More Details of South Carolina Hacking Episode





ATLANTA — Gov. Nikki R. Haley said on Tuesday that South Carolina officials had not done enough to stop computer hackers who recently stole millions of personal financial records.




A new report shows that outdated computers and security flaws at the state’s Department of Revenue allowed international hackers to steal 3.8 million tax records, the governor said. She announced that the agency’s director, James Etter, would resign at the end of the year.


“Could South Carolina have done a better job? Absolutely,” she said. “We did not do enough.”


Experts say the cyberattack, which resulted in the theft of 3.8 million Social Security numbers and 387,000 credit and debit card numbers, was the largest ever against a state government agency.


On Tuesday, the computer security firm Mandiant released a report with new details about the attack. Hackers broke into the agency’s computer system by sending state employees spam e-mail that contained an embedded link. If employees clicked on the link, software was activated on their computers that stole their user names and passwords, Mandiant found. Using this information, the hackers were able to log in as tax officials and steal the data.


In addition to stealing records for the 3.8 million taxpayers, the hackers stole information on nearly 1.9 million dependents and nearly 700,000 businesses between August and October.


Ms. Haley said the report revealed two basic security flaws: state employees did not need multiple passwords and user names to obtain sensitive tax data, and the state did not encrypt Social Security numbers, which could have reduced the harm if any were stolen.


The state is paying up to $12 million to provide a free year of credit monitoring and identity theft prevention to anyone affected.


One victim, Tina Mather, the owner of a catering company in Columbia, says $4,000 was stolen from her bank account and was transferred to companies in Boston and Atlanta and then to unknown people.


“It has put our life through hell trying to figure out where our money went,” said Ms. Mather, whose bank is investigating and plans to reimburse her.


Ms. Haley said similar attacks would probably happen in other states if security was not enhanced. She called on the Internal Revenue Service and Congress to adopt new protocols for state tax agencies.


“Every state needs to be looking at this,” she said. “It is a new part of any governor’s role to make sure this data is secure.”


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





JERUSALEM — Efforts to agree on a cease-fire between Israel and Hamas intensified 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 Mrs. 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 had also been 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, wounding 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 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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Global Update: Meningitis Vaccine Gets Longer Window Without Refrigeration





In what may prove to be a major advance for Africa’s “meningitis belt,” regulatory authorities have decided that a new meningitis vaccine could be stored without refrigeration for up to four days.




The announcement was made last week at a conference in Atlanta of the American Society of Tropical Medicine and Hygiene. While a few days may seem trivial, the hardest part of protecting poor countries is often keeping a vaccine cold while moving it from electrified cities to villages with no power. In antipolio drives, for example, the freezers, generators and fuel needed to make ice for the shoulder bags of vaccinators can cost more than the vaccine.


The new vaccine, MenAfriVac, made in India for 50 cents a dose, was introduced in 2010. In bad years, epidemics during the hot harmattan winds have killed as many as 25,000 Africans and disabled 50,000 more. In Chad this year, vaccination drove down cases to near zero in districts where it was used, while others nearby had serious outbreaks.


Experts decided that the vaccine is safe for four days as long as it stays below 104 degrees.


While temperatures get higher than that in Africa, said Dr. Godwin Enwere, medical director for the Meningitis Vaccine Project, teams normally get the vaccine out of coolers at dawn, drive to villages and finish before the day heats up. Other experts said it should be kept in the shade and monitored with colored paper “dots” that darken after hours in the heat.


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Global Update: Meningitis Vaccine Gets Longer Window Without Refrigeration





In what may prove to be a major advance for Africa’s “meningitis belt,” regulatory authorities have decided that a new meningitis vaccine could be stored without refrigeration for up to four days.




The announcement was made last week at a conference in Atlanta of the American Society of Tropical Medicine and Hygiene. While a few days may seem trivial, the hardest part of protecting poor countries is often keeping a vaccine cold while moving it from electrified cities to villages with no power. In antipolio drives, for example, the freezers, generators and fuel needed to make ice for the shoulder bags of vaccinators can cost more than the vaccine.


The new vaccine, MenAfriVac, made in India for 50 cents a dose, was introduced in 2010. In bad years, epidemics during the hot harmattan winds have killed as many as 25,000 Africans and disabled 50,000 more. In Chad this year, vaccination drove down cases to near zero in districts where it was used, while others nearby had serious outbreaks.


Experts decided that the vaccine is safe for four days as long as it stays below 104 degrees.


While temperatures get higher than that in Africa, said Dr. Godwin Enwere, medical director for the Meningitis Vaccine Project, teams normally get the vaccine out of coolers at dawn, drive to villages and finish before the day heats up. Other experts said it should be kept in the shade and monitored with colored paper “dots” that darken after hours in the heat.


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The iEconomy: As Boom Lures App Creators, Tough Part Is Making a Living


Daniel Rosenbaum for The New York Times


Shawn and Stephanie Grimes’s efforts have cost $200,000 in lost income and savings, but their apps have earned less than $5,000 this year.







ROSEDALE, Md. — Shawn and Stephanie Grimes spent much of the last two years pursuing their dream of doing research and development for Apple, the world’s most successful corporation.




But they did not actually have jobs at Apple. It was freelance work that came with nothing in the way of a regular income, health insurance or retirement plan. Instead, the Grimeses tried to prepare by willingly, even eagerly, throwing overboard just about everything they could.


They sold one of their cars, gave some possessions to relatives and sold others in a yard sale, rented out their six-bedroom house and stayed with family for a while. They even cashed in Mr. Grimes’s 401(k).


“We didn’t lose any sleep over it,” said Mr. Grimes, 32. “I’ll retire when I die.”


The couple’s chosen field is so new it did not even exist a few years ago: writing software applications for mobile devices like the iPhone or iPad. Even as unemployment remained stubbornly high and the economy struggled to emerge from the recession’s shadow, the ranks of computer software engineers, including app writers, increased nearly 8 percent in 2010 to more than a million, according to the latest available government data for that category. These software engineers now outnumber farmers and have almost caught up with lawyers.


Much as the Web set off the dot-com boom 15 years ago, apps have inspired a new class of entrepreneurs. These innovators have turned cellphones and tablets into tools for discovering, organizing and controlling the world, spawning a multibillion-dollar industry virtually overnight. The iPhone and iPad have about 700,000 apps, from Instagram to Angry Birds.


Yet with the American economy yielding few good opportunities in recent years, there is debate about how real, and lasting, the rise in app employment might be.


Despite the rumors of hordes of hip programmers starting million-dollar businesses from their kitchen tables, only a small minority of developers actually make a living by creating their own apps, according to surveys and experts. The Grimeses began their venture with high hopes, but their apps, most of them for toddlers, did not come quickly enough or sell fast enough.


And programming is not a skill that just anyone can learn. While people already employed in tech jobs have added app writing to their résumés, the profession offers few options to most unemployed, underemployed and discouraged workers.


One success story is Ethan Nicholas, who earned more than $1 million in 2009 after writing a game for the iPhone. But he says the app writing world has experienced tectonic shifts since then.


“Can someone drop everything and start writing apps? Sure,” said Mr. Nicholas, 34, who quit his job to write apps after iShoot, an artillery game, became a sensation. “Can they start writing good apps? Not often, no. I got lucky with iShoot, because back then a decent app could still be successful. But competition is fierce nowadays, and decent isn’t good enough.”


The boom in apps comes as economists are debating the changing nature of work, which technology is reshaping at an accelerating speed. The upheaval, in some ways echoing the mechanization of agriculture a century ago, began its latest turbulent phase with the migration of tech manufacturing to places like China. Now service and even white-collar jobs, like file clerks and data entry specialists or office support staff and mechanical drafters, are disappearing.


“Technology is always destroying jobs and always creating jobs, but in recent years the destruction has been happening faster than the creation,” said Erik Brynjolfsson, an economist and director of the M.I.T. Center for Digital Business.


Still, the digital transition is creating enormous wealth and opportunity. Four of the most valuable American companies — Apple, Google, Microsoft and I.B.M. — are rooted in technology. And it was Apple, more than any other company, that set off the app revolution with the iPhone and iPad. Since Apple unleashed the world’s freelance coders to build applications four years ago, it has paid them more than $6.5 billion in royalties.


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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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Which Tablet to Buy Among Dozens Confuses Shoppers





Holiday shoppers with a tablet computer on their gift list this year might be forgiven for feeling a little panicked.




Look at the tablets available online or at a consumer electronics store and it can be dizzying to choose from among the dozens of slim rectangles with touch screens — each with various sizes, features, prices and applications.


Tablets were supposed to be a simple alternative to the bloated personal computer market. And when “tablet” was synonymous with “iPad,” that was true.


But this is the first holiday season in which the iPad faces competitors that have built up a solid footing in the market. Amazon and Google introduced tablets just in time for the shopping rush. As a result, many consumers and analysts say, the new market of keyboardless computers is quickly becoming as confusing as that of the old-school PC.


“What’s different about this holiday season is that consumers have not just more choice, but really good choices,” said Sarah Rotman Epps, who studies consumer computing trends at Forrester. “There have been many iPad wannabes but no real quality alternatives, and now there are several.”


While choice is a good thing for consumers, she said, it also makes shopping “confusing and complicated.”


For the companies that make tablets, the choice means everything. The stakes are much higher than the sale of individual devices. Each company is trying to snag lifelong customers for their other products — like music, apps, e-books, movies, Web search or word-processing software.


While Apple has dominated the market until now, selling more tablets than any other company, its perch is being threatened by the newcomers.


“Apple left a lot of room for rivals to grow,” said Tero Kuittinen, an independent mobile analyst.


By keeping its tablet prices so high, he said, Apple could lose its place as the biggest tablet seller, just as it did with smartphones when it lost the first-place position to Samsung, which makes less expensive phones using Google’s Android software. The iPad still dominates the market with a 50 percent share, according to third-quarter figures from the research firm IDC, but that is down from 60 percent a year ago. Samsung is in second place with an 18 percent share, Amazon is third with 9 percent, and Asus, which makes Google’s Nexus 7 tablet, is in fourth with 8.6 percent of the market.


But Google, which makes the vast majority of its revenue on Web ads, still lags in the tablet market, even though sales of its Nexus 7 tablet are approaching one million a month, according to Asus. About 98 percent of Web traffic from tablets comes from iPads, according to Onswipe, a digital publishing company. Google would like more of that traffic, as well as more buyers for apps and media from its Google Play store, as would Amazon and Microsoft.


“The first decision you make is what ecosystem am I in, do I want the Android Play store and content or some other?” said Hiroshi Lockheimer, Google’s vice president for engineering for Android. “So the importance of the ecosystem can’t be overstated.”


But the decisions after that are still complex.


Say, for example, that you want a tablet that runs Google’s Android operating system. There is the Nexus 7, a seven-inch tablet made by Asus, and the Nexus 10, a 10-inch tablet made by Samsung. Then there are the Samsung Galaxy Tab 2 10.1 and the Samsung Galaxy Note 10.1 (not to be confused with the Samsung Galaxy Note 2, a 5.5-inch smartphone). And that’s not to mention the dozens of Android tablets made by Lenovo, Toshiba and others.


This year, Microsoft also has a tablet, called Surface. Amazon has the Kindle Fire and Fire HD, and Barnes & Noble has the Nook HD and HD+. Once shoppers choose one, they have more choices to make, like whether they want to pay $15 more for the privilege of not seeing ads on the Kindle Fire.


Even Apple, which has always prided itself on having simple product lines, now offers the new iPad, the older iPad 2 and the iPad Mini. If you factor in the various amounts of storage and the choice of cellular data or just Wi-Fi, there are essentially 14 iPad models to choose from.


Complicating the decision on hardware, different tablets connect to different online stores for apps, music and video. If you have built your music and app collection on Apple devices, an Android tablet may mean starting from scratch, and vice versa.


The proliferation of products is nothing new for a mature market, as anyone who has stood in front of a wall of televisions at Best Buy or in a parking lot of Priuses at a Toyota dealership knows.


But some consumer electronics companies that have given their customers too many options have run into trouble, said Shaw Wu, an analyst at Sterne Agee. They include Motorola Mobility, which is trying to rescue its cellphone business by paring its lineup of 27 devices, and Research in Motion, which offers a perplexing matrix of BlackBerrys with confusing names, like the BlackBerry Torch 9810, 9850 and 9860.


Google in particular runs this risk, said Michael Gartenberg, a technology analyst at Gartner, because it gives away its Android operating system to any device manufacturer that wants to use it, resulting in an uncontrolled array of Android devices running different versions of the software. Some apps will work only with particular versions, making it difficult to know exactly what you are getting.


Google has tried to address this problem in recent months. It gave its line of Nexus products names corresponding to their screen size and began selling them in its Play store. (Google teams up with manufacturers to build the Nexus devices.) It began running ads for the tablets online, on billboards, in print and on television, which had been rare for the company, and assigned a public relations employee to focus on selling hardware to consumers.


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Novelties: Single-Incision Surgery, Via New Robotic Systems





SURGEONS once made incisions large enough to get to a gallbladder or other organs by using conventional tools they held in their own hands. Today, many sit at a computer console instead, guiding robotic arms that enter the patient’s body through small openings not much larger than keyholes.




But even this minimally invasive surgery usually requires multiple incisions: one for the camera system showing the way to the surgeon at the console, and others for each of the robotic arms that do the cutting and stitching.


Now there are robotic systems — one on the market, others in development — that are even less intrusive. They require only a single, small incision through which the robotic arms and camera enter.


This could lead to faster recovery, said Dr. Michael Hsieh, a Stanford professor and a urologist at Lucile Packard Children’s Hospital and Stanford Hospital. “There’s only one wound to heal with this procedure, rather than three,” he said.


Dr. Hsieh, who performs abdominal surgery on small children, uses minimally invasive techniques that typically now require three incisions. His patients generally go home a day or two after surgery, he said, “but I think they would recover more quickly if I could reduce my multiple incisions to just one,” he said. “And there will be less scarring, or even no scarring, if you enter through the navel.”


He will soon have a chance to try out the new method on his patients. Stanford Hospital is buying a system from Intuitive Surgical called Single-Site that requires only a single incision of about one inch. The system, approved by the Food and Drug Administration only for gallbladder removal, is used as an add-on to a basic robotic system from Intuitive, known as the da Vinci Si.


The Si costs $1.3 million to $2.2 million, said Angela Wonson, a spokeswoman for Intuitive, based in Sunnyvale, Calif. The Single-Site can add $60,000 or more to the bill, or far less, depending in part on the equipment that hospitals might already have.


The East Jefferson General Hospital in Metairie, La., has bought a Single-Site system. Seated at a computer there, Dr. Joseph Uddo Jr. can control the instruments, which can enter the body by way of one incision in the navel. Surgical instruments like scissors are at the ends of the robotic arms. “To change a tool, you take out one instrument and load in another,” he said.


ANOTHER surgical robotic system, now in development, enters the body through a remarkably small incision — six-tenths of an inch, or 15 millimeters. The robot was designed by Drs. Dennis Fowler and Peter Allen of Columbia University and Dr. Nabil Simaan of Vanderbilt University. Once inside the body, it unfolds to reveal a camera system and two snakelike arms that perform the surgery. The system has been licensed to Titan Medical in Toronto.


Minimally invasive surgery through a single incision can also be performed with long, thin laparoscopic tools that surgeons wield as they watch a video monitor. But single-incision laparoscopic surgery with hand-held instruments can have problems, said Dr. Adrian Park, chairman of the department of surgery at the Anne Arundel Medical Center in Annapolis, Md., who specializes in minimally invasive gastrointestinal surgery. One difficulty is its ergonomic challenge to doctors, while another is the pressure that the tools place on tissue during single-incision operations.


Robotic systems, by contrast, are likely to ease single-incision surgery, said Jeffrey J. Tomaszewski, a fellow in urologic oncology at the Fox Chase Cancer Center in Philadelphia.


“Robots are an extension and multiplier of our own surgical hands,” Dr. Tomaszewski said. He has done traditional laparoscopic surgery with hand-held instruments, including operations through a single incision. “But you can be working at constrained angles,” he said. “A robot can improve the angle of workability.”


Robotic systems, though, have yet to show that they are always worth the extra money they cost. Such proof will take time, said Allison Okamura, an associate professor of mechanical engineering at Stanford who directs the Collaborative Haptics and Robotics in Medicine Lab. “The jury is still out because of the longevity of the studies that are required,” she said.


Dr. Tomaszewski agreed. “We surgeons love using the robot,” he said. “But the question is, and what we all have to fight hard to do, is to determine for what procedure the robotic approach provides the best benefit.”


Dr. Hsieh says he hopes that single-site robotic systems will someday bring a benefit he’s long dreamed about.


“We may get to the point where we do outpatient, scarless robotic surgery,” he said. “That’s what I’m shooting for.”


E-mail: novelties@nytimes.com.



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You for Sale: Your Online Attention, Bought in an Instant by Advertisers


Monica Almeida/The New York Times


Frank Addante, 36, chief executive of the Rubicon Project, says that 97 percent of American Internet users encounter its electronic ad sales system every month. And most aren’t even aware of it.







YOU can be sold in seconds.






Beverly Orr

“Online consumers are being bought and sold like chattel,” says Jeffrey Chester, executive director of the Center for Digital Democracy.






No, wait: make that milliseconds.


The odds are that access to you — or at least the online you — is being bought and sold in less than the blink of an eye. On the Web, powerful algorithms are sizing you up, based on myriad data points: what you Google, the sites you visit, the ads you click. Then, in real time, the chance to show you an ad is auctioned to the highest bidder.


Not that you’d know it. These days in the hyperkinetic world of digital advertising, all of this happens automatically, and imperceptibly, to most consumers.


Ever wonder why that same ad for a car or a couch keeps popping up on your screen? Nearly always, the answer is real-time bidding, an electronic trading system that sells ad space on the Web pages people visit at the very moment they are visiting them. Think of these systems as a sort of Nasdaq stock market, only trading in audiences for online ads. Millions of bids flood in every second. And those bids — essentially what your eyeballs are worth to advertisers — could determine whether you see an ad for, say, a new Lexus or a used Ford, for sneakers or a popcorn maker.


One big player in this space is the Rubicon Project. Never heard of it? Consider this: Rubicon, based in Los Angeles, has actually eclipsed Google in one crucial area — the percentage of Internet users in the United States reached by display ads sold through its platform, according to comScore, a digital analytics company.


Rubicon is among a handful of technology companies that have quietly developed automated ad sales systems for Web site operators. The bidders are marketers seeking to identify their best prospects and pitch them before they move to the next Web page. It is a form of high-frequency trading — that souped-up business of algorithm-loving Wall Streeters. But in this case, the prize is the attention of ordinary people. And it all depends on data-mining to instantly evaluate the audiences available to see those online display ads, the ones that appear on Web sites next to or around content.


In industry parlance, each digital ad space is an impression. The value of an impression depends on several factors, like the size of the ad, the type of person who is available to see it and that person’s location.


“The first impression seen by a high-value person on the opening page of a major newspaper first thing in the morning has a different value than a user from China who is 12 and has been on the Web all day long playing games,” says Frank Addante, the founder and chief executive of Rubicon.


Yet for most of us, real-time bidding is invisible. About 97 percent of American Internet users interact with Rubicon’s system every month, Mr. Addante says, and most of them aren’t aware of it.


That worries some federal regulators and consumer advocates, who say that such electronic trading systems could unfairly stratify consumers, covertly offering better pricing to certain people while relegating others to inferior treatment. A computer-generated class system is one risk, they say, of an ad-driven Internet powered by surveillance.


“As you profile more and more people, you’ll start to segregate people into ‘the people you can get money out of’ and ‘the people you can’t get money out of,’ ” says Dan Auerbach, a staff technologist at the Electronic Frontier Foundation, a digital civil rights group in San Francisco, who formerly worked in digital ad data-mining. “That is one of the dangers we should be worried about.”


Of course, ad agencies and brands can tailor ads to Web users without real-time bidding. They can also buy ads without aiming them at narrow audience groups. But for marketers, the marriage of ad- and audience-buying is one of the benefits of real-time bidding.


Not so long ago, they simply bought ad spaces based on a site’s general demographics and then showed every visitor the same ad, a practice called “spray and pray.” Now marketers can aim just at their ideal customers — like football fans who earn more than $100,000 a year, or mothers in Denver in the market for an S.U.V. — showing them tailored ads at the exact moment they are available on a specific Web page.


“We are not buying content as a proxy for audience,” says Paul Alfieri, the vice president for marketing at Turn, a data management company and automated buy-side platform for marketers based in Redwood City, Calif. “We are just buying who the audience is.”


Still, for many consumer advocates, real-time bidding resembles nothing so much as a cattle auction.


“Online consumers are being bought and sold like chattel,” says Jeffrey Chester, the executive director of the Center for Digital Democracy, a consumer group in Washington that has filed a complaint about real-time bidding with the Federal Trade Commission. “It’s dehumanizing.”


FRANK ADDANTE is 36 years old and given to wearing black shirts with a white Rubicon logo on the front. Rubicon is the fifth company he has started or helped to found.


In 1996, in his dorm room at the Illinois Institute of Technology, he developed and introduced a search engine. He later helped found L90, a digital ad technology company that went public and was later acquired by DoubleClick. His fourth enterprise, StrongMail Systems, provides e-mail delivery infrastructure to large companies.


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Gaza Clash Escalates With Deadliest Israeli Strike


Bernat Armangue/Associated Press


Smoke rose over Gaza City on Sunday, as Israel widened its range of targets to include buildings used by the news media.







CAIRO — Emboldened by the rising power of Islamists around the region, the Palestinian militant group Hamas demanded new Israeli concessions to its security and autonomy before it halts its rocket attacks on Israel, even as the conflict took an increasing toll on Sunday.






Pavel Wolberg for The New York Times

 A woman and her child took cover in the southern Israeli town of Ashod, which was the target of several missiles on Sunday.






After five days of punishing Israeli airstrikes on the Hamas-controlled Gaza Strip and no letup in the rocket fire in return, representatives of Israel and Hamas met separately with Egyptian officials in Cairo on Sunday for indirect talks about a truce.


The talks came as an Israeli bomb struck a house in Gaza on Sunday afternoon, killing 11 people, in the deadliest single strike since the conflict between Israel and Hamas escalated on Wednesday. The strike, along with several others that killed civilians across the Gaza Strip, signaled that Israel was broadening its range of targets on the fifth day of the campaign.


By the end of the day, Gaza health officials reported that 70 Palestinians had been killed in airstrikes since Wednesday, including 20 children, and that 600 had been wounded. Three Israelis have been killed and at least 79 wounded by unrelenting rocket fire out of Gaza into southern Israel and as far north as Tel Aviv.


Hamas, badly outgunned on the battlefield, appeared to be trying to exploit its increased political clout with its ideological allies in Egypt’s new Islamist-led government. The group’s leaders, rejecting Israel’s call for an immediate end to the rocket attacks, have instead laid down sweeping demands that would put Hamas in a stronger position than when the conflict began: an end to Israel’s five-year-old embargo of the Gaza Strip, a pledge by Israel not to attack again and multinational guarantees that Israel would abide by its commitments.


Prime Minister Benjamin Netanyahu of Israel stuck to his demand that all rocket fire cease before the air campaign lets up, and Israeli tanks and troops remained lined up outside Gaza on Sunday. Tens of thousands of reserve troops had been called up. “The army is prepared to significantly expand the operation,” Mr. Netanyahu said at the start of a cabinet meeting.


Reda Fahmy, a member of Egypt’s upper house of Parliament and of the nation’s dominant Islamist party, who is following the talks, said Hamas’s position was just as unequivocal. “Hamas has one clear and specific demand: for the siege to be completely lifted from Gaza,” he said. “It’s not reasonable that every now and then Israel decides to level Gaza to the ground, and then we decide to sit down and talk about it after it is done. On the Israeli part, they want to stop the missiles from one side. How is that?”


He added: “If they stop the aircraft from shooting, Hamas will then stop its missiles. But violence couldn’t be stopped from one side.”


Hamas’s aggressive stance in the cease-fire talks is the first test of the group’s belief that the Arab Spring and the rise in Islamist influence around the region have strengthened its political hand, both against Israel and against Hamas’s Palestinian rivals, who now control the West Bank with Western backing.


It also puts intense new pressure on President Mohamed Morsi of Egypt, a former leader of the Muslim Brotherhood who was known for his fiery speeches defending Hamas and denouncing Israel. Mr. Morsi must now balance the conflicting demands of an Egyptian public that is deeply sympathetic to Hamas and the Palestinian cause against Western pleadings to help broker a peace and Egypt’s need for regional stability to help revive its moribund economy.


Indeed, the Egyptian-led cease-fire talks illustrate the diverging paths of the Muslim Brotherhood and Hamas, a Palestinian offshoot of the original Egyptian Islamist group. Hamas has evolved into a more militant insurgency and is labeled a terrorist organization by the United States and Israel, while the Brotherhood has effectively become Egypt’s ruling party. Mr. Fahmy said in an interview in March that the Brotherhood’s new responsibilities required a step back from its ideological cousins in Hamas, and even a new push to persuade the group to compromise.


Reporting was contributed by Ethan Bronner, Irit Pazner Garshowitz and Isabel Kershner from Jerusalem, and Peter Baker from Bangkok.



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