Australian swim chief quits over Olympics' poor performance

SYDNEY: Swimming Australia chief executive Kevin Neil has quit his post in the wake of the team's poor showing at the London Olympics, which was tarred by reports of pranks and ill-discipline.

Australia's swimmers won just one gold, six silver and three bronze in London, their lowest tally in the pool since the 1992 Barcelona Games, and were without an individual gold medallist for the first time since Montreal in 1976.

"I have witnessed great changes and seen how swimming continues to be Australia's premier Olympic and Commonwealth Games sport," Neil said in a statement.

"Following the below-expected results at the London Olympics, swimming is now undertaking various reviews to set the new course for the future and it is therefore appropriate to step aside to allow the sport to progress to its next exciting phase."

Earlier this month, Australian swimming officials announced an independent review of the sport's culture at elite level after rumours of initiation rituals involving prescription drugs in London.

Swimming Australia, the sport's governing body in the country, said consultancy Bluestone Edge would lead a probe of top level "culture and leadership", in parallel with a broader post-Olympics review already under way.

That review launched in August is examining why the once-dominant swimming team fell so short.

In the lead-up to the Games, reports suggested some members of the much-vaunted but ultimately unsuccessful six-man freestyle relay team had an initiation ritual that involved taking the sedative Stilnox.

Stilnox was banned by Australian Olympic officials ahead of the London Games.

There were also claims of swimmers upsetting teammates and coaches by prank-calling and knocking on their doors late at night at their camp in Manchester, two days before the team went to London.

Neil was appointed to Swimming Australia's board of directors in February 2008, taking over as chief from Glenn Tasker later the same year.

- AFP/sf

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Four Tamil Nadu fishermen attacked by Lankan navy

RAMESWARAM: Four fishermen were injured today when they were attacked allegedly by Sri Lankan naval personnel when they were fishing near Katchatheevu in the Palk Straits.

Sticks, bottles and stones were allegedly hurled by the Lankan navalmen at the fishermen and their boats also suffered damage in the attack, officials said.

They also snapped the fishing nets, and seized global positioning and wireless equipment.

The injured fishermen have been admitted to a hospital at Ramanathpuram.

Katchatheevu is an islet ceded to Sri Lanka by India under a 1974 agreement between the two countries.

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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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Egypt's Morsi Wins U.S., Israeli Gratitude

Egyptian President Mohammed Morsi is being credited with brokering the cease-fire today between Israel and Hamas, but the international gratitude and praise he is gettting could come with a political price at home.

Both Secretary of State Hillary Clinton and President Obama heaped praise on the Egyptian president. Obama called his Egyptian counterpart today to thank him for his efforts in the negotiations, and Clinton expressed her gratitude personally in the press conference announcing the deal.

"I want to thank President Morsi for his personal leadership to de-escalate the situation in Gaza and end the violence," said Clinton. "This is a critical moment for the region. Egypt's new government is assuming the responsibility and leadership that has long made this country a cornerstone of regional stability and peace."

FULL COVERAGE: Israel-Gaza Conflict

In the last week Egypt emerged as the third and maybe the most pivotal party in the conflict between Israel and Hamas. Both Obama and Clinton made multiple calls to Morsi, understanding the long-term diplomatic consequences for America's historically strongest Arab ally in the Middle East, an ally that receives billions of dollars in aid annually.

Khaed Desouki/AFP/Getty Images

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The latest crisis was considered a crucial moment for Morsi. Both the U.S. and Israel for years had come to trust and depend on former Egyptian President Hosni Mubarak's right hand man, Intelligence Chief Omar Suleiman. He brokered the initial peace deal between Hamas and Israel and was respected by both sides. Suleiman lost power when Mubarak stepped down and died in July.

Under Morsi, Egypt, whose new governing Muslim Brotherhood party has a relationship with Hamas, also must maintain its peace treaty with Israel to keep diplomatic relations with the United States. But Morsi has a different mandate. As the first democratically-elected president, he is accountable to the people of Egypt, and must walk a fine line between meeting his constituents wants' and maintaining Egypt's diplomatic needs.

Throughout the crisis Morsi and Egyptian officials have spouted harsh rhetoric against Israel, calling the Jewish state the aggressors in the conflict and declaring that the Palestinians have the right to self-defense.

PHOTOS: Israel, Hamas Fight Over Gaza

Behind the scenes, however, Morsi has received high marks by his Israeli counterparts with Israeli President Shimon Peres calling the Egyptian president a "nice surprise" at the height of the talks on Tuesday.

Those familiar with how the cease-fire was eventually brokered credit the Egyptians, and say this was an Egyptian achievement, announced in Egypt.

But the fact that the announcement was made by Egyptian Foreign Minister Mohamed Kamel Amr, allowed Morsi some political cover from the negative swelling of Egyptian opinion over this deal.

While the U.S., Israel and Hamas may be happy about the deal, there has been significant backlash from Egyptian citizens who claim that despite the election and Morsi's Muslim Brotherhood background, he is no different than Mubarak, a puppet of the West. There are reports of calls for national protests this Friday.

There are also Egyptians who claim the president they elected cares more about the Palestinians than the many domestic problems Egyptians are facing.

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Gaza shakes, Israelis killed as Clinton seeks truce

GAZA/JERUSALEM (Reuters) - Israeli air strikes shook the Gaza Strip and Palestinian rockets struck across the border as U.S. Secretary of State Hillary Clinton held talks in Jerusalem in the early hours of Wednesday, seeking a truce that can hold back Israel's ground troops.

Hamas, the Islamist movement controlling Gaza, and Egypt, whose new, Islamist government is trying to broker a truce, had floated hopes for a ceasefire by late Tuesday; but by the time Clinton met Israeli Prime Minister Benjamin Netanyahu it was clear there would be more argument, and more violence, first.

Hamas leaders in Cairo accused the Jewish state of failing to respond to proposals and said an announcement on holding fire would not come before daylight on Wednesday. Israel Radio quoted an Israeli official saying a truce was held up due to "a last-minute delay in the understandings between Hamas and Israel".

An initial halt to attacks may, however, not see the sides stand their forces down from battle stations immediately; Clinton, who flies to Cairo to see Egyptian President Mohamed Mursi later on Wednesday, spoke of a deal "in the days ahead".

As she arrived in Israel after nightfall, Israel was stepping up its bombardment. Artillery shells and missiles fired from naval gunboats offshore slammed into the territory and air strikes came at a frequency of about one every 10 minutes.

After seven days of hostilities that have killed over 130 Palestinians and five Israelis, two of these on Tuesday, both sides are looking for more than a return to the sporadic calm that has prevailed across the blockaded enclave since Israel ended a much bloodier air and ground offensive four years ago.

ELECTION

Netanyahu, who faces an election in two months that he is, for now, favored to win, told Clinton he wanted a "long-term" solution. Failing that, Netanyahu made clear, he stood ready to step up the military campaign to silence Hamas's rockets.

Hamas for its part is exploring the opportunities that last year's Arab Spring has given it to enjoy favor from the new Islamist governments of states once ruled by U.S. proteges, and from Sunni Gulf powers keen to woo it away from Shi'ite Iran. It has used longer-range missiles, some sent by Tehran, and hopes to eclipse Western-backed Palestinian President Mahmoud Abbas.

Hamas has spoken of an easing of Israel's blockade on the 40-km (25-mile) slice of Mediterranean coast that is home to 1.7 million people. It may count on some sympathy from Mursi, though Egypt's first freely elected leader, whose Muslim Brotherhood inspired Hamas's founders, has been careful to stick by the 1979 peace deal with Israel struck by Cairo's former military rulers.

Clinton, who broke off from an Asian tour with President Barack Obama and assured Netanyahu of "rock-solid" U.S. support for Israel's security, spoke of seeking a "durable outcome" and of Egypt's "responsibility" for promoting peace.

She repeated international calls for the kind of lasting, negotiated, comprehensive Israeli-Palestinian settlement that has eluded the two peoples for decades - something neither of the two warring parties seems seriously to be anticipating.

"In the days ahead, the United States will work with our partners here in Israel and across the region toward an outcome that bolsters security for the people of Israel, improves conditions for the people of Gaza and moves toward a comprehensive peace for all people of the region," Clinton said.

"It is essential to de-escalate the situation in Gaza. The rocket attacks from terrorist organizations inside Gaza on Israeli cities and towns must end and a broader calm restored.

"The goal must be a durable outcome that promotes regional stability and advances the security and legitimate aspirations of Israelis and Palestinians alike."

"SELF-DEFENCE"

Netanyahu, who has appeared in no immediate rush to repeat the invasion of winter 2008-09 in which over 1,400 Palestinians died, said: "If there is a possibility of achieving a long-term solution to this problem with diplomatic means, we prefer that.

"But if not, I'm sure you understand that Israel will have to take whatever action is necessary to defend its people."

As Israeli aircraft have carried out hundreds of strikes on rocket stores, launchpads and suspected Hamas command posts since assassinating the head of its military wing a week ago, tens of thousands of Israeli soldiers have been preparing tanks and infantry units for a possible invasion.

During the night, explosions again rocked the city of Gaza and other parts of the Strip, while rockets from the enclave, some essentially home-made, others Iranian-designed and smuggled through tunnels from Egypt, landed in southern Israel.

One reached as far as Rishon Lezion, near Tel Aviv, on Tuesday, the latest to jar Israel's metropolis, long untroubled by Palestinian attacks. Another rocket fell close to Jerusalem, the holy city claimed by both sides in the conflict.

Medical officials in Gaza said 31 Palestinians were killed on Tuesday. An Israeli soldier and a civilian died when rockets exploded near the Gaza frontier, police and the army said.

Gaza medical officials say 138 people have died in Israeli strikes, mostly civilians, including 34 children. In all, five Israelis have died, including three civilians killed last week.

AMMUNITION STORES

Obama, whose relations with the hawkish Netanyahu have long been strained, has said he wants a diplomatic solution, rather than a possible Israeli ground operation in the densely populated territory, home to 1.7 million Palestinians.

Israel's military on Tuesday targeted more than 130 sites in Gaza, including ammunition stores and the Gaza headquarters of the National Islamic Bank. Israeli police said more than 150 rockets had been fired from Gaza by the evening.

"No country would tolerate rocket attacks against its cities and against its civilians," Netanyahu said with U.N. Secretary-General Ban Ki-moon, who arrived in Jerusalem from talks in Cairo, at his side. "Israel cannot tolerate such attacks."

Critics have accused Israel of using disproportionate force that has killed civilians. Israel accuses Hamas of putting Gaza's people in harm's way by siting rockets among them.

Media groups have criticized attacks on Gaza media facilities. On Tuesday, three local journalists died in air strikes on their vehicles.

A building housing AFP's bureau was bombed. The French news agency said its staff were unhurt. Israel's military said it had been targeting a Hamas intelligence center in the tower.

Hamas executed six Palestinians accused of spying for Israel, who a security source quoted by Hamas Aqsa radio said had been "caught red-handed" with "filming equipment to take footage of positions". The radio said they had been shot.

Militants on a motorcycle dragged the body of one of the men through the streets.

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

(Additional reporting by Cairo bureau; Writing by Alastair Macdonald)

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Former Japan PM dubbed "The Alien" to quit party

TOKYO: Former Japanese prime minister Yukio Hatoyama has reportedly announced he is to leave the party he founded as it heads to a general election it is likely to lose.

Hatoyama, whose wild-eyed expression contributed to his being dubbed "The Alien" by Japanese press -- a moniker he adopted -- said his beliefs were too far from the policies now espoused by the ruling Democratic Party of Japan (DPJ).

"I don't have a choice but to leave the party because the party's policy is way too different from my ideals," he told supporters, according to the Asahi Shimbun.

"I will talk to you after seeing the prime minister," he told reporters late Tuesday, after being asked about his retirement.

Hatoyama's opposition to Prime Minister Yoshihiko Noda's sales tax hike and plans to join a trans-Pacific free trade deal were instrumental in the decision, the report said.

Reports on Wednesday said the millionaire former academic would not be contesting a parliamentary seat. However, his personal wealth may appeal to some of the smaller parties that are mushrooming around single issues ahead of the December 16 poll.

Hatoyama became prime minister in 2009 when the Democratic Party of Japan ended half a century of almost unbroken rule by the conservative Liberal Democratic Party in a general election.

He was initially lauded as the bringer of change, but his reputation took a battering when he reversed course on a plan to remove a controversial US airbase in Okinawa.

Having angered voters and needlessly provoked Washington in a short space of time, he resigned from the post after just nine months in office, short even by the standards of Japan's revolving-door premiership.

Hatoyama, whose sometimes oddball comments proved a stumbling block for party managers, hails from a powerful political and business clan sometimes dubbed "Japan's Kennedys".

One of his grandfathers was a prime minister, while another founded tyremaker Bridgestone.

His wife Miyuki is a former actress-turned-lifestyle guru with an interest in spirituality. She famously said her soul once visited Venus on a triangular spaceship, and that she met Tom Cruise in a previous life.

Opinion polls suggest no one party will achieve a majority in the election and that a possibly-shaky coalition is a likely outcome.

- AFP/xq

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Date of Kasab's hanging was decided by court: Shinde

NEW DELHI: Union home minister Sushil Kumar Shinde said 26/11 convict Ajmal Amir Kasab's file with the President's decision rejecting his mercy petition was signed by him and sent to the Maharashtra government on November 8 itself.

Kasab, he said, was hanged on the date pre-decided by the court. Shinde added that the due diplomatic process was followed before hanging Kasab. This included sending a fax, through the ministry of external affairs, to the Pakistan foreign office. Islamabad did not acknowledge the fax, though New Delhi has retained its delivery report and had sent the same to Maharashtra authorities. A courier was also sent to Kasab's recorded Pakistani address in Faridkot village in Okara district. A receipt of the courier is also with the government.

"Since Pakistan has not come forward to acknowledge India's messages on Kasab hanging or to claim his body, his burial had to be done here," Shinde told newspersons this morning.

The MHA recommended rejection of Kasab's mercy petition on October 16 and forwarded the same to President Pranab Mukherjee. Mukherjee sent back the file, accepting the MHA advice, on November 5. "I was out of the country then for the Interpol meet in Rome. I returned on November 7 and found the file on my table. I signed and sent it to Maharashtra government on November 8," said Shinde.

The home minister rebutted suggestions that the hanging was deliberately timed ahead of start of winter session of Parliament, saying that the hanging schedule had been pre-decided by the court.

When asked if Kasab's burial in India could be a reason for trouble - as was apprehended by US forces after they killed Osama bin Laden, leading them to bury him at sea - Shinde ruled it out completely. "India has suffered too much and seen killing of 162 people over three days of war against humanity," he 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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Ceasefire or 'De-Escalation'? Words Chosen Carefully

Nov 20, 2012 7:27pm

AP Photo/Hatem Moussa

As news reports emerged Tuesday of a cease-fire or truce to end the crisis in Gaza, American officials made it a point not to use either of those terms.

Instead, U.S. officials were  talking about “de-escalating” the violence in Gaza as a step toward a long-term resolution.

Briefing White House reporters in Phnom Penh, Cambodia,  Deputy National Security Advisor Ben Rhodes repeatedly said “de-escalation” was the goal for ending the violence in Gaza and Israel.

When asked if he was avoiding using the term “cease-fire,” Rhodes said,  ”No, I mean, there are many ways that you can achieve the goal of a de-escalation.”  He added, ” Our bottom line is, is an end to rocket fire. We’re open to any number of ideas for achieving that goal. We’ve discussed any number of ideas for accomplishing that goal. But it’s going to have to begin with a reduction of tensions and space created for the situation to calm. ”

At the State Department briefing earlier in the day, spokesperson Victoria Nuland was also using “de-escalation.”

Nuland was asked several times why she was using that term instead of “ceasefire”  or “truce.”  She indicated it was because the State Department did not want to get into characterizing acceptable terminology.  “I’m not going to characterize X is acceptable, Y is not acceptable. That’s a subject for negotiation,” she said.

Furthermore, she said, “because the parties are talking, we’re going to be part of that, and we’re not going to negotiate it here from the podium. We’re not going to characterize it here from the podium.”

The message she did want to get across was that “any de-escalation is a step forward.”

Of the long-term aims of Secretary of State Clinton’s last minute mission to Jerusalem, Ramallah and Cairo, Nuland said you “obviously start with a de-escalation of this conflict.”  From there, “we have to see an end to the rocket fire on Israel. We have to see a restoration of calm in Gaza. And the hope is that if we can get through those stages, that will create space for the addressing of broader issues, but I don’t want to prejudge. This is obviously ongoing and live diplomacy.”

Before her meeting  in Jerusalem with Israeli Prime Minister Benjamin Netanyahu, Clinton too avoided using the term “cease-fire.”

After describing America’s commitment to Israel’s security as “rock-solid and unwavering,” Clinton said, “That is why we believe it is essential to de-escalate the situation in Gaza.”

Clinton said that the rocket attacks into Israel from Gaza “must end and a broader calm restored.”  She added that the focus was on  ”a durable outcome that promotes regional stability and advances the security and legitimate aspirations of Israelis and Palestinians alike.”

SHOWS: World News

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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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