Mayim Bialik and Michael Stone Divorcing

By Mike Fleeman

11/21/2012 at 05:00 PM EST

After "much consideration and soul-searching," Mayim Bialik announced Wednesday that she and husband Michael Stone are divorcing after nine years of marriage.

The Big Bang Theory star, who has sons Miles, 7, and Fred, 4, with Stone, cites "irreconcilable differences" for the split, which she revealed in a statement on her Kveller.com parenting blog.

"Divorce is terribly sad, painful and incomprehensible for children. It is not something we have decided lightly," she writes.

The former star of TV's Blossom, 36, also says that the split is not due to the attachment parenting she discusses in her book Beyond the Sling. "Relationships are complicated no matter what style of parenting you choose," she says.

"The main priority for us now is to make the transition to two loving homes as smooth and painless as possible," Bialik continues. "Our sons deserve parents committed to their growth and health and that’s what we are focusing on. Our privacy has always been important and is even more so now, and we thank you in advance for respecting it as we negotiate this new terrain."

She concludes by saying, "We will be ok."

The couple were married in August 2003 in Pasadena, Calif.

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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.

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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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Global shares gain as economic outlook improves

LONDON (Reuters) - World share markets extended a week-long rally on Thursday as manufacturing surveys in China and the United States boosted confidence over global growth and euro zone data at least didn't worsen the already weak outlook for the region.

The euro also touched a three-week high against the dollar on renewed optimism that a Greek funding deal will eventually be agreed, and despite the data indicating the region's economy is on course for its deepest downturn since early 2009.

"The driving factors behind euro/dollar are that the global macroeconomic backdrop seems to be improving and people are pricing out the tail risk on Greece," said Arne Lohmann Rasmussen, head of currency research at Danske Bank.

The euro rose 0.4 percent to $1.2884, its highest level since November 2.

The prospect of a deal to help Athens was boosted when German Chancellor Angela Merkel said on Wednesday, after the failure of overnight talks, that an agreement was possible at a euro zone ministers meeting on Monday.

The hopes for a Greek deal, combined with the better economic data and a growing view that a resolution can be found to the U.S. fiscal crisis, lifted the MSCI world equity index 0.35 percent to 326.1 points, putting it on track for its best week since mid-September.

Europe's FTSE Eurofirst 300 index rose 0.4 percent to a two-week high of 1,102.25 points, with London's FTSE 100, Paris's CAC-40 and Frankfurt's DAX between 0.3 and 0.8 percent higher.

However, trading was subdued, with U.S. markets closed for the Thanksgiving holiday.

CHINA BOOST

Confidence in the global economic outlook got its biggest boost from the HSBC flash Manufacturing Purchasing Managers Index (PMI) for China, which pointed to expansion in activity after seven consecutive quarters of slowdown.

"There have been a lot of concerns regarding the outlook for global growth. In this context, any improvement in Chinese data is welcome, given that investors are still risk averse," said Robert Parkes, equity strategist at HSBC Securities.

The Chinese data followed a report on Wednesday showing U.S. manufacturing grew in November at its quickest pace in five months, indicating strong economic growth in the fourth quarter.

PMI data on the manufacturing and services sectors in Europe's two biggest economies of Germany and France added to the better tone, revealing that conditions had not worsened in November, though both economies are still contracting.

However, the PMI numbers for the wider euro zone remain extremely weak, pointing to the recession-hit region shrinking by about 0.5 percent in the current quarter - its sharpest contraction since the first quarter of 2009.

"The weak PMI outturn for November is a major disappointment in light of the increases in the German and French PMI surveys, and suggest the recession on the euro zone's periphery is gathering further pace," said ING economist Martin van Vliet.

BOND DEMAND

In the fixed-income markets the improving tone enabled Spain to sell 3.88 billion euros ($4.97 billion) of new government bonds on Thursday, even though it has already raised enough funds for this year's needs.

The average yield on the three-year bonds in the auction was 3.617 percent, compared with 3.66 percent at a sale earlier in November and a 2012 average of 3.79 percent.

Ten-year Spanish yields were 7 basis points lower on the day at 5.66 percent, having traded above 6 percent at the start of the week.

"It's a clear reflection that sentiment in Spain has improved markedly," RIA Capital Markets bond strategist Nick Stamenkovic said. "They are already funded for 2012, and the market is betting that Spain will ask for a bailout early next year when they face a (wall of issuance)."

Expectations that Greece will soon get more cash set Greek yields on course for their 10th consecutive daily fall. The February 2023 bond yield dropped to 16.16 percent, its lowest since it was issued as part of a debt restructuring in March.

COMMODITIES STEADY

Commodity prices gained some support from the improving outlook for world demand from all the PMI data, but the prospect of only modest global growth in 2013 kept the gains in check.

Three-month copper on the London Metal Exchange rose 0.7 percent to $7,744.75 a metric tonne, and spot gold inched up to $1,729.56 an ounce.

Oil prices were more mixed as the ceasefire between Israel and Gaza's Hamas rulers on Thursday eased concerns over the impact the unrest may have on supply from the region offsetting support from the prospect of greater Chinese oil demand.

Brent slipped 30 cents to $110.56 a barrel, while U.S. crude was up 3 cents at $87.41.

($1 = 0.7801 euros)

(Additional reporting by Jessica Mortimer and Marius Zaharia; Editing by Will Waterman)

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Gaza shakes, bus explodes in Tel Aviv as Clinton seeks truce

GAZA/JERUSALEM (Reuters) - U.S. Secretary of State Hillary Clinton on Wednesday pursued a Gaza truce, with Israel and Hamas still at odds over key terms, as Israeli air strikes shook the enclave and a bomb exploded on a Tel Aviv bus.

After talks in Ramallah with Palestinian President Mahmoud Abbas, Clinton held a second meeting with Israeli Prime Minister Benjamin Netanyahu before heading to Egypt, the main broker in efforts to end eight days of fighting and avert a possible Israeli ground offensive.

In Tel Aviv, at least 10 people were wounded when a bus was blown up on a main street near the Defence Ministry and military headquarters. Israel's government called it a terrorist attack.

The explosion, which police said was caused by a bomb placed on the vehicle, touched off celebratory gunfire from militants in Gaza and threatened to complicate truce efforts.

Israel's best-selling Yedioth Ahronoth newspaper said an emerging outline of a ceasefire agreement called for Egypt to announce a 72-hour ceasefire followed by further talks on long-term understandings.

Under the proposed document, which the newspaper said neither party would be required to sign, Israel would hold its fire, end attacks against top militants and promise to examine ways to ease its blockade of the enclave.

Hamas, the report said, would pledge not to strike any Israeli target and ensure other Palestinian factions in the Gaza Strip also stop their attacks.

An Israeli political source said differences holding up a deal centered on a Hamas demand to lift the Gaza blockade completely and the kind of activity that would be allowed along the frontier, where Israeli troops often fire into the enclave to keep Palestinians away from an area near a border fence.

Hamas official Ezzat al-Rishq said the main stumbling block was "the temporary timeframe for a ceasefire that the Israelis want us to agree to".

"GOOD INTENTIONS"

The London-based Al Hayat newspaper, citing sources in Hamas and Islamic Jihad, said Israel wanted a 90-day period to determine "good intentions" before discussing Palestinian demands, a position the report said the groups have rejected.

Rishq said a short-term truce, whose proposed duration he did not disclose, "would only buy (Israel) time" until a general election in January and "we would have accomplished nothing in the way of a long-term truce".

Hamas sources said the group was also demanding control over Gaza's Rafah borders with Egypt, so that Palestinians could cross easily, and Israeli guarantees to stop assassinating Hamas leaders.

Israel, one of the Hamas sources said, wanted a commitment from the group to stop smuggling through tunnels that run into Gaza under the Egyptian border. The tunnel network is a conduit for weapons and commercial goods.

News of the Tel Aviv bus bombing, the first serious blast in Israel's commercial capital since 2006, emerged just after Clinton and Netanyahu ended their meeting. A spokesman for Netanyahu declined to give details on their discussions, which followed talks on Tuesday.

Clinton, who flew to the region from an Asian summit, said in her public remarks after Tuesday's meeting with Netanyahu that it was "essential to de-escalate the situation".

"The rocket attacks from terrorist organizations inside Gaza on Israeli cities and towns must end and a broader calm restored," she said.

Clinton earlier assured Netanyahu of "rock-solid" U.S. support for Israel's security, and praised Egyptian President Mohamed Mursi's "personal leadership and Egypt's efforts thus far" to end the Gaza conflict and promote regional stability.

"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 (Wednesday)," she said.

"LONG-TERM" SOLUTION

Netanyahu told Clinton he wanted a "long-term" solution. Failing that, Netanyahu made clear, that he stood ready to step up the military campaign to silence Hamas' rockets.

"A band-aid solution will only cause another round of violence," said Ofir Gendelman, a Netanyahu spokesman.

While diplomatic efforts continued, Israel struck more than 100 targets in Gaza overnight, killing a Hamas gunman and destroying a cluster of Hamas government buildings.

Palestinians militants fired 31 rockets at Israel, causing no casualties, and Israel's Iron Dome interceptor system shot down 14 of them, police said.

Israel has carried out more than 1,500 strikes since the offensive began. Medical officials in Gaza said 139 Palestinians, most of them civilians, including 34 children, have been killed. Nearly 1,400 rockets have been fired into Israel, killing four civilians and a soldier, the Israeli military said.

In the West Bank city of Ramallah, Clinton held talks with Palestinian President Abbas, whose bid to upgrade the Palestinians' status at the United Nations, in the absence of peace negotiations with Israel, is opposed by Washington.

"Secretary Clinton informed the president that the U.S. administration is exerting every possible effort to reach an immediate ceasefire and the president expressed his full support for this endeavor," said Palestinian chief negotiator Saeb Erekat.

"Once the Israelis accept to stop their bombardments, their assassinations, there will be a comprehensive ceasefire sustained from all parties," Erekat said.

A Palestinian official with knowledge of Cairo's mediation told Reuters that Egyptian intelligence officials would hold further discussions on Wednesday with leaders of Hamas and the Islamic Jihad group.

"There may be a response from Israel that Egyptian mediators want to present to Hamas and Islamic Jihad leaders," the official said. "Let's be hopeful it would be something Palestinian factions can accept."

Like most Western powers, Washington shuns Hamas as an obstacle to peace and has blamed it for the Gaza conflagration. A U.N. Security Council statement condemning the conflict was blocked on Tuesday by the United States, which complained that it "failed to address the root cause," the Palestinian rockets.

Hamas for its part is exploring the opportunities that last year's Arab Spring has given it to enjoy favor from new Islamist governments, and from Sunni Gulf powers keen to woo it away from Shi'ite Iran.

It may count on some sympathy from Mursi, although Egypt's first freely elected leader, whose Muslim Brotherhood inspired Hamas' founders, has been careful to stick by the 1979 peace deal with Israel struck by Cairo's former military rulers.

Along the Gaza border, Israeli tanks, artillery and infantry remained poised for a possible ground offensive in the densely populated enclave of 1.7 million Palestinians.

But an invasion, likely to entail heavy casualties, would be a major political risk for Netanyahu, who is currently favored to win the upcoming Israeli election. More than 1,400 Palestinians were killed in Israel's three-week war in the Gaza Strip in 2008-9, prompting international criticism of Israel.

(Additional reporting by Ari Rabinovitch in Jerusalem and Cairo bureau; Writing by Jeffrey Heller; Editing by Giles Elgood)

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The Petraeus Affair: How Jill Kelley Inadvertently Brought Down the CIA Director

By Sandra Sobieraj Westfall

11/21/2012 at 08:30 AM EST

Exclusive excerpt from this week's PEOPLE Magazine:

Jill Kelley had e-mailed the Tampa mayor before: to invite him to parties; to tell him she had talked him up to her pal "Dave" Petraeus; to drop the name of Gen. John Allen. But this time it was personal. On Nov. 14 she e-mailed Mayor Bob Buckhorn at 6:18 a.m. about the news crews camped outside her home: "To put insult to injury, your police dept. gave the local 911 tapes to the press! . . . I'm scared and cannot believe what my City – in which I have contributed so much of my love, time, money and leadership – has now done to me and my innocent family."

Buckhorn did nothing about Kelley's complaint and, asked by the Tampa Bay Times about the release of her embarrassing calls to police invoking "diplomatic protection" she's not entitled to, the mayor answered, "Public record." For Kelley, 37 – an unpaid community liaison at MacDill Air Force Base, who placed herself at the nexus of Tampa's military-civilian circles since moving there with her husband, Scott, and twin, Natalie Khawam, a decade ago – the mayor's response was a sign that her fall was now going to be as steep and spectacular as her climb. 

As the world saw this week, she had a lot of company on the way down. By cozying up to two four-star generals – and then flaunting her access to them – Kelley inadvertently exposed a scandal that involves both Petraeus, who stepped down as head of the CIA after admitting an affair with his biographer Paula Broadwell, and Allen, whose promotion to head NATO forces in Europe is in limbo while what government officials describe as suggestive e-mails he wrote to Kelley are reviewed by the Defense Department.

 
How did every thread in the web link back to a chatty, flirty mom of three in Florida? For military lifers like Petraeus and Allen stationed at Central Command in Tampa, the relative glitz Kelley and her sister brought proved enchanting. "Here's the thing about commanders: They can get isolated. It's nice to have civilian friends who support you and the mission," says an active duty Army community-outreach official. "Mostly it's a nice thing. This one backfired." ...

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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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Futures retreat on Greek deal impasse; U.S. data on tap

NEW YORK (Reuters) - U.S. stock index futures retreated Wednesday after international lenders were unable to agree on emergency aid for Greece, and ahead of data on the U.S. labor market and consumer confidence.

For a second week, euro zone finance ministers, the International Monetary Fund and the European Central Bank failed to agree on how to make Greece's debt sustainable, which is necessary before the next cash infusion can be made to the fiscally beleaguered nation.

The FTSEurofirst 300 <.fteu3> edged up 0.06 percent at 1,095.13.

Investors will also look to weekly initial jobless claims at 8:30 a.m. ET for signs of improvement in the labor market. Economists in a Reuters survey expect a total of 410,000 new filings compared with 439,000 in the prior week, when a surge in claims was linked to the impact of superstorm Sandy.

At 8:58 a.m., information services company Markit releases U.S. flash Markit Manufacturing PMI for November, expected to show a reading of 51, unchanged from October.

The Thomson Reuters/University of Michigan Surveys of Consumers release the final November consumer sentiment index at 9:55 a.m. Economists in a Reuters survey expect a reading of 84.5 compared with 84.9 in the final October report.

"The market has shifted into Thanksgiving mode, while waiting for more news from Greece - after three positive sessions coming off the low, the market is looking for the next driving theme which could be today's economic numbers," said Andre Bakhos, director of market analytics at Lek Securities in New York.

The S&P 500 <.spx> had risen for three straight sessions as rhetoric from Washington did little to erode investor optimism of a deal to avert the "fiscal cliff," a series of tax hikes and spending cuts which will go into effect in the new year and threaten to derail the nation's fragile economic recovery.

Still, earlier gains on Tuesday were mostly erased as Federal Reserve Chairman Ben Bernanke cautioned that the central bank lacked the tools to cushion the U.S. economy from the impact of the cliff in a worst-case scenario.

"Investors are ignoring the elephant in the room in the form of the fiscal cliff and much of the recent strength stems from hopes of a benign resolution; however, until a deal is actually done, it could come back to haunt at any time," said Bakhos.

Shortly after at 10:00 a.m. the Conference Board releases its report on October leading economic indicators. Economists in a Reuters survey forecast a 0.2 percent rise compared with a 0.6 percent rise in September.

S&P 500 futures shed 0.1 point and were below fair value, a formula that evaluates pricing by taking into account interest rates, dividends and time to expiration on the contract. Dow Jones industrial average futures fell 2 points, and Nasdaq 100 futures added 1.75 points.

Volume is expected to be light ahead of the Thanksgiving Day holiday on Thursday.

The National Labor Relations Board (NLRB) said it was unlikely to decide, before Thursday's holiday, on Wal-Mart Stores Inc's push to stop protests and rallies outside its stores. This was a blow to the company's attempt to avoid major protests at its stores on "Black Friday," the day after Thanksgiving and the busiest shopping day of the year.

Deere & Co slipped 1.2 percent to $85 in light premarket trading, even as the agricultural equipment maker reported higher fourth-quarter earnings.

Business software provider Salesforce.com Inc beat Wall Street expectations for the third quarter and maintained its earnings outlook for the rest of its fiscal year despite the uncertain economic outlook.

Asian shares fell after the failure to reach a deal on another bailout for Greece, a day after Federal Reserve Chairman Ben Bernanke highlighted the dangers of a U.S. fiscal crisis.

(Editing by Bernadette Baum)

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World pressure for Gaza truce intensifies

GAZA/JERUSALEM (Reuters) - The U.N. chief called for an immediate ceasefire in Gaza on Tuesday and U.S. Secretary of State Hillary Clinton headed to the region with a message that escalation of the conflict was in nobody's interest.

Nevertheless, Israeli air strikes and Palestinian rocket fire continued for a seventh day.

For the second time since the fighting began, a rocket was launched at Jerusalem, triggering warning sirens. Police said it fell in an open area in the occupied West Bank and did not cause any casualties. Hamas's armed wing said in Gaza it fired the projectile.

Egypt was trying to broker a truce between Israel and Gaza's ruling Hamas movement. An Egyptian intelligence source said "there is still no breakthrough and Egypt is working to find middle ground".

Israel's military on Tuesday targeted about 100 sites in Gaza, including ammunition stores and the Gaza headquarters of the National Islamic Bank. Gaza's Hamas-run Health Ministry said six Palestinians were killed.

Israeli police said more than 60 rockets were fired from Gaza by mid-day, and 25 of the projectiles were intercepted by Israel's Iron Dome system. The military said an officer was wounded.

Some 115 Palestinians have died in a week of fighting, the majority of them civilians, including 27 children, hospital officials said. Three Israelis died last week when a rocket from Gaza struck their house.

In Cairo, U.N. Secretary-General Ban Ki-moon called for an immediate ceasefire and said an Israeli ground operation in Gaza would be a "dangerous escalation" that must be avoided.

He had held talks in Cairo with Arab League chief Nabil Elaraby and Egyptian Prime Minister Hisham Kandil before travelling to Israel for discussions with its leader, Benjamin Netanyahu. Ban planned to return to Egypt on Wednesday to see Egypt's Islamist President Mohamed Mursi, who was unavailable on Tuesday due to the death of his sister.

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.

Clinton was going to the Middle East for talks in Jerusalem, Ramallah and Cairo to try to calm the conflict. An Israeli source said she was expected to meet Netanyahu on Wednesday.

"Her visits will build on American engagement with regional leaders over the past days - including intensive engagement by President Obama with Prime Minister Netanyahu and President Morsi - to support de-escalation of violence and a durable outcome that ends the rocket attacks on Israeli cities and towns and restores a broader calm," a State Department official said.

Netanyahu and his top ministers debated their next moves in a meeting that lasted into the early hours of Tuesday.

"Before deciding on a ground invasion, the prime minister intends to exhaust the diplomatic move in order to see if a long-term ceasefire can be achieved," a senior Israeli official, speaking on condition of anonymity, said after the meeting.

A delegation of nine Arab ministers, led by the Egyptian foreign minister, visted Gaza in a further signal of heightened Arab solidarity with the Palestinians.

EGYPT KEY PLAYER

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

Mursi, whose Muslim Brotherhood was mentor to the founders of Hamas, on Monday took a call from Obama, who told him Hamas must stop rocket fire into Israel - effectively endorsing Israel's stated aim in launching the offensive last week. Obama 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, adding that the U.S. leader had also called Netanyahu.

"In both calls, President Obama expressed regret for the loss of Israeli and Palestinian civilian lives."

Mursi has warned Netanyahu of serious consequences from a ground invasion of the kind that killed more than 1,400 people 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.

Egypt's Kandil told Reuters a ceasefire was possible: "I think we are close, but the nature of this kind of negotiation, (means) it is very difficult to predict."

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 on Wednesday of Hamas's Gaza military chief, a move that followed a scaling up of rocket fire onto Israeli towns over several weeks and attacks against Israeli troops along the border.

An official close to Netanyahu told Reuters: "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."

Fortified by the ascendancy of fellow Islamists in Egypt and elsewhere, and courted by 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.

Hamas said four-year-old twin boys had died with their father when their house in the town of Beit Lahiya was struck from the air during the night. Health officials had reported the children's mother also died but later said she was critically wounded. 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 placing 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."

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.

But Israel's shekel rose on Tuesday for a second straight session while Tel Aviv shares gained for a third day in a row on what dealers attributed to investor expectation that a ceasefire deal was imminent.

(Additional reporting by Marwa Awad in Cairo, Writing by Jeffrey Heller)

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Blake Shelton Has Unforgettable Night on The Voice

TV Watch

The Voice

By Julia Haskins

11/20/2012 at 08:15 AM EST

Cassadee Pope (Blake Shelton inset)

Tyler Golden/NBC (2)

It was a night of creative growth on The Voice Monday, as the top 10 wowed the coaches in unexpected ways.

"This may be the best episode of The Voice we've ever had," Blake Shelton said. But it was the top talent among the remaining handful of singers that really gave his statement weight.

Christina Aguilera and Shelton kicked off the night with "Just a Fool," a duet from her new album Lotus, which ushered in rousing performances from each team.

Melanie Martinez, the eccentric star of Team Adam, pleased fans with her offbeat take on the White Stripe's "Seven Nation Army." Cee Lo Green called her performance "one of the coolest things that's happened this season." It even had Shelton feeling envious. If there was one singer who wasn't on his team that he could coach, "It's you, Melanie," he told her.

Dez Duron took a grown-up approach to his choice of song with Nina Simone's "Feeling Good." "I'm so happy that you brought not only your stage presence to the table, but you dug deeper," his coach Aguilera said. "You made everyone's heart melt tonight."

Green's Trevin Hunte set out to show that he could go beyond ballads with Usher's "Scream," and the bold move paid off. Coupled with a sublime gospel choir, Hunte's moving vocals won over his astonished coach. "It was so sweet to me. It makes me cry," Green said.

Shelton hinted at an important development with a Tweet early in the night. "One of the biggest nights of my career on The Voice tonight for a couple reasons... Watch," he said.

His own Cassadee Pope had the honor of singing "Over You," the song Shelton and wife Miranda Lambert co-wrote about his late brother. Pope faced a big challenge, but the tenderness of her voice and the energy in her performance had Shelton on his feet in standing ovation.

"Ladies and gentlemen, you're looking at an artist standing up there," he said of his singer who had just honored his brother with her performance.

The Voice returns Tuesday night with the elimination round.

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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 that 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."

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