WASHINGTON (AP) — Republican Rep.&nbsp;<a href="https://apnews.com/article/jim-jordan-house-speaker-republicans-0f759a46f63aa9daf9e6939e45799329">Jim Jordan</a>&nbsp;failed again Wednesday on a crucial second ballot to become House speaker, the hard-fighting ally of Donald Trump losing even more GOP colleagues who refused to give him the the gavel.

Next steps were highly uncertain as a bipartisan group of lawmakers floated an extraordinary plan — to give the interim speaker-pro-tempore, Rep. Patrick McHenry, R-N.C., more power to reopen the House and temporarily conduct routine business.

What was clear was that Jordan's path to become House speaker was almost certainly lost. He was opposed by two more than the 20 Republican detractors he lost in first round voting the day before.

The House gaveled in with angry, frustrated GOP lawmakers looking at other options. And as the rollcall was underway, a few new detractors emerged to oppose Jordan who did not seem to be picking up new votes beyond one lawmaker who was absent the day before.

Ahead of the&nbsp;<a href="https://apnews.com/article/house-speaker-vote-guide-jordan-410d2f46378a7ab2fee9d6534fd2ef76">morning vote</a>, Jordan made an unexpected plea for party unity, the combative Judiciary Committee chairman telling his colleagues on social media, “We must stop attacking each other and come together.”

A surprisingly large and politically diverse group of&nbsp;<a href="https://apnews.com/article/jim-jordan-house-speaker-mccarthy-trump-f2b2bf9dc834742bde93d5fc918d9940">20 Republicans had rejected Jordan's nomination</a>&nbsp;the day before, many resenting the hardball tactics seeking to enforce support, and viewing the Ohio congressman as too extreme for the powerful position of House speaker, second in line to the presidency.

The House has hit a standstill, stuck while Jordan worked to shore up backing from Republican colleagues for the job to replace the ousted&nbsp;<a href="https://apnews.com/article/mccarthy-gaetz-speaker-motion-to-vacate-congress-327e294a39f8de079ef5e4abfb1fa555">Kevin McCarthy</a>. Republicans are exhausted by the infighting since McCarthy's sudden removal by hard-liners, who are now within reach of a central seat of U.S. power.

The vote for House speaker, once a formality in Congress, has devolved into&nbsp;<a href="https://apnews.com/article/speaker-jordan-scalise-mccarthy-election-votes-explainer-db85c1d80dcc36f296245851ad1278ab">another bitter showdown for the gavel</a>.

With Republicans in majority control 221-212, Jordan must pick up most of his GOP foes to win. Tuesday's tally, with 200 Republicans voting for Jordan and 212 for the Democratic leader Hakeem Jeffries of New York, left no candidate with a clear majority, as the 20 Republicans voted for someone else. .

In nominating Jordan, veteran Republican Rep. Tom Cole of Oklahoma said it was time to end the upheaval that he had warned against with McCarthy’s sudden ouster.

“We have a chance today to end that chaos, end that uncertainty,” Cole said.

He said that Jordan was “not a shrinking violet” but someone who could lead the House.

Democratic Rep. Pete Aguilar noted that Jeffries continues to win more votes and is the best choice to move the country forward.

“The country cannot afford more delays and more chaos,” Aguilar said.

Bipartisan groups of lawmakers have been floating ways to operate the House by&nbsp;<a href="https://apnews.com/article/house-speaker-powers-mchenry-875bebd218096a5252840cd8f52cc137">giving greater power</a>&nbsp;to McHenry or another temporary speaker. The House had never ousted its speaker before McCarthy.

The novel concept of boosting the interim speaker's role was gaining favor with a pair of surprising high-profile Republicans: Former GOP speakers Newt Gingrich and John Boehner.

Gingrich said while he likes Jordan, he has “no faith” the nominee can get much beyond the 200 votes he won in the first vote.

“We can’t sit around and suck our thumbs and hope the world will wait until the House Republicans get their act together,” Gingrich told Fox News' Sean Hannity on his show.

Boehner reposted Gingrich's views saying, “I agree,” on social media.

The two men have deep experience with the subject. Both were chased to early retirement by threats of ouster from right-flank insurgents&nbsp;<a href="https://apnews.com/article/kevin-mccarthy-republican-lawmakers-house-opponents-33c7d984964916f29d548b5b1dfe508b">like those who toppled McCarthy</a>.

“The Republicans are unable to function right now,” said Jeffries. He said talks would “accelerate” between Democrats and Republicans on alternative plans.

“Jim Jordan will be a great speaker,” Trump had said Tuesday said outside a courthouse in Manhattan, where he is facing&nbsp;<a href="https://apnews.com/article/trump-fraud-trial-net-worth-new-york-067501b1d742d4dccba2521ac3262fdb">business fraud charges</a>. "I think he’s going to have the votes soon, if not today, over the next day or two."

Flexing their independence, the holdouts are a mix of pragmatists — ranging from seasoned legislators and committee chairs worried about governing, to newer lawmakers from districts where voters back home prefer President Joe Biden to Trump.

Some Republicans resent being pressured by Jordan’s allies and say they are being threatened with primary opponents if they don’t support him as speaker. Others are simply upset at the way the whole process has dragged out.

One holdout, Republican Rep. Ken Buck of Colorado, said Tuesday that Jordan’s role in the runup to&nbsp;<a href="https://apnews.com/hub/capitol-siege">the Jan. 6, 2021, attack</a>&nbsp;on the Capitol and his refusal to admit that Biden, a Democrat, won the 2020 election remained an issue.

Jordan has been a top Trump ally, particularly during&nbsp;<a href="https://apnews.com/article/congress-confirm-joe-biden-78104aea082995bbd7412a6e6cd13818">the Jan. 6 Capitol attack</a>&nbsp;by the former president’s backers who were trying to overturn the 2020 election he lost to Biden. Days later, Trump awarded Jordan&nbsp;<a href="https://apnews.com/article/donald-trump-jim-jordan-impeachments-capitol-siege-eeadab127460dd5170e79608f654aca6">a Medal of Freedom</a>.

The political climb has been steep for Jordan, the combative Judiciary Committee chairman and a founding member of the right-flank Freedom Caucus. He is known more as a chaos agent than a skilled legislator, raising questions about how he would lead. Congress faces daunting challenges, risking&nbsp;<a href="https://apnews.com/article/government-shutdown-mccarthy-congress-republicans-732baaa19c91f981e492fd0e6a76aba8">a federal shutdown</a>&nbsp;at home if it fails to fund the government and fielding Biden's requests for aid to help&nbsp;<a href="https://apnews.com/article/mccarthy-gaetz-speaker-motion-to-vacate-congress-327e294a39f8de079ef5e4abfb1fa555">Ukraine</a>&nbsp;and&nbsp;<a href="https://newsroom.ap.org/a">Israel</a>&nbsp;in the wars abroad.

First elected in 2006, Jordan has few bills to his name from his time in office. He also faces questions about his past. Some years ago, Jordan&nbsp;<a href="https://apnews.com/general-news-6fb5bfff7db9439883907efce5c119fb">denied allegations</a>&nbsp;from former wrestlers during his time as an assistant wrestling coach at Ohio State University who accused him of knowing about claims they were inappropriately groped by an Ohio doctor. Jordan has said he was never aware of any abuse.

<figure>
 <img src="https://media.eaglewebservices.com/public/2023/10/1697646116539.png" alt="View of the House during the vote count on Wednesday-photo courtesy CSPAN" />
 <figcaption>View of the House during the vote count on Wednesday-photo courtesy CSPAN</figcaption>
 </figure>WASHINGTON (AP) — Republican Rep.&nbsp;<a href="https://apnews.com/article/jim-jordan-house-speaker-republicans-0f759a46f63aa9daf9e6939e45799329">Jim Jordan</a>&nbsp;failed again Wednesday on a crucial second ballot to become House speaker, the hard-fighting ally of Donald Trump losing even more GOP colleagues who refused to give him the the gavel.Next steps were highly uncertain as a bipartisan group of lawmakers floated an extraordinary plan — to give the interim speaker-pro-tempore, Rep. Patrick McHenry, R-N.C., more power to reopen the House and temporarily conduct routine business.What was clear was that Jordan's path to become House speaker was almost certainly lost. He was opposed by two more than the 20 Republican detractors he lost in first round voting the day before.The House gaveled in with angry, frustrated GOP lawmakers looking at other options. And as the rollcall was underway, a few new detractors emerged to oppose Jordan who did not seem to be picking up new votes beyond one lawmaker who was absent the day before.Ahead of the&nbsp;<a href="https://apnews.com/article/house-speaker-vote-guide-jordan-410d2f46378a7ab2fee9d6534fd2ef76">morning vote</a>, Jordan made an unexpected plea for party unity, the combative Judiciary Committee chairman telling his colleagues on social media, “We must stop attacking each other and come together.”A surprisingly large and politically diverse group of&nbsp;<a href="https://apnews.com/article/jim-jordan-house-speaker-mccarthy-trump-f2b2bf9dc834742bde93d5fc918d9940">20 Republicans had rejected Jordan's nomination</a>&nbsp;the day before, many resenting the hardball tactics seeking to enforce support, and viewing the Ohio congressman as too extreme for the powerful position of House speaker, second in line to the presidency.The House has hit a standstill, stuck while Jordan worked to shore up backing from Republican colleagues for the job to replace the ousted&nbsp;<a href="https://apnews.com/article/mccarthy-gaetz-speaker-motion-to-vacate-congress-327e294a39f8de079ef5e4abfb1fa555">Kevin McCarthy</a>. Republicans are exhausted by the infighting since McCarthy's sudden removal by hard-liners, who are now within reach of a central seat of U.S. power.The vote for House speaker, once a formality in Congress, has devolved into&nbsp;<a href="https://apnews.com/article/speaker-jordan-scalise-mccarthy-election-votes-explainer-db85c1d80dcc36f296245851ad1278ab">another bitter showdown for the gavel</a>.With Republicans in majority control 221-212, Jordan must pick up most of his GOP foes to win. Tuesday's tally, with 200 Republicans voting for Jordan and 212 for the Democratic leader Hakeem Jeffries of New York, left no candidate with a clear majority, as the 20 Republicans voted for someone else. .In nominating Jordan, veteran Republican Rep. Tom Cole of Oklahoma said it was time to end the upheaval that he had warned against with McCarthy’s sudden ouster.“We have a chance today to end that chaos, end that uncertainty,” Cole said.He said that Jordan was “not a shrinking violet” but someone who could lead the House.Democratic Rep. Pete Aguilar noted that Jeffries continues to win more votes and is the best choice to move the country forward.“The country cannot afford more delays and more chaos,” Aguilar said.Bipartisan groups of lawmakers have been floating ways to operate the House by&nbsp;<a href="https://apnews.com/article/house-speaker-powers-mchenry-875bebd218096a5252840cd8f52cc137">giving greater power</a>&nbsp;to McHenry or another temporary speaker. The House had never ousted its speaker before McCarthy.The novel concept of boosting the interim speaker's role was gaining favor with a pair of surprising high-profile Republicans: Former GOP speakers Newt Gingrich and John Boehner.Gingrich said while he likes Jordan, he has “no faith” the nominee can get much beyond the 200 votes he won in the first vote.“We can’t sit around and suck our thumbs and hope the world will wait until the House Republicans get their act together,” Gingrich told Fox News' Sean Hannity on his show.Boehner reposted Gingrich's views saying, “I agree,” on social media.The two men have deep experience with the subject. Both were chased to early retirement by threats of ouster from right-flank insurgents&nbsp;<a href="https://apnews.com/article/kevin-mccarthy-republican-lawmakers-house-opponents-33c7d984964916f29d548b5b1dfe508b">like those who toppled McCarthy</a>.“The Republicans are unable to function right now,” said Jeffries. He said talks would “accelerate” between Democrats and Republicans on alternative plans.“Jim Jordan will be a great speaker,” Trump had said Tuesday said outside a courthouse in Manhattan, where he is facing&nbsp;<a href="https://apnews.com/article/trump-fraud-trial-net-worth-new-york-067501b1d742d4dccba2521ac3262fdb">business fraud charges</a>. "I think he’s going to have the votes soon, if not today, over the next day or two."Flexing their independence, the holdouts are a mix of pragmatists — ranging from seasoned legislators and committee chairs worried about governing, to newer lawmakers from districts where voters back home prefer President Joe Biden to Trump.Some Republicans resent being pressured by Jordan’s allies and say they are being threatened with primary opponents if they don’t support him as speaker. Others are simply upset at the way the whole process has dragged out.One holdout, Republican Rep. Ken Buck of Colorado, said Tuesday that Jordan’s role in the runup to&nbsp;<a href="https://apnews.com/hub/capitol-siege">the Jan. 6, 2021, attack</a>&nbsp;on the Capitol and his refusal to admit that Biden, a Democrat, won the 2020 election remained an issue.Jordan has been a top Trump ally, particularly during&nbsp;<a href="https://apnews.com/article/congress-confirm-joe-biden-78104aea082995bbd7412a6e6cd13818">the Jan. 6 Capitol attack</a>&nbsp;by the former president’s backers who were trying to overturn the 2020 election he lost to Biden. Days later, Trump awarded Jordan&nbsp;<a href="https://apnews.com/article/donald-trump-jim-jordan-impeachments-capitol-siege-eeadab127460dd5170e79608f654aca6">a Medal of Freedom</a>.The political climb has been steep for Jordan, the combative Judiciary Committee chairman and a founding member of the right-flank Freedom Caucus. He is known more as a chaos agent than a skilled legislator, raising questions about how he would lead. Congress faces daunting challenges, risking&nbsp;<a href="https://apnews.com/article/government-shutdown-mccarthy-congress-republicans-732baaa19c91f981e492fd0e6a76aba8">a federal shutdown</a>&nbsp;at home if it fails to fund the government and fielding Biden's requests for aid to help&nbsp;<a href="https://apnews.com/article/mccarthy-gaetz-speaker-motion-to-vacate-congress-327e294a39f8de079ef5e4abfb1fa555">Ukraine</a>&nbsp;and&nbsp;<a href="https://newsroom.ap.org/a">Israel</a>&nbsp;in the wars abroad.First elected in 2006, Jordan has few bills to his name from his time in office. He also faces questions about his past. Some years ago, Jordan&nbsp;<a href="https://apnews.com/general-news-6fb5bfff7db9439883907efce5c119fb">denied allegations</a>&nbsp;from former wrestlers during his time as an assistant wrestling coach at Ohio State University who accused him of knowing about claims they were inappropriately groped by an Ohio doctor. Jordan has said he was never aware of any abuse.

House in chaos; still no Speaker: Neb. Rep Bacon votes McCarthy

&nbsp;(GRAND ISLAND, NEB.)&nbsp;&nbsp;— The Nebraska Department of Transportation is deeply saddened to report that a member of the NDOT team lost his life yesterday while working to keep the public safe.

The incident occurred yesterday afternoon at approximately 12:30 on Highway 34, near the Giltner Spur. Officials, including the Hamilton County Sheriff’s Office, Hamilton County Roads Department, and the Nebraska Department of Transportation were on scene assisting in clean-up after a spill of corn mash on the roadway. Preliminary investigation shows that during that process, a GMC Yukon was traveling westbound on Highway 34, lost control, and struck a member of the NDOT crew.

A sheriff’s deputy and others on scene responded immediately. Despite life-saving attempts, the NDOT crew member was pronounced deceased at the scene. Identities of those involved are being withheld at this time pending family notification. No other injuries were reported.

The Nebraska State Patrol is conducting a full crash reconstruction investigation.

Additional information will be released when possible.

&nbsp;(GRAND ISLAND, NEB.)&nbsp;&nbsp;— The Nebraska Department of Transportation is deeply saddened to report that a member of the NDOT team lost his life yesterday while working to keep the public safe.The incident occurred yesterday afternoon at approximately 12:30 on Highway 34, near the Giltner Spur. Officials, including the Hamilton County Sheriff’s Office, Hamilton County Roads Department, and the Nebraska Department of Transportation were on scene assisting in clean-up after a spill of corn mash on the roadway. Preliminary investigation shows that during that process, a GMC Yukon was traveling westbound on Highway 34, lost control, and struck a member of the NDOT crew.A sheriff’s deputy and others on scene responded immediately. Despite life-saving attempts, the NDOT crew member was pronounced deceased at the scene. Identities of those involved are being withheld at this time pending family notification. No other injuries were reported.The Nebraska State Patrol is conducting a full crash reconstruction investigation.Additional information will be released when possible.

NDOT Crew Member Killed in Traffic Incident

&nbsp;(GRAND ISLAND, NEB.)&nbsp;&nbsp;— Investigators with the Nebraska State Patrol have arrested the Valley County Sheriff following a months-long investigation.

Yesterday, NSP investigators arrested Casey Hurlburt for fraudulent insurance acts, a Class IV Felony.

NSP has been assisted in this investigation by the Nebraska Attorney General’s Office. Hurlburt was lodged in Hall County Jail. The investigation remains ongoing.

&nbsp;(GRAND ISLAND, NEB.)&nbsp;&nbsp;— Investigators with the Nebraska State Patrol have arrested the Valley County Sheriff following a months-long investigation.Yesterday, NSP investigators arrested Casey Hurlburt for fraudulent insurance acts, a Class IV Felony.NSP has been assisted in this investigation by the Nebraska Attorney General’s Office. Hurlburt was lodged in Hall County Jail. The investigation remains ongoing.

NSP Arrests Valley County Sheriff

TEL AVIV, Israel (AP) — President&nbsp;<a href="https://apnews.com/hub/joe-biden">Joe Biden</a>&nbsp;vowed to show the world that the U.S. stands in solidarity with Israelis during his visit there Wednesday, and offered an assessment that the&nbsp;<a href="https://apnews.com/article/israel-palestinians-gaza-hamas-war-biden-hospital-d9606e0ead1f8c4e9fd00b602ed14a38">deadly explosion at a Gaza Strip hospital</a>&nbsp;apparently was not carried out by the Israeli military.

“Based on what I’ve seen, it appears as though it was done by the other team, not you,” Biden told Israeli Prime Minister Benjamin Netanyahu during a meeting. But he said there were “a lot of people out there” who weren't sure what caused the blast, which sparked protests throughout the Middle East.

Biden didn't offer details on why he believed the Israelis were not responsible for the blast, and the White House did not immediately explain his assessment.

“The entire world was rightfully outraged but this outrage should be directed not at Israel but at the terrorists,” Netanyahu said during a subsequent meeting with Biden and Israel's war cabinet.

Biden had been scheduled to visit Jordan to meet with Arab leaders after the stop in Israel, but the summit was called off after the hospital explosion. And his remarks spoke both of the horrors the Israelis had endured, but also the growing humanitarian crisis for Palestinian civilians in Gaza.

He told Netanyahu he was “deeply saddened and outraged” by the hospital explosion. He stressed that “Hamas does not represent all the Palestinian people. and it has brought them only suffering.”

Biden spoke of the need to find ways of “encouraging life-saving capacity to help the Palestinians who are innocent, caught in the middle of this.”

But he also said Hamas had “slaughtered” Israelis in the Oct. 7 attack that killed 1,400 people. Biden described at length the horror of the killing of innocent Israelis, including children.

“Americans are grieving, they really are,” Biden said. “Americans are worried.”

“I want you to know you're not alone. We will continue to have Israel's back as you work to defend your people," Biden said during the larger meeting with Netanyahu and Israeli officials. "We'll continue to work with you and partners across the region to prevent more tragedy to innocent civilians."

Netanyahu thanked Biden for coming to Israel, telling him the visit was “deeply, deeply moving."

“I know I speak for all the people of Israel when I say thank you Mr. President, thank you for standing with Israel today, tomorrow and always.”

Netanyahu said Biden had rightly drawn a clear line between the “forces of civilization and the forces of barbarism,” saying Israel was united in its resolve to defeat Hamas.

“The civilized world must unite to defeat Hamas," he said.

Biden also planned to meet Israeli first responders and the families of victims and those being held hostage by Hamas. Netanyahu met Biden at Ben Gurion International Airport and the two embraced. It was almost exactly a month ago that they&nbsp;<a href="https://apnews.com/article/biden-israel-saudi-arabia-normalization-hamas-246213034afa75e4dff27e71362a1979">sat together at the United Nations General Assembly</a>, where Netanyahu marveled that a “historic peace between Israel and Saudi Arabia” seemed within reach.

The possibility of improved relations between Israel and its Arab neighbors appears to be dimming; Israel has been preparing for a potential ground invasion of Gaza in response to Hamas' attacks.

Roughly 2,800 Palestinians have been reported killed by Israeli strikes in Gaza. Another 1,200 people are&nbsp;<a href="https://apnews.com/article/israel-palestinians-gaza-siege-airstrikes-rescue-war-b4147d61a1fd1628e1029349224ab708">believed to be buried under the rubble</a>, alive or dead, health authorities said.

Those numbers predate the explosion at&nbsp;<a href="https://apnews.com/article/israel-palestinians-gaza-hamas-war-biden-rafah-e062825a375d9eb62e95509cab95b80c">the Al-Ahli hospital</a>&nbsp;on Tuesday. No clear cause has been established for the blast.

<a href="https://apnews.com/article/israel-gaza-hospital-jordan-egypt-protests-590f24d154fb3cb256ec1707ec78b816">Protests swept through the region</a>&nbsp;after the blast at the hospital, which had been treating wounded Palestinians and sheltering many more who were seeking a refuge from the fighting.

Hundreds of Palestinians flooded the streets of major West Bank cities including Ramallah. More people joined protests that erupted in Beirut, Lebanon and Amman, Jordan, where an angry crowd gathered outside the Israeli Embassy.

Outrage scuttled Biden's plans to visit Jordan, where King Abdullah II was to host meetings with Palestinian President Mahmoud Abbas and Egyptian President Abdel Fattah el-Sissi. But Abbas withdrew in protest, and the summit was subsequently canceled outright.

Ayman Safadi, Jordan’s foreign minister, told a state-run television network that the war is “pushing the region to the brink.”

Jordan declared three days of mourning after the hospital explosion and Safadi said the summit was canceled after speaking with all leaders. He said they had wanted the meeting to produce an end to the war, which seems unlikely now, and to give Palestinians the respect they deserve. Kirby said Biden understood the move was part of a “mutual” decision to call off the Jordan portion of his trip. He said Biden would speak to the Arab leaders by phone as he returned to Washington.

Riyad Mansour, the Palestinian U.N. ambassador, said Tuesday that Biden was “capable of telling Israel, Enough is enough."

“You have to stop this carnage against the Palestinian people in the Gaza Strip. Let this stop. Let humanitarian assistance take place,” he said. "Do not displace two million Palestinians and push them in the direction of Jordan and then let’s begin a political horizon.”

There are also fears that a new front could erupt along Israel’s northern border with Lebanon, where Hezbollah operates. The Iran-backed organization has been&nbsp;<a href="https://apnews.com/article/lebanon-israel-hezbollah-clashes-cadccde8c6ce5400ee36fd12d3bfea52">skirmishing with Israeli forces.</a>

Always a believer in the power of personal diplomacy, Biden's trip will test the limits of U.S. influence in the Middle East at a volatile time. It's his second trip to a conflict zone this year, after visiting Ukraine in February to show solidarity with the country as it battles a Russian invasion.

The visit to Israel coincides with rising humanitarian concerns in Gaza, where Israel has cut off the flow of food, fuel and water. Mediators have been struggling to break a deadlock over providing supplies to desperate civilians, aid groups and hospitals.

U.S. Secretary of State Antony Blinken, bouncing back and forth between Arab and Israeli leadership ahead of Biden’s visit, spent seven and a half hours meeting Monday in Tel Aviv in an effort to broker some kind of aid agreement and emerged with a green light to develop a plan on how aid can enter Gaza and be distributed to civilians.

Although only a modest accomplishment on the surface, U.S. officials stressed that Blinken's talks led to a significant change in Israel’s position going in — that Gaza would remain cut off from fuel, electricity, water and other essential supplies.

U.S. officials said it has become clear that already limited Arab tolerance of Israel’s military operations would evaporate entirely if conditions in Gaza worsened.

Their analysis projected that outright condemnation of Israel by Arab leaders would not only be a boon to Hamas but would likely encourage Iran to step up its anti-Israel activity, adding to fears that a regional conflagration might erupt, according to four officials who spoke to The Associated Press on condition of anonymity to discuss internal administration thinking.

TEL AVIV, Israel (AP) — President Joe Biden opened his visit to Israel on Wednesday vowing to show the world that the U.S. stands in solidarity with the Jewish people and offering an assessment that the deadly explosion at a Gaza Strip hospital appeared to have been carried out “by the other team” and not the Israeli military.

“Based on what I’ve seen, it appears as though it was done by the other team, not you,” Biden told Israeli Prime Minister Benjamin Netanyahu during a meeting, referring to Hamas militants. But Biden said there were “a lot of people out there” who weren't sure what caused the blast.

The Hamas-run Gaza Health Ministry said an Israeli airstrike caused the destruction and hundreds of deaths. The Israeli military denied involvement and blamed a misfired rocket from the Palestinian Islamic Jihad, another militant group. However, that organization also&nbsp;<a href="https://apnews.com/live/israel-hamas-war-live-updates#0000018b-401a-d2c3-a9ff-721a1d610000">rejected responsibility.</a>

Biden had been scheduled to visit Jordan after the stop in Israel, but meetings there with Arab leaders were called off after the hospital explosion. He told Netanyahu he was “deeply saddened and outraged” by the explosion. But he also said it was not hyperbole to say Hamas had “slaughtered” Israelis in the Oct. 7 attack.

Netanyahu thanked Biden for coming to Israel, telling him the visit was “deeply, deeply moving.”

Netanyahu met Biden at Ben Gurion Airport and they embraced before speeding away for hours of meetings, where the U.S. president is expected to push for allowing critical humanitarian aid to be delivered to Palestinians in the Gaza Strip.

Israel has been preparing for a potential ground invasion of Gaza in response to Hamas' attacks on Oct. 7, which killed 1,400 Israelis.

John Kirby, a White House national security spokesperson, told reporters aboard Air Force One that Biden “wants to get a sense from the Israelis on the situation on the ground” and will “ask some tough questions."

“He'll be asking them as a friend,” Kirby added.

The president also planned to meet Israeli first responders and the families of victims killed and hostages taken when Hamas made its incursion into Israel.

Protests swept through the region after the blast at the hospital, which had been treating wounded Palestinians and sheltering many more who were seeking a refuge from the fighting.

Outrage scuttled Biden's plans to visit Jordan, where King Abdullah II had planned to host meetings with Palestinian President Mahmoud Abbas and Egyptian President Abdel Fattah el-Sissi. But Abbas withdrew in protest, and the summit was subsequently canceled outright.

Jordan declared three days of mourning after the hospital explosion. Kirby said Biden understood the move was part of a “mutual” decision to call off the Jordan portion of his trip. He said Biden would speak to the Arab leaders by phone as he returned to Washington.

Ayman Safadi, Jordan’s foreign minister, told a state-run television network that the war is "pushing the region to the brink.”

<figure>
 <img src="https://media.eaglewebservices.com/public/2023/10/1697623511291.png" alt="Israeli Prime Minister Benjamin Netanyahu after arriving at Ben Gurion International Airport, Wednesday-photo office of Israel Prime Minister" />
 <figcaption>Israeli Prime Minister Benjamin Netanyahu after arriving at Ben Gurion International Airport, Wednesday-photo office of Israel Prime Minister</figcaption>
 </figure>TEL AVIV, Israel (AP) — President&nbsp;<a href="https://apnews.com/hub/joe-biden">Joe Biden</a>&nbsp;vowed to show the world that the U.S. stands in solidarity with Israelis during his visit there Wednesday, and offered an assessment that the&nbsp;<a href="https://apnews.com/article/israel-palestinians-gaza-hamas-war-biden-hospital-d9606e0ead1f8c4e9fd00b602ed14a38">deadly explosion at a Gaza Strip hospital</a>&nbsp;apparently was not carried out by the Israeli military.“Based on what I’ve seen, it appears as though it was done by the other team, not you,” Biden told Israeli Prime Minister Benjamin Netanyahu during a meeting. But he said there were “a lot of people out there” who weren't sure what caused the blast, which sparked protests throughout the Middle East.Biden didn't offer details on why he believed the Israelis were not responsible for the blast, and the White House did not immediately explain his assessment.“The entire world was rightfully outraged but this outrage should be directed not at Israel but at the terrorists,” Netanyahu said during a subsequent meeting with Biden and Israel's war cabinet.Biden had been scheduled to visit Jordan to meet with Arab leaders after the stop in Israel, but the summit was called off after the hospital explosion. And his remarks spoke both of the horrors the Israelis had endured, but also the growing humanitarian crisis for Palestinian civilians in Gaza.He told Netanyahu he was “deeply saddened and outraged” by the hospital explosion. He stressed that “Hamas does not represent all the Palestinian people. and it has brought them only suffering.”Biden spoke of the need to find ways of “encouraging life-saving capacity to help the Palestinians who are innocent, caught in the middle of this.”But he also said Hamas had “slaughtered” Israelis in the Oct. 7 attack that killed 1,400 people. Biden described at length the horror of the killing of innocent Israelis, including children.“Americans are grieving, they really are,” Biden said. “Americans are worried.”“I want you to know you're not alone. We will continue to have Israel's back as you work to defend your people," Biden said during the larger meeting with Netanyahu and Israeli officials. "We'll continue to work with you and partners across the region to prevent more tragedy to innocent civilians."Netanyahu thanked Biden for coming to Israel, telling him the visit was “deeply, deeply moving."“I know I speak for all the people of Israel when I say thank you Mr. President, thank you for standing with Israel today, tomorrow and always.”Netanyahu said Biden had rightly drawn a clear line between the “forces of civilization and the forces of barbarism,” saying Israel was united in its resolve to defeat Hamas.“The civilized world must unite to defeat Hamas," he said.Biden also planned to meet Israeli first responders and the families of victims and those being held hostage by Hamas. Netanyahu met Biden at Ben Gurion International Airport and the two embraced. It was almost exactly a month ago that they&nbsp;<a href="https://apnews.com/article/biden-israel-saudi-arabia-normalization-hamas-246213034afa75e4dff27e71362a1979">sat together at the United Nations General Assembly</a>, where Netanyahu marveled that a “historic peace between Israel and Saudi Arabia” seemed within reach.<figure>
 <img src="https://media.eaglewebservices.com/public/2023/10/1697623831480.png" alt="photo office of Israel Prime Minister" />
 <figcaption>photo office of Israel Prime Minister</figcaption>
 </figure>The possibility of improved relations between Israel and its Arab neighbors appears to be dimming; Israel has been preparing for a potential ground invasion of Gaza in response to Hamas' attacks.Roughly 2,800 Palestinians have been reported killed by Israeli strikes in Gaza. Another 1,200 people are&nbsp;<a href="https://apnews.com/article/israel-palestinians-gaza-siege-airstrikes-rescue-war-b4147d61a1fd1628e1029349224ab708">believed to be buried under the rubble</a>, alive or dead, health authorities said.Those numbers predate the explosion at&nbsp;<a href="https://apnews.com/article/israel-palestinians-gaza-hamas-war-biden-rafah-e062825a375d9eb62e95509cab95b80c">the Al-Ahli hospital</a>&nbsp;on Tuesday. No clear cause has been established for the blast.<a href="https://apnews.com/article/israel-gaza-hospital-jordan-egypt-protests-590f24d154fb3cb256ec1707ec78b816">Protests swept through the region</a>&nbsp;after the blast at the hospital, which had been treating wounded Palestinians and sheltering many more who were seeking a refuge from the fighting.Hundreds of Palestinians flooded the streets of major West Bank cities including Ramallah. More people joined protests that erupted in Beirut, Lebanon and Amman, Jordan, where an angry crowd gathered outside the Israeli Embassy.Outrage scuttled Biden's plans to visit Jordan, where King Abdullah II was to host meetings with Palestinian President Mahmoud Abbas and Egyptian President Abdel Fattah el-Sissi. But Abbas withdrew in protest, and the summit was subsequently canceled outright.Ayman Safadi, Jordan’s foreign minister, told a state-run television network that the war is “pushing the region to the brink.”Jordan declared three days of mourning after the hospital explosion and Safadi said the summit was canceled after speaking with all leaders. He said they had wanted the meeting to produce an end to the war, which seems unlikely now, and to give Palestinians the respect they deserve. Kirby said Biden understood the move was part of a “mutual” decision to call off the Jordan portion of his trip. He said Biden would speak to the Arab leaders by phone as he returned to Washington.Riyad Mansour, the Palestinian U.N. ambassador, said Tuesday that Biden was “capable of telling Israel, Enough is enough."“You have to stop this carnage against the Palestinian people in the Gaza Strip. Let this stop. Let humanitarian assistance take place,” he said. "Do not displace two million Palestinians and push them in the direction of Jordan and then let’s begin a political horizon.”There are also fears that a new front could erupt along Israel’s northern border with Lebanon, where Hezbollah operates. The Iran-backed organization has been&nbsp;<a href="https://apnews.com/article/lebanon-israel-hezbollah-clashes-cadccde8c6ce5400ee36fd12d3bfea52">skirmishing with Israeli forces.</a>Always a believer in the power of personal diplomacy, Biden's trip will test the limits of U.S. influence in the Middle East at a volatile time. It's his second trip to a conflict zone this year, after visiting Ukraine in February to show solidarity with the country as it battles a Russian invasion.The visit to Israel coincides with rising humanitarian concerns in Gaza, where Israel has cut off the flow of food, fuel and water. Mediators have been struggling to break a deadlock over providing supplies to desperate civilians, aid groups and hospitals.U.S. Secretary of State Antony Blinken, bouncing back and forth between Arab and Israeli leadership ahead of Biden’s visit, spent seven and a half hours meeting Monday in Tel Aviv in an effort to broker some kind of aid agreement and emerged with a green light to develop a plan on how aid can enter Gaza and be distributed to civilians.Although only a modest accomplishment on the surface, U.S. officials stressed that Blinken's talks led to a significant change in Israel’s position going in — that Gaza would remain cut off from fuel, electricity, water and other essential supplies.U.S. officials said it has become clear that already limited Arab tolerance of Israel’s military operations would evaporate entirely if conditions in Gaza worsened.Their analysis projected that outright condemnation of Israel by Arab leaders would not only be a boon to Hamas but would likely encourage Iran to step up its anti-Israel activity, adding to fears that a regional conflagration might erupt, according to four officials who spoke to The Associated Press on condition of anonymity to discuss internal administration thinking.___TEL AVIV, Israel (AP) — President Joe Biden opened his visit to Israel on Wednesday vowing to show the world that the U.S. stands in solidarity with the Jewish people and offering an assessment that the deadly explosion at a Gaza Strip hospital appeared to have been carried out “by the other team” and not the Israeli military.“Based on what I’ve seen, it appears as though it was done by the other team, not you,” Biden told Israeli Prime Minister Benjamin Netanyahu during a meeting, referring to Hamas militants. But Biden said there were “a lot of people out there” who weren't sure what caused the blast.The Hamas-run Gaza Health Ministry said an Israeli airstrike caused the destruction and hundreds of deaths. The Israeli military denied involvement and blamed a misfired rocket from the Palestinian Islamic Jihad, another militant group. However, that organization also&nbsp;<a href="https://apnews.com/live/israel-hamas-war-live-updates#0000018b-401a-d2c3-a9ff-721a1d610000">rejected responsibility.</a>Biden had been scheduled to visit Jordan after the stop in Israel, but meetings there with Arab leaders were called off after the hospital explosion. He told Netanyahu he was “deeply saddened and outraged” by the explosion. But he also said it was not hyperbole to say Hamas had “slaughtered” Israelis in the Oct. 7 attack.“Americans are grieving, they really are,” Biden said. “Americans are worried.”Netanyahu thanked Biden for coming to Israel, telling him the visit was “deeply, deeply moving.”“I know I speak for all the people of Israel when I say thank you Mr. President, thank you for standing with Israel today, tomorrow and always.”Netanyahu met Biden at Ben Gurion Airport and they embraced before speeding away for hours of meetings, where the U.S. president is expected to push for allowing critical humanitarian aid to be delivered to Palestinians in the Gaza Strip.Israel has been preparing for a potential ground invasion of Gaza in response to Hamas' attacks on Oct. 7, which killed 1,400 Israelis.John Kirby, a White House national security spokesperson, told reporters aboard Air Force One that Biden “wants to get a sense from the Israelis on the situation on the ground” and will “ask some tough questions."“He'll be asking them as a friend,” Kirby added.The president also planned to meet Israeli first responders and the families of victims killed and hostages taken when Hamas made its incursion into Israel.Roughly 2,800 Palestinians have been reported killed by Israeli strikes in Gaza. Another 1,200 people are&nbsp;<a href="https://apnews.com/article/israel-palestinians-gaza-siege-airstrikes-rescue-war-b4147d61a1fd1628e1029349224ab708">believed to be buried under the rubble</a>, alive or dead, health authorities said.Those numbers predate the explosion at&nbsp;<a href="https://apnews.com/article/israel-palestinians-gaza-hamas-war-biden-rafah-e062825a375d9eb62e95509cab95b80c">the Al-Ahli hospital</a>&nbsp;on Tuesday. No clear cause has been established for the blast.Protests swept through the region after the blast at the hospital, which had been treating wounded Palestinians and sheltering many more who were seeking a refuge from the fighting.Hundreds of Palestinians flooded the streets of major West Bank cities including Ramallah. More people joined protests that erupted in Beirut, Lebanon and Amman, Jordan, where an angry crowd gathered outside the Israeli Embassy.Outrage scuttled Biden's plans to visit Jordan, where King Abdullah II had planned to host meetings with Palestinian President Mahmoud Abbas and Egyptian President Abdel Fattah el-Sissi. But Abbas withdrew in protest, and the summit was subsequently canceled outright.Jordan declared three days of mourning after the hospital explosion. Kirby said Biden understood the move was part of a “mutual” decision to call off the Jordan portion of his trip. He said Biden would speak to the Arab leaders by phone as he returned to Washington.Ayman Safadi, Jordan’s foreign minister, told a state-run television network that the war is "pushing the region to the brink.”There are also fears that a new front could erupt along Israel’s northern border with Lebanon, where Hezbollah operates. The Iran-backed organization has been&nbsp;<a href="https://apnews.com/article/lebanon-israel-hezbollah-clashes-cadccde8c6ce5400ee36fd12d3bfea52">skirmishing with Israeli forces.</a>Always a believer in the power of personal diplomacy, Biden's trip will test the limits of U.S. influence in the Middle East at a volatile time. It's his second trip to a conflict zone this year, after visiting Ukraine in February to show solidarity with the country as it battles a Russian invasion.The visit to Israel coincides with rising humanitarian concerns in Gaza, where Israel has cut off the flow of food, fuel and water. Mediators have been struggling to break a deadlock over providing supplies to desperate civilians, aid groups and hospitals.U.S. Secretary of State Antony Blinken, bouncing back and forth between Arab and Israeli leadership ahead of Biden’s visit, spent seven and a half hours meeting Monday in Tel Aviv in an effort to broker some kind of aid agreement and emerged with a green light to develop a plan on how aid can enter Gaza and be distributed to civilians.Although only a modest accomplishment on the surface, U.S. officials stressed that Blinken's talks led to a significant change in Israel’s position going in — that Gaza would remain cut off from fuel, electricity, water and other essential supplies.U.S. officials said it has become clear that already limited Arab tolerance of Israel’s military operations would evaporate entirely if conditions in Gaza worsened.Their analysis projected that outright condemnation of Israel by Arab leaders would not only be a boon to Hamas but would likely encourage Iran to step up its anti-Israel activity, adding to fears that a regional conflagration might erupt, according to four officials who spoke to The Associated Press on condition of anonymity to discuss internal administration thinking.

President Biden in Israel amid anger over Gaza hospital attack

<a href="https://nebraskaexaminer.com/2023/10/17/final-draft-regulations-for-nebraska-gender-care-law-released-ahead-of-november-hearing/">Nebraska Examiner</a>

LINCOLN — The Nebraska Department of Health and Human Services has released final regulations for the state’s minor gender care restrictions, with a slightly changed therapy definition and clarified pharmacy requirements.

The&nbsp;<a href="https://nebraskaexaminer.com/wp-content/uploads/2023/10/574-final-regs-hearing-notice.pdf">final draft regulations</a>&nbsp;released Tuesday, required under Legislative Bill 574&nbsp;<a href="https://nebraskaexaminer.com/2023/05/19/nebraska-passes-stricter-abortion-ban-limits-on-gender-affirming-care/">passed in the spring</a>, specify the requirements for Nebraskans under age 19 to receive puberty blockers or cross-sex hormones. Temporary regulations issued Oct. 1, the same day the restrictions took effect, expire Dec. 30 and can be extended for one 90-day period.

All LB 574 regulations do not restrict the specific care that patients started prior to Oct. 1. The law prohibits transition surgeries for minors after that date.

The new regulations will be the subject of a 12-hour hearing in Lincoln on Nov. 28 at the Lancaster Event Center, 4100 N. 84th St., from 7 a.m. to 7 p.m., or until there are no additional speakers. In-person comments will be limited to three minutes and could be limited to two minutes as necessary.

Written comments may be mailed, faxed or emailed no later than 11:59 p.m. on Nov. 27 to DHHS Legal Services — 402-742-2382 (fax) or&nbsp;<a target="_blank" href="mailto:dhhs.regulations@nebraska.gov">dhhs.regulations@nebraska.gov</a>.

“​​Please also note that all written and oral comments will be equally reviewed and considered by the Chief Medical Officer, Nebraska Department of Health and Human Services,” the&nbsp;<a target="_blank" href="https://dhhs.ne.gov/Pages/Upcoming-Public-Hearings.aspx">hearing notice</a>&nbsp;states.

Dr. Timothy Tesmer, the state’s chief medical officer, is&nbsp;<a href="https://nebraskaexaminer.com/2023/05/10/final-say-on-nebraska-gender-care-legislation-would-be-delegated-to-executive-appointee-and-dhhs/">charged with crafting the regulations</a>&nbsp;before they are sent to Attorney General Mike Hilgers and Gov. Jim Pillen for final approval.

State regulations are tracked by the Nebraska Secretary of State’s Office&nbsp;<a target="_blank" href="https://www.nebraska.gov/nesos/rules-and-regs/regtrack/index.cgi">here</a>.

The final regulations are largely the same as those released in October, including at least 40 hours of gender-identity-focused contact hours of therapy prior to the prescription of puberty-blocking drugs or cross-sex hormones. LB 574 requires this specific therapy.

The&nbsp;<a href="https://nebraskaexaminer.com/2023/10/01/nebraska-approves-emergency-regulations-regarding-gender-care-for-minors/">temporary regulations</a>&nbsp;state the hours must be “clinically neutral and not in a gender-affirming or conversion context” and must include “sufficient parental or legal guardian support during and post treatment.”

However, the new regulations instead state the hours must:

After an initial assessment of up to four consecutive hours, youths could not bank more than two hours per week of gender-identity-focused therapy. This pushes the minimum time to at least five months.

Youths must also live primarily as their preferred gender for at least six months and, after the prescriptions, receive at least one therapy hour every 90 days during ongoing treatment.

The restrictions state that to acquire informed patient consent, the following must be addressed:

There is a seven-day waiting period between obtaining informed patient consent and the prescription of blockers or hormones.

The regulations also clarify requirements for pharmacists for the dispensing of cross-sex hormones. This includes the prescriptions identifying the patient’s parent or legal guardian who must pick up the prescription after displaying a valid ID. Prescription drugs lawful for home delivery are also allowed to the parent or legal guardian’s address.

The specific section clarifies that pharmacists are not restricted in dispensing medications to minors who started hormones prior to Oct. 1.

Two weeks ago, State Sen. Megan Hunt of Omaha&nbsp;<a href="https://nebraskaexaminer.com/2023/10/04/nebraska-lawmakers-request-guidance-more-information-on-gender-care-restrictions/">requested immediate guidance</a>&nbsp;because some patients had been denied prescriptions. DHHS did not provide new guidance and pointed Hunt to its frequently asked questions pages on&nbsp;<a target="_blank" href="https://dhhs.ne.gov/Documents/CMO-LetThemGrow-FAQ.pdf">the law</a>&nbsp;and the&nbsp;<a target="_blank" href="https://dhhs.ne.gov/Documents/Let-Them-Grow-Act-Emergency-Regulations-FAQ.pdf">emergency regulations</a>.

“What we need is clarity fast,” Hunt told the Nebraska Examiner on Oct. 4. “A lot of this could be avoided if DHHS had had a more transparent process in making these regulations.”

The Nov. 28 hearing notice estimates possible increased costs to the public because of the 40 therapy hours or for those who do not have a valid license or identification card.&nbsp;

“The exact cost to the minor patient and parent is unknown and is likely contingent on the medical insurance available to the patient,” the hearing notice adds.

Nebraska DHHS in&nbsp;<a target="_blank" href="https://www.lgbtmap.org/img/maps/citations-medicaid.pdf">1990</a>&nbsp;explicitly excluded “<a target="_blank" href="https://dhhs.ne.gov/Documents/Title-471-complete.pdf">sex change procedures</a>” in Medicaid coverage.

<figure>
 <img src="https://media.eaglewebservices.com/public/2023/10/1697570032673.jpeg" alt=" Advocates rally outside the Nebraska State Capitol in support of transgender youths Sunday, Oct. 1, 2023, in Lincoln. The same day, Gov. Jim Pillen and the state chief medical officer issued emergency regulations as gender care restrictions for minors take effect.. (Zach Wendling/Nebraska Examiner)" />
 <figcaption> Advocates rally outside the Nebraska State Capitol in support of transgender youths Sunday, Oct. 1, 2023, in Lincoln. The same day, Gov. Jim Pillen and the state chief medical officer issued emergency regulations as gender care restrictions for minors take effect.. (Zach Wendling/Nebraska Examiner)</figcaption>
 </figure>Zach Wendling<a href="https://nebraskaexaminer.com/2023/10/17/final-draft-regulations-for-nebraska-gender-care-law-released-ahead-of-november-hearing/">Nebraska Examiner</a>LINCOLN — The Nebraska Department of Health and Human Services has released final regulations for the state’s minor gender care restrictions, with a slightly changed therapy definition and clarified pharmacy requirements.The&nbsp;<a href="https://nebraskaexaminer.com/wp-content/uploads/2023/10/574-final-regs-hearing-notice.pdf">final draft regulations</a>&nbsp;released Tuesday, required under Legislative Bill 574&nbsp;<a href="https://nebraskaexaminer.com/2023/05/19/nebraska-passes-stricter-abortion-ban-limits-on-gender-affirming-care/">passed in the spring</a>, specify the requirements for Nebraskans under age 19 to receive puberty blockers or cross-sex hormones. Temporary regulations issued Oct. 1, the same day the restrictions took effect, expire Dec. 30 and can be extended for one 90-day period.All LB 574 regulations do not restrict the specific care that patients started prior to Oct. 1. The law prohibits transition surgeries for minors after that date.The new regulations will be the subject of a 12-hour hearing in Lincoln on Nov. 28 at the Lancaster Event Center, 4100 N. 84th St., from 7 a.m. to 7 p.m., or until there are no additional speakers. In-person comments will be limited to three minutes and could be limited to two minutes as necessary.Written comments may be mailed, faxed or emailed no later than 11:59 p.m. on Nov. 27 to DHHS Legal Services — 402-742-2382 (fax) or&nbsp;<a target="_blank" href="mailto:dhhs.regulations@nebraska.gov">dhhs.regulations@nebraska.gov</a>.“​​Please also note that all written and oral comments will be equally reviewed and considered by the Chief Medical Officer, Nebraska Department of Health and Human Services,” the&nbsp;<a target="_blank" href="https://dhhs.ne.gov/Pages/Upcoming-Public-Hearings.aspx">hearing notice</a>&nbsp;states.Dr. Timothy Tesmer, the state’s chief medical officer, is&nbsp;<a href="https://nebraskaexaminer.com/2023/05/10/final-say-on-nebraska-gender-care-legislation-would-be-delegated-to-executive-appointee-and-dhhs/">charged with crafting the regulations</a>&nbsp;before they are sent to Attorney General Mike Hilgers and Gov. Jim Pillen for final approval.State regulations are tracked by the Nebraska Secretary of State’s Office&nbsp;<a target="_blank" href="https://www.nebraska.gov/nesos/rules-and-regs/regtrack/index.cgi">here</a>.<h2>Therapy definition changed</h2>The final regulations are largely the same as those released in October, including at least 40 hours of gender-identity-focused contact hours of therapy prior to the prescription of puberty-blocking drugs or cross-sex hormones. LB 574 requires this specific therapy.The&nbsp;<a href="https://nebraskaexaminer.com/2023/10/01/nebraska-approves-emergency-regulations-regarding-gender-care-for-minors/">temporary regulations</a>&nbsp;state the hours must be “clinically neutral and not in a gender-affirming or conversion context” and must include “sufficient parental or legal guardian support during and post treatment.”However, the new regulations instead state the hours must:<ul>
 <li>Be clinically objective and non-biased.</li><li>Assess factors contributing to the patient’s presenting emotions, actions and beliefs.</li><li>Not merely affirm the patient’s beliefs.</li>
 </ul>After an initial assessment of up to four consecutive hours, youths could not bank more than two hours per week of gender-identity-focused therapy. This pushes the minimum time to at least five months.Youths must also live primarily as their preferred gender for at least six months and, after the prescriptions, receive at least one therapy hour every 90 days during ongoing treatment.The restrictions state that to acquire informed patient consent, the following must be addressed:<ul>
 <li>Discussion of appropriateness of care.</li><li>All known side effects, including long-term effects on bone density, brain development, impact on fertility and sexual side effects.</li><li>List of alternative treatments, including social, behavioral and physical alternatives.</li><li>Whether the medication is being prescribed for off-label use or otherwise not approved by the U.S. Food and Drug Administration.</li>
 </ul>There is a seven-day waiting period between obtaining informed patient consent and the prescription of blockers or hormones.<h2>Pharmacy, ID requirements</h2>The regulations also clarify requirements for pharmacists for the dispensing of cross-sex hormones. This includes the prescriptions identifying the patient’s parent or legal guardian who must pick up the prescription after displaying a valid ID. Prescription drugs lawful for home delivery are also allowed to the parent or legal guardian’s address.The specific section clarifies that pharmacists are not restricted in dispensing medications to minors who started hormones prior to Oct. 1.Two weeks ago, State Sen. Megan Hunt of Omaha&nbsp;<a href="https://nebraskaexaminer.com/2023/10/04/nebraska-lawmakers-request-guidance-more-information-on-gender-care-restrictions/">requested immediate guidance</a>&nbsp;because some patients had been denied prescriptions. DHHS did not provide new guidance and pointed Hunt to its frequently asked questions pages on&nbsp;<a target="_blank" href="https://dhhs.ne.gov/Documents/CMO-LetThemGrow-FAQ.pdf">the law</a>&nbsp;and the&nbsp;<a target="_blank" href="https://dhhs.ne.gov/Documents/Let-Them-Grow-Act-Emergency-Regulations-FAQ.pdf">emergency regulations</a>.“What we need is clarity fast,” Hunt told the Nebraska Examiner on Oct. 4. “A lot of this could be avoided if DHHS had had a more transparent process in making these regulations.”The Nov. 28 hearing notice estimates possible increased costs to the public because of the 40 therapy hours or for those who do not have a valid license or identification card.&nbsp;“The exact cost to the minor patient and parent is unknown and is likely contingent on the medical insurance available to the patient,” the hearing notice adds.Nebraska DHHS in&nbsp;<a target="_blank" href="https://www.lgbtmap.org/img/maps/citations-medicaid.pdf">1990</a>&nbsp;explicitly excluded “<a target="_blank" href="https://dhhs.ne.gov/Documents/Title-471-complete.pdf">sex change procedures</a>” in Medicaid coverage.

Final draft regulations for Nebraska gender care law released ahead of November hearing

Acting United States Attorney Susan Lehr announced the extradition of Alex Ogunshakin, 40, of Nigeria, to the District of Nebraska on a Conspiracy to Commit Wire Fraud Indictment, filed in August 2019 in Omaha, Nebraska. The Government of the Federal Republic of Nigeria granted the United States’ request for extradition, which was submitted in May 2020. Ogunshakin, a Nigerian national, was arrested in Nigeria and ultimately surrendered to the United States. Ogunshakin had an initial appearance on the Indictment on September 29, 2023. United States Magistrate Judge Michael D. Nelson ordered Ogunshakin remain detained pending trial.

Ogunshakin, who was on the FBI Cyber’s Most Wanted List, is alleged to have participated in a business email compromise (BEC) scheme from January 2015 to September 2016. The BEC scheme defrauded businesses in the District of Nebraska and elsewhere of more than $6 million. According to the indictment, Ogunshakin’s co-conspirators posed as the chief executive officer, president, owner, or other executive of the targeted company. Using e-mail accounts spoofed to make it appear as though they were from the company’s true business executive, Ogunshakin’s co-conspirators directed business employees or recipients of the e-mail to complete wire transfers. The business employees, believing the requests were legitimate, complied with the wire transfer requests and wired the money as instructed by Ogunshakin’s co-conspirators.

It is alleged Ogunshakin provided bank account information to the co-conspirators who sent the fraudulent e-mails, and which directed business employees to wire money to accounts controlled by Ogunshakin and others. These bank accounts largely belonged to victims of internet romance scams, who were instructed by co-conspirators to transfer the funds to other bank accounts.

Some of Ogunshakin’s co-conspirators have already been convicted and sentenced. Adewale Aniyeloye, one of the fraudsters sending the spoofed e-mails to the target business, was sentenced in February 2019 to 96 months’ imprisonment and ordered to pay $1,570,938.05 in restitution. Pelumi Fawehinimi, a bank account facilitator, was sentenced in March 2019 to 72 months’ imprisonment and ordered to pay $1,014,159.60 in restitution. Onome Ijomone, a romance scammer, was sentenced in January 2020 to 60 months’ imprisonment and ordered to pay $508,934.40 in restitution after his successful extradition from Poland. Other co-conspirators remain at large.

FBI Omaha Special Agent in Charge Eugene Kowel said, “Cyber Criminal Alex Ogunshakin worked with other co-conspirators (who remain at large and on the FBI Cyber's Most Wanted fugitive list) to defraud victims in the U.S. of millions of dollars. His indictment, arrest, and extradition should send a message to his co-conspirators and other cyber criminals: The FBI will remain vigilant in their pursuit of criminals both domestic and abroad. Disrupting these cyber criminal groups and their victimization of U.S. persons and businesses is a priority for the FBI, DOJ, and our international law enforcement partners. The FBI wishes to thank its partners in Nigeria, particularly the Economic and Financial Crimes Commission, the Federal Ministry of Justice, and National Central Bureau, Abuja – INTERPOL (Nigeria Police Force), for their past and continued assistance in pursuing those that engage in Business Email Compromise and other fraud schemes.”

This case was investigated by&nbsp;the Federal Bureau of Investigation.&nbsp;The Justice Department’s Office of International Affairs and the Nigerian Ministry of Justice’s Central Authority Unit provided substantial assistance in securing the arrest and extradition of Ogunshakin.

Acting United States Attorney Susan Lehr announced the extradition of Alex Ogunshakin, 40, of Nigeria, to the District of Nebraska on a Conspiracy to Commit Wire Fraud Indictment, filed in August 2019 in Omaha, Nebraska. The Government of the Federal Republic of Nigeria granted the United States’ request for extradition, which was submitted in May 2020. Ogunshakin, a Nigerian national, was arrested in Nigeria and ultimately surrendered to the United States. Ogunshakin had an initial appearance on the Indictment on September 29, 2023. United States Magistrate Judge Michael D. Nelson ordered Ogunshakin remain detained pending trial.Ogunshakin, who was on the FBI Cyber’s Most Wanted List, is alleged to have participated in a business email compromise (BEC) scheme from January 2015 to September 2016. The BEC scheme defrauded businesses in the District of Nebraska and elsewhere of more than $6 million. According to the indictment, Ogunshakin’s co-conspirators posed as the chief executive officer, president, owner, or other executive of the targeted company. Using e-mail accounts spoofed to make it appear as though they were from the company’s true business executive, Ogunshakin’s co-conspirators directed business employees or recipients of the e-mail to complete wire transfers. The business employees, believing the requests were legitimate, complied with the wire transfer requests and wired the money as instructed by Ogunshakin’s co-conspirators.It is alleged Ogunshakin provided bank account information to the co-conspirators who sent the fraudulent e-mails, and which directed business employees to wire money to accounts controlled by Ogunshakin and others. These bank accounts largely belonged to victims of internet romance scams, who were instructed by co-conspirators to transfer the funds to other bank accounts.Some of Ogunshakin’s co-conspirators have already been convicted and sentenced. Adewale Aniyeloye, one of the fraudsters sending the spoofed e-mails to the target business, was sentenced in February 2019 to 96 months’ imprisonment and ordered to pay $1,570,938.05 in restitution. Pelumi Fawehinimi, a bank account facilitator, was sentenced in March 2019 to 72 months’ imprisonment and ordered to pay $1,014,159.60 in restitution. Onome Ijomone, a romance scammer, was sentenced in January 2020 to 60 months’ imprisonment and ordered to pay $508,934.40 in restitution after his successful extradition from Poland. Other co-conspirators remain at large.FBI Omaha Special Agent in Charge Eugene Kowel said, “Cyber Criminal Alex Ogunshakin worked with other co-conspirators (who remain at large and on the FBI Cyber's Most Wanted fugitive list) to defraud victims in the U.S. of millions of dollars. His indictment, arrest, and extradition should send a message to his co-conspirators and other cyber criminals: The FBI will remain vigilant in their pursuit of criminals both domestic and abroad. Disrupting these cyber criminal groups and their victimization of U.S. persons and businesses is a priority for the FBI, DOJ, and our international law enforcement partners. The FBI wishes to thank its partners in Nigeria, particularly the Economic and Financial Crimes Commission, the Federal Ministry of Justice, and National Central Bureau, Abuja – INTERPOL (Nigeria Police Force), for their past and continued assistance in pursuing those that engage in Business Email Compromise and other fraud schemes.”This case was investigated by&nbsp;the Federal Bureau of Investigation.&nbsp;The Justice Department’s Office of International Affairs and the Nigerian Ministry of Justice’s Central Authority Unit provided substantial assistance in securing the arrest and extradition of Ogunshakin.

Nigerian National Extradited to Nebraska to Face Fraud Scheme Charge

WASHINGTON (AP) — President Joe Biden’s efforts to tamp down tensions in the escalating war between Israel and Hamas faced massive setbacks even before he departed for the Middle East on Tuesday, as Jordan called off the president's planned summit with Arab leaders after a deadly explosion at a Gaza hospital killed hundreds.

Biden now will visit only Israel and will postpone his travel to Jordan, a White House official said as Biden departed.

The postponement of the Amman summit comes after Palestinian leader Mahmoud Abbas withdrew from the scheduled meetings in protest of the attacks, which the Hamas-run Health Ministry in Gaza blamed on an Israeli airstrike. The Israeli military said it had no involvement and pinned the blame on a misfired Palestinian rocket.

“This war and this aggression are pushing the region to the brink,” Ayman Safadi, Jordan’s foreign minister, told al-Mamlaka TV, a state-run network. He said Jordan would only host the summit when all participants agreed on its purpose, which would be to “stop the war, respect the humanity of the Palestinians, and deliver the aid they deserve.”

The cancellation reflects an increasingly volatile situation that will test the limits of American influence in the region as Biden visits Wednesday.

Biden’s decision to put himself in a conflict zone —&nbsp;<a href="https://apnews.com/article/russia-ukraine-zelenskyy-biden-f00af220669457d5ba07127c7e57a27b">the same year he made a surprise visit to Ukraine</a>&nbsp;— demonstrates his willingness to take personal and political risks as he becomes heavily invested in another intractable foreign conflict with no clear end game and plenty of opportunity for things to spiral out of control.

The high-stakes presidential trip is emblematic of Biden’s belief that the United States should not turn back from its central role on the global stage and his faith that personal diplomacy can play a decisive role.

“This is how Joe Biden believes politics works and history is made,” said Jon Alterman, a senior vice president at the Center for Strategic and International Studies who worked on the Senate Foreign Relations Committee while Biden was a member.

<a href="https://apnews.com/article/israel-gaza-palestinian-civilians-safety-airstrikes-f38f27da1dd995acc14e6db1524761e7">There's been no water, fuel or food delivered to Gaza since the brutal Oct. 7 attack</a>&nbsp;by Hamas that killed more than 1,400 Israelis and triggered the unfolding war. Mediators have been struggling to break a deadlock over providing supplies to desperate civilians, aid groups and hospitals.

As the humanitarian crisis grows, so too does the concern of a spiraling conflict that stretches beyond the borders of Gaza. There have already been skirmishes on&nbsp;<a href="https://apnews.com/article/hezbollah-israel-hamas-lebanon-war-423f5f20d691dcd0cc8af1788f11857b">Israel’s northern border with Hezbollah</a>, an Iran-backed group that’s based in Southern Lebanon.

“There’s a lot that can go wrong on this trip,” Alterman said.

Biden's travels will be rife with security concerns, and visits by other U.S. officials have been disrupted by rocket launches into Israel. Additional Israeli airstrikes in Gaza could also prompt more condemnation at a time when Biden is intending to demonstrate solidarity with the United States' closest ally in the region.

<a href="https://apnews.com/article/biden-israel-hamas-war-egypt-elsissi-a08b6e4f8fe5edeab4c97753d254f8b9">The U.S. has subtly shifted its message over the past week</a>, maintaining full-throated support for Israel while slowly turning up the diplomatic volume on the need for humanitarian assistance in Gaza, as Biden and aides have heard increasingly dire predictions about the potential for images of suffering Palestinians to ignite protests and broader unrest throughout the Middle East.

U.S. Secretary of State Antony Blinken, bouncing back and forth between Arab and Israeli leadership ahead of Biden's visit, spent seven and a half hours meeting Monday in Tel Aviv in an effort to broker some kind of aid agreement and emerged with a green light to create a plan on how aid can enter Gaza and be distributed to civilians.

It was on the surface a modest accomplishment, but U.S. officials stressed that it represented a significant change in Israel’s position going in — that Gaza would remain cut off from fuel, electricity, water and other essential supplies.

Biden has a long track record of showing public support for Israel while expressing concerns privately to the Israelis about their behavior.

“He believes the only way to get inside the Israelis’ heads is to demonstrate profound empathy, but also to be there,” Alterman said.

In the U.S., Biden has won rare praise from Republicans over his leadership on Israel, but prospects for providing additional aid are uncertain. The administration has said it would ask for more than $2 billion in aid for both Israel and Ukraine,&nbsp;<a href="https://apnews.com/article/jim-jordan-house-speaker-mccarthy-trump-f2b2bf9dc834742bde93d5fc918d9940">though House Republicans remain in disarray.</a>

Still,&nbsp;<a href="https://apnews.com/article/congress-ukraine-budget-security-assistance-799067491a1bba9671b4dfdf491d0a8e">Biden is committed to both Ukraine and Israel.</a>

“We’re the United States of America, for God’s sake, the most powerful nation in the history of the world,” he said this week on CBS' “60 Minutes” when asked whether the wars in Israel and Ukraine were more than the U.S. can take on at once. “We have the capacity to do this and we have an obligation to. ... And if we don’t, who does?”

In Israel, Biden was expected to meet with Prime Minister Benjamin Netanyahu and other Israeli officials. His plans to then meet in Jordan with King Abdullah II, Egyptian President Abdel Fattah el-Sissi and Palestinian leader Mahmoud Abbas were scrapped.

<a href="https://apnews.com/hub/israel-palestinian-conflict">The Israel-Palestinian conflict</a>&nbsp;has been ongoing for decades, and to a large extent, it's involved the same cadre of men. Netanyahu is the longest-serving prime minister in Israeli history. Abbas has been Palestinian president for nearly 20 years. Abdullah II has been king since 1999 — Biden has called the&nbsp;<a href="https://apnews.com/article/joe-biden-middle-east-government-and-politics-jordan-5c527e77c5e9c5b74f88dbfa9920e707">Jordanian king a loyal ally in a “tough neighborhood."</a>&nbsp;El-Sissi is the newest leader, president since 2014.

It's important for these leaders, too, to avoid a prolonged and engulfing regional escalation, particularly as Egypt and Jordan face growing economic tumult.

In September, the&nbsp;<a href="https://www.imf.org/en/Publications/fandd/issues/2023/09/debt-clouds-over-the-middle-east-adnan-mazarei">International Monetary Fund</a>&nbsp;issued a report saying that Egypt and Jordan are among the countries in the region that “stand at the brink of a debt crisis.” Egypt in particular is struggling with high inflation.

Neither nation wants to absorb refugees. Jordan already has a large Palestinian population, and the country is coping with hundreds of thousands of refugees from neighboring Syria, Iraq and elsewhere.

With tens of thousands of troops massed along the Israel-Gaza border, Israel has been expected to launch a ground invasion — but plans remain uncertain. U.S. officials have refused to say whether the Israelis were holding off in order for Biden to visit.

“We are preparing for the next stages of war,” Israeli military spokesman Lt. Col. Richard Hecht said. “We haven’t said what they will be. Everybody’s talking about a ground offensive. It might be something different.”

Meanwhile, the death toll is mounting even without the war's next stage. Israeli strikes on Gaza have killed at least 2,700 people and wounded more than 9,700, according to the Gaza Health Ministry. Nearly two-thirds of those killed were children, a ministry official said.

Another 1,200 people across Gaza are&nbsp;<a href="https://apnews.com/article/israel-palestinians-gaza-siege-airstrikes-rescue-war-b4147d61a1fd1628e1029349224ab708">believed to be buried under the rubble</a>, alive or dead.&nbsp;<a href="https://apnews.com/article/israel-palestinians-gaza-hamas-war-c8b4fc20e4fd2ef381d5edb7e9e8308c">More than 1 million Palestinians have fled their homes</a>&nbsp;— roughly half of Gaza’s population — and 60% are now in the approximately 8-mile-long (14-kilometer-long) area south of the evacuation zone, according to the United Nations.

RAMALLAH, West Bank (AP) — The Hamas-run Health Ministry in the Gaza Strip says at least 500 people have been killed in an explosion that it says was caused by an Israeli airstrike on a Gaza City Hospital.

If confirmed, the attack on the al-Ahli Hospital in Gaza City would be by far the deadliest Israeli airstrike in five wars fought since 2008. Hundreds of people were seeking shelter at the hospital at the time of the blast.

Hamas authorities said most of the people killed were hospital patients and displaced families.

“A new war crime committed by the (Israeli) occupation by bombing the Al-Ahli Hospital in the center of Gaza City,” said Salama Marouf, a spokesperson for Hamas. ” The hospital was housing hundreds of patients, wounded, and those forcibly displaced from their homes due to the strikes.”

&nbsp;The Israeli military says it had no involvement and that the blast was caused by a misfired Palestinian rocket.

A senior Palestinian official says President Mahmoud Abbas canceled his participation in a meeting scheduled Wednesday with President Joe Biden and other Mideast leaders.

Abbas was scheduled to join Jordan’s King Abdullah II and Egyptian President Abdel Fattah el-Sissi at Wednesday’s summit in Amman, Jordan, where they are to discuss the Israel-Hamas war with Biden.

But the senior official said Abbas was withdrawing to protest an alleged Israeli airstrike on the hospital&nbsp;

“The president is very angry after the news of the Israeli massacre at the hospital in Gaza, and he decided to immediately return to Ramallah,” the official said.

The official spoke on condition of anonymity because the cancelation has not been formally announced.

<figure>
 <img src="https://media.eaglewebservices.com/public/2023/10/1697584258512.png" alt="Biden now will visit only Israel and will postpone his travel to Jordan, a White House official said as Biden departed.-White House photo" />
 <figcaption>Biden now will visit only Israel and will postpone his travel to Jordan, a White House official said as Biden departed.-White House photo</figcaption>
 </figure>WASHINGTON (AP) — President Joe Biden’s efforts to tamp down tensions in the escalating war between Israel and Hamas faced massive setbacks even before he departed for the Middle East on Tuesday, as Jordan called off the president's planned summit with Arab leaders after a deadly explosion at a Gaza hospital killed hundreds.Biden now will visit only Israel and will postpone his travel to Jordan, a White House official said as Biden departed.The postponement of the Amman summit comes after Palestinian leader Mahmoud Abbas withdrew from the scheduled meetings in protest of the attacks, which the Hamas-run Health Ministry in Gaza blamed on an Israeli airstrike. The Israeli military said it had no involvement and pinned the blame on a misfired Palestinian rocket.“This war and this aggression are pushing the region to the brink,” Ayman Safadi, Jordan’s foreign minister, told al-Mamlaka TV, a state-run network. He said Jordan would only host the summit when all participants agreed on its purpose, which would be to “stop the war, respect the humanity of the Palestinians, and deliver the aid they deserve.”The cancellation reflects an increasingly volatile situation that will test the limits of American influence in the region as Biden visits Wednesday.Biden’s decision to put himself in a conflict zone —&nbsp;<a href="https://apnews.com/article/russia-ukraine-zelenskyy-biden-f00af220669457d5ba07127c7e57a27b">the same year he made a surprise visit to Ukraine</a>&nbsp;— demonstrates his willingness to take personal and political risks as he becomes heavily invested in another intractable foreign conflict with no clear end game and plenty of opportunity for things to spiral out of control.The high-stakes presidential trip is emblematic of Biden’s belief that the United States should not turn back from its central role on the global stage and his faith that personal diplomacy can play a decisive role.“This is how Joe Biden believes politics works and history is made,” said Jon Alterman, a senior vice president at the Center for Strategic and International Studies who worked on the Senate Foreign Relations Committee while Biden was a member.<a href="https://apnews.com/article/israel-gaza-palestinian-civilians-safety-airstrikes-f38f27da1dd995acc14e6db1524761e7">There's been no water, fuel or food delivered to Gaza since the brutal Oct. 7 attack</a>&nbsp;by Hamas that killed more than 1,400 Israelis and triggered the unfolding war. Mediators have been struggling to break a deadlock over providing supplies to desperate civilians, aid groups and hospitals.As the humanitarian crisis grows, so too does the concern of a spiraling conflict that stretches beyond the borders of Gaza. There have already been skirmishes on&nbsp;<a href="https://apnews.com/article/hezbollah-israel-hamas-lebanon-war-423f5f20d691dcd0cc8af1788f11857b">Israel’s northern border with Hezbollah</a>, an Iran-backed group that’s based in Southern Lebanon.“There’s a lot that can go wrong on this trip,” Alterman said.Biden's travels will be rife with security concerns, and visits by other U.S. officials have been disrupted by rocket launches into Israel. Additional Israeli airstrikes in Gaza could also prompt more condemnation at a time when Biden is intending to demonstrate solidarity with the United States' closest ally in the region.<a href="https://apnews.com/article/biden-israel-hamas-war-egypt-elsissi-a08b6e4f8fe5edeab4c97753d254f8b9">The U.S. has subtly shifted its message over the past week</a>, maintaining full-throated support for Israel while slowly turning up the diplomatic volume on the need for humanitarian assistance in Gaza, as Biden and aides have heard increasingly dire predictions about the potential for images of suffering Palestinians to ignite protests and broader unrest throughout the Middle East.U.S. officials said it has become clear that already limited Arab tolerance of Israel’s military operations would evaporate entirely if conditions in Gaza worsened.Their analysis projected that outright condemnation of Israel by Arab leaders would not only be a boon to Hamas but would likely encourage Iran to step up its anti-Israel activity, adding to fears that a regional conflagration might erupt, according to four officials who spoke to The Associated Press on condition of anonymity to discuss internal administration thinking.U.S. Secretary of State Antony Blinken, bouncing back and forth between Arab and Israeli leadership ahead of Biden's visit, spent seven and a half hours meeting Monday in Tel Aviv in an effort to broker some kind of aid agreement and emerged with a green light to create a plan on how aid can enter Gaza and be distributed to civilians.It was on the surface a modest accomplishment, but U.S. officials stressed that it represented a significant change in Israel’s position going in — that Gaza would remain cut off from fuel, electricity, water and other essential supplies.Biden has a long track record of showing public support for Israel while expressing concerns privately to the Israelis about their behavior.“He believes the only way to get inside the Israelis’ heads is to demonstrate profound empathy, but also to be there,” Alterman said.In the U.S., Biden has won rare praise from Republicans over his leadership on Israel, but prospects for providing additional aid are uncertain. The administration has said it would ask for more than $2 billion in aid for both Israel and Ukraine,&nbsp;<a href="https://apnews.com/article/jim-jordan-house-speaker-mccarthy-trump-f2b2bf9dc834742bde93d5fc918d9940">though House Republicans remain in disarray.</a>Still,&nbsp;<a href="https://apnews.com/article/congress-ukraine-budget-security-assistance-799067491a1bba9671b4dfdf491d0a8e">Biden is committed to both Ukraine and Israel.</a>“We’re the United States of America, for God’s sake, the most powerful nation in the history of the world,” he said this week on CBS' “60 Minutes” when asked whether the wars in Israel and Ukraine were more than the U.S. can take on at once. “We have the capacity to do this and we have an obligation to. ... And if we don’t, who does?”In Israel, Biden was expected to meet with Prime Minister Benjamin Netanyahu and other Israeli officials. His plans to then meet in Jordan with King Abdullah II, Egyptian President Abdel Fattah el-Sissi and Palestinian leader Mahmoud Abbas were scrapped.<a href="https://apnews.com/hub/israel-palestinian-conflict">The Israel-Palestinian conflict</a>&nbsp;has been ongoing for decades, and to a large extent, it's involved the same cadre of men. Netanyahu is the longest-serving prime minister in Israeli history. Abbas has been Palestinian president for nearly 20 years. Abdullah II has been king since 1999 — Biden has called the&nbsp;<a href="https://apnews.com/article/joe-biden-middle-east-government-and-politics-jordan-5c527e77c5e9c5b74f88dbfa9920e707">Jordanian king a loyal ally in a “tough neighborhood."</a>&nbsp;El-Sissi is the newest leader, president since 2014.It's important for these leaders, too, to avoid a prolonged and engulfing regional escalation, particularly as Egypt and Jordan face growing economic tumult.In September, the&nbsp;<a href="https://www.imf.org/en/Publications/fandd/issues/2023/09/debt-clouds-over-the-middle-east-adnan-mazarei">International Monetary Fund</a>&nbsp;issued a report saying that Egypt and Jordan are among the countries in the region that “stand at the brink of a debt crisis.” Egypt in particular is struggling with high inflation.Neither nation wants to absorb refugees. Jordan already has a large Palestinian population, and the country is coping with hundreds of thousands of refugees from neighboring Syria, Iraq and elsewhere.With tens of thousands of troops massed along the Israel-Gaza border, Israel has been expected to launch a ground invasion — but plans remain uncertain. U.S. officials have refused to say whether the Israelis were holding off in order for Biden to visit.“We are preparing for the next stages of war,” Israeli military spokesman Lt. Col. Richard Hecht said. “We haven’t said what they will be. Everybody’s talking about a ground offensive. It might be something different.”Meanwhile, the death toll is mounting even without the war's next stage. Israeli strikes on Gaza have killed at least 2,700 people and wounded more than 9,700, according to the Gaza Health Ministry. Nearly two-thirds of those killed were children, a ministry official said.Another 1,200 people across Gaza are&nbsp;<a href="https://apnews.com/article/israel-palestinians-gaza-siege-airstrikes-rescue-war-b4147d61a1fd1628e1029349224ab708">believed to be buried under the rubble</a>, alive or dead.&nbsp;<a href="https://apnews.com/article/israel-palestinians-gaza-hamas-war-c8b4fc20e4fd2ef381d5edb7e9e8308c">More than 1 million Palestinians have fled their homes</a>&nbsp;— roughly half of Gaza’s population — and 60% are now in the approximately 8-mile-long (14-kilometer-long) area south of the evacuation zone, according to the United Nations.-----------RAMALLAH, West Bank (AP) — The Hamas-run Health Ministry in the Gaza Strip says at least 500 people have been killed in an explosion that it says was caused by an Israeli airstrike on a Gaza City Hospital.If confirmed, the attack on the al-Ahli Hospital in Gaza City would be by far the deadliest Israeli airstrike in five wars fought since 2008. Hundreds of people were seeking shelter at the hospital at the time of the blast.Hamas authorities said most of the people killed were hospital patients and displaced families.“A new war crime committed by the (Israeli) occupation by bombing the Al-Ahli Hospital in the center of Gaza City,” said Salama Marouf, a spokesperson for Hamas. ” The hospital was housing hundreds of patients, wounded, and those forcibly displaced from their homes due to the strikes.”&nbsp;The Israeli military says it had no involvement and that the blast was caused by a misfired Palestinian rocket.A senior Palestinian official says President Mahmoud Abbas canceled his participation in a meeting scheduled Wednesday with President Joe Biden and other Mideast leaders.Abbas was scheduled to join Jordan’s King Abdullah II and Egyptian President Abdel Fattah el-Sissi at Wednesday’s summit in Amman, Jordan, where they are to discuss the Israel-Hamas war with Biden.But the senior official said Abbas was withdrawing to protest an alleged Israeli airstrike on the hospital&nbsp;“The president is very angry after the news of the Israeli massacre at the hospital in Gaza, and he decided to immediately return to Ramallah,” the official said.The official spoke on condition of anonymity because the cancelation has not been formally announced.

Summit with Arab leaders called off as President Biden heads to Israel

LINCOLN, Neb. (AP) — A Nebraska police officer and a Chicago man were both injured during a confrontation on a bus in front of about 20 people early Tuesday after the man refused to get off and pulled a knife, authorities said.

Officers were called to the Lincoln bus depot around 12:15 a.m. Tuesday because the 27-year-old Chicago man who didn't have a ticket or money for the fare to Iowa, acting Lincoln Police Chief Michon Morrow said.

The man pulled a knife and lunged at one of the officers in the back of the bus, striking him in the neck, police said. Morrow said the man refused several commands to drop the knife before reaching for the officer's gun. At that point, another officer fired and wounded him once.

Morrow said the situation could have easily been much worse, but fortunately no one else was hurt and the injured officer and suspect are both expected to live.

“I’m very proud of our officers and the quick actions that they took to minimize the impact of injury to again those on the bus and additionally the suspect,” Morrow said. “They showed incredible restraint based on the struggle that they had with an armed assailant at that point in time.”

Authorities did not immediately release the names of the suspect or the officers involved, so their families could be notified first. Both the injured officer and suspect were being treated at a hospital Tuesday morning. Prosecutors plan to charge the Chicago man with assaulting an officer and using a weapon to commit a felony after he's released from the hospital.

Morrow said that investigators determined that the Chicago man had been reported missing Monday night with an RV that had been stolen Sunday. The Nebraska State Patrol found the stolen RV Monday near the small town of Goehner, Nebraska, which is about 30 miles west of Lincoln.

The officer who shot the suspect has been put on leave while the shooting is investigated.

LINCOLN, Neb. (AP) — A Nebraska police officer and a Chicago man were both injured during a confrontation on a bus in front of about 20 people early Tuesday after the man refused to get off and pulled a knife, authorities said.Officers were called to the Lincoln bus depot around 12:15 a.m. Tuesday because the 27-year-old Chicago man who didn't have a ticket or money for the fare to Iowa, acting Lincoln Police Chief Michon Morrow said.The man pulled a knife and lunged at one of the officers in the back of the bus, striking him in the neck, police said. Morrow said the man refused several commands to drop the knife before reaching for the officer's gun. At that point, another officer fired and wounded him once.Morrow said the situation could have easily been much worse, but fortunately no one else was hurt and the injured officer and suspect are both expected to live.“I’m very proud of our officers and the quick actions that they took to minimize the impact of injury to again those on the bus and additionally the suspect,” Morrow said. “They showed incredible restraint based on the struggle that they had with an armed assailant at that point in time.”Authorities did not immediately release the names of the suspect or the officers involved, so their families could be notified first. Both the injured officer and suspect were being treated at a hospital Tuesday morning. Prosecutors plan to charge the Chicago man with assaulting an officer and using a weapon to commit a felony after he's released from the hospital.Morrow said that investigators determined that the Chicago man had been reported missing Monday night with an RV that had been stolen Sunday. The Nebraska State Patrol found the stolen RV Monday near the small town of Goehner, Nebraska, which is about 30 miles west of Lincoln.The officer who shot the suspect has been put on leave while the shooting is investigated.

Nebraska police officer and Chicago man hurt after the man pulled a knife on a bus in Lincoln

LINCOLN, Neb. (AP) — Harper Murray puts on her Adidas volleyball shoes when she practices or plays in a match for Nebraska, one of the top teams in the country. It's not necessarily the brand she would choose; it's because the German company is her school's official supplier and athletes, coaches and staff are required to wear its products.

Texas's Reilly Heinrich and Virginia's Ashley Le wear Nikes because their schools are under contract with the shoe giant. Heinrich actually wears basketball shoes bearing the familiar swoosh because she says they fit better than Nike's volleyball shoes.

All three also are brand ambassadors for a&nbsp;<a href="https://avoli.com/">new volleyball shoe brand, Avoli</a>, which they promote on social media platforms as part of their name, image and likeness compensation deals with the startup based in Portland, Oregon, also the hometown of Nike.

The three can tout Avoli all they want, but it is highly unlikely they will ever wear the brand when they actually represent their schools in competition. It's a familiar and seemingly immovable hurdle for athletes in many college sports. While they now have the freedom to earn money from NIL endorsements, they remain beholden to terms of apparel contracts paying millions to their schools and nothing to them.

Murray, the No. 1 high school recruit last year and already one of the top players for the nation's second-ranked team, said she accepts she must wear Adidas as part of playing for the Cornhuskers.

“I think if I had the option to wear another shoe, I’d 100% pick Avoli,” she said. “Obviously, that’s not really an option.”

It should be, according to Ramogi Huma, the executive director of the advocacy group College Athletes Players Association. He said college athletes should be able to wear shoes of their choice.

Limiting athletes to the brand with which their school is affiliated creates two problems, he said. First, it prevents athletes from achieving their full NIL earning potential because they can’t wear the shoes in competition, when they get the most attention. Second, an athlete’s performance could be compromised if the shoe she's wearing doesn't fit properly.

“It’s a health and safety issue,” Huma said. “If your foot is being squeezed, that’s a problem. Look at volleyball players. A lot of them are tall, and they may have wider feet than the average person. Everybody is made differently.”

Footwear is an issue in any sport, Le said, but the movements associated with volleyball make it critical to have the right fit.

“Volleyball is one of the most jumping-related sports,” she said. “The shoe — especially with ankle stability and the ability to move laterally and vertically without feeling in danger of hurting yourself — is very important.”

It would be rare for a college athlete to wear a shoe other than the school sponsor's brand.

For example, the Adidas contract with Nebraska says if an athlete experiences injury, pain or discomfort serious enough to affect performance, Adidas will be given an opportunity to remedy the problem. If the problem persists, the athlete can wear another brand but its logo must be covered. Nike contracts have similar language. Typically, an independent physician must verify the athlete's need for an exception.

Missouri in 2021 considered but did not pass an amendment to its NIL state law that would have allowed athletes to wear shoes of their choice in mandatory team activities. New Mexico passed a bill last year giving athletes freedom to choose their shoes but that language was removed during the 2023 session; state Sen. Antonio Maestas, one of the original bill’s co-sponsors, said he did not know how that happened.

Nebraska's Murray said she has switched between volleyball and basketball shoes over the years. Heinrich said she wore volleyball shoes she didn't really like when she was a high school and club player and settled on Nike basketball shoes at Texas because she found they gave her foot more support. Le has worn volleyball shoes since she was little, mainly because she found basketball shoes to be too heavy and wide for her.

The athletic shoe giants all have lines of volleyball shoes, but Avoli co-founders Mark Oleson and Rick Anguilla said their brand is fully dedicated to what they believe is&nbsp;<a href="https://apnews.com/article/nebraska-volleyball-attendance-record-38f103fe2100a368cddb19b75e1adb8d">an underserved market.</a>&nbsp;A feature of the Avoli shoe are tiny holes in the soles to provide ventilation, something young players said they wanted.

Oleson and Anguilla, who have years of experience in various aspects of the athletic shoe business with different brands, declined to criticize their giant competitors.

“Are they making bad volleyball shoes?” Oleson said. “I would say what we’re doing is we’re making a very specific volleyball shoe for the female athlete, how she moves, jumps, squats, pivots, dives and how she’s basically going to live throughout her entire tournament.”

Sophie LeRoux, a spokeswoman for Adidas, said in an email that her company's volleyball shoes are "built with a women's first approach” and designed in collaboration with professional and amateur players. Adidas has partnerships with volleyball federations in Europe and China as well as throughout North America.

LeRoux declined comment on the company's sponsorship contracts with colleges. Nike did not respond to messages.

Anguilla said Avoli is content to sell its volleyball products to younger players and is not worried about penetrating the college sponsorship market.

“With somebody like Harper Murray or any of the athletes we've signed to NIL deals, they’re reaching 25, 50, 100,000 people on their social media,” Anguilla said. “When we start thinking about the audience, NIL is going to really impact the value of those all-school contracts long-term. If we can use athletes to bring awareness to our product, and if the product is great, we like that equation.”

That doesn't help athletes who can't wear the shoes they would like in competition. Harper said she has no problem with Adidas shoes. She just likes the support and feel of her Avolis better.

The matter of shoes is personal to Huma, a former UCLA football player who said he had to have foot surgery in 1996 because of ill-fitting shoes.

Huma said college athletes should get a cut of the revenue from school apparel contracts and that, as partners with the schools, athletes could agree to wear socks, wristbands, headbands and other accessories under those contracts.

Shoes, Huma said, are different because certain brands don't always provide an optimal fit.

“Wearing the same jersey isn’t going to be an issue when it comes to your health," he said. "Shoes? That matters a lot.”

<figure>
 <img src="https://media.eaglewebservices.com/public/2023/10/1697559337119.jpeg" alt="University of Nebraska volleyball player Harper Murray poses with her Avoli, right, and Adidas, left, volleyball shoes on the school campus in Lincoln, Neb., Sunday, Oct. 8, 2023. A volleyball shoe startup is bringing attention to colleges' multi-million-dollar contracts with athletic apparel companies and terms that prevent athletes from wearing other brands. Nebraska volleyball player Harper Murray is an ambassador for Avoli. (AP Photo/Eric Olson)" />
 <figcaption>University of Nebraska volleyball player Harper Murray poses with her Avoli, right, and Adidas, left, volleyball shoes on the school campus in Lincoln, Neb., Sunday, Oct. 8, 2023. A volleyball shoe startup is bringing attention to colleges' multi-million-dollar contracts with athletic apparel companies and terms that prevent athletes from wearing other brands. Nebraska volleyball player Harper Murray is an ambassador for Avoli. (AP Photo/Eric Olson)</figcaption>
 </figure>LINCOLN, Neb. (AP) — Harper Murray puts on her Adidas volleyball shoes when she practices or plays in a match for Nebraska, one of the top teams in the country. It's not necessarily the brand she would choose; it's because the German company is her school's official supplier and athletes, coaches and staff are required to wear its products.Texas's Reilly Heinrich and Virginia's Ashley Le wear Nikes because their schools are under contract with the shoe giant. Heinrich actually wears basketball shoes bearing the familiar swoosh because she says they fit better than Nike's volleyball shoes.All three also are brand ambassadors for a&nbsp;<a href="https://avoli.com/">new volleyball shoe brand, Avoli</a>, which they promote on social media platforms as part of their name, image and likeness compensation deals with the startup based in Portland, Oregon, also the hometown of Nike.The three can tout Avoli all they want, but it is highly unlikely they will ever wear the brand when they actually represent their schools in competition. It's a familiar and seemingly immovable hurdle for athletes in many college sports. While they now have the freedom to earn money from NIL endorsements, they remain beholden to terms of apparel contracts paying millions to their schools and nothing to them.Murray, the No. 1 high school recruit last year and already one of the top players for the nation's second-ranked team, said she accepts she must wear Adidas as part of playing for the Cornhuskers.“I think if I had the option to wear another shoe, I’d 100% pick Avoli,” she said. “Obviously, that’s not really an option.”It should be, according to Ramogi Huma, the executive director of the advocacy group College Athletes Players Association. He said college athletes should be able to wear shoes of their choice.Limiting athletes to the brand with which their school is affiliated creates two problems, he said. First, it prevents athletes from achieving their full NIL earning potential because they can’t wear the shoes in competition, when they get the most attention. Second, an athlete’s performance could be compromised if the shoe she's wearing doesn't fit properly.“It’s a health and safety issue,” Huma said. “If your foot is being squeezed, that’s a problem. Look at volleyball players. A lot of them are tall, and they may have wider feet than the average person. Everybody is made differently.”Footwear is an issue in any sport, Le said, but the movements associated with volleyball make it critical to have the right fit.“Volleyball is one of the most jumping-related sports,” she said. “The shoe — especially with ankle stability and the ability to move laterally and vertically without feeling in danger of hurting yourself — is very important.”It would be rare for a college athlete to wear a shoe other than the school sponsor's brand.For example, the Adidas contract with Nebraska says if an athlete experiences injury, pain or discomfort serious enough to affect performance, Adidas will be given an opportunity to remedy the problem. If the problem persists, the athlete can wear another brand but its logo must be covered. Nike contracts have similar language. Typically, an independent physician must verify the athlete's need for an exception.Missouri in 2021 considered but did not pass an amendment to its NIL state law that would have allowed athletes to wear shoes of their choice in mandatory team activities. New Mexico passed a bill last year giving athletes freedom to choose their shoes but that language was removed during the 2023 session; state Sen. Antonio Maestas, one of the original bill’s co-sponsors, said he did not know how that happened.Nebraska's Murray said she has switched between volleyball and basketball shoes over the years. Heinrich said she wore volleyball shoes she didn't really like when she was a high school and club player and settled on Nike basketball shoes at Texas because she found they gave her foot more support. Le has worn volleyball shoes since she was little, mainly because she found basketball shoes to be too heavy and wide for her.The athletic shoe giants all have lines of volleyball shoes, but Avoli co-founders Mark Oleson and Rick Anguilla said their brand is fully dedicated to what they believe is&nbsp;<a href="https://apnews.com/article/nebraska-volleyball-attendance-record-38f103fe2100a368cddb19b75e1adb8d">an underserved market.</a>&nbsp;A feature of the Avoli shoe are tiny holes in the soles to provide ventilation, something young players said they wanted.Oleson and Anguilla, who have years of experience in various aspects of the athletic shoe business with different brands, declined to criticize their giant competitors.“Are they making bad volleyball shoes?” Oleson said. “I would say what we’re doing is we’re making a very specific volleyball shoe for the female athlete, how she moves, jumps, squats, pivots, dives and how she’s basically going to live throughout her entire tournament.”Sophie LeRoux, a spokeswoman for Adidas, said in an email that her company's volleyball shoes are "built with a women's first approach” and designed in collaboration with professional and amateur players. Adidas has partnerships with volleyball federations in Europe and China as well as throughout North America.LeRoux declined comment on the company's sponsorship contracts with colleges. Nike did not respond to messages.Anguilla said Avoli is content to sell its volleyball products to younger players and is not worried about penetrating the college sponsorship market.“With somebody like Harper Murray or any of the athletes we've signed to NIL deals, they’re reaching 25, 50, 100,000 people on their social media,” Anguilla said. “When we start thinking about the audience, NIL is going to really impact the value of those all-school contracts long-term. If we can use athletes to bring awareness to our product, and if the product is great, we like that equation.”That doesn't help athletes who can't wear the shoes they would like in competition. Harper said she has no problem with Adidas shoes. She just likes the support and feel of her Avolis better.The matter of shoes is personal to Huma, a former UCLA football player who said he had to have foot surgery in 1996 because of ill-fitting shoes.Huma said college athletes should get a cut of the revenue from school apparel contracts and that, as partners with the schools, athletes could agree to wear socks, wristbands, headbands and other accessories under those contracts.Shoes, Huma said, are different because certain brands don't always provide an optimal fit.“Wearing the same jersey isn’t going to be an issue when it comes to your health," he said. "Shoes? That matters a lot.”