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Death Toll in Gaza Likely 40 Percent Higher Than Reported, Researchers Say

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Death Toll in Gaza Likely 40 Percent Higher Than Reported, Researchers Say

Deaths from bombs and other traumatic injuries during the first nine months of the war in Gaza may have been underestimated by more than 40 percent, according to a new analysis published in The Lancet.

The peer-reviewed statistical analysis, led by epidemiologists at the London School of Hygiene and Tropical Medicine, used modeling in an effort to provide an objective third-party estimate of casualties. The United Nations has relied on the figure from the Hamas-led Ministry of Health, which it says has been largely accurate, but which Israel criticizes as inflated.

But the new analysis suggests the Hamas health ministry tally is a significant undercount. The researchers concluded that the death toll from Israel’s aerial bombardment and military ground operation in Gaza between October 2023 and the end of June 2024 was about 64,300, rather than the 37,900 reported by the Palestinian Ministry of Health.

The estimate in the analysis corresponds to 2.9 percent of Gaza’s prewar population having been killed by traumatic injury, or one in 35 inhabitants. The analysis did not account for other war-related casualties such as deaths from malnutrition, water-borne illness or the breakdown of the health system as the conflict progressed.

The study found that 59 percent of the dead were women, children and people over the age of 65. It did not establish what share of the reported dead were combatants.

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Mike Spagat, an expert on calculating casualties of war who was not involved in this research, said the new analysis convinced him that Gaza casualties were underestimated.

“This is a good piece of evidence that the real number is higher, probably substantially higher, than the Ministry of Health’s official numbers, higher than I had been thinking over the last few months,” said Dr. Spagat, who is a professor at Royal Holloway College at the University of London.

But the presentation of precise figures, such as a 41 percent underreported mortality, is less useful, he said, since the analysis actually shows the real total could be less than, or substantially more. “Quantitatively, it’s a lot more uncertain than I think comes out in the paper,” Dr. Spagat said.

The researchers said their estimate of 64,260 deaths from traumatic injury has a “confidence interval” between 55,298 and 78,525, which means the actual number of casualties is likely in that range.

If the estimated level of underreporting of deaths through June 2024 is extrapolated out to October 2024, the total Gazan casualty figure in the first year of the war would exceed 70,000.

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“There is an importance to war injury deaths, because it speaks to the question of whether the campaign is proportional, whether it is, in fact, the case that sufficient provisions are made to to avoid civilian casualties,” said Francesco Checchi, an epidemiologist with an expertise in conflict and humanitarian crises and a professor at the London School of Hygiene and Tropical Medicine who was an author on the study. “I do think memorializing is important. There is inherent value in just trying to come up with the right number.”

The analysis uses a statistical method called capture-recapture analysis, which has been used to estimate casualties in other conflicts, including civil wars in Colombia and Sudan.

For Gaza, the researchers drew on three lists: The first is a register maintained by the Palestinian Ministry of Health, which mainly comprises the dead in hospital morgues and estimates of the number of unrecovered people buried in rubble. The second is deaths reported by family or community members through an online survey form the ministry established on Jan. 1, 2024, when the prewar death registration system had broken down. It asked Palestinians inside and outside Gaza to provide names, ages, national ID number and location of death for casualties. The third source was obituaries of people who died from injuries that were published on social media, which may not include all of the same biographical details and which the researchers compiled by hand.

The researchers analyzed these sources to look for individuals who appear on multiple lists of those killed. A high level of overlap would have suggested that few deaths were uncounted; the low amount they found suggested the opposite. The researchers used models to calculate the probability of each individual appearing on any of the three lists.

“Models enable us to actually estimate the number of people who have not been listed at all,” Dr. Checchi said. That, combined with the listed number, gave the analysts their total.

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Patrick Ball, director of research at the Human Rights Data Analysis Group, and a statistician who has conducted similar estimates of violent deaths in conflicts in other regions, said the study was strong and well reasoned. But he cautioned that the authors may have underestimated the amount of uncertainty caused by the ongoing conflict.

The authors used different variations of mathematical models in their calculations, but Dr. Ball said that rather than presenting a single figure — 64,260 deaths — as the estimate, it may have been more appropriate to present the number of deaths as a range from 47,457 to 88,332 deaths, a span that encompasses all of the estimates produced by modeling the overlap among the three lists.

“It’s really hard to do this kind of thing in the middle of a conflict,” Dr. Ball said. “It takes time, and it takes access. I think you could say the range is larger, and that would be plausible.”

While Gaza had a strong death registration process before the war, it now has only limited function after the destruction of much of the health system. Deaths are uncounted when whole families are killed simultaneously, leaving no one to report, or when an unknown number of people die in the collapse of a large building; Gazans are increasingly buried near their homes without passing through a morgue, Dr. Checchi said.

The authors of the study acknowledged that some of those assumed dead may in fact be missing, most likely taken as prisoners in Israel.

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Roni Caryn Rabin and Lauren Leatherby contributed reporting.

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Woman discovers missing nose ring traveled to her lungs, causing month-long cough

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Woman discovers missing nose ring traveled to her lungs, causing month-long cough

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A TikToker in Mexico thought her cough that wouldn’t go away was just a reaction to the changing weather. Instead, it was her own nose ring, lodged deep within her lungs.

The 26-year-old, Monica Deyanira Cabrera Barajas, recently went viral on TikTok, amassing 4.7 million views after revealing the freak medical accident.

In videos, she shared that the stray accessory sat a mere 0.5 millimeters from her aorta, Jam Press reported.

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Deyanira, who has a large number of piercings, didn’t initially notice the jewelry was missing. It wasn’t until she developed a “chronic cough” lasting over a month that she went to see a doctor.

“The only theory I have, which I told the pulmonologist, is that I fell asleep, the little ball fell out, and that was it,” Deyanira told creatorzine.com.

What was supposed to be a routine 20-minute extraction turned into a high-stakes medical procedure. (Jam Press)

“I was lying on my back, I didn’t realize, and that’s how I messed up.”

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What was supposed to be a routine 20-minute extraction turned into a high-stakes medical procedure. During the initial attempt, surgeons were unable to budge the object because it had already begun attaching to her internal tissue.

“It ended up taking an hour and 20 minutes, and they still couldn’t remove it because it was attached to my body,” she said, according to the Jam Press report.

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Facing a second, more invasive surgery and the risk of a fatal hemorrhage, Deyanira prepared for the worst. The night before the surgery, she wrote a farewell letter to her loved ones.

The nose ring was lodged dangerously close to her aorta, the body’s primary artery. (Jam Press)

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“I was honestly thinking, ‘I’m going to die,’” she said. “It’s a horror I wouldn’t wish on anyone.”

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The woman’s surgeon was equally stunned by how close the metal was to her heart. According to Deyanira, the doctor told her, “It seems God takes care of his creatures.”

If the metal had punctured her lung or heart before doctors discovered it, Deyanira said she likely would have died from a lung collapse or perforated aorta.

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Now, the TikToker says her days of septum rings are over.

After the ordeal, Deyanira said she’s permanently done with piercings. (Jam Press)

“I love piercings, and I really liked my septum piercing, but in my case, I wouldn’t get it again because of the terror I experienced,” she said.

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Followers commented that the ordeal “unlocked a fear I didn’t know I had.”

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Inside a One-Man Workshop for Ultrapotent Drugs

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Inside a One-Man Workshop for Ultrapotent Drugs

Last fall, a man who calls himself Chemical Analyst allowed the two of us – New York Times reporters writing about the illegal drug trade – to watch on a secure video call as he packaged ultrapotent synthetic drugs for distribution.

These chemicals now flood the modern drug market. Many have psychoactive effects that are much more intense than those of traditional drugs. One newly emerging drug, cychlorphine, can be 250 to 500 times as strong as heroin and 10 times as strong as fentanyl.

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Chemical Analyst is a small-time, independent dealer who supplies powerful drugs without a cartel or gang for support. From an apartment in the northeastern United States, he places online orders for drugs made in a lab in China, repackages them and sells them domestically.

Operations like this represent the frontier of a drug market that is increasingly democratized. Compounds can be made in labs all over the world, ordered online and shipped anywhere. And because these drugs are often entirely new chemical compounds, they are difficult for law enforcement officials to detect.

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We interviewed Chemical Analyst over the course of a year, after meeting him through others who use and sell these new, potent drugs.

He allowed The Times to observe his operation on the condition that his identity would remain confidential. He is a felon on probation who fears further prosecution. He is also a functional addict who regularly buys, sells and ingests some of the most potent drugs in the world.

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The Times decided to describe parts of his process because they are vital to understanding both the origins of ultrapotent drugs and the difficulties faced by law enforcement in tracking and interdicting these new compounds.

In 2022 and 2023, Chemical Analyst was a street dealer of fentanyl and crack. His setup at an apartment “is so much safer,” he said. “I don’t have to worry about running if a cop rolls up through the alley,” he added. As his own use gravitated to more potent drugs, he developed the connections and expertise to sell them, too.

His latest drugs arrived in mid-October from China in a silver Mylar bag. He paid $4,370 in cryptocurrency for the shipment, which contained several powerful and potentially deadly synthetic compounds.

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One bag held a 100-gram slab of MD-PiHP. The drug is a cathinone, a class of stimulants often sold as “bath salts” that can induce psychosis. In markets where these stimulants are particularly popular, like Miami, they are increasingly showing up in toxicology reports from people who suffer fatal overdoses.

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A 16-gram chunk of MD-PiHP. The drug arrived as a 100-gram slab. Photo by Chemical Analyst

On the secure video call, Chemical Analyst measured 100-milligram crystals of the drug into small bags. He sprayed the bags with bleach to remove his DNA, applied labels from an untraceable thermal printer and wore textured latex gloves to keep the bags clean of fingerprints. Because Chemical Analyst is a convicted felon, his prints are already in state databases.

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Chemical Analyst weighs crystals of MD-PiHP, a potent synthetic drug. Screen recording of a video call with Chemical Analyst.

He moved the drugs into smaller baggies and weighed them. He then sealed them into packages for shipment. He wrote a false return address so he could not be traced and drove far from his residence to drop them in the mail.

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Chemical Analyst said that people might assume he sold on the “darknet,” a restricted network that requires special software to access. But he has a website on the regular internet, and he takes steps to conceal his whereabouts and identity. He accepts cryptocurrency payments, but he avoids Bitcoin because he worries that it might be trackable.

Drugs like this are hard to police in part because their composition changes all the time. The molecular structure of MD-PiHP is nearly identical to that of MDPV, a potent cathinone that appeared in 2010 and can cause extreme psychosis and death.

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Chemical Analyst spoke in detail about the chemistry of these novel drugs. He offered to draw MD-PiHP to show important facets of its structure; shortly after the video call, he texted his illustration.

Chemical Analyst first spotted an online listing for the drug in early 2025. He is familiar enough with drug molecules that the structure alone made him want to try it. He was surprised by its potency and effects. “This is not something humans should be getting high on,” he said, adding an expletive.

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He worried that the drug’s potency could produce a high so intense that it “could easily cause anhedonia,” an inability to experience joy when sober. He said that, unlike other suppliers, he did not adulterate his products, so they were predictable and therefore safer. “It’s how I pay the bills,” he said.

A weighed and labeled bag of MD-PiHP. Photo by Chemical Analyst

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His operation also shows just how inexpensive illicit drugs have become in the age of synthetics. In his recent shipment from China, he ordered half a dozen different substances, paying between $6 and $28 for a pure gram, depending on the drug. A standard dose is 50 to 100 milligrams, meaning that the cost of getting high is often less than $1.

He keeps a collection of novel drug samples, as well as a separate stash for his own consumption.

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Chemical Analyst plays another important role in the emergence of ultrapotent synthetic drugs. He is part of a small but influential circle of armchair chemists and theorists who discuss ideas for new drugs and scour medical literature for forgotten molecules.

He said that some members of these groups interacted with Chinese manufacturers to discuss new drug ideas. “They get ideas from us,” he said. “We have direct contact with them.”

A source at a Chinese drug manufacturer confirmed to The Times that new drug ideas were introduced first to small dealers and users like Chemical Analyst to test their popularity. If a drug catches on, it might be introduced to the mass market, which continues to rapidly transform.

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Simple dinner table habit linked to poor diet and higher health risks in adults over 60

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Simple dinner table habit linked to poor diet and higher health risks in adults over 60

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Reaching for the salt shaker at the kitchen table may seem like second nature for some – but it could reveal troubling details about your health.

Recent Brazilian research, published in the journal Frontiers in Public Health, investigated the impact of adding salt to food with a focus on older adults.

The study used national survey data from more than 8,000 Brazilians over the age of 60, collected between 2017 and 2018.

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Participants were asked the question, “Do you have the habit of adding salt to food at the table?” The researchers then deciphered certain traits that were linked to the habit.

About 10.9% of older adults said they used salt at the table. Men reported this habit more than women – 12.7% compared to 9.4%, according to the published study.

About 10.9% of older adults said they used salt at the table in a recent Brazilian survey. (iStock)

Men not following a diet for high blood pressure were more than twice as likely to add salt compared to men who follow this diet.

Men who reported living alone had a 62% higher likelihood of using salt compared to men who lived with others.

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Women not following a high blood pressure diet had 68% higher likelihood of using extra salt.

Adding salt was also associated with a lower intake of fruits and vegetables among women. The odds of adding salt to food were 81% higher in women who did not eat fruit, and 40% higher in those who did not eat vegetables.

Women who have a high concentration of ultraprocessed foods in their diet were more than twice as likely to add salt to food, as were those living in urban areas.

Women who added salt were less likely to eat fruits and vegetables, the data showed. (iStock)

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As this study was cross-sectional, it showed an association but could not prove that one thing caused another, the researchers acknowledged. Some of the information was self-reported, which could also limit the findings.

Diets high in sodium are known to cause an increase in blood pressure, which also raises the risk of heart disease, gastric cancer, obesity, osteoporosis and kidney disease, according to the World Health Organization.

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About 1.89 million deaths each year are associated with consuming too much sodium, the organization reported.

The WHO recommends that adults consume less than 5 grams of salt per day, or just under a teaspoon, for best health outcomes.

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Study co-author Dr. Débora Santos, a titular professor at Rio de Janeiro State University, called for alternative ways to decrease additional use of salt.

“The use of herbs and natural seasonings as alternatives to salt, or culinary techniques such as using the acidity of citrus fruits, may help reduce discretionary salt use while maintaining food palatability,” she wrote in a press release.

“Practical strategies, such as avoiding the routine placement of saltshakers on the table, may also help reduce habitual salt use.”

About 1.89 million deaths each year are associated with consuming too much sodium, the organization reported. (iStock)

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Los Angeles-based registered dietitian nutritionist Ilana Muhlstein said adding salt to food before trying it is one of her “biggest pet peeves.”

“It’s interesting that this study found that men were significantly more likely to add salt to their food compared to women, because this is an observation I’ve had as well,” Muhlstein, who was not involved in the study, told Fox News Digital.

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“It could be because women are more bloat-conscious overall and may be more informed on the medical harms of excessive salt, as well as the more superficial ones like making your rings hard to take on or off (when you’re dealing with water retention from increased salt intake).”

For men, Muhlstein suggested that those who live alone are potentially more likely to order takeout – and restaurants “tend to use much more salt than home cooking, which could make someone’s preference for salty food much higher.”

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“Public health officials [should] promote nutrition education and the importance of whole foods, less processed foods and reduced salt intake overall,” a nutritionist said. (iStock)

“That is further reflected in the stats showing that the less fruits and vegetables one eats, and the more processed foods consumed, the more likely one was to add salt to their food,” she noted.

The finding that a low blood pressure diet positively influences a person’s salt intake is “promising and intriguing,” according to Muhlstein.

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“This should encourage HHS and public health officials to promote nutrition education and the importance of whole foods, less processed foods and reduced salt intake overall,” she said.

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