Football: Madrid slump at Betis as title hopes suffer

MADRID: Real Madrid suffered a major setback to their Spanish title hopes when they slumped to a 1-0 defeat at Real Betis on Saturday, handing Barcelona the opportunity to open an 11-point gap over their bitter rivals on Sunday.

Jose Mourinho's side remain eight points behind leaders Barcelona and five off city rivals Atletico who they host in the Madrid derby next Saturday.

Betis midfielder Benat Etxebarria's third goal of the season decided the game on Saturday.

All of his goals have been hit from outside the area, and he proved once again why Vicente del Bosque has been including him in recent Spain squads.

For Betis, the result comes on the back of a disappointing 5-1 defeat to their local rivals Sevilla last Sunday and puts them four points behind Madrid in fifth.

"I try to be fair when my team lose and not look for excuses but it's obvious that the side that plays Wednesday (in the Champions League) should not play on Saturday," said Mourinho.

"It's true that other sides have a control over the calendar that we do not have, but I congratulate Betis who played a great game from start to finish."

Cristiano Ronaldo fired in two shots in the opening exchanges.

However, neither side had taken charge of the game when Benat hit what was to be the winner on 17 minutes.

Betis had played the ball into the corner only for Angel Di Maria to badly hook a clearance that the little midfielder controlled before evading the challenge of Sami Khedira to fire a drive past Iker Casillas.

Madrid continued to enjoy more of the possession and Di Maria twice went close to making amends for his mistake.

When Ronaldo crossed from the left the Argentinian was inches from levelling the game and moments later a Chechu Dorado block looped his goal bound shot over the bar.

Mourinho made two changes at half-time, as he has done on a number of occasions this season.

Luka Modric and Kaka replaced Khedira and Mesut Ozil as the Portuguese coach searched for more urgency going forward.

They started brightly with more purpose and Ronaldo and Kaka forced good saves from Adrian in the Betis goal.

At the other end Juan Carlos hit a venomous free-kick just over the bar.

Then Mourinho made an early last throw of the dice, replacing Di Maria with Jose Callejon on 62 minutes.

Madrid pressed in search of an equaliser leaving spaces that Betis were clever enough to expose and Salva Sevilla and Ruben Castro went close for the home side.

Adrian stood firm again to tip over a whipped free-kick from Ronaldo as Madrid's challenge uncharacteristically fizzled out on a night to forget for Mourinho's side.

Malaga thrashed rivals Valencia 4-0 to move behind Madrid into fourth, level on 22 points with Betis.

Francisco Portillo fired the Costa del Sol side into an early lead on eight minutes and Javier Saviola should have doubled the lead before half-time when put through on goal only to slice his shot wide.

The Argentine made up for that miss by doubling the lead on 75 minutes. Roque Santa Cruz hit a third 10 minutes from time before Isco rounded off a brilliant Malaga performance with a crisply struck shot.

Both teams qualified for the knock-out stages of the Champions League in midweek, but this win puts Malaga four points ahead of Valencia in the fight to qualify for next season's competition.

Also on Saturday there were home wins for Rayo Vallecano and Valladolid over Mallorca and Granada respectively.

Brazilian striker Leo Baptistao was the star for Rayo breaking the deadlock with a low drive on 87 minutes before turning provider two minutes later for Andrija Delibasic.

Former Manchester United striker Manucho powered home his fourth goal of the season with a second-half winner for Valladolid, making it four league goals for the Angolan this season.

On Sunday, Barcelona travel to Levante while Atletico Madrid welcome Sevilla.

-AFP/ac

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AP PHOTOS: Simple surgery heals blind Indonesians

PADANG SIDEMPUAN, Indonesia (AP) — They came from the remotest parts of Indonesia, taking crowded overnight ferries and riding for hours in cars or buses — all in the hope that a simple, and free, surgical procedure would restore their eyesight.

Many patients were elderly and needed help to reach two hospitals in Sumatra where mass eye camps were held earlier this month by Nepalese surgeon Dr. Sanduk Ruit. During eight days, more than 1,400 cataracts were removed.

The patients camped out, sleeping side-by-side on military cots, eating donated food while fire trucks supplied water for showers and toilets. Many who had given up hope of seeing again left smiling after their bandages were removed.

"I've been blind for three years, and it's really bad," said Arlita Tobing, 65, whose sight was restored after the surgery. "I worked on someone's farm, but I couldn't work anymore."

Indonesia has one of the highest rates of blindness in the world, making it a target country for Ruit who travels throughout the developing world holding free mass eye camps while training doctors to perform the simple, stitch-free procedure he pioneered. He often visits hard-to-reach remote areas where health care is scarce and patients are poor. He believes that by teaching doctors how to perform his method of cataract removal, the rate of blindness can be reduced worldwide.

Cataracts are the leading cause of blindness globally, affecting about 20 million people who mostly live in poor countries, according to the World Health Organization.

"We get only one life, and that life is very short. I am blessed by God to have this opportunity," said Ruit, who runs the Tilganga Eye Center in Katmandu, Nepal. "The most important of that is training, taking the idea to other people."

During the recent camps, Ruit trained six doctors from Indonesia, Thailand and Singapore.

Here, in images, are scenes from the mobile eye camps:

Read More..

Sandy-Hit Stores Seek Small Business Saturday Boost

Nov 24, 2012 3:35pm

                                                                                      (Image Credit: Associated Press)

Superstorm Sandy delivered a one-two punch on small businesses, creating millions of dollars in damage and in turn, delivering a debilitating blow to their revenue.

But on Small Business Saturday, when  shoppers are encouraged to support local businesses,  those mom-and-pop stores are hoping for a rebound.

Donna Scofield and her family have sold toys at their Manhattan shop, called Stationery & Toy World, for the past 25 years. Although the store is located on Manhattan’s Upper West Side, where the storm did little damage, $500,000 of Scofield’s inventory, which she kept in her home and three Staten Island warehouses, was destroyed.

“Some days are easier than others,” she told ABC New York station WABC-TV last week. “We’re taking each day at a time.”

PHOTOS: Superstorm Sandy’s Wide Swath of Destruction

Mayor Michael Bloomberg announced today that more than $45 million in loans, grants and financial assistance would be made available to businesses like Scofield’s that were hurt by the storm.

“Getting New York City small businesses back on their feet is key to helping our economy recover from Sandy,” Bloomberg said in a statement. “The capital provided through this program will help businesses purchase supplies, make repairs, and get back up and running.”

Small Business Saturday, which is going on its third year, is being celebrated nationwide.

Andrea Evans, the owner of Pink Boutique in Phoenix, said stores like hers don’t stand a chance with shoppers on Black Friday.

“Everyone’s up so early, and they’re going more for, you know, appliances and TVs and stuff like that, and I think by the time noon hits, they’re done,” she told ABC News Radio.

Over the past two decades, small and new businesses have created two out of every three net new jobs in the United States, according to the U.S. Small Business Administration.

It is estimated that half of all working Americans either own a small business or are employed by one.

SHOWS: World News

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Egypt's Mursi faces judicial revolt over decree

CAIRO (Reuters) - Egyptian President Mohamed Mursi faced a rebellion from judges who accused him on Saturday of expanding his powers at their expense, deepening a crisis that has triggered violence in the street and exposed the country's deep divisions.

The Judges' Club, a body representing judges across Egypt, called for a strike during a meeting interrupted with chants demanding the "downfall of the regime" - the rallying cry in the uprising that toppled Hosni Mubarak last year.

Mursi's political opponents and supporters, representing the divide between newly empowered Islamists and their critics, called for rival demonstrations on Tuesday over a decree that has triggered concern in the West.

Issued late on Thursday, it marks an effort by Mursi to consolidate his influence after he successfully sidelined Mubarak-era generals in August. The decree defends from judicial review decisions taken by Mursi until a new parliament is elected in a vote expected early next year.

It also shields the Islamist-dominated assembly writing Egypt's new constitution from a raft of legal challenges that have threatened the body with dissolution, and offers the same protection to the Islamist-controlled upper house of parliament.

Egypt's highest judicial authority, the Supreme Judicial Council, said the decree was an "unprecedented attack" on the independence of the judiciary. The Judges' Club, meeting in Cairo, called on Mursi to rescind it.

That demand was echoed by prominent opposition leader Mohamed ElBaradei. "There is no room for dialogue when a dictator imposes the most oppressive, abhorrent measures and then says 'let us split the difference'," he said.

"I am waiting to see, I hope soon, a very strong statement of condemnation by the U.S., by Europe and by everybody who really cares about human dignity," he said in an interview with Reuters and the Associated Press.

More than 300 people were injured on Friday as protests against the decree turned violent. There were attacks on at least three offices belonging to the Muslim Brotherhood, the movement that propelled Mursi to power.

POLARISATION

Liberal, leftist and socialist parties called a big protest for Tuesday to force Mursi to row back on a move they say has exposed the autocratic impulses of a man once jailed by Mubarak.

In a sign of the polarization in the country, the Muslim Brotherhood called its own protests that day to support the president's decree.

Mursi also assigned himself new authority to sack the prosecutor general, who was appointed during the Mubarak era, and appoint a new one. The dismissed prosecutor general, Abdel Maguid Mahmoud, was given a hero's welcome at the Judges' Club.

In open defiance of Mursi, Ahmed al-Zind, head of the club, introduced Mahmoud by his old title.

The Mursi administration has defended the decree on the grounds that it aims to speed up a protracted transition from Mubarak's rule to a new system of democratic government.

Analysts say it reflects the Brotherhood's suspicion towards sections of a judiciary unreformed from Mubarak's days.

"It aims to sideline Mursi's enemies in the judiciary and ultimately to impose and head off any legal challenges to the constitution," said Elijah Zarwan, a fellow with The European Council on Foreign Relations.

"We are in a situation now where both sides are escalating and its getting harder and harder to see how either side can gracefully climb down."

ADVISOR TO MURSI QUITS

Following a day of violence in Cairo, Alexandria, Port Said and Suez, the smell of tear gas hung over the capital's Tahrir Square, the epicentre of the uprising that toppled Mubarak in 2011 and the stage for more protests on Friday.

Youths clashed sporadically with police near the square, where activists camped out for a second day on Saturday, setting up makeshift barricades to keep out traffic.

Al-Masry Al-Youm, one of Egypt's most widely read dailies, hailed Friday's protest as "The November 23 Intifada", invoking the Arabic word for uprising.

But the ultra-orthodox Salafi Islamist groups that have been pushing for tighter application of Islamic law in the new constitution have rallied behind Mursi's decree.

The Nour Party, one such group, stated its support for the Mursi decree. Al-Gama'a al-Islamiya, which carried arms against the state in the 1990s, said it would save the revolution from what it described as remnants of the Mubarak regime.

Samir Morkos, a Christian assistant to Mursi, had told the president he wanted to resign, said Yasser Ali, Mursi's spokesman. Speaking to the London-based Asharq Al-Awsat newspaper, Morkos said: "I refuse to continue in the shadow of republican decisions that obstruct the democratic transition".

Mursi's decree has been criticized by Western states that earlier this week were full of praise for his role in mediating an end to the eight-day war between Israel and Palestinians.

"The decisions and declarations announced on November 22 raise concerns for many Egyptians and for the international community," State Department spokeswoman Victoria Nuland said.

The European Union urged Mursi to respect the democratic process.

(Additional reporting by Omar Fahmy, Marwa Awad, Edmund Blair and Shaimaa Fayed and Reuters TV; Editing by Jon Hemming)

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Large explosion reported in Massachusetts city

WASHINGTON: An explosion thought to have been triggered by a gas leak levelled a bar in downtown Springfield, Massachusetts on Friday, moments after dancers were warned to flee, local media reported.

WWLP TV quoted police as saying several people were taken to local hospitals by ambulance after the Friday afternoon explosion, which blew out windows two blocks away and knocked people to the ground.

The building housing the Scores Gentlemen's Club was flattened by the blast, the Republican newspaper said on its website. WWLP said two buildings were destroyed in the explosion.

Dancers at Scores told the newspaper they were warned by a manager to clear out of the building, and were having a drink in a bar across the street when their workplace blew up.

A dancer who identified herself only as Deb said she was on stage dancing when a "house mom" told everyone to evacuate, according to the newspaper.

She said she saw smoke in the upstairs floor of the building as she was gathering her clothes.

At that point, she said, the manager told everyone: "I don't care if you're (expletive) naked or not, get out."

She said there had been a smell of gas all week, and that the gas company had been called in but had found nothing.

- AFP/xq

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Cash transfer: PM to play UPA-2's trump card on Monday

NEW DELHI: The Prime Minister is expected to formally kick off cash transfer of subsidies and entitlements, one of the most ambitious policy initiatives of UPA-2, on Monday. The scheme for cash transfers is visualized as a game-changer for UPA-2, like NREGA was for UPA-1, and is expected to give rich dividends at the elections.

Manmohan Singh is expected to set January 1, 2013 as the launch date for the rollout when he meets his ministerial colleagues on Monday. The plan to transfer cash directly into bank accounts of beneficiaries instead of handing over subsidised foodgrains, fertilizer or fuel is aimed to not only check leakages from the system, but also empower consumers with the choices and ensure big savings for the cash-strapped government.

Compared to NREGA, the size and scale of the cash-transfer programme is several times the rural job guarantee scheme, with the government planning to transfer over Rs 4 lakh crore annually to the public, with each BPL (below poverty line) family getting over Rs 3,000 a month.

Sources said the PM is also planning to address the nation on the scheme in the coming days, explaining the ambitious plan that would be bigger than similar programmes around the world. The government, which accords high importance to the scheme, proposes to appoint a national coordinator to oversee the programme. It will also ensure its rapid scalability.

Singh on Monday will address a meeting of ministers in-charge of subsidies, pension and scholarships and there he will disclose the government intent to formally launch the programme on January 1. The programme would begin by covering 51 districts where the Aadhar card has a high penetration. By April 1 next year, 18 states will be covered.

A senior official said the Planning Commission has identified seven flagship programmes, including pensions and 22 scholarship schemes given by nine central ministries, for cash transfers, excluding those related to subsidies on food, fertilizer and fuel.

Ministries are being asked to digitize their databases of beneficiaries and link them with Aadhar, so that Aadhar-enabled bank accounts and Aadhar-enabled payment systems can function through what's being called the Aadhar Payment Bridge - essentially, a mechanism for giving cash cards to beneficiaries who don't have bank accounts.

According to latest estimates provided by the Department of Financial Services, by March 31, 2012 all banks will migrate to the core banking platform which will facilitate direct cash transfers. The plan is to cover all villages with a population of more than 5,000 with branches, and those with population of more than 2,000 with business correspondents. Seven states have committed to make electronic payments.

Times View

The government clearly believes that cash transfers can be a game-changer. In theory, they would indeed appear to be justified in this view. However, whether the practice lives up to the theory is what will ultimately determine how much of a game-changer this move is and whether the change is for the better or for worse. That is why it is important that the government acts as soon as possible to even out the more obvious glitches to smooth implementation of cash transfers, like a large proportion of the population having neither identification documents nor bank accounts. This is particularly true of the poorest sections, who really ought to be the main beneficiaries of the government's welfare programmes.

Read More..

AP PHOTOS: Simple surgery heals blind Indonesians

PADANG SIDEMPUAN, Indonesia (AP) — They came from the remotest parts of Indonesia, taking crowded overnight ferries and riding for hours in cars or buses — all in the hope that a simple, and free, surgical procedure would restore their eyesight.

Many patients were elderly and needed help to reach two hospitals in Sumatra where mass eye camps were held earlier this month by Nepalese surgeon Dr. Sanduk Ruit. During eight days, more than 1,400 cataracts were removed.

The patients camped out, sleeping side-by-side on military cots, eating donated food while fire trucks supplied water for showers and toilets. Many who had given up hope of seeing again left smiling after their bandages were removed.

"I've been blind for three years, and it's really bad," said Arlita Tobing, 65, whose sight was restored after the surgery. "I worked on someone's farm, but I couldn't work anymore."

Indonesia has one of the highest rates of blindness in the world, making it a target country for Ruit who travels throughout the developing world holding free mass eye camps while training doctors to perform the simple, stitch-free procedure he pioneered. He often visits hard-to-reach remote areas where health care is scarce and patients are poor. He believes that by teaching doctors how to perform his method of cataract removal, the rate of blindness can be reduced worldwide.

Cataracts are the leading cause of blindness globally, affecting about 20 million people who mostly live in poor countries, according to the World Health Organization.

"We get only one life, and that life is very short. I am blessed by God to have this opportunity," said Ruit, who runs the Tilganga Eye Center in Katmandu, Nepal. "The most important of that is training, taking the idea to other people."

During the recent camps, Ruit trained six doctors from Indonesia, Thailand and Singapore.

Here, in images, are scenes from the mobile eye camps:

Read More..

Black Friday: Bargains, Brawls and Gunfire

Two people were shot outside a Walmart in Florida today, one of a rash of fights, robberies and other incidents that have cropped up on one of the most ballyhooed shopping days of the year.

The shooting took place at a Walmart in Tallahassee about 12:30 p.m., said Dave Northway, public information officer for the Tallahassee Police Department.

Investigators believe a scuffle over a parking space outside the store escalated into gunplay leaving two people shot.

The two victims, whose names and genders have not been released, were taken to a hospital with what are believed to be non-life threatening injuries.

Police are looking for a dark green Toyota Camry in connection with this case.

At a Walmart parking lot on Thanksgiving night in Covington, Wash., two people were run down by a driver police suspected of being intoxicated.

The 71-year-old driver was arrested on a vehicular assault charge after the incident, spokeswoman Sgt. Cindi West of the Kings County Sheriff's Office said.

The female victim, whose identity has yet to be released, was pinned beneath the driver's Mercury SUV until being rescued by the fire department. She was flown to Harborview Medical Center, where she was listed in serious condition, West said.

The male victim was also taken to Harborview Medical Center, where, West said, he was listed in good condition.

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Tensions were high at the entrances as people lined up outside stores, waiting for the doors to open.

At a San Antonio, Texas, Sears, one man argued with customers and even punched one in order to get to the front of the line, prompting a man with a concealed carry permit to pull a gun, said Matthew Porter, public information officer of the San Antonio Police Department.

"It was a little chaotic. People were exiting the store," Porter said. "Fortunately for us, officers responded quickly and were able to ease the commotion."

The man who allegedly caused the altercation fled the scene and remains at large, Porter said. The shopper who pulled the gun will not face charges, he said, because of his concealed carry permit.

One man was treated at the scene for injuries sustained when people rushed out of the store, Porter said.

PHOTOS: Black Friday Shoppers Hit Stores

The crush of shoppers in the middle of the night were prey once again this year for thieves, who hid out in parking lots.

In Myrtle Beach, S.C., a woman said a man pulled a gun on her just as she exited her car to go inside a Best Buy store. The thief made off with $200, according to a police report.

In Maryland, 14-year-old boy told police he was robbed of his Thanksgiving night purchases by five men in the parking lot of a Bed Bath and Beyond store early this morning, the Baltimore Sun reported.

And in Massachusetts, Kmart employees tried to locate a shopper over the intercom after a 2-year-old was reported to be alone in a car, ABC News affiliate WCVB-TV reported.

Police arrived to break into the car and remove the child. The boy's caretaker, his mother's boyfriend, denied the incident took place, according to the station, and was not arrested.

ABC News' Candace Smith contributed to this report

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Japanese police rescue bank hostages

TOKYO: Japanese police rescued four hostages from a bank on Friday and arrested the knife-wielding man who had held them captive for more than 12 hours while demanding the prime minister resign, officials said.

In a televised news conference, a police spokesman said the hostage-taker, identified as Koji Nagakubo, was arrested on suspicion of taking a total of five people captive, including one person whom he had released earlier.

All the hostages were safe and in protective custody following the pre-dawn police raid, the spokesman said, though local media reported one of them -- a 19-year-old female bank employee -- was slightly injured.

The 32-year-old man began the siege on Thursday afternoon at the Zoshi branch of the Toyokawa Shinkin Bank in the otherwise quiet residential area of Toyokawa city in central Aichi prefecture.

Wielding a survival knife, he took four employees and a female customer captive and demanded the cabinet of Prime Minister Yoshihiko Noda step down, local media said. Noda last week called an election for December 16, which he is expected to lose.

In initial questioning by police, the suspect admitted the allegations but had yet to give details about his motive, public broadcaster NHK reported.

About 13 hours after the incident began, police wearing protective gear and carrying shields rushed the office before dawn, overpowered the man and escorted out the remaining four hostages.

"It was difficult to check inside, but we took action placing top priority on the safety of the hostages," an investigator told NHK. "We believe we took the best possible way."

Television footage showed a dozen police breaking the window on the second floor before moving to the ground floor, where the man pointed his knife at the hostages.

The man, who also held another knife, handcuffed at least one of the hostages, NHK said, adding that all police involved in the rescue operation were also unhurt.

"I was so relieved because no one was (seriously) injured," one neighbour told Tokyo Broadcasting System Television.

Television footage earlier showed a man who appeared to be a police officer carrying a megaphone and a plastic bag to a side door of the building guarded by police. The building's shutters were down but lights could be seen inside.

Shortly before the incident, a man police believe was the hostage-taker had attempted to break in another bank just 150 metres (yards) away from the site, NHK reported.

- AFP/xq

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Congress withdraws second list of candidates in Gujarat after protests

NEW DELHI: Resentment in Congress ranks over ticket distribution for Gujarat elections broke out in the open, forcing the party to withdraw its second list of 46 candidates released late on Wednesday night.

The anger in Congress was evident when party MPs engaged heir apparent Rahul Gandhi in animated discussion in Parliament in the presence of the head of the screening committee and Union minister C P Joshi.

The discontent was evident with a Union minister from the state saying early in the day that the party had put the list on hold. The decision was announced only in the evening. He said the names of candidates may undergo serious changes after the protests.

Congress is locked in a lopsided battle with BJP headed by Narendra Modi in Gujarat and protests over nominations do no augur well for the party. Even the first list of 52 candidates led to protests and resignations in Ahmedabad.

Congress leaders conceded that the party had failed to build momentum despite favourable factors like rebellion by BJP veteran Keshubhai Patel. The selection of candidates was said to have been the final weapon to rally opinion in its favour but the initial reaction has disappointed the party.

An agitated Congress MP threatened to walk out of the party and even "expose" senior leaders for doing the bidding of an industrial house by "planting" candidates.

He said the partnership with NCP was being used to settle scores with in-house aspirants. NCP general secretary D P Tripathi said the junior partner was allocated nine of the 182 seats in the state.

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Study finds mammograms lead to unneeded treatment

Mammograms have done surprisingly little to catch deadly breast cancers before they spread, a big U.S. study finds. At the same time, more than a million women have been treated for cancers that never would have threatened their lives, researchers estimate.

Up to one-third of breast cancers, or 50,000 to 70,000 cases a year, don't need treatment, the study suggests.

It's the most detailed look yet at overtreatment of breast cancer, and it adds fresh evidence that screening is not as helpful as many women believe. Mammograms are still worthwhile, because they do catch some deadly cancers and save lives, doctors stress. And some of them disagree with conclusions the new study reached.

But it spotlights a reality that is tough for many Americans to accept: Some abnormalities that doctors call "cancer" are not a health threat or truly malignant. There is no good way to tell which ones are, so many women wind up getting treatments like surgery and chemotherapy that they don't really need.

Men have heard a similar message about PSA tests to screen for slow-growing prostate cancer, but it's relatively new to the debate over breast cancer screening.

"We're coming to learn that some cancers — many cancers, depending on the organ — weren't destined to cause death," said Dr. Barnett Kramer, a National Cancer Institute screening expert. However, "once a woman is diagnosed, it's hard to say treatment is not necessary."

He had no role in the study, which was led by Dr. H. Gilbert Welch of Dartmouth Medical School and Dr. Archie Bleyer of St. Charles Health System and Oregon Health & Science University. Results are in Thursday's New England Journal of Medicine.

Breast cancer is the leading type of cancer and cause of cancer deaths in women worldwide. Nearly 1.4 million new cases are diagnosed each year. Other countries screen less aggressively than the U.S. does. In Britain, for example, mammograms are usually offered only every three years and a recent review there found similar signs of overtreatment.

The dogma has been that screening finds cancer early, when it's most curable. But screening is only worthwhile if it finds cancers destined to cause death, and if treating them early improves survival versus treating when or if they cause symptoms.

Mammograms also are an imperfect screening tool — they often give false alarms, spurring biopsies and other tests that ultimately show no cancer was present. The new study looks at a different risk: Overdiagnosis, or finding cancer that is present but does not need treatment.

Researchers used federal surveys on mammography and cancer registry statistics from 1976 through 2008 to track how many cancers were found early, while still confined to the breast, versus later, when they had spread to lymph nodes or more widely.

The scientists assumed that the actual amount of disease — how many true cases exist — did not change or grew only a little during those three decades. Yet they found a big difference in the number and stage of cases discovered over time, as mammograms came into wide use.

Mammograms more than doubled the number of early-stage cancers detected — from 112 to 234 cases per 100,000 women. But late-stage cancers dropped just 8 percent, from 102 to 94 cases per 100,000 women.

The imbalance suggests a lot of overdiagnosis from mammograms, which now account for 60 percent of cases that are found, Bleyer said. If screening were working, there should be one less patient diagnosed with late-stage cancer for every additional patient whose cancer was found at an earlier stage, he explained.

"Instead, we're diagnosing a lot of something else — not cancer" in that early stage, Bleyer said. "And the worst cancer is still going on, just like it always was."

Researchers also looked at death rates for breast cancer, which declined 28 percent during that time in women 40 and older — the group targeted for screening. Mortality dropped even more — 41 percent — in women under 40, who presumably were not getting mammograms.

"We are left to conclude, as others have, that the good news in breast cancer — decreasing mortality — must largely be the result of improved treatment, not screening," the authors write.

The study was paid for by the study authors' universities.

"This study is important because what it really highlights is that the biology of the cancer is what we need to understand" in order to know which ones to treat and how, said Dr. Julia A. Smith, director of breast cancer screening at NYU Langone Medical Center in New York. Doctors already are debating whether DCIS, a type of early tumor confined to a milk duct, should even be called cancer, she said.

Another expert, Dr. Linda Vahdat, director of the breast cancer research program at Weill Cornell Medical College in New York, said the study's leaders made many assumptions to reach a conclusion about overdiagnosis that "may or may not be correct."

"I don't think it will change how we view screening mammography," she said.

A government-appointed task force that gives screening advice calls for mammograms every other year starting at age 50 and stopping at 75. The American Cancer Society recommends them every year starting at age 40.

Dr. Len Lichtenfeld, the cancer society's deputy chief medical officer, said the study should not be taken as "a referendum on mammography," and noted that other high-quality studies have affirmed its value. Still, he said overdiagnosis is a problem, and it's not possible to tell an individual woman whether her cancer needs treated.

"Our technology has brought us to the place where we can find a lot of cancer. Our science has to bring us to the point where we can define what treatment people really need," he said.

___

Online:

Study: http://www.nejm.org/doi/full/10.1056/NEJMoa1206809

Screening advice: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm

___

Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

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2 Dead, Dozens to Hospital After 100-Car Pileup

At least two people died and more than 80 were injured after a 100-plus car pileup in Texas today, according the Department of Public Safety.

A man and a woman died from their injuries, ABC News affiliate KBMT-TV reported. Their names were not immediately available.

The DPS said it won't know the exact number of cars involved in the pileup until officials finish untangling the wrecks.

At least five people who were taken to the hospital are in critical condition, KBMT reported.

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The accident happened in Jefferson County shortly after 8 a.m. Thanksgiving morning on Interstate 10 between Taylor Bayou and Hampshire Road.

Fog blinded drivers, with investigators saying most couldn't see a foot in front of them at the time of the crash.

"The cause of the accident was a heavy fog bank rolled into this area this morning, which caused nobody to be able to see and caused one accident that triggered another accident and then a chain reaction," said Deputy Rod Carroll of the Jefferson County Sheriff's Department.

"Even as the deputies were pulling up we still had a continuous chain of accidents," Carroll said.

An 18-wheeler tanker truck began leaking after the chain-reaction accident, KBMT reported.

The eastbound side of the freeway was closed for hours and remained closed into the afternoon, DPS told ABC News. The westbound lanes opened shortly after noon.

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Pakistan attacks kill 28 on eve of summit

ISLAMABAD: A suicide bomber attacked a Shiite Muslim procession in Pakistan on Wednesday, killing 16 people in the most deadly incident on a day of violence that left at least 28 dead on the eve of a major international summit.

The blast in Rawalpindi near the capital Islamabad came after a series of earlier attacks across the nation, a stark reminder of the security challenges facing a country plagued by Taliban and Al-Qaeda-linked violence.

The Rawalpindi police chief said the blast in the city during the holy month of Muharram -- a magnet for sectarian attacks -- occurred when a suicide bomber entered the procession and security officials were checking him.

"The suicide bomber blew himself up when the security officials were checking (his body). We had prior information about the attacks and were fully alert," said Azhar Hameed Khokhar.

"The total number of dead people has now reached 16. Some 32, including nine children, have got injured," Waqas Rehman, a spokesman for the Rescue 1122 service, told AFP.

Another police official, Muhammad Haroon, told AFP that the attack took place when the procession was almost 500 metres (yards) from the mosque where it was heading.

In the southwestern city of Quetta, bombers hit an army vehicle escorting children home from school, killing four soldiers and a woman, police said.

More than 20 people were wounded when the bomb, planted on a motorcycle, was detonated by remote control, said city police chief Hamid Shakeel.

"The target was an army vehicle which was escorting a school bus carrying children of local army officers from different schools," he told AFP.

"Six or seven of them (the wounded) are in a serious condition," Shakeel added.

Witnesses said the motorbike appeared to have been parked near shops to avoid any suspicion in the Shahbaz Town neighbourhood near prestigious private schools.

"I was returning to my shop after saying prayers in a nearby mosque," said shopkeeper Mohammad Talib, 45.

"Soon after, I heard a huge blast. There was dust and smoke. I saw an army vehicle in flames. Shards of glass were littered on the road. There was panic, people were screaming, others were fleeing the area."

Fruit vendor Abdul Karim, 30, said the army vehicle took the same route every day after school.

"After some time police and FC (Frontier Corps paramilitary) troops arrived. They fired in the air to scare people away. Soon shops were closed and people emptied the area."

Two people were killed in the country's largest city, Karachi, as a bomb-laden motorcycle collided with a rickshaw near a mosque in the Orangi neighbourhood, city police chief Iqbal Hussain told AFP.

Minutes after the Karachi attack, there was another blast that wounded seven people including journalists, policemen and paramilitary soldiers who had gathered after the first explosion, said Javed Odho, another senior police official.

In northwest Pakistan, four police died when gunmen ambushed a routine patrol in Bannu district, Nisar Ahmed Tanoli, the local police official, told AFP.

And a roadside bomb in Shangla district killed another police official and injured four others, according to police.

Thousands of extra police and paramilitaries will be deployed in the city for the Developing 8 (D8) summit, which starts on Thursday, bringing together Egypt, Bangladesh, Indonesia, Iran, Malaysia, Nigeria, Pakistan and Turkey.

Iranian President Mahmoud Ahmadinejad and Turkish Prime Minister Recep Tayyip Erdogan are among those expected to attend.

- AFP/xq

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Full stop for Ajmal Kasab, comma in terror war

NEW DELHI: Many questions are being raised over the timing of Ajmal Kasab's execution a day ahead of Parliament's winter session, but the date for it — November 21 — was actually set over two months ago.

After Supreme Court confirmed Kasab's death sentence on August 29, the Maharashtra government, in consultation with the additional sessions judge on September 11, agreed on November 21 as the date for his execution. Though a mercy petition was filed subsequently, it was turned down by Maharashtra governor K Sankaranarayanan on September 26.

On October 1, the Maharashtra government reconfirmed November 21 as Kasab's hanging date, and conveyed this to the Union home ministry. The Centre acted with extraordinary prompteness in clearing the Kasab file, given the enormity of his crime. The MHA opinion was formulated in less than three weeks and the file forwarded to President Pranab Mukherjee on October 16 with the recommendation that the mercy plea be rejected.

The President acted expeditiously. He sent back the file to MHA on November 5, accepting its recommendation to turn down Kasab's petition, again just 20 days after he received the MHA opinion.

Shinde signed the file on November 7 and sent it to Maharashtra for action on November 8. Still left with two weeks before the initially agreed date of Kasab's hanging, November 21, the Centre and Maharashtra had the leeway to stick to the original timeframe and decided to do so. The only uncertainty on that count arose because of Pakistan's reluctance to accept the communication that the government was obliged to send under rules, intimating the kin of the death convict.

Union home secretary R K Singh wrote to the foreign secretary on November 14 informing him of the decision to hang Kasab on November 21 at Yerwada Central prison and requesting that the information be passed on to Kasab's kin in Pakistan.

Consultations followed among Singh, foreign secretary Ranjan Mathai, additional secretary in the foreign ministry and India's high commissioner to Islamabad, Sharat Sabarwal, and it was decided that the deputy high commissioner in Islamabad would deliver the information to the Pakistan foreign office, to be passed on to Kasab's family in Okara, Pakistan.

Indian deputy high commissioner Gopal Baglay's interlocutor in the Pakistan foreign ministry refused to accept the communication after going through its contents. A fresh round of consultations followed with the home secretary taking the view that the obligation to inform would be deemed to have been discharged by sending a fax, so long as they had a transmission report.

There was no doubt about the execution on November 21 once the MEA sent across the "transmission report" to MHA. As a matter of ultraprecaution, MHA also asked the deputy high commissioner to courier the information to Kasab's family at the given Pakistani address in Faridkot village, Okara district. The courier was sent on November 20 morning. The Indian authorities did not have to wait to find out whether the document was actually delivered to Kasab's family, as home secretary took the view that the obligation to inform was fulfilled the moment the courier agreed to deliver the packet.

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Study finds mammograms lead to unneeded treatment

Mammograms have done surprisingly little to catch deadly breast cancers before they spread, a big U.S. study finds. At the same time, more than a million women have been treated for cancers that never would have threatened their lives, researchers estimate.

Up to one-third of breast cancers, or 50,000 to 70,000 cases a year, don't need treatment, the study suggests.

It's the most detailed look yet at overtreatment of breast cancer, and it adds fresh evidence that screening is not as helpful as many women believe. Mammograms are still worthwhile, because they do catch some deadly cancers and save lives, doctors stress. And some of them disagree with conclusions the new study reached.

But it spotlights a reality that is tough for many Americans to accept: Some abnormalities that doctors call "cancer" are not a health threat or truly malignant. There is no good way to tell which ones are, so many women wind up getting treatments like surgery and chemotherapy that they don't really need.

Men have heard a similar message about PSA tests to screen for slow-growing prostate cancer, but it's relatively new to the debate over breast cancer screening.

"We're coming to learn that some cancers — many cancers, depending on the organ — weren't destined to cause death," said Dr. Barnett Kramer, a National Cancer Institute screening expert. However, "once a woman is diagnosed, it's hard to say treatment is not necessary."

He had no role in the study, which was led by Dr. H. Gilbert Welch of Dartmouth Medical School and Dr. Archie Bleyer of St. Charles Health System and Oregon Health & Science University. Results are in Thursday's New England Journal of Medicine.

Breast cancer is the leading type of cancer and cause of cancer deaths in women worldwide. Nearly 1.4 million new cases are diagnosed each year. Other countries screen less aggressively than the U.S. does. In Britain, for example, mammograms are usually offered only every three years and a recent review there found similar signs of overtreatment.

The dogma has been that screening finds cancer early, when it's most curable. But screening is only worthwhile if it finds cancers destined to cause death, and if treating them early improves survival versus treating when or if they cause symptoms.

Mammograms also are an imperfect screening tool — they often give false alarms, spurring biopsies and other tests that ultimately show no cancer was present. The new study looks at a different risk: Overdiagnosis, or finding cancer that is present but does not need treatment.

Researchers used federal surveys on mammography and cancer registry statistics from 1976 through 2008 to track how many cancers were found early, while still confined to the breast, versus later, when they had spread to lymph nodes or more widely.

The scientists assumed that the actual amount of disease — how many true cases exist — did not change or grew only a little during those three decades. Yet they found a big difference in the number and stage of cases discovered over time, as mammograms came into wide use.

Mammograms more than doubled the number of early-stage cancers detected — from 112 to 234 cases per 100,000 women. But late-stage cancers dropped just 8 percent, from 102 to 94 cases per 100,000 women.

The imbalance suggests a lot of overdiagnosis from mammograms, which now account for 60 percent of cases that are found, Bleyer said. If screening were working, there should be one less patient diagnosed with late-stage cancer for every additional patient whose cancer was found at an earlier stage, he explained.

"Instead, we're diagnosing a lot of something else — not cancer" in that early stage, Bleyer said. "And the worst cancer is still going on, just like it always was."

Researchers also looked at death rates for breast cancer, which declined 28 percent during that time in women 40 and older — the group targeted for screening. Mortality dropped even more — 41 percent — in women under 40, who presumably were not getting mammograms.

"We are left to conclude, as others have, that the good news in breast cancer — decreasing mortality — must largely be the result of improved treatment, not screening," the authors write.

The study was paid for by the study authors' universities.

"This study is important because what it really highlights is that the biology of the cancer is what we need to understand" in order to know which ones to treat and how, said Dr. Julia A. Smith, director of breast cancer screening at NYU Langone Medical Center in New York. Doctors already are debating whether DCIS, a type of early tumor confined to a milk duct, should even be called cancer, she said.

Another expert, Dr. Linda Vahdat, director of the breast cancer research program at Weill Cornell Medical College in New York, said the study's leaders made many assumptions to reach a conclusion about overdiagnosis that "may or may not be correct."

"I don't think it will change how we view screening mammography," she said.

A government-appointed task force that gives screening advice calls for mammograms every other year starting at age 50 and stopping at 75. The American Cancer Society recommends them every year starting at age 40.

Dr. Len Lichtenfeld, the cancer society's deputy chief medical officer, said the study should not be taken as "a referendum on mammography," and noted that other high-quality studies have affirmed its value. Still, he said overdiagnosis is a problem, and it's not possible to tell an individual woman whether her cancer needs treated.

"Our technology has brought us to the place where we can find a lot of cancer. Our science has to bring us to the point where we can define what treatment people really need," he said.

___

Online:

Study: http://www.nejm.org/doi/full/10.1056/NEJMoa1206809

Screening advice: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm

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Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

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White House: Cease-Fire Is 'Tenuous'

Bernat Armangue/AP Photo

The Israel-Hamas cease-fire brokered by the Obama administration, Israeli Prime Minister Benjamin Netanyahu and Egyptian president Mohammed Morsi, and announced today is fragile, White House officials acknowledged.

“The way we view this is that it’s an important step,” a senior White House official said, “but our concerns are Egypt can’t control all of Hamas,” the ruling party in Gaza designated a terrorist group by the U.S. State Department, “and Hamas doesn’t control every extremist with a rocket in Gaza. So there is a tenuous nature to this.”

But for now, senior White House officials say that from their perspective, three phone calls with Egyptian President Morsi seemed significant.

The president spoke to Netanyahu every day since the crisis began, but his first significant call with Morsi was on Monday, November 19 in Phnom Penh, Cambodia.

President Obama left a dinner for the Association of Southeast Asian Nations a tad early to phone Morsi, aides said. They discussed ways to “de-escalate” the violence in Gaza and Israel, with President Obama underscoring “the necessity of Hamas ending rocket fire into Israel,” aides said. The president offered his condolences for the loss of life in Gaza, as well as for the Saturday incident when a train collided with a school bus, killing more than 50 people most of them children.

He then spoke with Netanyahu, receiving an update on the situation, and expressing regret for the loss of Israeli lives.

The president then told his team that if Morsi called back to talk, they should wake him up. Morsi did so, at 2:30 a.m. Cambodia time. The president and Morsi spoke again.

Another senior White House official declined to get into the substance of the calls, but said the president was reviewing ideas with Morsi and Netanyahu, so it would be natural for him to follow up with Morsi after speaking to Netanyahu. The president told Morsi he intended to send Secretary of State Hillary Clinton to the region.

The next day, Tuesday, President Obama announced that Clinton would head to Egypt and Israel to try to broker a cease-fire. The president and Clinton, the second senior White House official said, talked about the Gaza-Israel fighting throughout the Asia trip.

The president today phoned both Morsi and Netanyahu “to seal the deal,” the first senior White House official said.

The president, this official said, was struck by the fact that Morsi “was being pragmatic. He wanted to get to yes.”

ABC News’ Reena Ninan asked Ben Rhodes, deputy National Security adviser for strategic communication, if Morsi was a better broker for peace than his predecessor, Hosni Mubarak.

“Egypt has been a critical part of our effort to manage that conflict and pursue peace,” Rhodes said. “That was the case under President Mubarak and it continues to be the case under President Morsi, who has upheld the peace treaty with Israel. What we’ve seen is, again, our engagement has been focused on practical and constructive cooperation that can reduce tensions but ultimately, again, it’s going to have to be Hamas within Gaza that takes the step of, again, not pursing rocket fire into Israeli territory. But we agree that Egypt can and should be a partner in seeking to bring about that outcome.”

Another interesting development, the White House official said, is that Hamas in this instance was looking to Egypt for leadership and not Iran, even though the latter country has been extremely supportive of Hamas.

-Jake Tapper

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Hamas-Israel ceasefire takes hold but mistrust runs deep

CAIRO/GAZA (Reuters) - A ceasefire between Israel and Gaza's Hamas rulers took hold on Thursday after eight days of conflict, although deep mistrust on both sides cast doubt on how long the Egyptian-sponsored deal can last.

Even after the ceasefire came into force late on Wednesday, a dozen rockets from the Gaza Strip landed in Israel, all in open areas, a police spokesman said. In Gaza, witnesses reported an explosion shortly after the truce took effect at 9 p.m (1900 GMT), but there were no casualties and the cause was unclear.

The deal prevented, at least for the moment, an Israeli ground invasion of the Palestinian enclave following bombing and rocket fire which killed five Israelis and 162 Gazans, including 37 children.

But trust was in short supply. The exiled leader of Hamas, Khaled Meshaal, said his Islamist movement would respect the truce if Israel did, but would respond to any violations. "If Israel complies, we are compliant. If it does not comply, our hands are on the trigger," he told a news conference in Cairo.

Israeli Prime Minister Benjamin Netanyahu said he had agreed to "exhaust this opportunity for an extended truce", but told his people a tougher approach might be required in the future.

Both sides quickly began offering differing interpretations of the ceasefire, brokered by Egypt's new Islamist government and backed by the United States, highlighting the many actual or potential areas of discord.

If it holds, the truce will give 1.7 million Gazans respite from days of ferocious air strikes and halt rocket salvoes from militants that unnerved a million people in southern Israel and reached Tel Aviv and Jerusalem for the first time.

"Allahu akbar, (God is greatest), dear people of Gaza you won," blared mosque loudspeakers in Gaza as the truce took effect. "You have broken the arrogance of the Jews."

Fifteen minutes later, wild celebratory gunfire echoed across the darkened streets, which gradually filled with crowds waving Palestinian flags. Ululating women leaned out of windows and fireworks lit up the sky.

Meshaal thanked Egypt for mediating and praised Iran for providing Gazans with financing and arms. "We have come out of this battle with our heads up high," he said, adding that Israel had been defeated and failed in its "adventure".

Some Israelis staged protests against the deal, notably in the southern town of Kiryat Malachi, where three people were killed by a Gaza rocket during the conflict, army radio said.

Netanyahu said he was willing to give the truce a chance but held open the possibility of reopening the conflict. "I know there are citizens expecting a more severe military action, and perhaps we shall need to do so," he said.

The Israeli leader, who faces a parliamentary election in January, delivered a similar message earlier in a telephone call with U.S. President Barack Obama, his office said.

"AN OPEN PRISON"

According to a text of the agreement seen by Reuters, both sides should halt all hostilities, with Israel desisting from incursions and targeting of individuals, while all Palestinian factions should cease rocket fire and cross-border attacks.

The deal also provides for easing Israeli restrictions on Gaza's residents, who live in what British Prime Minister David Cameron has called an "open prison".

The text said procedures for implementing this would be "dealt with after 24 hours from the start of the ceasefire".

Israeli sources said Israel would not lift a blockade of the enclave it enforced after Hamas, which rejects the Jewish state's right to exist, won a Palestinian election in 2006.

However, Meshaal said the deal covered the opening of all of the territory's border crossings. "The document stipulates the opening of the crossings, all the crossings, and not just Rafah," he said. Israel controls all of Gaza's crossings apart from the Rafah post with Egypt.

Hamas lost its top military commander to an Israeli strike in the conflict and suffered serious hits to its infrastructure and weaponry, but has emerged with its reputation both in the Arab world and at home stronger.

Israel can take comfort from the fact it dealt painful blows to its enemy, which will take many months to recover, and showed that it can defend itself from a barrage of missiles.

"No one is under the illusion that this is going to be an everlasting ceasefire. It is clear to everyone it will only be temporary," said Michael Herzog, a former chief of staff at the Israeli ministry of defence.

"But there is a chance that it could hold for a significant period of time, if all goes well," he told Reuters.

Egypt, an important U.S. ally now under Islamist leadership, took centre stage in diplomacy to halt the bloodshed. Cairo has walked a fine line between its sympathies for Hamas, an offshoot of the Muslim Brotherhood to which President Mohamed Mursi belongs, and its need to preserve its 1979 peace treaty with Israel and its ties with Washington, its main aid donor.

Announcing the agreement in Cairo, Egyptian Foreign Minister Mohamed Kamel Amr said mediation had "resulted in understandings to cease fire, restore calm and halt the bloodshed".

U.S. Secretary of State Hillary Clinton, standing beside Amr, thanked Mursi for peace efforts that showed "responsibility, leadership" in the region.

The Gaza conflict erupted in a Middle East already shaken by last year's Arab uprisings that toppled several veteran U.S.-backed leaders, including Egypt's Hosni Mubarak, and by a civil war in Syria, where President Bashar al-Assad is fighting for survival.

In his call with Netanyahu, Obama in turn repeated U.S. commitment to Israel's security and promised to seek funds for a joint missile defence program, the White House said.

BUS BOMBING

The ceasefire was forged despite a bus bomb explosion that wounded 15 Israelis in Tel Aviv earlier in the day and despite more Israeli air strikes that killed 10 Gazans. It was the first serious bombing in Israel's commercial capital since 2006.

Israel, the United States and the European Union all classify Hamas as a terrorist organization. It seized the Gaza Strip from the Western-backed Palestinian President Mahmoud Abbas in 2007 in a brief but bloody war with his Fatah movement.

"This is a critical moment for the region," Clinton said. "Egypt's new government is assuming the responsibility and leadership that has long made this country a cornerstone for regional stability and peace."

In Amman, U.N. chief Ban Ki-moon urged both sides to stick to their ceasefire pledges. "There may be challenges implementing this agreement," he said, urging "maximum restraint".

(Additional reporting by Noah Browning in Gaza, Ori Lewis, Allyn Fisher-Ilan and Crispian Balmer in Jerusalem, Yasmine Saleh, Shaimaa Fayed and Tom Perry in Cairo, Suleiman al-Khalidi in Amman and Margaret Chadbourn in Washington; Writing by Alistair Lyon and David Stamp; Editing by Louise Ireland)

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Tennis: Nadal back in training after layoff

MADRID: Former world No.1 Rafael Nadal has returned to training at his Mallorca base after nearly five months on the sidelines with a knee injury.

"Today was my first training session after so many weeks out," the Spaniard said on his Facebook page "I am making progress and I hope to continue to do so."

Nadal last played at Wimbledon on June 28 when he lost to the unseeded Lukas Rosol of the Czech Republic in the second round.

The 26-year-old was subsequently diagnosed as suffering with Hoffa syndrome, an inflammation of the fatty tissue situated behind the kneecap in his left knee, a problem that has sidelined him several times over the years.

He was unable to defend his title at the London Olympics, missed out on the US Open and was also unavailable for last weekend's Davis Cup final which saw the Czech Republic unseat Spain as title-holders.

Nadal's world ranking has fallen to fourth behind, Novak Djokovic, Roger Federer and Andy Murray, and compatriot David Ferrer is close to moving past him also.

There was no word on when Nadal would return to competitive action, but he has said that his next target would be to get fully fit in time for the year's first Grand Slam event - the Australian Open in the second half of January.

- AFP/fa

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Cyclists set out for green GDP

SILIGURI: A group of environmental activists set out from here on a 2,000km awareness yatra on Tuesday to press for the introduction of what they are calling gross environmental product (GEP), a measure similar to GDP for monitoring India's natural resources.

The 11-member team will travel on bicycles from Siliguri in north Bengal to Dehradun in Uttarakhand, covering the distance in 40 days. They will hold meetings along the way to spread the word on why India needs to track its natural resources such as water, air, soil, forests etc.

"Only a stable ecology can lead to a stable economy. Just as the government releases GDP figures, it should also come out with an annual GEP, which would be a tabulation of how each of our natural resources was spent in that year," said Anil P Joshi, who is leading the yatra. The group, consisting of activists aged 19 to 72, would be travelling through Patna, Varanasi, Allahabad, Kanpur, Mathura and Delhi, interacting with people to popularize the demand for GEP. "Our mission is to create mass awareness about the need to formulate an ecological growth measure so people know about the health of India's environment," said Joshi, a Padma Shri-awardee who runs a Dehra Dun-based NGO, Himalayan Environmental Studies and Conservation Organization.

GEP is somewhat similar to the concept of a 'green GDP' — gross domestic product after being adjusted for environmental costs of economic activity — which the Union environment ministry hopes to roll out by 2015.

The team would cross 55 districts and more than a 1,000 villages to reach the Himalayas. "Our other motto is save the Himalayas. For ages, this mountain range has been providing life to 65% of Indians. Today, Himalayan ecology is threatened and we wish to raise awareness about what this means for people living in the plains," Joshi said.

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OB/GYNs back over-the-counter birth control pills

WASHINGTON (AP) — No prescription or doctor's exam needed: The nation's largest group of obstetricians and gynecologists says birth control pills should be sold over the counter, like condoms.

Tuesday's surprise opinion from these gatekeepers of contraception could boost longtime efforts by women's advocates to make the pill more accessible.

But no one expects the pill to be sold without a prescription any time soon: A company would have to seek government permission first, and it's not clear if any are considering it. Plus there are big questions about what such a move would mean for many women's wallets if it were no longer covered by insurance.

Still, momentum may be building.

Already, anyone 17 or older doesn't need to see a doctor before buying the morning-after pill — a higher-dose version of regular birth control that can prevent pregnancy if taken shortly after unprotected sex. Earlier this year, the Food and Drug Administration held a meeting to gather ideas about how to sell regular oral contraceptives without a prescription, too.

Now the influential American College of Obstetricians and Gynecologists is declaring it's safe to sell the pill that way.

Wait, why would doctors who make money from women's yearly visits for a birth-control prescription advocate giving that up?

Half of the nation's pregnancies every year are unintended, a rate that hasn't changed in 20 years — and easier access to birth control pills could help, said Dr. Kavita Nanda, an OB/GYN who co-authored the opinion for the doctors group.

"It's unfortunate that in this country where we have all these contraceptive methods available, unintended pregnancy is still a major public health problem," said Nanda, a scientist with the North Carolina nonprofit FHI 360, formerly known as Family Health International.

Many women have trouble affording a doctor's visit, or getting an appointment in time when their pills are running low — which can lead to skipped doses, Nanda added.

If the pill didn't require a prescription, women could "pick it up in the middle of the night if they run out," she said. "It removes those types of barriers."

Tuesday, the FDA said it was willing to meet with any company interested in making the pill nonprescription, to discuss what if any studies would be needed.

Then there's the price question. The Obama administration's new health care law requires FDA-approved contraceptives to be available without copays for women enrolled in most workplace health plans.

If the pill were sold without a prescription, it wouldn't be covered under that provision, just as condoms aren't, said Health and Human Services spokesman Tait Sye.

ACOG's opinion, published in the journal Obstetrics & Gynecology, says any move toward making the pill nonprescription should address that cost issue. Not all women are eligible for the free birth control provision, it noted, citing a recent survey that found young women and the uninsured pay an average of $16 per month's supply.

The doctors group made clear that:

—Birth control pills are very safe. Blood clots, the main serious side effect, happen very rarely, and are a bigger threat during pregnancy and right after giving birth.

—Women can easily tell if they have risk factors, such as smoking or having a previous clot, and should avoid the pill.

—Other over-the-counter drugs are sold despite rare but serious side effects, such as stomach bleeding from aspirin and liver damage from acetaminophen.

—And there's no need for a Pap smear or pelvic exam before using birth control pills. But women should be told to continue getting check-ups as needed, or if they'd like to discuss other forms of birth control such as implantable contraceptives that do require a physician's involvement.

The group didn't address teen use of contraception. Despite protests from reproductive health specialists, current U.S. policy requires girls younger than 17 to produce a prescription for the morning-after pill, meaning pharmacists must check customers' ages. Presumably regular birth control pills would be treated the same way.

Prescription-only oral contraceptives have long been the rule in the U.S., Canada, Western Europe, Australia and a few other places, but many countries don't require a prescription.

Switching isn't a new idea. In Washington state a few years ago, a pilot project concluded that pharmacists successfully supplied women with a variety of hormonal contraceptives, including birth control pills, without a doctor's involvement. The question was how to pay for it.

Some pharmacies in parts of London have a similar project under way, and a recent report from that country's health officials concluded the program is working well enough that it should be expanded.

And in El Paso, Texas, researchers studied 500 women who regularly crossed the border into Mexico to buy birth control pills, where some U.S. brands sell over the counter for a few dollars a pack. Over nine months, the women who bought in Mexico stuck with their contraception better than another 500 women who received the pill from public clinics in El Paso, possibly because the clinic users had to wait for appointments, said Dr. Dan Grossman of the University of California, San Francisco, and the nonprofit research group Ibis Reproductive Health.

"Being able to easily get the pill when you need it makes a difference," he said.

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Online:

OB/GYN group: http://www.acog.org

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Clinton Pledges to 'De-Escalate' Gaza Conflict

Secretary of State Hillary Clinton met for more than two hours today behind closed doors with Israeli Prime Minister Benjamin Netanyahu and other Israeli officials, saying she sought to "de-escalate the situation in Gaza."

Clinton, who flew to Israel today, appeared with Netanyahu ahead of their 4 p.m. ET meeting to discuss a possible ceasefire to the fighting between Israel and Islamic militants in Gaza.

"They discussed efforts to de-escalate the situation and bring about a sustainable outcome that protects Israel's security and improves the lives of civilians in Gaza," State Department spokeswoman Victoria Nuland said in a written statement after the meeting. "They also consulted on [Clinton's] impending stops in Ramallah and Cairo, including Egyptian efforts to advance de-escalation. They pledged to stay in close touch as she continues her travels."

The meeting came amid statements from Hamas earlier today that a ceasefire would soon be announced.

Netanyahu said he would prefer to use "diplomatic means" to find a solution to the fighting, but that Israel would take "whatever actions necessary" to defend its people.

"One of the things that we are doing is trying to resist and counter a terrorist barrage which is aimed directly at our civilians," Netanyahu said. "No country can tolerate a wanton attack on its civilians."

Clinton relayed a message from President Obama, reinforcing America's commitment to Isarael's security and calling for an end to the rockets coming from "terrorist orgnaizations in Gaza."

The Israel-Gaza Conflict in Pictures

Matty Stern/U.S. Embassy Tel Aviv/Getty Images

Israeli-Palestinian Conflict: Families Pray for Ceasefire Watch Video

Middle East on the Brink: Israel Prepared to Invade Gaza Watch Video

"America's commitment to Israel's security is rock solid and unwavering. That is why we believe it is essential to de-escalate the situation in Gaza," Clinton said.

Clinton added that she would reiterate her message to Egyptian President Mohamed Morsi during a meeting on Wednesday.

"President Obama has emphasized the same points in his multiple conversations with president Morsi of Egypt and we appreciate President Morsi's personal leadership and Egypt's efforts thus far," she said. "As a regional leader and neighbor, Egypt has the opportunity and responsibility to continue playing a crucial and constructive role in this process. I will carry this message to Cairo tomorrow."

Clinton expressed her condolences for the Palestinian and Israeli civilians who have been killed in the violent outbreak.

The rocket fire between Israel and Hamas, which began six days ago, has claimed 126 Palestinian lives and three Israeli lives. A ceasefire, if reached, would bring a halt to the worst violence between Gaza and Israel in four years.

Israeli officials told ABC News earlier today that a final deal had not been brokered between Israel and Hamas, and that if a pact were reached, it would not be announced until after midnight local time, or 5 p.m. ET.

Hamas spokesman Sami Abu Zuhri told ABC News the news would be announced at a press conference in Cairo where Egyptian President Mohammed Morsi has been trying to broker an end to the fighting.

An Islamic Jihad website also reported that the ceasefire would go into effect tonight.

Clinton will also meet with Palestinian Authority President Mahmoud Abbas about the fighting.

In the meantime, however, Abu Zuhri called on all militant groups to continue firing rockets on Israel "in retaliation for the Israeli massacres."

Israeli missiles also continued to explode in Gaza while sirens sounded in Israel, signalling incoming rocket fire from Gaza.

Hamas said three Palestinian journalists were killed by an Israeli missile today and Israel said one of its soldiers was killed in by a Palestinian rocket today.

Gazans streamed out of northern neighborhoods during the afternoon after the Israel Defense Forces dropped leaflets telling residents to evacuate before dark. Scared Palestinians poured into Gaza City, cars and trucks piled high with belongings, many heading to schools for shelter.

There have been 126 Palestinian deaths in six days of fighting, just under half were civilians. Three Israelis were killed last Thursday when a rocket slammed into their apartment.

ABC News' Matt Gutman contributed to this report

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UN calls for tougher prosecution of pirates

UNITED NATIONS: The United Nations on Monday called for stronger prosecutions of pirates and more action by shipping companies to deter bandits at sea.

At a UN Security Council debate on maritime piracy, UN deputy secretary-general Jan Eliasson said that while attacks had been reduced off the coast of Somalia this year, numbers could take off again unless countries take action.

According to International Maritime Organization (IMO) figures, there were 291 attacks against ships in the first 10 months of the year and 293 crew are still hostage. East Africa, West Africa and Asia-Pacific are the worst hit zones.

Eliasson said there had to be tougher legal action against pirates.

"We need to strengthen the capacity of states to prosecute individuals suspected of piracy and to imprison convicted pirates," he said. "That effort must include deterring and suppressing the financing of piracy and the laundering of ransom money."

Eliasson also called on shipping firms to do more to protect themselves.

"Twenty per cent of vessels transiting high-risk waters do not implement security measures, and those vessels account for the overwhelming number of successfully pirated ships," he told the Security Council.

Piracy off Somalia has been curtailed because of fleets of international warships patrolling in shipping lanes and because so many tankers and freighters now have devoted security guards, according to experts.

The maritime industry estimates it is now paying at least $6.6 billion a year in extra security costs.

A Security Council statement released at the meeting called on all states "to criminalize piracy under their domestic law and to favorably consider the prosecution of suspected, and imprisonment of convicted pirates and their facilitators and financiers."

-AFP/ac

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Guj Parsis being cremated as vultures dwindle

VADODARA: When Dara Hakim, 89, a former Indian Navy deep-sea diver and prominent member of Vadodara's Parsi community passed away recently, his family chose cremation for his last rites. Though he did not leave any specific instructions, his wife Roda Hakim arranged for a cremation instead of the traditional Tower of Silence.

According to Zoroastrian beliefs, the best way to dispose of a body is to let it remain in the open at the Tower of Silence and be consumed by scavenging birds. With the vulture population dwindling in Vadodara, many in this community are preferring cremation as the final rite for their loved ones.

The first woman photo-journalist of the country, Homai Vyarawalla, too had left unambiguous instructions with her lawyer about her desire to be cremated. The Modi family, which owns the popular confectionaries store and restaurant in the city, had cremated their matriarch, Roshan Modi, after she wished for the same, last year. The oldest cremation that the community members recall is that of Dr Rustom Cama, father of Boman Cama, who now heads the Vadodara Parsi panchayat, in the 1980s.

It is individual choice. The Parsi panchayat has never formally discussed the topic. The families are free to take a decision, said Jal Patel, the immediate past president of the panchayat. Some families have opted for cremation in the past, although the majority still prefer the Tower of Silence, he added.

The community welcomes this liberal approach. Everyone realizes that the decision to cremate does not mean moving away from our tradition, itas a very practical solution to a raging problem, explained Modi.

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New push for most in US to get at least 1 HIV test

WASHINGTON (AP) — There's a new push to make testing for the AIDS virus as common as cholesterol checks.

Americans ages 15 to 64 should get an HIV test at least once — not just people considered at high risk for the virus, an independent panel that sets screening guidelines proposed Monday.

The draft guidelines from the U.S. Preventive Services Task Force are the latest recommendations that aim to make HIV screening simply a routine part of a check-up, something a doctor can order with as little fuss as a cholesterol test or a mammogram. Since 2006, the Centers for Disease Control and Prevention also has pushed for widespread, routine HIV screening.

Yet not nearly enough people have heeded that call: Of the more than 1.1 million Americans living with HIV, nearly 1 in 5 — almost 240,000 people — don't know it. Not only is their own health at risk without treatment, they could unwittingly be spreading the virus to others.

The updated guidelines will bring this long-simmering issue before doctors and their patients again — emphasizing that public health experts agree on how important it is to test even people who don't think they're at risk, because they could be.

"It allows you to say, 'This is a recommended test that we believe everybody should have. We're not singling you out in any way,'" said task force member Dr. Douglas Owens, of Stanford University and the Veterans Affairs Palo Alto Health Care System.

And if finalized, the task force guidelines could extend the number of people eligible for an HIV screening without a copay in their doctor's office, as part of free preventive care under the Obama administration's health care law. Under the task force's previous guidelines, only people at increased risk for HIV — which includes gay and bisexual men and injecting drug users — were eligible for that no-copay screening.

There are a number of ways to get tested. If you're having blood drawn for other exams, the doctor can merely add HIV to the list, no extra pokes or swabs needed. Today's rapid tests can cost less than $20 and require just rubbing a swab over the gums, with results ready in as little as 20 minutes. Last summer, the government approved a do-it-yourself at-home version that's selling for about $40.

Free testing is available through various community programs around the country, including a CDC pilot program in drugstores in 24 cities and rural sites.

Monday's proposal also recommends:

—Testing people older and younger than 15-64 if they are at increased risk of HIV infection,

—People at very high risk for HIV infection should be tested at least annually.

—It's not clear how often to retest people at somewhat increased risk, but perhaps every three to five years.

—Women should be tested during each pregnancy, something the task force has long recommended.

The draft guidelines are open for public comment through Dec. 17.

Most of the 50,000 new HIV infections in the U.S. every year are among gay and bisexual men, followed by heterosexual black women.

"We are not doing as well in America with HIV testing as we would like," Dr. Jonathan Mermin, CDC's HIV prevention chief, said Monday.

The CDC recommends at least one routine test for everyone ages 13 to 64, starting two years younger than the task force recommended. That small difference aside, CDC data suggests fewer than half of adults under 65 have been tested.

"It can sometimes be awkward to ask your doctor for an HIV test," Mermin said — the reason making it routine during any health care encounter could help.

But even though nearly three-fourths of gay and bisexual men with undiagnosed HIV had visited some sort of health provider in the previous year, 48 percent weren't tested for HIV, a recent CDC survey found. Emergency rooms are considered a good spot to catch the undiagnosed, after their illnesses and injuries have been treated, but Mermin said only about 2 percent of ER patients known to be at increased risk were tested while there.

Mermin calls that "a tragedy. It's a missed opportunity."

___

Online:

Task force recommendation: http://www.uspreventiveservicestaskforce.org

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Indy Home Blast Intentional? Now a Homicide Probe

The probe into a massive explosion earlier this month in Indianapolis that killed two people and damaged dozens of homes is now an active criminal homicide investigation, with authorities saying they believe the blast was caused intentionally, ABC News has learned.

At a meeting this evening at the Southport Presbyterian Church to update residents of the Richmond Hill subdivision where the blast occurred, Marion County prosecutor Terry Curry said the criminal homicide investigation is ongoing.

The ATF offered up to $10,000 for information that leads to an arrest in the case.

Matt Kryger/The Indianapolis Star/AP Photo

Indianapolis Neighborhood Devastated by Explosion Watch Video

Breezy Point, Queens Fire: Neighborhood Burned Down Overnight Watch Video

The explosion in the subdivision just south of the city on Saturday, Nov. 10, killed John and Jennifer Longworth. Their funeral was held earlier today.

Much of the attention since the explosion has centered on Monserrate Shirley and her boyfriend Mark Leonard, who lived at the house in the center of the blast area.

John Shirley, who owns that house but now lives elsewhere, told ABC News two days after the blast that he believed that his ex-wife, who still lives in the house, was to blame for the explosion.

Shirley claimed he knew that the furnace in the house was broken and had not been fixed properly, if at all.

"If I were to suspect anything, that's where the problem was," said Shirley, who noted that his ex-wife Monserrate Shirley had a "protective order" against him. However, Shirley said he did not believe his ex-wife would have caused the explosion intentionally.

"I don't think so, because there was no real reason to," Shirley said. "I pay a thousand dollars a month for one kid because she had a lawyer and I did not, so she has more than enough money. At one point the house was slipping into foreclosure. Last spring she had a buyer but she chose not to sell. We were in some bankruptcy but that's pretty well cleared up."

Monserrate Shirley and Leonard were reportedly visiting a casino at the time of the blast.

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Gaza truce pressure builds, Cairo in focus

GAZA/JERUSALEM (Reuters) - International pressure for a ceasefire in the Gaza Strip puts Egypt's new Islamist president in the spotlight on Tuesday after a sixth day of Palestinian rocket fire and Israeli air strikes that have killed over 100 people.

Israel's leaders weighed the benefits and risks of sending tanks and infantry into the densely populated coastal enclave two months before an Israeli election, and indicated they would prefer a diplomatic path backed by world powers, including U.S. President Barack Obama, the European Union and Russia.

Any such solution may pass through Egypt, Gaza's other neighbor and the biggest Arab nation, where the ousting of U.S. ally Hosni Mubarak and election of President Mohamed Mursi is part of a dramatic reshaping of the Middle East, wrought by the Arab Spring and now affecting the Israeli-Palestinian conflict.

Mursi, whose Muslim Brotherhood was mentor to the founders of Hamas, took a call from Obama on Monday telling him the group must stop rocket fire into Israel - effectively endorsing Israel's stated aim in launching the offensive last week. Obama, as quoted by the White House, also said he regretted civilian deaths - which have been predominantly among the Palestinians.

"The two leaders discussed ways to de-escalate the situation in Gaza, and President Obama underscored the necessity of Hamas ending rocket fire into Israel," the White House said.

"President Obama then called Prime Minister Netanyahu of Israel and received an update on the situation in Gaza and Israel. In both calls, President Obama expressed regret for the loss of Israeli and Palestinian civilian lives."

Three Israeli civilians and 108 Palestinians have been killed. Gaza officials say over half of those killed in the enclave were civilians, 27 of them children.

EGYPT SEES DEAL

Mursi has warned Netanyahu of serious consequences from a ground invasion of the kind that left over 1,400 people dead in Gaza four years ago. But he has been careful not to alienate Israel, with whom Egypt's former military rulers signed a peace treaty in 1979, or Washington, a major aid donor to Egypt.

A meeting on Tuesday in Cairo between Mursi and Ban Ki-moon, the secretary-general of the United Nations who flew in late on Monday, could shed light on the shape of any truce proposals.

Egyptian Prime Minister Hisham Kandil told Reuters: "I think we are close, but the nature of this kind of negotiation, (means) it is very difficult to predict."

Israeli media have said Israeli officials are also in Cairo to talk. And Ban is due to meet Netanyahu in Jerusalem soon.

After Hamas leader Khaled Meshaal laid out demands in Cairo that Israel take the first step in restoring calm, and warned Netanyahu that a ground war in Gaza could wreck his re-election prospects in January, a senior Israeli official denied a Hamas assertion that the prime minister had asked for a truce.

"Whoever started the war must end it," Meshaal said, referring to Israel's assassination from the air last Wednesday of Hamas's Gaza military chief, a move that followed a scaling up of rocket fire onto Israeli towns over several weeks.

An official close to Netanyahu told Reuters: "Israel is prepared and has taken steps and is ready for a ground incursion which will deal severely with the Hamas military machine.

"We would prefer to see a diplomatic solution that would guarantee the peace for Israel's population in the south. If that is possible, then a ground operation would no longer be required," he added. "If diplomacy fails, we may well have no alternative but to send in ground forces."

NETANYAHU CONSIDERS

Fortified by the ascendancy of fellow Islamists in Egypt and elsewhere, and courted by fellow Sunni Arab leaders in the Gulf, keen to draw the Palestinian group away from old ties to Shi'ite Iran, Hamas has tested its room for maneuver, as well as longer-range rockets that have reached the Tel Aviv metropolis.

As Netanyahu and his top ministers debated their next moves in a meeting that lasted past midnight, Israeli statistics showed some easing in the ferocity of the exchanges on Monday.

Israeli police counted 110 rockets, causing no casualties, of which 42 were shot down by anti-missile batteries. Israel said it had conducted 80 air strikes. Compared to over 1,000 rockets fired in total, and 1,350 air strikes, the indications were that the level of violence had fallen on Monday.

Nonetheless, blood was shed and anger seethed. Hamas said 4-year-old twin boys had died with their parents when their house in the town of Beit Lahiya was struck from the air. Neighbors said the occupants were not involved with militant groups.

Israel had no immediate comment on that attack. It says it takes extreme care to avoid civilians and accuses Hamas and other militant groups of deliberately placing Gaza's 1.7 million people in harm's way by siting rocket launchers among them.

Nonetheless, fighting Israel, whose right to exist Hamas refuses to recognize, is popular with many Palestinians and has kept the movement competitive with the secular Fatah movement of Palestinian President Mahmoud Abbas, who remains in the West Bank after losing Gaza to Hamas in a civil war five years ago.

"Hamas and the others, they're our sons and our brothers, we're fingers on the same hand," said 55-year-old Faraj al-Sawafir, whose home was blasted by Israeli forces. "They fight for us and are martyred, they take losses and we sacrifice too."

Thousands turned out on Monday to mourn four children and five women who were among 11 people killed in an Israeli air strike that flattened a three-storey home the previous day.

The bodies were wrapped in Palestinian and Hamas flags. Echoes of explosions mixed with cries of grief and defiant chants of "God is greatest!".

ISRAELI INVESTIGATION

Israel said it was investigating the strike that brought the block crashing down on the al-Dalu family, where the dead spanned four generations. Some Israeli newspapers said the house might have been targeted by mistake.

For the second straight day, Israeli missiles blasted a tower block in the city of Gaza housing international media. Two people were killed there, one of them an Islamic Jihad militant.

In scenes recalling Israel's 2008-2009 winter invasion of the coastal enclave, tanks, artillery and infantry have massed in field encampments along the sandy, fenced-off border.

Israel has also authorized the call-up of 75,000 military reservists, so far mobilizing around half that number.

Although 84 percent of Israelis support the current Gaza assault, according to a poll by Israel's Haaretz newspaper, only 30 percent want an invasion.

With the power balances of the Middle East drastically shifted by the Arab Spring during a first Obama term that began two days after Israel ended its last major Gaza offensive, the newly re-elected U.S. president faces testing choices to achieve Washington's hopes for peace and stability across the region.

In an echo of frictions over the civil war in Syria, Russia accused the United States on Monday of blocking a bid by the U.N. Security Council to condemn the escalating conflict in the Gaza Strip. Washington has generally stopped the U.N. body from putting what it sees as undue pressure on its Israeli ally.

(Writing by Alastair Macdonald; Editing by Kevin Liffey)

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