Government
How do blood tests work? Medical laboratory scientists explain the pathway from blood draw to diagnosis and treatment
Lab testing provides doctors with essential information to help them diagnose and treat disease. Here’s what happens behind the scenes after you roll…
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Medical laboratory testing is the heartbeat of medicine. It provides critical data for physicians to diagnose and treat disease, dating back thousands of years. Unfortunately, laboratory medicine as a field is poorly understood by both the public and health care communities.
Laboratory medicine, also known as clinical pathology, is one of two main branches of pathology, or the study of the causes and effects of disease. Pathology covers many laboratory areas, such as blood banking and microbiology. Clinical pathology diagnoses a disease through laboratory analysis of body fluids such as blood, urine, feces and saliva. The other branch of pathology, anatomic pathology, diagnoses a disease by examining body tissues.
We are public health and medical laboratory scientists who specialize in microbiology and infectious diseases. There are a lot of steps between when your doctor orders a blood test to establishing a diagnosis. From the bedside to the lab bench, here’s how laboratory testing works.
It all starts with a specimen
When you see a doctor, sometimes a physical exam and detailed medical history are enough for them to make a diagnosis, offer recommendations or prescribe medications for your condition. There are many instances, however, where your doctor may need additional information to make an accurate diagnosis. This information is often obtained from procedures like imaging scans or blood tests.
The first step involves getting your blood drawn through a practice known as phlebotomy. A health care professional, typically a phlebotomist or a nurse, inserts a needle into a vein to collect a blood specimen.
Multiple tubes of blood may be needed, as certain tests are only performed using certain types of blood specimens. For example, one test commonly used to diagnose anemia requires blood to be collected in a chemical that prevents the blood from clotting. Patients being evaluated for a clotting disorder, on the other hand, often have their blood collected in a tube containing another anticoagulant.
Testing pathways
Specimens then make their way to a clinical laboratory. Laboratories can be found within hospitals, reference labs or physician offices, or they can be located in a public health setting such as the Centers for Disease Control and Prevention or a state public health laboratory. In 2021, there were more than 329,000 laboratory professionals working in the U.S. in more than 320,000 federally regulated laboratories. An estimated 14 billion laboratory tests are ordered annually in the U.S., on top of over 1 billon COVID-19 tests during the pandemic. With such a large volume of specimens to test and examine, various sections of a laboratory are automated.
Laboratory tests examine the biological, chemical and physical properties of the cells and molecules that make up a blood specimen. The first step is often to centrifuge a blood specimen into separate components. This divides the sample into one portion that contains solid components, such as cells, and another that contains liquid components and dissolved solutes, known as serum or plasma.
Analyzing the serum or plasma portion of a blood specimen measures the levels of different substances within the body. One of the most common is your blood sugar, or glucose concentration. For the doctors of more than 37 million Americans with diabetes, knowing how high their patient’s blood glucose is helps them establish a new diagnosis or ensure their condition is under control.
If your doctor suspects you have an infection, they will collect specimens to test for the presence of a pathogen. For example, they might collect a throat swab for strep throat or a urine sample for a urinary tract infection. Scientists incubate these samples to screen any organisms that grow and resemble pathogens of interest. They may perform additional testing to identify the microbe. Once an organism is identified, the medical laboratory professional can then test a variety of antimicrobial agents against it to inform your doctor what the best treatment would be against your infection.
Evolution of medical laboratory testing
The first hospital clinical laboratory in the U.S. was established in 1894. Some of the methods laboratory professionals use to analyze samples have been in use for over a century.
One such staple, the Gram stain, was introduced in 1882. It uses two different dyes and exploits differences in the bacterial cell wall to discriminate between two different groups of bacteria. This helps lab scientists identify the correct antimicrobial therapy to use against an infection.
Another commonly used technology, the Coulter Principle, was developed in the 1940s to identify and sort individual cells based on physical size and resistance to an electrical current. Medical laboratory professionals routinely use this technique to conduct complete blood count tests, which measure unusual increases or decreases in the number of different types of blood cells that could provide insights into a disease or condition, such as cancer or sickle cell anemia.
In 1986, scientists devised the Nobel Prize-winning polymerase chain reaction method to amplify, or rapidly produce, multiple copies of the DNA of a pathogen present within a sample. PCR is widely used to diagnose infections, identify genetic disorders and monitor cancer progression.
An explosion of modern laboratory tools to research and diagnose disease followed PCR. To name a few of these cutting-edge tools, matrix-assisted laser desorption ionization, or MALDI, is one of the most commonly used techniques to identify microbes that are difficult or impossible to culture. Genome editing and CRISPR-Cas9 give scientists the ability to change an organism’s DNA, aiding in identifying pathogens and detecting dysfunctional genes by adding, removing or altering genes of interest. Next-generation sequencing has become a powerful modern tool to determine the sequence of the genetic material in biological samples and has been extensively used to identify variants and wastewater surveillance of pathogens like the virus that causes COVID-19.
Challenges and solutions
One of the most critical challenges in laboratory medicine is understanding and interpreting test results, because errors can occur throughout the testing process. Specimens must be properly collected and transported to the lab for accurate results. Likewise, at-home tests need to be properly stored. Clinicians and patients need to take into account the chances of false positive or negative results by considering the limitations of the test alongside the patient’s individual case.
Collaboration between clinicians and medical laboratory professionals could help reduce errors in diagnosis and treatment. Laboratory data can and often is extremely useful to patient care, but a holistic approach that takes into account a patient’s medical history, genetics and health habits, among other factors, is necessary for an accurate diagnosis and treatment. While powerful, a laboratory result should not be used in isolation. Clear and accurate communication on laboratory testing is critical for effective patient care.
Rodney E. Rohde has received funding from the American Society of Clinical Pathologists, American Society for Clinical Laboratory Science, U.S. Department of Labor (OSHA), and other public and private entities/foundations. Rohde is affiliated with ASCP, ASCLS, ASM, and serves on several scientific advisory boards. See https://rodneyerohde.wp.txstate.edu/service/.
Nicholas Moore previously received funding from Abbott Molecular, bioMerieux, and Cepheid for contracted research work related to the development of laboratory assays. Funds were paid directly to Rush University. Nicholas Moore is a volunteer with the American Society for Clinical Laboratory Science, the American Society for Clinical Pathology, the American Society for Microbiology, and the Clinical and Laboratory Standards Institute. He is a member of the editorial board of Clinical Microbiology Reviews and BMC Infectious Diseases.
disease control pandemic covid-19 treatment testing genome genetic therapy dna
Government
Court Rules No Evidence Georgia’s Voting Law Discriminates Against Black Voters
Court Rules No Evidence Georgia’s Voting Law Discriminates Against Black Voters
Authored by Jack Phillips via The Epoch Times (emphasis ours),
A…
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Authored by Jack Phillips via The Epoch Times (emphasis ours),
A federal judge in Georgia has declined to block several provisions of a sweeping election law while multiple legal challenges play out.
Several left-wing advocacy and civil rights groups, as well as the U.S. Department of Justice (DOJ, sued in 2021 after Republican state lawmakers passed the measure amid claims about election fraud in the state in 2020. Those lawsuits claim that black voters are now denied equal access to voting, which violates the Voting Rights Act.
“Plaintiffs have not shown, at least at this stage of the proceedings, that any of the provisions have a disparate impact on black voters,” U.S. District Judge J.P. Boulee wrote in an order issued Wednesday. The jurist also wrote that the court “cannot find that Plaintiffs have presented enough evidence to show that the Legislature foresaw or knew that S.B. 202 would have a disparate impact on minority voters.”
The Biden administration and the Democrat-affiliated groups also “failed to show a substantial likelihood of success on the merits as to their claims that the provisions” of the election law "intentionally discriminate against black voters in violation of the Fourteenth Amendment, Fifteenth Amendment and Section 2 of the [Voting Rights Act]," the judge ruled.
The plaintiffs, in their lawsuit, sought to prevent the law's enforcement pertaining to drop boxes as well as the distribution of food, water, and other gifts to voters who are waiting at polling locations. The law also set a deadline to submit applications for absentee ballots, among other measures.
Another section of the law says that provisional ballots cast at the wrong precinct cannot be counted if they are case prior to 5 p.m. on Election Day. The final provision requires that a voter provide their driver’s license or state identification card number when requesting an absentee ballot.
In response, the plaintiffs said they were disappointed in Judge Boulee's decision, with reports suggesting that the challenged provisions will remain intact during the 2024 election cycle. Georgia was a key battleground state during the 2020 election and during the January 2021 runoff election for two U.S. Senate seats.
“The fight for voting rights in the South has never been easy, especially for Black voters. We will never stop advocating on behalf of our clients and voters across the state. We look forward to presenting our case at trial,” Rahul Garabadu, an attorney with the American Civil Liberties Union of Georgia, said in a statement.
And Alaizah Koorji, assistant counsel at the Legal Defense Fund, one of the plaintiffs, claimed that the law will continue to present barriers to black voters, alleging they are "designed to dilute Black political power."
The judge, however, said that the differences that were shown by the civil rights groups' lawyers in the election case were not "statistically significant enough to demonstrate that black voters wait in longer lines at a meaningfully higher rate than white voters."
In rejecting the claims that absentee ballots violate the Voting Rights Act, the judge wrote, "Without more, generalized evidence regarding the use of absentee voting is not sufficient to show that this particular provision, pertaining to one aspect of absentee voting, is discriminatory."
He added that the plaintiffs also didn't provide evidence suggesting that registered black voters could not obtain a state-issued identification card or driver's license at a higher rate than white voters.
Some Democratic lawmakers, the judge wrote, were also in favor of several of the law's provisions that required more election workers and equipment to be made available if a line occurs at a polling location on Election day. During the 2020 election, there were reports of lengthy lines at a number of precincts across Georgia, pushing the time back beyond the closing time to vote in-person.
On Thursday, Secretary of State Brad Raffensperger hailed the judge's ruling in a news release, saying that "the court confirmed what we’ve been saying all along." The release added that the law “strengthens election integrity while increasing the opportunity for Georgia voters to cast a ballot.”
The Republican-controlled Legislature in Georgia passed the law in March 2021 before it was signed by Gov. Brian Kemp, a Republican, weeks later.
The bill and law drew a wave of corporate backlash, which included Georgia-based firms like Coca-Cola and Delta Air Lines. For example, Delta's CEO, Ed Bastian, claimed at the time that the law is "unacceptable" and "based on a lie," drawing backlash from Mr. Kemp and other Republicans.
“Mr. Bastian should compare voting laws in Georgia—which include no-excuse absentee balloting, online voter registration, 17 days of early voting with an additional two optional Sundays, and automatic voter registration when obtaining a driver’s license—with other states Delta Airlines operates in,” Mr. Kemp told CNBC more than two years ago.
The Associated Press contributed to this report.
International
Hard Choices & the Conservative Mind
A brief essay on The Thoughts of Blaise Pascal
Blaise Pascal plumbs the depths of the human condition and establishes the logic of conservatism by examining…
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A brief essay on The Thoughts of Blaise Pascal
Blaise Pascal plumbs the depths of the human condition and establishes the logic of conservatism by examining hard choices in high-stakes situations. Pascal expresses his insights in brilliant pensées—fireworks of thought.
Let me focus on Pascal’s thoughts about two kinds of hard choices: (a) Who shall rule? (b) How shall I behave if God’s existence is uncertain?
Pascal’s general approach to hard choices is to clarify the limits of reason and the power of psychology, the better to chart a narrow path for rational choice: “There is nothing so conformable to reason as the disavowal of reason.” Pensée no. 272
Knowledge is incomplete. A (partial) increase in one’s knowledge tends to induce overconfidence. Wisdom consists in cognitive humility—an elusive frame of mind for intellectuals:
Who shall rule?
Pascal foreshadows the conservative principle, Chesterton’s fence. One should hesitate to change a rule, or to break with tradition, unless one understands the origin or function of the rule or tradition.
Pascal makes a case that traditions deserve legitimacy. Traditions have stood the test of time because they reduce conflict: “Do we follow ancient laws and opinions because they are more sound? No; but because they stand alone and take from us the root of diversity [conflict].” Pensée no. 589
Pascal then illustrates the conservative principle’s function by concrete analysis of a fundamental political institution in early modern Europe: monarchy with dynastic succession by primogeniture:
Here Pascal foreshadows Nobel Laureate Thomas C. Schelling’s theory of the crucial role of salient focal points in strategic interaction and conflict resolution. Salience is psychological, not strictly logical. If there exists a clear, preferably unique, focal point, it can forestall or overcome bargaining impasses and self-serving conceptions of justice. If the focal point is recurrent—for example, primogeniture—it may readily become a tradition, a Chesterton fence.
How shall I behave if God’s existence is uncertain?
‘Pascal’s Wager,’ his most famous pensée, deploys both the logic of games of chance, and the psychology of belief-formation, to try and convince freethinkers to bet on God, and to dupe themselves!
Pascal’s interlocutor is someone who does not believe in God. Their dialogue has three background empirical premises:
- If God exists, then belief in God is a necessary condition for salvation in the afterlife.
- One cannot prove the existence of God.
- One cannot simply decide to believe.
Given these premises, Pascal first makes a gambler’s case that it would be prudent to believe in God. Pascal makes an appeal to interest, not evidence:
“Let us then examine this point, and say, ‘God is, or he is not.’ But to which side shall we incline? Reason can determine nothing about it. There is an infinite gulf fixed between us. A game is playing at the extremity of this infinite distance in which heads or tails may turn up. What will you wager? [… .]
Let us weigh the gain and the loss in choosing heads that God is. [… .] But there is here an infinity of an infinitely happy life to win, a chance of gain against a finite number of chances of loss, and what you stake is finite; that is decided. Wherever the infinite exists and there is not an infinity of chances of loss against that of gain, there is no room for hesitation, you must risk the whole. [… .]
Every gambler stakes a certainty to gain an uncertainty, and yet he stakes a finite certainty against a finite uncertainty without acting unreasonably. [… .] So that our argument is of infinite force, if we stake the finite in a game where there are equal chances of gain and loss, and the infinite is the winnings. This is demonstrable, and if men are capable of any truths, this is one.” Pensée no. 233
The intuition is that any positive chance at an infinite reward has infinite value, and so trumps any finite worldly pleasures here and now.
Pascal’s wager triggered an ongoing avalanche of analysis of the logic of ‘expected utility.’ It gets complicated fast. Let me mention just a few issues for flavor. What if God exists, but punishes gamblers? What if a gambler has a high ‘discount rate’ (i.e., cares about the present, not the afterlife)? What if there are many Gods?
Howsoever that may be, Pascal is certain that he has got the gambler’s attention. A quandary—a psychological challenge—then naturally arises. If it would be prudent to believe in God, but there is no proof of God and one cannot simply decide to believe in God, then what is a non-believer to do?!
Pascal’s answer is to take steps to dupe oneself by going through the motions of religious practice:
“I confess and admit it [that belief in God would be prudent]. Yet is there no means of seeing the hands at the game? — Yes, the Scripture and the rest, etc. — Well, but my hands are tied and my mouth is gagged: I am forced to wager and am not free, none can release me, but I am so made that I cannot believe. What then would you have me do? [… .]
Labor then to convince yourself, not by increase of the proofs of God, but by the diminution of your passions. You would fam arrive at faith, but know not the way; you would heal yourself of unbelief, and you ask remedies for it. Learn of those who have been bound as you are, but who now stake all that they possess; these are they who know the way you would follow, who are cured of a disease of which you would be cured. Follow the way by which they began, by making believe that they believed, taking the holy water, having masses said, etc. Thus you will naturally be brought to believe, and will lose your acuteness. — But that is just what I fear. — Why? what have you to lose?
The last process of reason is to recognize that there is an infinity of things which transcend it; it is but weak if it does not go so far as to know that.” Pensée no. 233
The psychological thesis is that faking it is transformative. Going through the motions will eventually (a) dull one’s critical faculties, (b) erase one’s awareness of faking it, and (c) induce faith. The rational, self-interested choice is to submit to tradition as a means to psychological transformation.
Pascal’s thoughts about politics (legitimacy of dynastic succession) and about religion (prudent make-believe to achieve faith)—his thoughts about hard choices in high stakes situations—unflinchingly demonstrate the limits of reason and strategically enlist rational choice and psychology to harness traditions. The Pensées are the dawn of the modern conservative mind.
John Alcorn is Principal Lecturer in Formal Organizations, Shelby Cullom Davis Endowment, Trinity College, Connecticut. Scruples about principles of historical inquiry, and a stint teaching in Columbia’s ‘great books’ core curriculum led him to explore methodological individualism and the social sciences. As in the Dry Bones song, a concatenation of authors—Jon Elster, Diego Gambetta, Thomas C. Schelling, Robert Sugden, David Friedman, and Michael Munger—eventually brought him to discover EconTalk and EconLog.
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Israel-Hamas War Latest: Israeli Troops Amass At Border As Iran Warns It Will Intervene If Ground Offensive Launched
Israel-Hamas War Latest: Israeli Troops Amass At Border As Iran Warns It Will Intervene If Ground Offensive Launched
Summary:
After giving…
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Summary:
After giving the northern Gaza strip an evacuation ultimatum on Friday, Israel has so far withheld from launching a "significant" ground operation, with some speculating that requests from the US to evacuate all US citizens out of Palestine ahead of the invasion is what is holding Israel back. Meanwhile, Iran’s foreign minister on Saturday said that if Israeli “war crimes & genocide” are not stopped, the war might expand to other parts of the Middle East if Hezbollah joins the battle, and that would make Israel suffer “a huge earthquake.” Meanwhile, Axios reported that Tehran has sent Jerusalem a message through the UN that it will intervene if the campaign in Gaza continues, and particularly if it launches a ground offensive.
This was followed by news Sunday morning that the US has been backchanneling with Iran in recent days to warn against escalating the conflict in Israel (after all, Biden can't afford to lose those sanctioned Iranian oil exports whose re-embargo would promptly send the price of oil above $100).
Another reason why Israel may be waiting: the Pentagon confirmed that it has ordered a second carrier strike group to the eastern Mediterranean Sea after a first carrier strike group, led by the USS Gerald R. Ford, arrived off the coast of Israel last week.
Background:
On Saturday, the Israeli army said it’s making preparations for “significant ground operations” in Gaza, with the Israel Defense Forces saying in a statement that the next phase of the war can include a coordinated land, sea and air assault.
Israel has called up a record 300,000 reservists and has been pounding Gaza after the unprecedented incursion in which more than 1,000 Hamas fighters swept across the border and attacked Israeli military posts, bases and settlements. More than 1,300 Israelis died, mostly civilians, and up to 150 people were abducted and taken into Gaza. More than 1,900 Palestinians have been killed in the Israeli bombing campaign as fears mount of major casualties once Israel sends troops into the crowded coastal strip, home to 2.3 million people. Israel on Friday gave 24 hours for more than 1 million Palestinians to evacuate their homes in Gaza.
Separately, Israel confirmed for the first time that there were intelligence indications of something happening in Gaza two hours before the attacks last week. The head of Shin Bet, Israel’s internal security service, spoke with military personnel about the reports, said Tzachi Hanegbi, head of Israel’s National Security Council. “Both sides assessed that this is something other than it turned out to be,” he said.
Meanwhile, Hamas, which has been designated as a terrorist group by the US and the European Union, said Israeli air strikes killed another nine of its hostages in the past 24 hours, raising the total to 26. Many governments, including the US and European countries, are rushing to evacuate citizens in anticipation of an Israeli incursion into Gaza, though the Rafah border crossing out of Gaza to Egypt was reported to be closed to foreign nationals Saturday.
On the diplomatic front, Joe Biden’s team has voiced anxiety about Israel’s 24-hour evacuation demand, a deadline that the European Union and the United Nations called unrealistic. On Friday, Biden said people shouldn’t “lose sight of the fact that the overwhelming majority of Palestinians had nothing to do with Hamas” something Biden tweeted on Sunday morning.
We must not lose sight of the fact that the overwhelming majority of Palestinians had nothing to do with Hamas’s appalling attacks, and are suffering as a result of them.
— President Biden (@POTUS) October 15, 2023
The US Embassy in Israel said it’s “working on potential options for departure from Gaza.” US citizens living in or visiting Gaza may be allowed to leave on Saturday, according to a US official. The embassy said it’s facilitating more chartered evacuation flights from Tel Aviv’s Ben Gurion Airport and urged US citizens and immediate family members to use them “while they are available.” The US government also said it is assisting US nationals and their immediate family members with a valid travel document to depart Haifa via sea for Cyprus on Oct. 16, according to a statement on the US Embassy in Israel website.
The State Department in Washington authorized the departure of non-emergency embassy personnel on Friday, citing an “unpredictable security situation.” With commercial flights to Israel disrupted, European countries such as France and Germany also have been providing planes to get their citizens out of the region.
Latest Developments:
Iran’s foreign minister on Saturday called on Israel to stop its attacks on Gaza, warning that the war might expand to other parts of the Middle East if Hezbollah joins the battle, and that would make Israel suffer “a huge earthquake.” Hossein Amirabdollahian told reporters in Beirut that Lebanon’s Hezbollah terror group has taken all war scenarios into consideration and Israel should stop its attacks on Gaza as soon as possible. Meanwhile, the Axios news site reported that Tehran has sent Jerusalem a message through the UN that it will intervene if the campaign in Gaza continues, and particularly if it launches a ground offensive. The report cited two diplomatic sources with knowledge of the matter. The report said Amirabdollahian made the comments when he met Saturday with UN Middle East envoy Tor Wennesland in Beirut, a meeting that led to intense criticism from Israel. A short while later, Iran’s mission to the UN warned in a tweet that if Israel’s “war crimes & genocide” are not stopped immediately, this could have “far-reaching consequences” and the situation could “spiral out of control.”
If the Israeli apartheid’s war crimes & genocide are not halted immediately, the situation could spiral out of control & ricochet far-reaching consequences—the responsibility of which lies with the UN, the Security Council & the states steering the Council toward a dead end.
— Permanent Mission of I.R.Iran to UN, NY (@Iran_UN) October 14, 2023
* * *
US Warned Iran in Back-Channel Talks on War: The US has held back-channel talks with Iran in recent days to warn the country against escalating the conflict in Israel, as Israeli forces prepare an expected ground assault in response to last weekend’s surprise attack by Hamas. “We have means of communicating privately with Iran, and we have availed ourselves of those means over the past few days to make clear privately that which we have said publicly,” White House National Security Advisor Jake Sullivan said Sunday on CBS News’s Face the Nation. Sullivan said the US couldn’t rule out that Iran might intervene in the conflict, and was monitoring both the possibility of direct involvement by Tehran and proxy activity by Hezbollah across the border with Lebanon.
* * *
Israeli army awaits "political" green light for Gaza invasion: The Israeli army is awaiting a "political decision" on the timing of a major ground offensive on the Gaza Strip, military spokesmen said Sunday as civilians stepped up desperate efforts to flee northern Gaza. Military spokesmen Lt. Col. Richard Hecht and Rear Adm. Daniel Hagari told separate briefings on Sunday that "a political decision" will set off any action against Hamas. "We will be holding discussions with our political leadership," Hecht told one briefing.
Prime Minister Benjamin Netanyahu told troops near the Gaza border on Saturday that "more is coming." But he did not say when any ground operation would start. Military spokesmen have told reporters that any invasion would aim to eradicate Hamas' militant network and leadership so that it cannot stage more attacks. The Israeli military has particularly singled out Yahya Sinwar, the chief of Hamas in Gaza who they blame for the Oct. 7 attacks. "That man is in our sights," Hecht said on Saturday. "He is a dead man walking and we will get to that man."
* * *
Rockets were fired at Tel Aviv and southern Israel overnight, and the Israel Defense Forces attacked targets in and around the northern part of Gaza. It was not immediately clear how much damage, if any, was caused in the rocket attacks. One Israeli died on Sunday in a Hezbollah attack on Israeli army posts near the border with Lebanon. Subsequent reports indicate that more rockets had been fired into northern Israel from Lebanon.
Initial reports say that rockets were fired from Lebanon. Waiting for further confirmation.
— Joe Truzman (@JoeTruzman) October 15, 2023
Impacts reported in norther Israel. pic.twitter.com/YZgIoofboU
— Moshe Schwartz (@YWNReporter) October 15, 2023
* * *
Moroccans Push to Sever Israel Ties in Mass Protest: Tens of thousands of protesters took to the streets of Rabat, Morocco’s capital, demanding King Mohammed VI to severe ties with Israel which were restored in 2020. The marchers denounced as “barbaric” ongoing military intervention by Israel in Gaza and demanded the closing of its liaison office in the Moroccan capital.
* * *
Blinken Meets With Saudi Crown Prince: Blinken travelled to Riyadh on Sunday for an hour-long talk with Saudi Crown Prince Mohammed bin Salman that the top US diplomat deemed “very productive.” MBS highlighted Riyadh’s diplomatic outreach “to calm the situation,” the official Saudi Press Agency reported.
Saudi Crown Prince Mohammed bin Salman and I met today in Riyadh and discussed the Hamas terrorist attacks on Israel. pic.twitter.com/HjoGMmTzqi
— Secretary Antony Blinken (@SecBlinken) October 15, 2023
* * *
Blinken Will Return to Israel on Monday: US Secretary of State Antony Blinken will return to Israel on Monday for further consultations with senior officials there, his spokesman said. The top US diplomat was previously in Israel on Thursday as part of a frenetic tour of the region that included stops in Qatar, Jordan, Bahrain and the United Arab Emirates as well as Saudi Arabia, as the Biden administration tries to limit the threat of a spreading conflict in the Middle East.
* * *
Blinken Urges China to Use Its Influence: US Secretary of State Antony Blinken urged Beijing to use its influence to prevent other state or non-state actors from attacking Israel and widening its war with Hamas, the State Department said. Blinken spoke with Foreign Minister Wang Yi before departing from Riyadh, where the top US diplomat was attempting to shore up support for Israel among Arab nations, said State Department spokesman Matthew Miller. He met with Saudi Arabia’s Crown Prince Mohammed bin Salman, the State Department said.
* * *
Israel, Hezbollah exchange fire, heightening fears of a second front opening: Cross-border fire erupted between Israel and Lebanon early Sunday, killing at least one person on the Israeli side of the border. Both the Israeli military and the Lebanese militant group Hezbollah acknowledged the fighting. Hezbollah says it fired guided missiles toward an Israel army post in Shtula from Lebanon, according to the militant group’s Al-Manar TV. The Israeli military said earlier it was targeting southern Lebanon after initial report of a shooting near the Lebanese border.
The group said in a statement the attack was in retaliation for Israeli shelling that killed Reuters videographer Issam Abdallah on Friday and two Lebanese civilians on Saturday. Israel has responded by targeting the outskirts of the town of Ait el-Shaab, the Israeli military said. The Israel Defense Forces also banned civilians from going within two-and-a-half miles of the Lebanese border. In addition, the Reuters news service reports, Israel disrupted GPS electronic location services in the northern border area and at the Gaza front, according to Reuters. Israel's Magen David Adom rescue service said a 40-year-old man was killed in the attack from Lebanon, without elaborating or giving his nationality. As Israel wages its war against Hamas over last week's unprecedented attack by the Gaza Strip militant group, there's been concern that Hezbollah could enter the war as well as Israel moves toward launching a ground offensive in Gaza.
* * *
Hezbollah Strikes Israeli Army Posts: Iran-backed Hezbollah attacked two Israeli army posts near the border with Lebanon in response to what the militant group said was the killing of Lebanese nationals in recent days. One of the Middle East’s most powerful militias, Hezbollah said it fired guided missiles against an Israeli army post in Shtula in Upper Galilee. An hour later, it said its members used “live ammunition” to target an army post in Al-Raheb and destroyed a tank.
* * *
Israeli Shares Down 3% As War Enters Second Week: Israel’s TA-35 stock index fell sharply on Sunday as Israel continues to strike back against Hamas targets and tensions rise on the northern border with Hezbollah. The index was down 3.3% in early afternoon, having reached the lowest levels since mid-2021. Banking stocks led the decline. The sector was down 12.3% last week “on account of volatility concerns,” the Tel Aviv Stock Exchange said. Other Middle Eastern markets were narrowly mixed.
* * *
Israel Acknowledges Reports of Gaza Activity: Israel confirmed for the first time that there were intelligence indications of something happening in Gaza two hours before the attacks last week. The head of Shin Bet, Israel’s internal security service, spoke with military personnel about the reports, said Tzachi Hanegbi, head of Israel’s National Security Council. “Both sides assessed that this is something other than it turned out to be,” he said.
* * *
Abbas Stresses Need for Humanitarian Corridor in Biden Call: In a phone call with US President Joe Biden late Saturday, Palestinian President Mahmoud Abbas stressed the urgent need for humanitarian corridors to be opened in the Gaza Strip so that basic materials and medical supplies such as water, electricity and fuel, can be delivered to civilians. Abbas also told Biden he rejected the displacement of Palestinians from Gaza and affirmed his rejection of the killing or abusing of civilians on both sides, calling for the release of civilians, priosners and detainees.
* * *
Pope calls for humanitarian corridors for Gaza residents: Pope Francis called on Sunday for humanitarian corridors to allow the delivery of essentials to the Gaza Strip, which is under heavy Israeli bombardment following a bloody attack on Israel by Gaza's rulers, Hamas. "Humanitarian law must be respected, especially in Gaza, where it is urgent and necessary to guarantee humanitarian corridors and help the population," said the Pope after his traditional Angelus prayer in Rome's Saint Peter's Square.
* * *
U.S. arranges for ship to evacuate Americans from Israel to Cyprus Monday: The United States has organized a ship to take Americans out of Israel to Cyprus on Monday, the U.S. Embassy said. With Israel moving toward an invasion of the Gaza Strip, the ship will leave from the Israeli port of Haifa for Limassol, taking "U.S. nationals and their immediate family members with a valid travel document," the U.S. embassy said in a security alert Sunday. Tens of thousands of U.S. passport holders live in Israel and 29 have been confirmed killed in the Hamas attacks on October 7. Another 15 are missing and believed to be among hostages held by Hamas since the attacks. The U.S. embassy didn't say how many people would fit on the ship but said "boarding will proceed in order of arrival and is on a space limited basis." Each passenger will have to sign a document promising to repay the cost of the trip and will only be allowed to bring one suitcase. The embassy said some chartered flights would be arranged from Cyprus for onward travel.
* * *
UK Foreign Minister Urges Israel to Show Restraint: James Cleverly called on Israel to avoid civilian casualties in Gaza and respect international law in any military operations against Hamas, saying his “strong advice” was being offered from a position of friendship.” It’s in Israel’s interest to avoid civilian casualties because Hamas wants to turn the conflict “into a wider Arab-Israeli war, or indeed a war between the Muslim world and and the wider world,” the UK foreign minister said on Sky News. His comments came hours after Prime Minister Rishi Sunak said the UK stood unequivocally with Israel, making no mention of the plight facing Palestinian civilians.
* * *
Gaza Death Toll Reaches 2,300: The number of people killed in Israeli attacks on Gaza has reached more than 2,300, local authorities said, with thousands more wounded in the past eight days. This now outnumbers the death toll of the 51-day Israel-Hamas war of 2014, according to Ashraf Al-Qedra, a spokesperson for the Gaza health ministry. The 2014 war killed more than 2,200 Palestinians, according to UN figures. At the time it was the deadliest and most destructive violence since Hamas took over the Gaza Strip.
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Situation in Gaza hospitals getting ever more desperate: Medics in Gaza warned Sunday that thousands could die as hospitals packed with wounded people run desperately low on fuel and basic supplies. Palestinians in the besieged coastal enclave struggled to find food, water and safety ahead of an expected Israeli ground offensive in the war sparked by Hamas' deadly attack. A week of blistering airstrikes have demolished entire Gaza neighborhoods but failed to stem militant rocket fire into Israel. Hospitals are expected to run out of generator fuel within two days, according to the U.N., which said that would endanger the lives of thousands of patients. Gaza's sole power plant shut down for lack of fuel after Israel completely sealed off the 25-mile-long territory following the Hamas attack.
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Israel Says it Killed Hamas Military Leader: The Israeli military said on Sunday its fighter jets killed the Hamas military leader responsible for the attack on one of Israel’s communities last Saturday, Kibbutz Nirim. In a statement, the military said this occurred Saturday night during operations that also took out Hamas rocket launchers. It said the man was commander of the Nukhba forces in Khan Yunis in the southern Gaza Strip. Nukhba are the elite Hamas military unit that Israel says trained and led the October 7 attack. Hamas has been designated as a terrorist group by the US and the European Union.
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