighborly as they used to be. We have a lot of foreclosed homes in the city. And this is how things like this happen,” Johnson said.

Prevention

Preventing this from happening again has been a topic of discussion in the neighborhood for the past week. Lillian Lequay says she’s doing her part.

“Now when I see something weird, I say, ‘Oh, let me check that guy.’ I think everybody has opened their eyes. In everybody’s mind, they’re more protective of their kids. I have a 17-year-old and I’m afraid for her to even step out of the house.”

“If you see something, say something.”

During a prayer vigil last week, community leaders like activist Khalid Samad urged residents to be more vigilant in the future.

“Let’s continue to understand: if you see something, say something. It’s not snitching. It’s telling the story. It’s reporting a crime.”

Gina DeJesus, Amanda Berry and Michelle Knight were allegedly abducted by Ariel Castro when they were 14, 16 and 20-years-old. Castro has been charged with three counts of rape and four counts of kidnapping.

One of the kidnapping charges applies to the now 6-year-old daughter he fathered with Amanda Berry. The Cuyahoga County prosecutor plans to file additional charges.

In a police report that NPR has been shown, Amanda Berry, Gina DeJesus and Michelle Knight are quoted as saying that suspect Ariel Castro’s approach was simple. On Morning Edition, NPR’s Cheryl Corley said it’s alleged that:

“Nearly 10 years ago, [Castro] told then 14-year-old DeJesus he’d drop her off at his house so she could meet with his daughter. … He lured Amanda Berry [in 2003] by telling her his son worked at the same restaurant she did. He offered Michelle Knight a ride home [in 2002].”

As Cheryl adds, all three — according to their accounts — “would end up chained in the basement of the house before living later on the second floor. They were allegedly forced to have sex with Castro. One victim told police she became pregnant several times but Castro punched her in the stomach so she would miscarry. Amanda Berry give birth to a daughter who is now six. Authorities will give the child a paternity test to confirm Castro is the father.”

The women say they were almost never allowed outside. Martin Flask, Cleveland’s public safety director, said Wednesday that “in the last decade, they’ve only known themselves to be outside of the home on two separate occasions and that was only briefly.”

The Cleveland Plain Dealer says that the police report also states “that Berry’s 6-year-old daughter was born in a small inflatable swimming pool during the time the three women were held in captivity, [a Cleveland police] source said. The initial report says Castro forced Knight to deliver Berry’s baby. He threatened to kill Knight if the baby did not survive the birth, the source said.”

As we reported Wednesday, prosecutors say Castro is being charged with four counts of kidnapping (one for each of the three women and another for Berry’s daughter) and three counts of rape. Castro, 52, is due in court later today.

The suspect’s brothers Pedro and Onil, who were taken into custody with him on Monday, will not face any criminal charges, as WCPN reports. According to the Plain Dealer, “Victor Perez, the chief assistant city prosecutor, said there was no evidence linking Onil and Pedro Castro to the [alleged] torture that took place at their brother’s home.”

Berry and DeJesus are now at relatives’ homes in Cleveland. Knight remains in a hospital, where she’s said to be in good condition.

We’ll watch for more news and update as warranted.

Update at 8:40 a.m. ET. Castro Arraigned, Bond Set At $8 Million:

Ariel Castro, the 52-year-old former bus driver accused of holding three women captive in his home for about a decade, just stood silent and with his head bowed as Cleveland Municipal Court Lauren C. Moore set his bond at $2 million per case against him. He’s accused of kidnapping and raping the three women, and kidnapping the child that one of them bore while in captivity. It appeared Moore was saying that the total for the bonds was $8 million, given that Castro is accused of crimes against four individuals.

Castro’s brothers Onil and Pedro, who were taken into custody along with him on Monday, also appeared. Authorities have said they now do not think the brothers were involved in the alleged kidnappings, rapes and captivity. Both brothers had outstanding misdemeanor charges (for drinking in public from open containers), however, and were assessed small fines.

Update at 8:25 a.m. ET. Arraignment About To Begin:

Ariel Castro’s arraignment is about to get started. Cleveland’s NewsNet5 is among the stations streaming the hearing.

Related NPR posts and stories:

– Another Neighbor Of Rescued Cleveland Women Says He Helped

– Specially Trained FBI Agents Will Help Kidnapped Women Heal

– The Missing Women Were Seemingly In Plain Sight

Note: As happens when stories such as this are developing, there will likely be reports that turn out to be mistaken. We will focus on news being reported by NPR, other news outlets with expertise, and statements from authorities who are in a position to know what’s going on. And if some of that information turns out to be wrong, we’ll explain.

Copyright 2013 NPR. To see more, visit http://www.npr.org/.

“Help! Help Me!”

A young woman’s desperate cries alerted neighbors Monday to a frightening tale in Cleveland.

As we reported last evening, three young women who had gone missing between 2002 and 2004 were found Monday afternoon inside a home where the shades were said to be always drawn. No one who lives nearby seems to have suspected that there might be kidnap victims inside.

The women are Amanda Berry (27), Gina DeJesus (23) and Michelle Knight (32), whose disappearances generated much attention in local media over the past decade. Three brothers in their 50s have been arrested.

According to The Associated Press: “Berry disappeared at age 16 on April 21, 2003, when she called her sister to say she was getting a ride home from her job at a Burger King. About a year later, DeJesus vanished at age 14 on her way home from school. Police said Knight disappeared in 2002 and is 32 now.” They are being treated at a Cleveland area hospital, where they’re reported to be in fair condition.

As Tuesday dawns, we’re learning more about how the women were discovered and what neighbors say about the man who they would see coming and going from the home.

On Morning Edition, WCPN’s Bill Rice played a clip from a frantic 911 call Berry made after her escape. “Help me, I’m Amanda Berry. … I’ve been kidnapped and been missing for 10 years. I am here, I’m free now,” she says. (A transcript of her call is posted here.)

WCPN’s Rice also reported on neighbor Charles Ramsey’s account of Berry’s cries for help from inside the house.

“I heard screaming,” Ramsey said. “I come outside I see this girl going nuts trying to get out of the house. So I go on the porch and she says help me get out. I’ve been in here a long time.”

Ramsey says Berry was pushing her hand out of part of a door as she yelled. According to the Cleveland Plain Dealer, “Ramsey said Castro took off running while Ramsey kicked and broke the bottom of a door, allowing Berry to crawl out. Police arrested Castro at a nearby McDonald’s restaurant and brought the other two women out of the house, witnesses said.”

A young child also emerged from the home, according to local news reports.

As for Aerial Castro, the man who lived in the home, the Plain Dealer writes that “Mike Iwais, a longtime resident in the neighborhood, lives in a house just a parking lot away — about 200 feet — from Castro’s house. ‘I used to see him walking around all the time,’ he said. ‘But I never saw nothing crazy. This is unbelievable. It’s a miracle they found him, and it’s a miracle those girls are alive. It’s a blessing from God.’ ”

On Morning Edition, WCPN’s Rice reported that other neighbors “say Castro would park his red pickup truck behind his house, lock the gate and enter though a back door. The house was often dark, with shades blocking the windows.” Rice also reported that:

“Rescuer Charles Ramsey says he never saw Castro do anything suspicious. ‘He just comes out to his backyard, plays with the dogs, tinkers with his cars and with his motorcycles, and goes back in the house,’ Ramsey said. “So he’s just somebody who you look, and then look away, because he’s not doing’ nothin’ but the average stuff.’ ”

Cleveland’s NewsNet5 has more coverage here.

We’ll be monitoring and plan to update as this story develops.

Update at 11 a.m. ET. The Latest From WCPN:

The three suspects — 52-year-old Ariel Castro, 54-year-old Pedro Castro, and 50-year-old O’Neal Castro — are in custody and expected to be charged within the next 36 hours.

Also:

“Department officials say their records show there were never any calls for service to Ariel Castro’s home on Seymour Ave, the location where the three women were rescued Monday evening. Police say Ariel worked as a Cleveland Schools bus driver, and was questioned once in connection with a child left on the bus, but no charges were ever filed in relation to the incident.

“Meanwhile, police say the three women appear to be in okay condition, and were released from Metro Health Hospital earlier this morning.”

Update at 9:45 a.m. ET. Suspects’ Uncle Says Family Is Surprised:

CNN just spoke with Julio Castro, an uncle of the three men suspected of holding the young women against their will. The family’s reaction to this news is “surprise,” Julio Castro said. He never had any reason to think that three young women (and a child) might be held captive in his nephew Ariel’s home, Julio Castro said, and had not seen Ariel in recent years. As for how he thinks others will react to his news about members of his family, Julio said he trusts people will realize there’s “a bad one in every family.”

Update at 9:25 a.m. ET. Suspects Named, Child Is Thought To Be Berry’s Daughter:

At a news conference now underway in Cleveland, Police Chief Michael McGrath identified the three brothers who are under arrest as Ariel Castro, 52, Pedro Castro, 54, and O’Neill (spelling not confirmed), 50.

Authorities also said that they believe the 6-year-old girl found at the home is Amanda Berry’s daughter. They would not comment on the father’s identity.

Update at 9:04 a.m. ET. VIDEO: Charles Ramsey talks about helping Amanda Berry and about the man who lived in the house.

Note: As happens when stories such as this are developing, there will likely be reports that turn out to be mistaken. We will focus on news being reported by NPR, other news outlets with expertise, and statements from authorities who are in a position to know what’s going on. And if some of that information turns out to be wrong, we’ll update.

Take me back to the top of this post.

Copyright 2013 NPR. To see more, visit http://www.npr.org/.

Big Data – according to Charlie Lougheed –is all about the three V’s: volume, velocity, and variety.

“So if you think about an organization like Google, they have massive amounts of volume coming at them. If you think about a large bank, there are a lot of transactions coming through, that’s velocity, it’s coming at you very quickly. If you think about a healthcare org. there’s a huge degree of variety in the data.”

Lougheed is president of Explorys, a Cleveland start-up that has created a Google-type tool for the medical industry to help make sense of the tsunami of data sloshing around.

From a volume standpoint today we’ve curated 85 billion clinical, financial, and operational data facts, and those are the data facts that make-up the process of care.

Every time you see your family doctor, or take a drug, or enter the hospital you generate potentially useful data that, taken together, could lead to better treatment for you, and a way for hospital administrators to streamline care.

Lougheed says Explorys uses anonymous patient information in the aggregate to do basic research to “more or less have a conversation with your data, because that’s what’s always been missing within large sets of healthcare data, it’s taken a long time to ask a basic question.”

Explorys got its start three years ago from an idea hatched by a Cleveland Clinic physician who mined the hospital’s database to uncover trends and insights for his practice. The company incubated in a suite at the Clinic’s business development arm before landing last November in the spacious digs of the former MOCA galleries and hiring 85 employees.

Cleveland Clinic Innovations director Chris Coburn says Explorys is a response to enormous changes happening in the healthcare industry.

What we’re heading in to is an era where information management is going to dominate healthcare – the groups, the companies, the hospitals that best manage data are going to come out on top.

Explorys CEO Steve McHale says the value of big data comes from the Affordable Care Act’s shift from piece-meal payments, or ‘fee-for-service’ patient care, to a lump-sum, outcome-based system.

McHale says today’s hospital leaders are facing a steep learning curve.

“They need to now prepare for new payment models and new care models, the fee for service model will become a thing of the past. Now the key is, how do you transform yourself into that new model without going under.”

And like the airlines, banking, and other industries, he says healthcare is undergoing rapid consolidation.

There’s not going to be all these little mom and pop systems and hospitals. It’s going to come down to mega-systems we think.

McHale predicts about a-third of hospitals will be gone, or absorbed in mergers over the next seven years.

Right now Explorys counts 13 hospital chains in its network, including the Cleveland Clinic, University Hospitals, MetroHealth, Akron General, Summa and Catholic Health Partners.

The network tracks 31 million patients and 120 hospitals, and 85 billion data points.

McHale says analytic tools like Explorys could give providers an edge in the new era of slimmer profit margins, and higher risk.

Big data-driven healthcare is his prescription for hospitals hoping to survive this coming revolution.

But the tools to measure fat are much more diverse – and each has its drawbacks.

First, let’s dispose of a common misconception: “To measure fat, just jump on a scale.”

Seems logical; it’s what everyone talks about when discussing obesity but a scale is a primary tool to measure…well, weight.

It’s precise as far as it goes – weight is an indicator of health – but it doesn’t shed much light on how much fat you’re carrying around, along with bone, muscle, organs and other body content.

“Your weight tells you nothing. Your weight tells you nothing,” says Gina Shaffer, a personal trainer in Elyria.

You have to find out what you’re composed of. When you find that out, then you know where to go, then you know what’s happening to you, then you know how you are succeeding.

Doctors couldn’t agree more.

The most common fat measurement they use is low-tech. It’s called the Body Mass Index.

You’ve probably heard of it, but not a lot of people can rattle off their BMI number.

MetroHealth’s Dr. Eileen Seeholzer says that’s changing.

At her clinic, everyone goes home with a sheet in hand about their B-M-I.

“Body Mass Index is basically a ratio of two measurements: a person’s height, and their weight.

“The BMI gives you a common number.”

That’s weight divided by height, squared.

There are lots of easy-to-use calculators online to get your personal number. A BMI of over 25 is considered overweight; 30 and above is obese. High BMIs are a red flag for health problems like diabetes and heart disease.

But the BMI doesn’t directly measure the fat in your body; it’s just an estimate.

It doesn’t breakdown your body composition.

That’s why they call it a screen; this isn’t a lab measurement.

The second fat measurer in our little tour is a gadget, one you might find in a health club or gym.

Let’s go back to Gina Shaffer, the personal trainer.

“Alright, so take your shoes and socks off.”

Shaffer is working with Julie Rush from Avon Lake and she’s about to step on a scale at the gym in the EMH Elyria Medical Center.

The first thing on Schaffer’s agenda is to get some measurements.

“Let me just program this in…and how old are you?

Rush: “55.”

Schaffer: “And how tall?”

Rush: “5’ 8”.”

And go ahead and hop on.”

This isn’t your typical scale. It’s a “bio-electrical impedance” machine.

It sends an imperceptible, safe electric current through the body. The current passes through lean body mass faster than when it encounters fat. By measuring this resistance, the machine computes the amount of fat in the body.

Rush gained five pounds since the last check in and she’s a little disappointed. But Shaffer says that’s not the thing to focus on:

Look at your body fat: your body fat was at 51.8 and now you’re at 51.5, so you lost a little bit of body fat…Then right here you got—see you’re up like three pounds muscle.

There are many other ways to get at a body’s fat content.

Calipers – those tong-things a doctor pinches your skin with; an underwater measuring tank.

Some can seem a little weird.

"We call this the egg," says Alicia Thomas. She runs studies at a MetroHealth research lab.

She shows off what’s called the Bod-Pod.

"It smells like a boat—it’s made of fiberglass. It has a nice seat in here for the patient…"

The Bod-Pod is a high-tech way to precisely measure body fat. It’s used in research, and health spas and clinics.

Thomas says it’s quick and safe.

"The worst part is that you have to put a bathing suit on."

I climb inside to see what it’s like, and they close the hatch.

It blows puffs of air at you. It measures fat through changes in air pressure. It’s accurate and expensive.

Maybe fun, but is it necessary?

"I don’t think I could ever say one needs a bod-pod," Dr. Seeholzer says.

She says the main thing is to keep track of your measurements – no matter which method is used.

Those who do tend to make more progress with their health goals.

Tuesday DeWine released the first detailed account of the Nov. 29 shooting. He turned it over to the Cuyahoga County prosecutor, who said the case will be presented to a grand jury to determine if the officers should face charges. There was no timeframe announced.

DeWine described a confusing scene where officers kept shooting at a likely unarmed driver and passenger at the end of a chase because they thought shots had been fired from the car. He said officers positioned on both sides mistook crossfire for shots from the car, leading to many more shots fired.

Police spokesman Sgt. Sammy Morris says the shooting late Sunday morning on the employee parking lot of the Cleveland Hopkins International Airport was an apparent homicide and suicide.

The police spokesman says the man, identified as 28-year-old Ahmad Alkahder, apparently followed her to the off-site lot, blocked her in her car by his vehicle and then began firing. Authorities say Alkahder fired at another Transportation Security Administration employee who was commuting to work with the man’s estranged wife but missed.

The shooting occurred at the Riveredge airport employee parking lot, located north of the airport in an industrial area along Interstate 480.

Police were not sure of a motive for the shooting.

Fares Raslan came to the United States from Syria in 23 years ago to pursue his studies in anesthesiology. Life’s been good to him over here. He and his wife Lila raised a family and have a nice house in suburban Cleveland.

It’s a sharp contrast to life back in Syria — a country in the grip of a civil war, as rebels try to topple the government of president Bashar al-Assad. After televised reports of bloody violence in the streets, the world medical community rallied its support.

We knew about other groups that were going. We were watching on the news that there were French nationals that were operating in Syria. They were on CNN on Anderson Cooper.

A local surgeon named Mohammed saw those same reports. Mohammed won’t give his full name for fear of repercussions against his family back in Syria, but he can’t hide the passion that he felt, watching the horrific images.

It just stirred in us a flame that we need to do something.

They connected with a Canadian physician who had made numerous medical visits to Syria himself, and was recruiting others to do the same.

The two Clevelanders soon found themselves in a refugee camp along the Syrian border in Turkey. There was plenty of work to do there, but the call of their country was stronger.

Still, the danger of entering an active war zone gave them pause, until they saw others going in.

“We heard that the Egyptian team left a few days ago; the Saudi team went inside today; a surgeon from Alabama was inside, along with another surgeon from Utah,” Raslan says. And him and I were just looking at each other, you know? And then, we saw the orphan.”

“We saw this little boy, sitting, and they told us that he lost all his family, and there’s nobody to take care of him,” Mohammed remembers.

It just touched something in you that — you need to do something.

FARES RASLAN: That was the tipping point for both of us. He said, “I don’t know about you, but I’m going in.”

The poignancy of that story isn’t lost on Dr. Marisa Herran.

“The mantra that should move us is to help children,” Herran says.

A pediatric specialist at Case Western Reserve University, Herran has tended to the needs of children in disaster zones ranging from Darfur to Kosovo, and she’s seen a shift on the battle front

Decades ago, wars used to be between factions and armies — not anymore. Now, the civilians are more affected than even the armed forces.

Lately, she’s been following events in Syria – and is all too aware of the dangers medical professionals can face in the modern world of warfare.

“The Red Cross is not a protection anymore — just the opposite. Health workers are easy targets,” Herran says.

Crossing the Turkish border into Syria, Fares Raslan and Mohammed set-up shop in a little town called al-Dana where the medical facilities were woefully inadequate

They were dropping patients by the dozens. They throw them on the floor, and then they go to get another group in a pick-up truck. The hospital equipment is very, very primitive. When I left Syria in the late 80s, it’s still the same, same equipment — probably worse, now.

“The last day was the most troubling, because we had 60-70 patients within about 10 hours,” says Mohammed. “It was really overwhelming. We were just jumping from one patient to another, to see who needed the most help.”

But for all the chaos in the operating room and the danger just outside the hospital, Fares Raslan says his fear vanished quickly.

“You are a target. But, when you look around, you see the ladies cleaning blood off the floor, the kids running in and out, all the local doctors are around you — you feel like you’re in a big community here.”

I didn’t see anybody who had any sign of fear. This is what really lifted me up.

The two men are back, safe at home. They can now chuckle at the memories of barely dodging a bomb that fell from the skies. And they are still full of wonder at the spirit of their people in the face of adversity. Fares Raslan says he’s making arrangements to return in January.

In the meantime, Cleveland’s mayor says he will back police in the shooting deaths of two people during a chase if procedures were followed, but there will be consequences if they weren’t.

The comments from Mayor Frank Jackson on Monday came as city hall dealt with the fallout from Thursday night’s shooting barrage of 137 bullets with 13 officers involved.

No weapon or shell casings were found in the vehicle in which two people fled downtown Cleveland after an officer heard a gunshot near police headquarters.

The medical examiner said Monday that the victims were tested for gunpowder residue, which could indicate if they fired a weapon and tossed it. Results on the gunpowder residue tests could take weeks.

Officers say the driver rammed a patrol car and nearly hit an officer.