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:

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Wall Street Week Ahead: Political wrangling to pinch market's nerves

NEW YORK (Reuters) - Volatility is the name of this game.

With the S&P 500 above 1,400 following five days of gains, traders will be hard pressed not to cash in on the advance at the first sign of trouble during negotiations over tax hikes and spending cuts that resume next week in Washington.

President Barack Obama and U.S. congressional leaders are expected to discuss ways to reduce the budget deficit and avoid the "fiscal cliff" of automatic tax increases and spending cuts in 2013 that could tip the economy into recession.

As politicians make their case, markets could react with wild swings.

The CBOE Volatility Index <.vix>, known as the VIX, Wall Street's favorite barometer of market anxiety that usually moves in an inverse relationship with the S&P 500, is in a long-term decline with its 200-day moving average at its lowest in five years. The VIX could spike if dealings in Washington begin to stall.

"If the fiscal cliff happens, a lot of major assets will be down on a short-term basis because of the fear factor and the chaos factor," said Yu-Dee Chang, chief trader and sole principal of ACE Investments in Virginia.

"So whatever you are in, you're going to lose some money unless you go long the VIX and short the market. The 'upside risk' there is some kind of grand bargain, and then the market goes crazy."

He set the chances of the economy going over the cliff at only about 5 percent.

Many in the market agree there will be some sort of agreement that will fuel a rally, but the road there will be full of political landmines as Democrats and Republicans dig in on positions defended during the recent election.

Liberals want tax increases on the wealthiest Americans while protecting progressive advances in healthcare, while conservatives make a case for deep cuts in programs for the poor and a widening of the tax base to raise revenues without lifting tax rates.

"Both parties will raise the stakes and the pressure on the opposing side, so the market is going to feel much more concerned," said Tim Leach, chief investment officer of U.S. Bank Wealth Management in San Francisco.

"The administration feels really confident at this point, or a little more than the Republican side of Congress may feel," he said. "But it's still a balanced-power Congress so neither side can feel that they can act with impunity."

THE MIDDLE EAST AND EUROPE

Tension in the Middle East and unresolved talks in Europe over aid for Greece could add to the uncertainty and volatility on Wall Street could surge, analysts say.

An Egypt-brokered ceasefire between Israel and Hamas came into force late on Wednesday after a week of conflict, but it was broken with the shooting of a Palestinian man by Israeli soldiers, according to Palestine's foreign minister.

Buoyed by accolades from around the world for mediating the truce, Egyptian President Mohamed Mursi assumed sweeping powers, angering his opponents and prompting violent clashes in central Cairo and other cities on Friday.

"Those kinds of potential large-scale conflicts can certainly overwhelm some of the fundamental data here at home," said U.S. Bank's Leach.

"We are trying to keep in mind the idea that there are a lot of factors that are probably going to contribute to higher volatility."

On a brighter note for markets, Greece's finance minister said the International Monetary Fund has relaxed its debt-cutting target for Greece and a gap of only $13 billion remains to be filled for a vital aid installment to be paid.

Still, a deal has not been struck, and Greece is increasingly frustrated at its lenders, still squabbling over a deal to unlock fresh aid even though Athens has pushed through unpopular austerity cuts.

HOUSING DATA COULD CONFIRM RECOVERY

Next week is heavy on economic data, especially on the housing front. Some of the numbers have been affected by Superstorm Sandy, which hit the U.S. East Coast more than three weeks ago, killing more than 100 people in the United States alone and leaving billions of dollars in damages.

The housing data, though, could continue to confirm a rebound in the sector that is seen as a necessary step to unlock spending and lower the stubbornly high unemployment rate.

Tuesday's S&P/Case-Shiller home price index for September is expected to show the eighth straight month of increases, extending the longest continuous string of gains since prices were boosted by a homebuyer tax credit in 2009 and 2010.

New home sales for October, due on Wednesday, and October pending home sales data, due on Thursday, are also expected to show a stronger housing market.

Other data highlights next week include durable goods orders for October and consumer confidence for November on Tuesday and the Chicago Purchasing Managers Index on Friday.

At Friday's close, the S&P 500 wrapped up its second-best week of the year with a 3.6 percent gain. Encouraging economic data next week could confirm that regardless of the ups and downs that the fiscal cliff could bring, the market's fundamentals are solid.

Jeff Morris, head of U.S. equities at Standard Life Investments in Boston, said that "it's kind of noise here" in terms of whether the market has spent "a few days up or down. It has made some solid gains over the course of the year as the housing recovery has come into view, and that's what's underpinning the market at these levels.

"I would caution against reading too much into the next few days."

(Wall St Week Ahead runs every Friday. Questions or comments on this column can be emailed to: rodrigo.campos(at)thomsonreuters.com)

(Reporting by Rodrigo Campos; Editing by Tim Dobbyn and Jan Paschal)

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Swallowing Rain Forest, Brazilian Cities Surge in Amazon

Lalo de Almeida for The New York Times

The torrid growth is visible in places like Parauapebas. On the outskirts, slums stretch to the horizon and houses continue to go up. More Photos »

PARAUAPEBAS, Brazil — The Amazon has been viewed for ages as a vast quilt of rain forest interspersed by remote river outposts. But the surging population growth of cities in the jungle is turning that rural vision on its head and alarming scientists, as an array of new industrial projects transforms the Amazon into Brazil’s fastest-growing region.

The torrid expansion of rain forest cities is visible in places like Parauapebas, which has changed in a generation from an obscure frontier settlement with gold miners and gunfights to a sprawling urban area with an air-conditioned shopping mall, gated communities and a dealership selling Chevy pickup trucks.

Scientists are studying such developments and focusing on the demands on the resources of the Amazon, the world’s largest remaining area of tropical forest. Though Brazilian officials have historically viewed the colonization of the Amazon as a matter of national security — military rulers built roads to the forest under the slogan “Occupy it to avoid surrendering it” — deforestation in the region already ranks among the largest contributors to global greenhouse-gas emissions.

Brazil has shifted away from colonization, but policies that regularize land claims by squatters still lure migrants to the Amazon. And while the country has recently made progress in curbing deforestation, largely by enforcing logging laws and carving out protected forest areas, biologists and other climate researchers fear that the sharp increase in migration to cities in the Amazon, which now has a population approaching 25 million, could erode those gains.

“More population leads to more deforestation,” said Philip M. Fearnside, a researcher at the National Institute for Amazon Research in Manaus, an Amazonian city that registered by far the fastest growth of Brazil’s 10 largest cities from 2000 to 2010. The number of residents grew 22 percent to 1.7 million, according to government statistics.

Of the 19 Brazilian cities that the latest census indicates have doubled in population over the past decade, 10 are in the Amazon. Altogether, the region’s population climbed 23 percent from 2000 to 2010, while Brazil as a whole grew just 12 percent.

Various factors are fueling this growth, among them larger family sizes and the Amazon’s high levels of poverty in comparison with other regions that draw people to the cities for work. While Brazil’s birthrate has fallen to 1.86 children per woman, one of the lowest in Latin America, the Amazon has Brazil’s highest rate, at 2.42.

Then there is the region’s economic allure.

Sinop, a city of 111,000 people in Mato Grosso State, grew about 50 percent in the past decade as soybean farmers expanded operations there. Fiscal incentives for manufacturing promote growth in Manaus and satellite towns like Manacapuru and Rio Preto da Eva. Logging still provides the lifeblood for growing towns along BR-163, an important Amazon highway now being paved.

Elsewhere in the Amazon, the biggest linchpins for the fast-growing cities are major energy and industrial projects. The construction of dozens of hydroelectric projects, including sprawling dams that have drawn protests, are luring manual laborers from around Brazil to cities like Pôrto Velho, in Rondônia State, and Altamira, in Pará.

Here in Parauapebas, which is also in Pará, a vast open-pit iron ore mine provides thousands of jobs. Plans for additional mines here, supported largely by forecasts of robust mineral demand in China, have lured many to this corner of the Amazon in search of work. Just since the 2010 census, the city’s population has swelled to an estimated 220,000 from 154,000.

“This entire area was thick, almost impenetrable, jungle,” said Oriovaldo Mateus, an engineer who arrived here in 1981 to work for Vale, the Brazilian mining giant. That was about the time that the authorities cut a road through the forest, making the settlement of Parauapebas feasible. By the early 1990s, he said, it had muddy roads, brothels and more than 25,000 people.

“Now, Brazil’s future is in Parauapebas and other cities of the Amazon,” said Mr. Mateus, 62, who heads the city’s business association and owns a company that leases mining equipment. He boasted that on some frenetic days, as many as two homes are built each hour to meet surging demand in the city’s settlements.

Indeed, the streets of Parauapebas pulse with vitality. People shout to be heard along Rua 24 de Março, a traffic-clogged thoroughfare reverberating with the buzzing of motorcycle taxis, Pentecostal preachers bellowing warnings of sin and car stereos blaring eletromelody, the thumping electronic music style popular in this part of the Amazon.

Venture to the outskirts of Parauapebas, and slums of wooden shacks stretch to the horizon. One area where squatters have put down stakes is called Nova Vitória. With about 1,200 such homes, it is a magnet for strivers.

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6 ways to tweet yourself out of a job

Hate your job? Want to leave without giving two weeks notice? Thanks to Twitter, it’s never been easier to get fired, says Rob Lammie at Mental Floss

Step 1: Drunk tweet
As any Spring Break partier knows, drinking impairs your judgment. It seems to have also impaired the judgment of Major League pitcher-turned-sports-radio-host Mike Bacsik, who put on quite a show during a San Antonio Spurs and Dallas Mavericks NBA game in April 2010. While watching the game, Bacsik bragged that he was “About 12 deep and some shots.” He proceeded to unleash a string of insults aimed at NBA commissioner David Stern, accused the refs of fixing the game, and even threatened to blow up the NBA’s offices. But the one that really got people riled up came after the Mavericks lost the game, when Bacsik tweeted: 

SEE MORE: Why popular kids make more money as adults

@MikeBacsik: “Congrats to all the dirty mexicans in San Antonio.”

After sobering up, Bacsik deleted the offending tweets and issued an apology. But it was too little, too late. Numerous people complained to his radio station, which first suspended Bacsik and later fired him. After his dismissal, he told ESPN Dallas, “When you tweet like that, it’s not a playful, harmless thing… I’m very sorry and will try my best for my actions to speak louder than my tweets.”

Step 2: Break the law (or just anger your governor)
Twitter has become a great tool for politicians to connect to the voting public. Former Mississippi Governor Haley Barbour, for one, has really embraced the technology as a way to share his opinions and views. For example, in December 2009, he sent out a tweet saying:

 @HaleyBarbour: “Glad the Legislature recognizes our dire fiscal situation. Look forward to hearing their ideas on how to trim expenses.”

Jennifer Carter, one of his Twitter followers who worked for the University of Mississippi Medical Center (UMC), read this message and offered up a suggestion on how Governor Barbour could personally save the taxpayers money:

“Schedule regular medical exams like everyone else instead of paying UMC employees overtime to do it when clinics are usually closed.” 

This “Oh, snap!” moment referred to an incident that had occurred three years earlier, when the governor requested the medical center open on a Saturday, when they were normally closed, and bring in a staff of 15-20 people who were paid overtime to administer his annual check-up. This happened before Carter worked for UMC and she was simply repeating what she had been told by other employees. 

SEE MORE: Does a shaved head give you an advantage in corporate America?

The governor’s office tracked down Carter and made a formal complaint to UMC, saying Carter had violated the Health Insurance Portability and Accountability Act, a privacy law that states no employee of a medical facility can reveal any information about a person’s “protected health information.” Some argued that Carter didn’t violate HIPAA, since she didn’t actually give out any information about the health of the governor. However, others believe that simply saying the governor had even visited a doctor is a violation. 

Semantics aside, UMC administrators said it was a violation, so they suspended Carter for three days without pay and strongly suggested she resign to avoid further disciplinary action, which she did.

SEE MORE: Facebook’s new jobs board: Is LinkedIn toast?

Step 3: Have an NSFW lifestyle
St. Louis-based blogger “The Beautiful Kind” had been writing online about her polyamorous sex life for years. Knowing that not everyone would agree with her chosen lifestyle, she was always very careful about maintaining her anonymity, especially when it came to the workplace. So when she signed up for Twitter, she wanted to be anonymous there as well. She thought that, thanks to the similarities between the two, it was like signing up for an online message board — you supplied your real name to the website privately, but could choose to be known publicly by your username only. But when she logged in for the first time and saw that, not only did it show her username (@TBK365), but also her real name on her profile, she immediately went back and removed it. 

Thinking she was now safely anonymous, she used Twitter to promote her blog and to discuss sexually explicit topics with her followers. However, when her boss at the non-profit group where she worked was told by upper management to do a Google search of all employees, TBK’s Twitter account information — with her real name still associated — came up on the Twitter tracking site topsy.com.

The next day, TBK was called into her boss’ office and fired on the spot. Afterwards, her former boss sent her a letter saying, “While I know you are a good worker and an intelligent person, I hope you try to understand that our employees are held to a different standard. When it comes to private matters, such as one’s sexual explorations and preferences, our employees must keep their affairs private.” Because Missouri is an at-will employment state, meaning employers can fire someone for just about any reason, TBK was SOL.

Step 4: Question company policy
When California Pizza Kitchen (CPK) traded in their standard white shirts for black ones, employee Tim Chantarangsu wasn’t happy with the change. So he tweeted @calpizzakitchen his opinion:

@traphik: “black button ups are the lamest s**t ever!!!”

He didn’t expect anyone to notice or care, but the next day he received a direct message from corporate asking what restaurant he worked for. He knew better than to respond, but they tracked him down anyway and he was fired. They not only referenced his tweet about the shirts, but also an earlier one where he had said he was getting ready to work at “Calipornia Skeetza Kitchen.” 

Little did they know that Chantarangsu is kind of a big deal on another social website, YouTube. Under the name TimothyDeLaGhetto2, Chantarangsu has hundreds of thousands of subscribers, accounting for over 10,500,000 views of his videos at the time. Of course he made a YouTube video telling his Twitter story and it has been viewed well more than 100,000 times. Shortly after the incident, he asked his followers to bombard CPK’s Twitter account with RTs (re-tweets) of his offending message, which they were more than happy to oblige.

Step 5: Make a celebrity look bad
During his five years on the job, Jon Barrett-Ingels had served a lot of celebrities as a waiter at Barney Greengrass, an upscale restaurant in Beverly Hills. One day, Jane Adams, star of the HBO series Hung, came in and had lunch to the tune of $ 13.44. Unfortunately, when the bill came, Adams realized she had left her wallet in the car. Ingels knew who she was, so he told her she could run out and grab it and come back. The actress left, but didn’t return. Instead, someone from her agency called the next day and paid the bill. However, they didn’t leave a tip. Ingels had recently signed up for Twitter and so, his sixth tweet to his 40 followers said:

@PapaBarrett: Jane Adams, star of HBO series “Hung” skipped out on a $ 13.44 check. Her agent called and payed the following day. NO TIP!!!” 

Over the next few weeks, Ingels started using Twitter to send out a few harmless observations about celebrities that came in to eat — mainly what they ordered or what they looked like that day. Then, out of the blue, Jane Adams came back to the restaurant. According to Ingels’ blog, she was clearly upset and begrudgingly slapped $ 3 on the bar for Ingels as a tip. Surprised, Ingels told the actress she really didn’t have to do that, but her gesture was appreciated. She allegedly replied with, “My friend read about it on Twitter!” before storming off. Adams complained about the tweet to management, so someone from Barney’s corporate started following Ingels on Twitter to see what he was up to. After reading his celebrity tweets, it didn’t take long before they gave him the boot.

Step 6: Don’t get hired in the first place
If you’ve followed steps 1 – 5 and you still have a job, here’s the ultimate way to make sure Twitter will keep you from gainful employment.

When recent college grad Skye Riley heard back from Cisco, the computer networking giant, about her job application, one of her first instincts was to tweet about it. Unfortunately, this is what she tweeted:

@theconnor: Cisco just offered me a job! Now I have to weigh the utility of a fatty paycheck against the daily commute to San Jose and hating the work.

The unfortunate part? An employee of Cisco, Tim Levad, came across her post while doing a Twitter search for Cisco. He replied to her by saying:

@timmylevad: Who is the hiring manager. I’m sure they would love to know that you will hate the work. We here at Cisco are versed in the web.

Riley’s story was the tweet heard round the world. It became a hot topic on tech blogs for weeks afterwards, with writers calling it the “Cisco Fatty” incident. She later claimed that the tweet was taken out of context — that part of her message was referring to a well-paid internship she had turned down — but it appears the damage had already been done. While only she and Cisco know what really happened, according to her online resume, she has never worked for the company.

 — Rob Lammie

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Beverley Mitchell Debuts Baby Bump

Mom & Babies
Celebrity Baby Blog

11/23/2012 at 11:00 AM ET

There’s not just turkey in there!

An expectant Beverley Mitchell debuted her baby bump on Twitter Thursday

“Happy Thanksgiving! Here is my first belly pic! 21 weeks,” the actress writes. “Watch out! The belly is getting bigger!”

Mitchell, 31, and husband Michael Cameron will welcome their first child in early April.

“I took seven pregnancy tests,” The Secret Life of the American Teenager star tells PEOPLE. “I went to the doctor and had two more tests and they were like, ‘Bev, usually when the first one comes out positive, the rest of them will all say the same thing.’”

RELATED: Beverley Mitchell Expecting First Child

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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..

Wall Street climbs in short session, led by tech stocks

NEW YORK (Reuters) - Stocks extended gains on Friday, with all three key indexes climbing 1 percent, as technology shares led the way in thin trading ahead of an early, post-Thanksgiving close for equity markets.

The Dow Jones industrial average <.dji> gained 133.01 points, or 1.04 percent, to 12,969.90. The Standard & Poor's 500 Index <.spx> rose 14.52 points, or 1.04 percent, to 1,405.55. The Nasdaq Composite Index <.ixic> climbed 36.11 points, or 1.23 percent, to 2,962.67.

(Reporting by Leah Schnurr; Editing by Bernadette Baum)

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Israeli Troops Kill a Palestinian in Shooting That Tests Cease-Fire

Said Khatib/Agence France-Presse — Getty Images

A group of Palestinians run from the Israel-Gaza border, as an Israeli army vehicle drives along the security fence, in the southeast Gaza Strip on Friday.

GAZA — Health officials said on Friday that a 20-year-old Palestinian was killed and nine others wounded in a clash with Israeli soldiers in the southeast Gaza Strip, testing the cease-fire between Hamas and Israel after wild celebrations here on Thursday.

The leadership in Gaza has said that the agreement, announced on Wednesday in Cairo to end eight days of ferocious exchanges, includes an Israeli promise to halt “incursions” into a 1,000-foot-wide buffer zone along Gaza’s northern and eastern borders where Palestinians have been banned.

Maan, the Palestinian news agency, reported that a group of Palestinians went to Abassan, a border area east of the southern town of Khan Younis, on Friday to pray on their land, and ended up throwing stones at soldiers, who responded with gunfire. Ashraf al-Qedra, a spokesman for the Health Ministry, identified the man who was killed as Ahmad Qudaih.

It remained unclear whether Hamas would depict the episode as a violation of the still uncertain cease-fire.

The border area has long been a focal point of tension. In the days leading up to Israel’s military offensive against Hamas and other armed groups in Gaza, Palestinian militants fired an anti-tank missile at an Israeli military jeep patrolling the border, injuring four soldiers, and Hamas claimed responsibility for detonating a tunnel packed with explosives that ran along the border while an Israeli force was nearby.

Capt. Eytan Buchman, a spokesman for the Israeli military, said that about 300 Palestinians were demonstrating at various points along the border fence on Friday, prompting Israeli soldiers to fire warning shots in the air. Then some demonstrators “tried to damage the fence and cross into Israel,” Captain Buchman said. “When that happened, the forces fired at their feet.”

Captain Buchman said that one Palestinian demonstrator had managed to cross into Israel but he was returned to Gaza immediately. Israel says its actions are designed to keep Palestinians away from the security fence.

The episode came a day after Palestinians erupted in triumphant celebrations here on Thursday, vowing new unity among rival factions and a renewed commitment to the tactic of resistance, while Israel’s leaders sought to soberly sell the achievements of their latest military operation to a domestic audience long skeptical of cease-fire deals like the one announced Wednesday night.

Witnesses and Hamas police officers said the shooting Friday happened near the spot where a missile fired by Palestinian militants injured three Israeli soldiers in a jeep stationed along the border fence earlier this month.

They said that as many as 2,000 people had flocked to the area on Thursday in celebration of the cease-fire, and that hundreds returned Friday morning.

Many of them had not been that close to the border in a decade or more: it was considered too dangerous at least since the onset of the second Palestinian uprising in 2000, and became officially off limits starting in 2008.

An Israeli government official said on Friday that, as part of the latest cease-fire understandings, Israel agreed to discuss the buffer zone with the Egyptian sponsors of the truce. But, the official added, no negotiations have taken place yet. For now, the official said, Israel’s regulations for maintaining the zone and the army’s rules of engagement remain unchanged.

A Palestinian who approached the security fence on Friday, Eyad Qudaih, 38, said he had not visited his modest farm measuring around 1.7 acres close to the fence in the 12 years he had lived in one of the few scattered houses in the buffer zone. The feeling of standing on his land, he said, “was like someone who is hungry and had a big meal, grilled sheep with nuts.”

Someone planted a green Hamas flag on a long pole atop the fence, and a smaller Palestinian one nearby, unimaginable sights only a few days ago. Some Palestinians talked to Israeli soldiers through the fence, according to witnesses and photographs posted on the Internet.

One Hamas police officer, speaking on the condition of anonymity because he was not authorized to talk to reporters, said some people went over a part of the fence knocked down by the jeep attack earlier this month, but it was unclear whether this happened Thursday or Friday.

Jodi Rudoren reported from Gaza, and Isabel Kershner from Jerusalem. Fares Akram contributed reporting from Gaza, and Tamir Elterman from Sderot, Israel.

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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 global 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 in global growth and euro zone data at least did not worsen the already weak outlook for that region.

The euro hit a three high against the dollar on optimism that a funding deal for debt-crippled Greece will ultimately be agreed - and despite data indicating the region's economy is on course for its deepest recession 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 $1.2880, its highest since November 2.

The view there will be a deal to help Athens was bolstered on Wednesday when German Chancellor Angela Merkel said after the failure of the latest talks, that an agreement was possible when euro zone ministers meet again on Monday.

The hopes for a Greek deal, combined with the better economic data and a growing view that a solution can be found to the U.S. fiscal crisis, lifted the MSCI world equity index 0.4 percent to 326 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 1,101.70 points, with London's FTSE 100, Paris's CAC-40 and Frankfurt's DAX between 0.3 and 0.7 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 an expansion in activity after seven consecutive quarters of slowdown.

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.

"There are questions over whether the Chinese economy is really that bad or if the U.S. will take a long time to recover, but we are getting signs that the situation is not as bad as assumed," said Peter Braendle, head of European equities at Zurich-based Swisscanto Asset Management.

PMI data on the manufacturing and services sectors in Europe's two biggest economies, 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 6 basis points lower on the day at 5.67 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, adding that the market was expecting Madrid to ask for an international bailout early next year.

Expectations 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 during a debt restructuring in March.

COMMODITIES STEADY

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

Three-month copper on the London Metal Exchange rose 0.6 percent to $7,735.25 a metric tonne, and spot gold inched up to $1,730.30 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 might have had on supply from the region, offsetting support from the prospect of more Chinese oil demand.

Brent slipped 7 cents to $110.90 a barrel, while U.S. crude was up 2 cents at $87.40.

($1 = 0.7801 euros)

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

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