Cease-Fire Between Israel and Hamas Takes Effect

CAIRO — Under intense Egyptian and American pressure, Israel and the Palestinian militant group Hamas halted eight days of bloody conflict on Wednesday, averting a full-scale Israeli ground invasion of the Gaza Strip without resolving the underlying disputes.

With Israeli forces still massed on the Gaza border, a tentative calm descended after the announcement of the agreement. The success of the truce will be an early test of how Egypt’s new Islamist government might influence the most intractable conflict in the Middle East.

The United States, Israel and Hamas all praised Egypt’s role in brokering the cease-fire as the antagonists pulled back from violence that had killed more than 150 Palestinians and five Israelis over the past week. The deal called for a 24-hour cooling-off period to be followed by talks aimed at resolving at least some of the longstanding grievances between the two sides.

Gazans poured into the streets declaring victory against the far more powerful Israeli military. In Israel, the public reaction was far more subdued. Many residents in the south expressed doubt that the agreement would hold, partly because at least five Palestinian rockets thudded into southern Israel after the cease-fire began.

The one-page memorandum of understanding left the issues that have most inflamed the tensions between the Israelis and the Gazans up for further negotiation. Israel demands long-term border security, including an end to Palestinian missile launching over the border. Hamas wants an end to the Israeli embargo.

The deal demonstrated the pragmatism of Egypt’s new Islamist president, Mohamed Morsi, who balanced public support for Hamas with a determination to preserve the peace with Israel. But it was unclear whether the agreement would be a turning point or merely a lull in the conflict.

The cease-fire deal was reached only through a final American diplomatic push: Secretary of State Hillary Rodham Clinton conferred for hours with Mr. Morsi and the United Nations secretary general, Ban Ki-moon, at the presidential palace here. Hanging over the talks was the Israeli shock at a Tel Aviv bus bombing — praised by Hamas — that recalled past Palestinian uprisings and raised fears of heavy Israeli retaliation. After false hopes the day before, Western and Egyptian diplomats said they had all but given up hope for a quick end to the violence.

Tellingly, neither Israel nor Hamas was represented in the final talks or the announcement, leaving it in the hands of a singular partnership between their proxies, the United States and Egypt.

There were immediate questions about the durability of the deal. Hamas, which controls Gaza, has in the past not fulfilled less formal cease-fires by failing to halt all missile fire into Israel by breakaway Palestinian militants.

Neither side retreated from threats to resume the conflict if the deal fell through, and both said they had only reluctantly agreed under international pressure. In a televised news conference, Prime Minister Benjamin Netanyahu of Israel declared that some Israelis still expected “a much harsher military operation, and it is very possible we will be compelled to embark on one.”

But he said that in a telephone conversation with Mr. Obama earlier in the evening, “I agreed with him that it is worth giving the cease-fire a chance.” He added that he had reached an undisclosed agreement with Mr. Obama to “work together against the smuggling of weapons” to Palestinian militants, for which Mr. Netanyahu blamed Iran.

Khaled Meshal, Hamas’s top leader, thanked Iran for its military support in a triumphal news conference in Cairo. “This is a point on the way to a great defeat for Israel,” he said. “Israel failed in all its objectives.”

He suggested that the West had come to Hamas and its Islamist allies in Egypt pleading for peace. “The Americans and the Europeans asked the Egyptians, ‘You have the ear of the resistance,’ ” he said, using the term Hamas prefers to describe itself and other Palestinian militants fighting the Israeli occupation. “Egypt did not sell out the resistance as some people have claimed. Egypt understood the demands of the resistance and the Palestinian people.”

David D. Kirkpatrick reported from Cairo, and Jodi Rudoren from Gaza. Reporting was contributed by Fares Akram from Gaza, Isabel Kershner and Ethan Bronner from Jerusalem, Mayy El Sheikh from Cairo, and Rick Gladstone from New York.

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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, 36, 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.

___

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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Torrance senior facility reportedly ignored warnings about gunman

Family members said Charlie Vanhager felt sorry for Chuck, a man in his 80s who lived in the Torrance senior citizens' home where she spent the last five years working as a manager.

Because Chuck had no family and few friends, Vanhager made extra attempts to be nice, despite his abrasive remarks toward her and other staff members — even inviting him to her family's Thanksgiving dinner a few years ago.

But about two years ago, the man's crass comments turned threatening. Family members said Vanhager reported his violent threats to upper management and took stress-related time off due to his harassment.

"He was a ticking time bomb and yesterday he went off," Nicole Daugherty, Vanhager's daughter, said Wednesday. "Yesterday, he killed my mom."

Police said that about noon, a man with a handgun, whom employees have identified as Chuck, walked into the lobby of the Golden West Tower, a high-rise senior living facility in the 3500 block of Maricopa Street.

The assailant, whose name has not been released pending notification of his family, shot and killed Vanhager, 54, and Maria Leon, 53, before turning the gun on himself, authorities said.

Torrance police said they had received no complaints about the threats, but relatives of the victims and employees of the senior living home told The Times that the gunman had a documented history of violent outbursts against the staff and other residents.

"He's threatened to hit her, to stab her and to shoot her," said Daugherty, who said her mother frequently reported her fears to upper management. "They had so much time to protect her, and they did nothing," she said.

Alex Galindo, a maintenance supervisor at Golden West Tower, said he knew both victims. Leon was a caregiver stationed in the South Bay and not an employee of the building. Vanhager was Galindo's frequent companion on coffee runs.

He said Chuck had a reputation for being an angry, violent man who harassed tenants, but mostly targeted Vanhager and Leon. At one point, Galindo said, residents started a petition to have Chuck removed from the facility.

The man had been in several fights, including one that left a man with a broken jaw, Galindo said. In another incident, he waved a knife at the building manager and threatened to slash her car tires. He made the same threat to some of the other tenants, Galindo said.

"This had been going on for years," Galindo said. "I'm really upset because this has been an ongoing thing and the corporation knew about this man and nothing was done."

A manager at the Golden West Tower declined to comment Wednesday morning on the allegations that management was aware of previous threats.

Daugherty, who lives in Sacramento and will travel to Los Angeles later this week to settle her mother's affairs, echoed Galindo's outrage.

"They've known about this for years and did nothing," she said.

wesley.lowery@latimes.com

ruben.vives@latimes.com

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Toll Rises as U.S. Pushes for Israel-Hamas Truce

Andrea Bruce for The New York Times

Flames from an Israeli F-16 jet attack on tunnels between Egypt and Gaza on Tuesday roared above the Gazan town of Rafah.

JERUSALEM — Efforts to agree on a cease-fire between Israel and Hamas intensified on Tuesday, but the struggle to achieve even a brief pause in the fighting emphasized the obstacles to finding any lasting solution.

On the deadliest day of fighting in the week-old conflict, Secretary of State Hillary Rodham Clinton arrived hurriedly in Jerusalem and met with Prime Minister Benjamin Netanyahu of Israel to push for a truce. She was due in Cairo on Wednesday to consult with Egyptian officials in contact with Hamas, placing her and the Obama administration at the center of a fraught process with multiple parties, interests and demands.

Officials on all sides had raised expectations that a cease-fire would begin around midnight, followed by negotiations for a longer-term agreement. But by the end of Tuesday, officials with Hamas, the militant Islamist group that governs Gaza, said any announcement would not come at least until Wednesday.

The Israelis, who have amassed tens of thousands of troops on the Gaza border and have threatened to invade for a second time in four years to end the rocket fire from Gaza, never publicly backed the idea of a short break in fighting. They said they were open to a diplomatic accord but were looking for something more enduring.

“If there is a possibility of achieving a long-term solution to this problem through diplomatic means, we prefer that,” Mr. Netanyahu said before meeting with Ms. Clinton at his office. “But if not, I’m sure you understand that Israel will have to take whatever actions necessary to defend its people.”

Mrs. Clinton spoke of the need for “a durable outcome that promotes regional stability and advances the security and legitimate aspirations of Israelis and Palestinians alike.” It was unclear whether she was starting a complex task of shuttle diplomacy or whether she expected to achieve a pause in the hostilities and then head home.

The diplomatic moves came as the antagonists on both sides stepped up their attacks. Israeli aerial and naval forces assaulted several Gaza targets in multiple strikes, including a suspected rocket-launching site near Al Shifa Hospital. That attack killed more than a dozen people, bringing the total number of fatalities in Gaza to more than 130 — roughly half of them civilians, the Gaza Health Ministry said.

A delegation visiting from the Arab League canceled a news conference at the hospital because of the Israeli aerial assaults as wailing ambulances brought victims in, some of them decapitated.

The Israeli assaults carried into early Wednesday, with multiple blasts punctuating the otherwise darkened Gaza skies.

Militants in Gaza fired a barrage of at least 200 rockets into Israel, killing an Israeli soldier — the first military casualty on the Israeli side since the hostilities broke out. The Israeli military said the soldier, identified as Yosef Fartuk, 18, had died from a rocket strike that hit an area near Gaza. Israeli officials said a civilian military contractor working near the Gaza border was also killed, bringing the number of fatalities in Israel from the week of rocket mayhem to five.

Other Palestinian rockets hit the southern Israeli cities of Beersheba and Ashdod, and longer-range rockets were fired at Tel Aviv and Jerusalem. Neither main city was struck, and no casualties were reported. One Gaza rocket hit a building in Rishon LeZion, just south of Tel Aviv, injuring one person and wrecking the top three floors.

Senior Egyptian officials in Cairo said Israel and Hamas were “very close” to a cease-fire agreement. “We have not received final approval, but I hope to receive it any moment,” said Essam el-Haddad, President Mohamed Morsi’s top foreign affairs adviser.

Foreign diplomats who were briefed on the outlines of a tentative agreement said it had been structured in stages — first, an announcement of a cease-fire, followed by its implementation for 48 hours. That would allow time for Mrs. Clinton to involve herself in the process on the ground here and create a window for negotiators to agree on conditions for a longer-term cessation of hostilities.

But it seemed that each side had steep demands of a longer-term deal that the other side would reject.

Khaled Meshal, the Hamas leader, said in Cairo that Israel needed to end its blockade of Gaza. Israel says the blockade keeps arms from entering the coastal strip.

Ethan Bronner reported from Jerusalem, and David D. Kirkpatrick from Cairo. Reporting was contributed by Jodi Rudoren and Fares Akram from Gaza; Isabel Kershner from Jerusalem; Peter Baker from Phnom Penh, Cambodia; David E. Sanger and Mark Landler from Washington; and Rick Gladstone from New York.

This article has been revised to reflect the following correction:

Correction: November 20, 2012

Because of an editing error, an earlier version of this article misspelled the family name of the Israeli soldier who was killed in a Palestinian rocket attack on Tuesday. He is Yosef Fartuk, not Yosef Faruk. 

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Dancing with the Stars Season 15 Finalists Revealed

TV Watch
Update

UPDATED
11/20/2012 at 09:10 PM EST

• Originally published 11/20/2012 at 08:30 PM EST

Tom Bergeron and Brooke Burke Charvet

Adam Larkey/ABC

They were so close!

After five couples performed mixed-up routines and a tribute to Michael Jackson on Dancing with the Stars the night before, two contestants will be sent packing Tuesday night, just one week short of season 15's all-star finale.

And that's got to hurt.

Going into the elimination, it stacked up like this: Shawn Johnson and Derek Hough were in the lead with 59 out of 60 points.

Melissa Rycroft and Tony Dovolani were in second place with 57.5 points, followed closely by Apolo Ohno and Karina Smirnoff with 57.

And Kelly Monaco and Val Chmerkovskiy, and Emmitt Smith and Cheryl Burke were tied with 54 points each.

Keep reading to find out whose scores and votes put them in the running for the mirror-ball trophy next week and which pairs are kaput ...

Here are your season 15 finalists, who will dance again next week: Shawn and Derek, Melissa and Tony, Kelly and Val.

That means that Apolo and Karina and Emmitt and Cheryl are heading home.

"This competition has been hard from the beginning," Ono said. But he added: "It's a been a blessing."

"It's been a tremendous experience," Emmitt said. "It's been a great ride."

So, who has what it takes to win it all? Discuss in the comments below.

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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.

___

Online:

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

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San Francisco officials wrap up public nudity debate with vote

SAN FRANCISCO — What started out as a discussion about whether people could stroll naked through this liberal city's storied streets ended up Tuesday as a discussion about the role of local government.

Faced with complaints about a band of so-called "Naked Guys" gathering daily in the Castro District, Supervisor Scott Wiener introduced legislation last month to ban public nudity citywide, except for at permitted festivals and parades.

"This legislation has strong support in the community," Wiener said to kick off the debate before Tuesday's vote. "I'm talking about support from everyday citizens who live and work in this wonderful neighborhood."

The stricture wasn't the brainchild of business owners, as some naturists have claimed. Nor did straight couples with children raise a fuss about freedom of expression — and freedom from clothing — in the heart of gay San Francisco.

"The dominant demographic expressing concern is gay men," Wiener told his colleagues as he implored them to expand on an earlier ordinance requiring clothing in restaurants and a barrier between naked bodies and public seating.

But the more progressive supervisors weren't buying it. Outgoing Supervisor Christina Olague called the proposal "a solution in search of a problem." Supervisor Eric Mar said the Naked Guys and the issue of public attire were well below the level of what the august body should be considering.

Supervisor John Avalos played a clip from the movie "Catch-22" of a soldier getting a medal while in the nude. He called the Naked Guys' daily strolls "inconsequential nudity" with meaningless effect.

Their point: that one neighborhood's problem was just that.

Opponents of the nudity ban cheered. But only briefly.

Because when the final vote was taken, the supervisors cast their ballots, 6 to 5, to require clothing under most circumstances on the streets of San Francisco.

The Naked Guys (and Gals) were not happy.

"It's not a legitimate government!" one shouted. "You're voting against the majority of the people," yelled another. "Shame!"

And with that, the Board of Supervisors took a 10-minute break.

maria.laganga@latimes.com

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Hamas Strengthens as Palestinian Authority Weakens

RAMALLAH, West Bank — In the daily demonstrations here of solidarity with Gaza, a mix of sympathy and anguish, there is something else: growing identification with the Islamist fighters of Hamas and derision for the Palestinian Authority, which Washington considers the only viable partner for peace with Israel.

“Strike a blow on Tel Aviv!” proclaimed the lyrics of a new hit song blasting from shops and speakers at Monday’s demonstration, in a reference to Hamas rockets that made it nearly to Israel’s economic and cultural capital. “Don’t let the Zionists sleep! We don’t want a truce or a solution! Oh, Palestinians, you can be proud!”

Pop songs everywhere are filled with bravado and aggression. But this one reflects a widespread sentiment that does not augur well for President Mahmoud Abbas and his Palestinian Authority, which is rapidly losing credibility, even relevance. The Gaza truce talks in Cairo, involving Egypt, Turkey and Qatar, offer a telling tableau. The Palestinian leader seen there is not Mr. Abbas, but Khaled Meshal, the leader of the militant group Hamas, who seeks to speak for all Palestinians as his ideological brothers in the Muslim Brotherhood rise to power around the region.

Israel is also threatening Mr. Abbas, even hinting that it may give up on him, as he prepares to go to the United Nations General Assembly on Nov. 29 to try to upgrade the Palestinian status to that of a nonmember state. The Israelis consider this step an act of aggression, and even some Palestinians say it is somewhat beside the point at this stage.

“His people are being killed in Gaza, and he is sitting on his comfortable chair in Ramallah,” lamented Firas Katash, 20, a student who took part in the Ramallah demonstration.

For the United States, as for other countries hoping to promote a two-state solution to this century-old conflict, a more radicalized West Bank with a discredited Palestinian Authority would mean greater insecurity for Israel and increased opportunity for anti-Western forces to take root in a region where Islamism is on the rise.

Since Hamas, which won parliamentary elections in 2006, threw the Fatah-controlled authority out of Gaza a year later, Mr. Abbas has not set foot there. Yet he will be asking the world to recognize the two increasingly distinct entities as a unified state.

Manar Wadi, who works in an office in Ramallah, put the issue this way: “What is happening in Gaza makes the Palestinian Authority left behind and isolated. Now we see the other face of Hamas, and its popularity is rising. It makes us feel that the Palestinian Authority doesn’t offer a path to the future.”

In Cairo on Monday, Mr. Meshal seemed defiant and confident in his new role, daring the Israelis to invade Gaza as a sixth day of Israeli aerial assaults brought the death toll there to more than 100 people, many of them militants of Hamas and its affiliates. Rockets launched from Gaza hit southern Israel, causing some damage and panic, but no casualties, leaving the death toll there at three.

“Whoever started the war must end it,” Mr. Meshal said at a news conference. “If Israel wants a cease-fire brokered through Egypt, then that is possible. Escalation is also possible.”

Officials in the authority have been holding leadership meetings, staying in close touch with the talks in Cairo and issuing statements of solidarity. They have also sent a small medical delegation to Gaza and argue that there is a new opportunity to forge unity between the two feuding movements. But they are acutely aware of their problem.

“The most dangerous thing is the fact that what we could not do in negotiations, Hamas did with one rocket,” one official said, speaking on the condition of anonymity. “The people had such excitement seeing the occupiers run in panic. It’s a very dangerous message.”

Mr. Abbas, whose popularity has been on the decline as the Palestinian Authority faces economic difficulty and growing Israeli settlements, also ran into trouble not long before the Gaza fighting began when he seemed to give up on the Palestinian demand of a right of return to what is now Israel.

Many Palestinians believe that Israel launched its latest operation in Gaza to block the Palestinian Authority’s United Nations plans by embarrassing it. Israeli officials say that is ridiculous: the operation’s purpose is to stop the growing number of rockets being fired at their communities, and Israelis interrupted their deliberations over the United Nations bid to wage the military campaign.

But Israel says anything that does not involve direct negotiations is a waste of time. The government of Prime Minister Benjamin Netanyahu has repeatedly threatened to take severe retaliatory steps against the Palestinian Authority, including cutting off badly needed tax receipts to Palestinian coffers, should Mr. Abbas go ahead at the United Nations.

In a speech here on Sunday night at a Palestinian leadership meeting, Mr. Abbas repeated his determination to go to New York and ask for a change in status to that of nonmember state. He has chosen the symbolically significant date of Nov. 29, when the General Assembly voted in 1947 to divide this land into two states, one Jewish and the other Palestinian Arab.

The United States has asked Mr. Abbas not to do so, but instead to resume direct negotiations with Israel, which have essentially been frozen since 2008.

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Miley Cyrus Celebrates in New York - with Her Entire Family!

11/19/2012 at 07:05 PM EST

From left: Noah, Bill Ray, Tish, Miley, Brandi and Braison Cyrus

Bruce Glikas/Filmmagic

The Cyrus family has a lot to be thankful for this year.

Miley Cyrus is celebrating her 20th birthday on Friday. Her dad, Billy Ray Cyrus, is starring as slick lawyer Billy Flynn in the Broadway hit musical Chicago. And it looks like (practically) the whole family is together for the occasions.

Photos show Billy Ray – dressed in a tuxedo – his wife Tish and their kids, Miley, 19, Noah, 12, Brandi, 25, and Braison, 18, all posing together backstage at the Ambassador Theater in New York City on Sunday. (Brother Trace is the only one absent.)

"The whole family had a great time," an observer tells PEOPLE.

They came backstage at intermission to spend time with Billy Ray in his dressing room, and again after the show to meet some of his fellow cast members.

Billy Ray, who began his Broadway run recently, told PEOPLE that his family hadn't come to see him yet partly because he wanted to get comfortable in the role. "I gotta get my legs up [before they see it]," he said. "I think everybody's coming in for Thanksgiving. So we'll see what happens."

Now that they've seen it, it seems his family is giving his performance a thumbs-up. "So glad to be back with my daddy (@billyraycyrus) for the first time in 3 MONTHS!! He was so great on broadway," Noah Tweeted on Monday.

Miley, too, is having a blast in the Big Apple. "What a dope morning. So many fans outside my hotel this a.m. in NYC. If there's this much chaos NOW imagine when I drop this record! #ohsnap," she Tweeted.

As for Billy Ray, whose Chicago run ends Dec. 23, he says taking the part on Broadway has been great fun – and a great challenge.

"I couldn't come up here and do something predictable," he says of the role. "I was offered Rock of Ages, and my instincts said, 'That's a bit predictable for me.' "

But when the role of Billy Flynn came up, Ray explained, "He's the total opposite of me" – and that was just what he wanted.

For more on Billy Ray Cyrus – including what he does (and doesn't) know about Miley's wedding plans – pick up PEOPLE, on newsstands Friday

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