Israeli-made weapons designed to spray high levels of shrapnel are causing horrific injuries to civilians in Gaza and disproportionately harming children, foreign surgeons who worked in the territory in recent months have told the Guardian.

The doctors say many of the deaths, amputations and life changing wounds to children they have treated came from the firing of missiles and shells – in areas crowded with civilians – packed with additional metal designed to fragment into tiny pieces of shrapnel.

Volunteer doctors at two Gaza hospitals said that a majority of their operations were on children hit by small pieces of shrapnel that leave barely discernible entry wounds but create extensive destruction inside the body. Amnesty International has said that the weapons appear designed to maximise casualties.

Feroze Sidhwa, a trauma surgeon from California, worked at the European hospital in southern Gaza in April.

“About half of the injuries I took care of were in young kids. We saw a lot of so-called splinter injuries that were very, very small to the point that you easily missed them while examining a patient. Much, much smaller than anything I’ve seen before but they caused tremendous damage on the inside,” he said.

Weapons experts said the shrapnel and wounds are consistent with Israeli-made weapons designed to create large numbers of casualties unlike more conventional weapons used to destroy buildings. The experts question why they are being fired into areas packed with civilians.

The Guardian spoke to six foreign doctors who have worked at two hospitals in Gaza, the European and al-Aqsa, in the last three months. All of them described encountering extensive wounds caused by “fragmentation” weapons, which they said have contributed to alarming rates of amputations since the war began. They said the injuries were seen in adults and children but that the damage done was likely to be more severe to younger bodies.

“Children are more vulnerable to any penetrating injury because they have smaller bodies. Their vital parts are smaller and easier to disrupt. When children have lacerated blood vessels, their blood vessels are already so small it’s very hard to put them back together. The artery that feeds the leg, the femoral artery, is only the thickness of a noodle in a small child. It’s very, very small. So repairing it and keeping the kid’s limb attached to them is very difficult,” Sidhwa said.

Mark Perlmutter, an orthopaedic surgeon from North Carolina, worked at the same hospital as Sidhwa.

“By far the most common wounds are one or two millimetre entry and exit wounds,” he said.

“X-rays showed demolished bones with a pinhole wound on one side, a pinhole on the other, and a bone that looks like a tractor trailer drove over it. The children we operated on, most of them had these small entrance and exit points.”

Perlmutter said children hit by multiple pieces of tiny shards often died and many of those who survived lost limbs.

“Most of the kids that survived had neurologic injuries and vascular injuries, a major cause of amputation. The blood vessels or the nerves get hit, and they come in a day later and the leg is dead or the arm is dead,” he said.

Sanjay Adusumilli⁩, an Australian surgeon who worked at the al-Aqsa hospital in central Gaza in April, recovered shrapnel made up of small metal cubes about three millimetres wide while operating on a young boy. He described wounds from fragmentation weapons distinguished by the shards of shrapnel destroying bone and organs while leaving just a scratch on the skin.

Explosives experts who reviewed pictures of the shrapnel and the doctors’ descriptions of the wounds said they were consistent with bombs and shells fitted with a “fragmentation sleeve” around the explosive warhead in order to maximise casualties. Their use has also been documented in past Israeli offensives in Gaza.

Trevor Ball, a former US army explosive ordnance disposal technician, said the explosive sprays out tungsten cubes and ball bearings that are far more lethal than the blast itself.

“These balls and cubes are the main fragmentation effect from these munitions, with the munition casing providing a much smaller portion of the fragmentation effect. Most traditional artillery rounds and bombs rely on the munition casing itself rather than added fragmentation liners,” he said.

Ball said the metal cubes recovered by Adusumilli are typically found in Israeli-made weapons such as certain types of Spike missiles fired from drones. He said the doctors’ accounts of tiny entry wounds are also consistent with glide bombs and tank rounds fitted with fragmentation sleeves such as the M329 APAM shell, which is designed to penetrate buildings, and the M339 round which its manufacturer, Elbit Systems of Haifa, describes as “highly lethal against dismounted infantry”.

Some of the weapons are designed to penetrate buildings and kill everyone within the walls. But when they are dropped onto streets or among tents, there is no such containment.

“The issue comes with how these small munitions are being employed,” said Ball. “Even a relatively small munition employed in a crowded space, especially a space with little to no protection against fragmentation, such as a refugee camp with tents, can lead to significant deaths and injuries.”

Amnesty International first identified ammunition packed with the metal cubes used in Spike missiles in Gaza in 2009.

“They appear designed to cause maximum injury and, in some respects, seem to be a more sophisticated version of the ball-bearings or nails and bolts which armed groups often pack into crude rockets and suicide bombs,” Amnesty said in a report at the time.

Ball said that weapons fitted with fragmentation sleeves are “relatively small munitions” compared with the bombs that have a wide blast area and have damaged or destroyed more than half the buildings in Gaza. But because they are packed with additional metal, they are very deadly in the immediate vicinity. The shrapnel from a Spike missile typically kills and severely wounds over a 20-metre (65-ft) radius.

Another weapons expert, who declined to be named because he sometimes works for the US government, questioned the use of such weapons in areas of Gaza crowded with civilians.

“The claim is that these weapons are more precise and limit casualties to a smaller area. But when they are fired into areas with high concentrations of civilians living in the open with nowhere to shelter, the military knows that most of the casualties will be those civilians,” he said.

In response to questions about the use of fragmentation weapons in areas with concentrations of civilians, the Israel Defense Forces said that military commanders are required “to consider the various means of warfare that are equally capable of achieving a defined military objective, and to choose the means that is expected to cause the least incidental damage under the circumstances.

“The IDF makes various efforts to reduce harm to civilians to the extent feasible in the operational circumstances ruling at the time of the strike,” it said.

“The IDF reviews targets before strikes and chooses the proper munition in accordance with operational and humanitarian considerations, taking into account an assessment of the relevant structural and geographical features of the target, the target’s environment, possible effects on nearby civilians, critical infrastructure in the vicinity, and more.”

The UN children’s agency, Unicef has said that “staggering” numbers of children have been wounded in Israel’s assault on Gaza. The United Nations estimates that Israel has killed more than 38,000 people in Gaza in the present war of which at least 8,000 are confirmed to be children, although the actual figure is likely to be much higher. Tens of thousands have been wounded.

In June, the UN added Israel to a list of states committing violations against children during conflict, describing the scale of killing in Gaza as “an unprecedented scale and intensity of grave violations against children”, principally by Israeli forces.

Many of the cases recalled by the surgeons involved children severely injured when missiles landed in or near areas where hundreds of thousands of Palestinians are living in tents after being driven from their homes by the Israeli assault.

Perlmutter described repeatedly encountering similar wounds.

“Most of our patients were under 16,” he said. “The exit wound is only a couple millimetres big. The entrance wound is that big or smaller. But you can see it is extremely high velocity because of the damage it does on the inside. When you have multiple small fragments travelling at insane speeds, it does soft tissue damage that far outweighs the size of the fragment.”

Adusumilli⁩ described treating a six-year-old boy who arrived at the hospital after an Israeli missile strike close to the tent where his family was living after fleeing their home under Israeli bombardment. The surgeon said the child had pinhole wounds that gave no indication of the scale of the damage beneath the skin.

“I had to open his abdomen and chest. He had lacerations to his lung, to his heart, and holes throughout his intestine. We had to repair everything. He was lucky that there was a bed in the intensive care unit. But, despite that, that young boy died two days later,” he said.

An American emergency room doctor now working in central Gaza, who did not want to be named for fear of jeopardising his work there, said that medics continue to treat deeply penetrating wounds created by fragmentation shards. The doctor said he had just worked on a child who suffered wounds to his heart and major blood vessels, and a build up of blood between his ribs and lungs that made it difficult to breathe.

Sidhwa said that “about half of the patients that we took care of were children”. He kept notes on several, including a nine year-old girl, Jouri, who was severely injured by shards of shrapnel in an air strike on Rafah.

“We found Jouri dying of sepsis in a corner. We took her to the operating room and found that both of her buttocks had been completely flayed open. The lowest bone in her pelvis was actually exposed to the skin. These wounds were covered in maggots. Her left leg she was missing a big chunk of the the muscles on the front and back of the leg, and then about two inches of her femur. The bone in the leg was just gone,” he said.

Sidhwa said doctors were able to save Jouri’s life and treat septic shock. But in order to save what remained of her leg, the surgeons shortened it during repeated operations.

The problem, said Sidhwa, is that Jouri will need constant care for years to come and she’s unlikely to find it in Gaza.

“She needs advanced surgical intervention every one to two years years as she grows to bring her left femur back to the length it needs to be to match her right leg, otherwise walking will be impossible,” he said.

“If she does not get out of Gaza, if she survives at all, she will be permanently and completely crippled.”

Adusumilli⁩ said fragmentation weapons resulted in high numbers of amputations among children who survived.

“It was unbelievable the number of amputations we had to do, especially on children, he said. “The option you’ve got to save their life is to amputate their leg or their hands or their arms. It was a constant flow of amputations every day.”

Adusumilli operated on a seven year-old girl who was hit by shrapnel from a missile that landed near her family’s tent.

“She came in with her left arm completely blown off. Her family brought the arm in wrapped in a towel and in a bag. She had shrapnel injuries to her abdomen so I had to open up her abdomen and control the bleeding. She ended up having her left arm amputated,” he said.

“She survived but the reason I remember her is because as I was rushing into the operating theatre, she reminded me of my own daughter and it sort of it was very difficult to accept emotionally.”

Unicef estimated that in the first 10 weeks of the conflict alone about 1,000 children lost one or both of their legs to amputations.

The doctors said that many of the limbs could be saved in more normal circumstances but that shortages of medicines and operating theatres limited surgeons to carrying out emergency procedures to save lives. Some children endured amputations without anaesthetic or painkillers afterwards which hindered their recovery alongside the challenges of rampant infections because of unsanitary conditions and lack of antibiotics.

Adusumilli said that, as a result, some children saved on the operating table died later when they could have been saved in different conditions.

“The sad part is that you do what you can to try and help these kids. But at the end of the day, the fact that the hospital is so overcrowded and doesn’t have the resources in intensive care, they just end up dying later on.”

Hungary’s prime minister, Viktor Orbán, will fly to Mar-a-Lago on Thursday to meet with Donald Trump, according to two sources with knowledge of the meeting.

Orbán has enraged his Nato allies by meeting with Vladimir Putin and Xi Jinping en route to the alliance’s summit in Washington DC. He has also met with Volodymyr Zelenskiy in Kyiv, and is said to be quietly negotiating his own ceasefire plan without consulting either the Biden administration or other EU countries.

The two men will meet at Mar-a-Lago at 7pm, a source close to Trump said. Orban’s 606 Dassault Falcon jet was one of the several international planes that flew into Joint Base Andrews on Tuesday to attend the 2024 Nato summit. As of 10.30am eastern time on Thursday, the Hungarian military plane was still parked in Maryland.

Orbán did not discuss details of his negotiations with Putin or Xi with the Biden administration. Three sources briefed on the summit preparations said that he did not ask for a bilateral meeting with Joe Biden. EU countries have complained that Orbán is negotiating without their consent as Hungary currently holds the presidency of the European Council.

Orbán and his campaign advisers have fully backed Trump for re-election in November. His foreign minister, Péter Szijjártó, told Reuters: “We see a chance for peace if President Trump is winning. We see a chance for good Hungary-US relationships if President Trump is winning.”

Orbán “wants to be the Trump guy in Europe if Trump wins the election so that then he can be … the one who can open the White House door for Europe”, a European Union diplomat told the Guardian.

Hungary will continue to hold the European Council presidency through the end of the year, coinciding with a period when Trump could be president-elect. “So for the last month before the swearing in he can be the European person in Washington making deals for everyone,” the diplomat said.

Members of the Hungarian Institute of International Affairs will hold a closed-door meeting today at noon ET with the conservative Heritage Foundation thinktank in Washington according to an email seen by the Guardian. The event is titled “on the sidelines of the Nato summit” and is focused around US and European security. Heritage regularly holds meetings with the Hungarian government foreign policy institution.

Joe Biden was gearing up for one of the most pivotal press conferences of his long political career on Thursday in Washington as the growing number of Democratic party members calling on him to step down has turned the eyes of the world to his performance tonight.

The US president was scheduled to face journalists at a news conference marking the end of Nato’s 75th anniversary summit at 5.30pm, while across the city senators were preparing to meet key members of Biden’s staff at the White House to air their concerns about Biden’s electability following last month’s disastrous debate performance with Donald Trump.

The press conference, which will include questions from reporters, is certain to be scrutinised minutely for any signs of verbal slip-up or mental frailty resembling those Biden displayed in the debate.

The event is the kind of unscripted set piece that Biden’s staff stand accused of shielding him from, and any repeat of the calamitous debate display could turn the steady trickle of public calls for Biden to stand aside into a flood.

Some of Biden’s most loyal acolytes at the top of the Democratic party have issued less than full-throated statements of support in recent days.

Chuck Schumer, the Senate majority leader, who has repeated the mantra “I’m for Joe” throughout the crisis, was reported to have signalled openness to having the president replaced at the top of the presidential ticket.

Axios reported that Schumer had been taking close account of the feelings of party donors and fellow senators in the 12 days since Biden’s meltdown in the 27 June debate, when he plunged the viability of his candidacy into doubt by abjectly failing to defend his own policies or counter Trump’s lies.

“As I have made clear repeatedly publicly and privately, I support President Biden and remain committed to ensuring Donald Trump is defeated in November,” Schumer said, in comments that fell short of a ringing endorsement. On Wednesday, Peter Welch of Vermont became the first Democratic senator to publicly tell Biden to step aside. Nine members of the House of Representatives have already done so.

“He saved us from Donald Trump once and wants to do it again. But he needs to reassess whether he is the best candidate to do so. In my view, he is not,” Welch wrote in a Washington Post opinion piece.

The president retains the support of Democratic governors, senators in the vital swing states of Michigan and Pennsylvania, the Black Congressional caucus, key progressive House members including Alexandra Ocasio-Cortez, and many others.

But the meeting between senators and Biden staff on Thursday will take place against the backdrop of backstage manoeuvring. The former House speaker, Nancy Pelosi, added pressure on Biden on Wednesday by telling MSNBC that it was up to the president to decide and “we are encouraging him to make that decision”. Behind the scenes, Pelosi has reportedly told Democratic Congress members that Biden cannot win the election and should stop aside, according to Politico.

She has also reportedly encouraged Democrats in swing districts threatened with losing their seats in November to do whatever is necessary to defend themselves, including calling on Biden to stand aside, while suggesting to others in safer districts that they should approach the White House directly with their concerns.

Crucially, she is also said to have advised members to wait until the end of today’s Nato gathering before going public. Some Congress members were understood to have drafted statements, ready to release as soon as the gathering of international leaders left Washington.

A fresh Washington Post-ABC News-Ipsos poll showed 56% of Democratic voters agreeing that Biden should end his campaign, against 42% who said he should stay put – a finding that undermined the president’s assertion that the effort to oust him was led by “elites” in the party.

Biden has held fewer news conferences with journalists in his three and a half years in office than any president since Ronald Reagan.

A previous press conference at the White House in February to counter criticisms by Robert Hur, a special prosecutor who criticised the president’s “poor memory”, backfired somewhat when Biden referred to the Egyptian president, Abdel Fattah al-Sisi, as “the president of Mexico”.

Nato leaders have labelled China a “decisive enabler” of Russia’s war against Ukraine and called its deepening ties with Moscow a cause of “deep concern”, in what has been seen as the most serious rebuke against Beijing from the alliance.

The final communique, approved by the 32 Nato members at the summit in Washington, also highlights concerns about Beijing’s nuclear arsenal and its capabilities in space.

“I think the message sent from Nato from this summit is very strong and very clear, and we are clearly defining China’s responsibility when it comes to enabling Russia’s war,” the Nato secretary general, Jens Stoltenberg said, calling the statement an important message.

Nato leaders have urged China “to cease all material and political support to Russia’s war effort”, adding that Beijing has become a large-scale supporter of Russia’s “defence industrial base”.

“This includes the transfer of dual-use materials, such as weapons components, equipment, and raw materials that serve as inputs for Russia’s defence sector,” the declaration said.

Beijing insists that it does not provide direct military aid to Russia, but has maintained strong trade ties with its neighbour throughout the conflict.

China’s foreign ministry expressed displeasure at Nato’s growing interest in Asia and demanded the alliance stay out of the Asia-Pacific region and not incite confrontation. Beijing’s mission to the EU said the summit was “filled with cold war mentality and belligerent rhetoric”.

“The China-related paragraphs are provocative with obvious lies and smears,” the mission said in a statement.

On Thursday, China’s foreign ministry spokesperson Lin Jian said the Nato statement was “malicious” and that China’s position on Ukraine was to “promote peace talks and political settlement”.

Last month, China skipped a peace summit for Ukraine held in Switzerland, on the grounds that it did not meet Beijing’s expectations, which included the participation of Russia.

The Nato statement came as leaders from Australia, Japan, New Zealand and South Korea were set to attend summit talks on Thursday. It will be the third year in a row that leaders from the four Asia-Pacific partners have met at the summit.

The final communique also accused China of being behind sustained, malicious cyber and hybrid activities, including disinformation. It also raised alarms that China is rapidly expanding and diversifying its nuclear arsenal with more warheads and a larger number of sophisticated delivery systems.

Danny Russel, the former US assistant secretary of state for Asia, called the new wording by Nato “an extraordinary step”.

“It is a mark of how badly Beijing’s attempt to straddle Russia and western Europe has failed and how hollow its claim of neutrality rings,” said Russel, who is vice-president for international security and diplomacy at the Asia Society Policy Institute. “China’s attempts at divide-and-conquer have instead produced remarkable solidarity between key nations of the Euro-Atlantic and the Asia-Pacific regions.”

This week Chinese troops have been conducting joint military drills in Belarus, to which neighbouring Poland says it is paying close attention. China and Belarus are allies of Russia, while Poland is a Nato member and supporter of Kyiv.

“The defence ministry is well aware of the risk of the operations in question being used for disinformation and propaganda purposes,” Poland’s defence ministry told Agence France-Presse on Wednesday.

China has previously held joint drills with Belarus, though these are the first since Russia invaded Ukraine in February 2022. The “Falcon Assault” drills started on Monday and are set to run until mid-July, with China’s defence ministry saying it hoped to deepen cooperation with Minsk.

Reuters, Agence France-Presse and the Associated Press contributed to this report

Shelley Duvall, the much-loved US character actor and star of films such as The Shining, Annie Hall and Popeye, has died shortly after her 75th birthday.

Duvall died in her sleep of complications from diabetes at her home in Blanco, Texas, according to Dan Gilroy, who had been her life partner since 1989.

Gilroy told The Hollywood Reporter: “My dear, sweet, wonderful life partner and friend left us. Too much suffering lately, now she’s free. Fly away, beautiful Shelley.”

Duvall made her name in a series of landmark 1970s classics, including seven films with the director Robert Altman, who first discovered her while she was in college in her hometown of Houston, Texas.

She made her debut in Brewster McCloud, as a teenage tour guide, before starring as a mail-order bride in McCabe & Mrs Miller in 1971. Other collaborations between the pair included Thieves Like Us, Nashville, Buffalo Bill and the Indians and 1977’s 3 Women as a fantasising health spa attendant, which many consider her finest work, and which won her the best actress prize at the Cannes film festival.

Duvall, said Altman, “was able to swing all sides of the pendulum: charming, silly, sophisticated, pathetic, even beautiful.”

“I love him,” she told the New York Times in 1977, asked about the longevity of their relationship. “He offers me damn good roles. None of them have been alike. He has a great confidence in me, and a trust and respect for me, and he doesn’t put any restrictions on me or intimidate me.”

She added: “I remember the first advice he ever gave me: ‘Don’t take yourself seriously.’ Sometimes I find myself feeling self-centered, and then all of a sudden that bit of advice will pop into my head and I’ll laugh.”

Duvall remains perhaps best known for her role as the wife of Jack Nicholson’s axe-wielding author in The Shining (1980). The film had a famously gruelling 13-month shoot, with one scene in which Nicholson’s character torments Duvall’s with a baseball bat reportedly running to 127 takes.

Kubrick had her “crying 12 hours a day for weeks on end,” said Duvall in a 1981 interview with People magazine. “I will never give that much again. If you want to get into pain and call it art, go ahead, but not with me.”

She also appeared in two landmark comedies: 1977’s Annie Hall, as the vague Rolling Stone reporter who describes sex with Woody Allen’s Alvy Singer as “really a Kafkaesque experience … I mean that as a compliment” and in 1980 opposite Robin Williams in Altman’s live-action Popeye.

Her iconic rendition of the song He Needs Me was later repurposed by Paul Thomas Anderson for the 2002 romcom Punch-Drunk Love.

More details soon …

Shelley Duvall, the much-loved US character actor and star of films such as The Shining, Annie Hall and Popeye, has died shortly after her 75th birthday.

Duvall died in her sleep of complications from diabetes at her home in Blanco, Texas, according to Dan Gilroy, who had been her life partner since 1989.

Gilroy told The Hollywood Reporter: “My dear, sweet, wonderful life partner and friend left us. Too much suffering lately, now she’s free. Fly away, beautiful Shelley.”

Duvall made her name in a series of landmark 1970s classics, including seven films with the director Robert Altman, who first discovered her while she was in college in her hometown of Houston, Texas.

She made her debut in Brewster McCloud, as a teenage tour guide, before starring as a mail-order bride in McCabe & Mrs Miller in 1971. Other collaborations between the pair included Thieves Like Us, Nashville, Buffalo Bill and the Indians and 1977’s 3 Women as a fantasising health spa attendant, which many consider her finest work, and which won her the best actress prize at the Cannes film festival.

Duvall, said Altman, “was able to swing all sides of the pendulum: charming, silly, sophisticated, pathetic, even beautiful.”

“I love him,” she told the New York Times in 1977, asked about the longevity of their relationship. “He offers me damn good roles. None of them have been alike. He has a great confidence in me, and a trust and respect for me, and he doesn’t put any restrictions on me or intimidate me.”

She added: “I remember the first advice he ever gave me: ‘Don’t take yourself seriously.’ Sometimes I find myself feeling self-centered, and then all of a sudden that bit of advice will pop into my head and I’ll laugh.”

Duvall remains perhaps best known for her role as the wife of Jack Nicholson’s axe-wielding author in The Shining (1980). The film had a famously gruelling 13-month shoot, with one scene in which Nicholson’s character torments Duvall’s with a baseball bat reportedly running to 127 takes.

Kubrick had her “crying 12 hours a day for weeks on end,” said Duvall in a 1981 interview with People magazine. “I will never give that much again. If you want to get into pain and call it art, go ahead, but not with me.”

She also appeared in two landmark comedies: 1977’s Annie Hall, as the vague Rolling Stone reporter who describes sex with Woody Allen’s Alvy Singer as “really a Kafkaesque experience … I mean that as a compliment” and in 1980 opposite Robin Williams in Altman’s live-action Popeye.

Her iconic rendition of the song He Needs Me was later repurposed by Paul Thomas Anderson for the 2002 romcom Punch-Drunk Love.

More details soon …

Kenya’s president, William Ruto, has fired his entire cabinet apart from his foreign minister, bowing to pressure after nationwide protests that have created the biggest crisis of his two-year presidency.

The youth-led protests against planned tax rises began peacefully but turned violent. A least 39 people were killed in clashes with police last month. Some demonstrators briefly stormed parliament before Ruto abandoned the new taxes.

“I will immediately engage in extensive consultations across different sectors and political formations and other Kenyans, both in public and private, with the aim of setting up a broad-based government,” he said in a televised address to the nation, adding that he would announce additional measures later.

He also dismissed the attorney general, but said the office of the deputy president was not affected.

The sweeping cabinet changes on Thursday were what Kenyans had been asking for, the veteran anti-corruption activist John Githongo said.

“Let us see what happens now if the new ministers deal with big issues around corruption and just the arrogance and excess of his administration and the fact that a lot of Kenyans died during the demonstrations,” he said. “Hopefully this should temporarily calm things.“

Ruto has been caught between the demands of lenders such as the International Monetary Fund (IMF) to cut deficits and a hard-pressed population reeling from the rising cost of living. He proposed spending cuts and additional borrowing in roughly equal measure last week to fill the near $2.7bn (£2.1bn) budget deficit caused by the withdrawal of the tax rises.

Analysts have said the tax rollback means Kenya is likely to miss IMF targets, although the government does not have debts that are due. The budget deficit is projected to be 4.6% of gross domestic product in the fiscal year that started on 1 July.

Ojango Omondi, a community activist from the Social Justice Centres Working Group in Nairobi, said dismissing so many cabinet ministers was a “move towards justice”, but the protesters would want to see who Ruto appointed in their place.

“It’s one thing to dismiss, the second is to ensure that the people that will be chosen in the cabinet are accountable to the constitution and the rule of law,” he said.

A food safety scandal has caused mounting public outrage in China days before a high-level Chinese Communist party meeting at which leaders will try to boost confidence in the economy.

Last week the state-run newspaper Beijing News published an in-depth exposé on the “open secret” of fuel tankers being used to transport cooking oil, without the tankers being washed or disinfected in between.

In the report, an undercover reporter interviewed a trucker who had driven a tanker of coal-derived fuel from Ningxia, a region in the west of China, to the east coast city of Qinhuangdao in Hebei, a journey of more than 800 miles (1,290km). The trucker told the journalist he was not allowed to return with an empty vehicle, and subsequently drove to a facility in another part of Hebei to load up with nearly 32 tons of soya bean oil, without cleaning the tanker. Several other tankers featured in the article made similar journeys.

The scandal has implicated several major Chinese companies including the state-owned oil and grain company Sinograin and Hopefull Grain and Oil Group, a private conglomerate. Both companies said they were investigating the claims.

This week the office of the food safety commission under China’s State Council said it was investigating the claims and that “individuals found violating the law through improper use of tanker trucks will face severe punishment”.

Chinese regulations state that different tankers should be used for transporting cooking oil and fuel, which is derived from coal and is potentially poisonous.

The Beijing News report revealed that inspections were often absent or cursory. In one case, on a tanker waiting to collect a load of edible oil, a piece of white paper was taped over the writing that indicated it should be used for fuel.

It is not clear where the cooking oil in the fuel-contaminated tankers ultimately ended up. Follow-up reports tracking the truckers identified in the Beijing News article suggested that the tankers delivered oil to packaging facilities run by household brand names in China, intensifying concerns that people could be consuming toxic oil. The article also quoted an industry insider as saying that some of the oil may ultimately be packaged into small bottles for foreign sales.

The news has caused widespread outrage in China, where there are deeply rooted fears about food safety after a series of scandals and perceived lack of accountability for rule-breakers.

In 2008, six babies died and 300,000 were sickened by contaminated baby formula. In 2013, more than 16,000 dead pigs were found in the Huangpu River, which supplies Shanghai with drinking water. Last year, images of a school canteen in Jiangxi went viral after a student found a rat’s head in his meal, which the school initially claimed was duck meat.

The hashtag #edibleoil had more than 16m views on Weibo on Thursday. Many commenters praised the role of journalists in exposing the scandal. “It’s been a long time since I’ve seen investigative journalism like this, kudos to the media,” one commenter wrote on Weibo.

Some analysts questioned why Beijing News, a Chinese Communist party-backed outlet, had been allowed to publish such a damning report shortly before CCP leaders meet for the third plenum, one of China’s most important political gatherings, next week.

Investigations into consumer and public health issues used to be relatively common in China’s media, but in the past decade the space for independent reporting has been dramatically squeezed and the CCP maintains a tight grip on what kind of information can be published.

Other hashtags relating to the incident, particularly those that named specific companies, appear to have been censored on Weibo.

One sensitive topic appears to be posts relating to Jinlongyu, a household brand of cooking oil that has been implicated in the scandal. Shares in Jinlongyu’s parent company fell by more than 8% on Wednesday amid concerns that its oil could be tainted. The company said its trucks met national requirements.

Additional research by Chi Hui Lin

Firefighters in the Normandy city of Rouen have managed to bring a fire in its world-famous gothic cathedral under control, calming fears of another disaster at one of France’s architectural jewels five years after the devastation of Notre Dame.

Initial television images showed a dark plume of smoke rising from the cathedral spire and people in the streets below looking up in horror.

In later images, smoke could still be seen through a gap in the white cover encircling the scaffolding around the spire, but it was no longer rising in a dark column. After about 90 minutes firefighters said the blaze had been contained.

Stéphane Gouezec of the Seine-Maritime firefighters said the source of the fire had been located and that crews were working to ensure there were no remaining “hotspots”. He told reporters the risk of the flames spreading was low because the fire was in an area where most of the structures were metal.

He said construction workers had been the first to notice the fire and had alerted the authorities.

Fire in the wooden frame of the roof caused devastating damage to Notre Dame Cathedral in Paris in 2019, and repairs are only now nearing completion.

Fire also engulfed Copenhagen’s Old Stock Exchange, one of the Danish capital’s most historic landmarks, in April, toppling its spire. Large parts of the outer walls also later collapsed.

The Rouen Cathedral spire had been surrounded by scaffolding and a white cover for several weeks.

The local prefecture, which exercises authority in the region, said the cathedral had been evacuated and emergency services were on the scene. A security cordon was in place around the building. The prefecture said there were no reports of casualties and the extent of the damage was unclear.

Rouen’s mayor, Nicolas Mayer-Rossignol, posted on X: “The beginning of a fire is under way on the spire of the cathedral of Rouen. The origin is unknown at this stage. All public resources are mobilised.”

Today’s cathedral, built on the site of a fourth-century basilica and an 11th-century Romanesque complex, is the outcome of construction projects that started in the 12th century.

It became especially well-known due to a series of paintings by the French impressionist Claude Monet, who captured the cathedral’s appearance at different times of day. The series was painted in part from a studio across the street from the cathedral.

“As long as the sun is on it, there will be as many ways of being Rouen Cathedral as man can make divisions in time,” Monet wrote.

The cathedral has a long history of damage and reconstruction: the spire of the central tower was destroyed after being hit by lightning in 1822.

Its reconstruction was undertaken by architect Jean-Antoine Alavoine, who also designed the column in the Place de la Bastille in Paris. Alavoine decided to build the spire in Rouen with cast iron. The idea of an iron spire was controversial; the novelist Gustave Flaubert denounced it as “the dream of a metalworker in a delirium”.

At 151 metres, the cast iron spire is the highest church spire in France. For a brief time, the cathedral was the world’s tallest building.

The cathedral was damaged in the second world war, and a turret fell during a storm in 1999.

Reuters and Associated Press contributed to this report

Firefighters in the Normandy city of Rouen have managed to bring a fire in its world-famous gothic cathedral under control, calming fears of another disaster at one of France’s architectural jewels five years after the devastation of Notre Dame.

Initial television images showed a dark plume of smoke rising from the cathedral spire and people in the streets below looking up in horror.

In later images, smoke could still be seen through a gap in the white cover encircling the scaffolding around the spire, but it was no longer rising in a dark column. After about 90 minutes firefighters said the blaze had been contained.

Stéphane Gouezec of the Seine-Maritime firefighters said the source of the fire had been located and that crews were working to ensure there were no remaining “hotspots”. He told reporters the risk of the flames spreading was low because the fire was in an area where most of the structures were metal.

He said construction workers had been the first to notice the fire and had alerted the authorities.

Fire in the wooden frame of the roof caused devastating damage to Notre Dame Cathedral in Paris in 2019, and repairs are only now nearing completion.

Fire also engulfed Copenhagen’s Old Stock Exchange, one of the Danish capital’s most historic landmarks, in April, toppling its spire. Large parts of the outer walls also later collapsed.

The Rouen Cathedral spire had been surrounded by scaffolding and a white cover for several weeks.

The local prefecture, which exercises authority in the region, said the cathedral had been evacuated and emergency services were on the scene. A security cordon was in place around the building. The prefecture said there were no reports of casualties and the extent of the damage was unclear.

Rouen’s mayor, Nicolas Mayer-Rossignol, posted on X: “The beginning of a fire is under way on the spire of the cathedral of Rouen. The origin is unknown at this stage. All public resources are mobilised.”

Today’s cathedral, built on the site of a fourth-century basilica and an 11th-century Romanesque complex, is the outcome of construction projects that started in the 12th century.

It became especially well-known due to a series of paintings by the French impressionist Claude Monet, who captured the cathedral’s appearance at different times of day. The series was painted in part from a studio across the street from the cathedral.

“As long as the sun is on it, there will be as many ways of being Rouen Cathedral as man can make divisions in time,” Monet wrote.

The cathedral has a long history of damage and reconstruction: the spire of the central tower was destroyed after being hit by lightning in 1822.

Its reconstruction was undertaken by architect Jean-Antoine Alavoine, who also designed the column in the Place de la Bastille in Paris. Alavoine decided to build the spire in Rouen with cast iron. The idea of an iron spire was controversial; the novelist Gustave Flaubert denounced it as “the dream of a metalworker in a delirium”.

At 151 metres, the cast iron spire is the highest church spire in France. For a brief time, the cathedral was the world’s tallest building.

The cathedral was damaged in the second world war, and a turret fell during a storm in 1999.

Reuters and Associated Press contributed to this report

A genetic disorder that causes severe disabilities in children and adults has been discovered by researchers who believe the newly identified condition could affect hundreds of thousands of people around the world.

Scientists have already diagnosed hundreds of people in the UK, Europe and the US after examining their DNA and spotting mutations in the gene linked to the disorder. Far more are expected to be found as further testing takes place.

The condition causes severe developmental delay and many of those diagnosed are unable to speak, are fed through a tube and have seizures. The disorder produces characteristic facial features, such as large cupped ears, full cheeks and a mouth with downturned corners.

“It’s not unusual to discover a neurodevelopmental disorder, but it is incredibly unusual to discover one that is this common,” said Nicola Whiffin, an associate professor at the Big Data Institute and Centre for Human Genetics at the University of Oxford. “This is surprisingly frequent. There are a lot of questions as to why we haven’t seen this before.”

About 60% of people with a neurodevelopmental disorder (NDD) remain undiagnosed after comprehensive genetic testing, leaving them in the dark about the underlying cause.

A formal diagnosis can help patients and families by identifying the reason for the condition and connecting them with others to form support groups. For scientists, knowing the genetics of an NDD paves the way for broader testing and research on future therapies.

Most work that aims to uncover the genetic causes of NDDs focuses on genes the body uses to make proteins, the building blocks of life. But after analysing the complete genomes of nearly 9,000 people with undiagnosed NDDs, an international collaboration led by Whiffin made a chance discovery.

Dozens of the patients, all of whom were enrolled on the 100,000 Genomes Project, led by Genomics England and NHS England, had mutations in the same gene, RNU4-2, which is not used to make proteins.

Mutations in the gene are estimated to account for nearly 0.5% of all neurodevelopmental disorders globally, a small proportion but one that amounts to hundreds of thousands of people. Details are published in Nature.

“We know of hundreds of patients, but one of the key issues is that we are limited to making diagnoses in patients where we have their whole genome,” Whiffin said.Decoding patients’ entire genetic code is becoming common in the UK and other developed countries, but some nations do not have the means to read whole genomes at scale.

One hope for the future is to use artificial intelligence tools to recognise the disorder from facial features alone. If that pans out, doctors could diagnose patients with the disorder by simply uploading their portrait for analysis.

Three years ago, Nicole Cedor, the mother of 10-year-old Mia Joy, was told there was nothing more doctors could do to identify her daughter’s condition. She was recently diagnosed with the disorder.

“We resigned ourselves to the fact that we may never find out. So, you can imagine our shock to get this news,” she said. “We are so grateful to each person on the research teams that worked tirelessly to find this diagnosis. It is one thing to write papers and crunch all that data, then another to see a family with a precious unique child who is living it day by day. This where the data meets real life. We like to refer to RNU4-2 as “renew”, as our family is being renewed by this new information and hope for the future.”

Whiffin said there were multiple benefits from having a diagnosis. Some mothers fear they may have caused the disorder by doing something wrong in pregnancy, which the diagnosis puts to bed. Perhaps the most important benefit is that affected families can come together and form groups to lobby for further research and support.

There was also hope for the future, Whiffin said. “We are at a really exciting point where we have all these genome-targeted therapies,” she said. “There’s a question around whether we can make much difference to something that is so developmental, but perhaps we can do something to improve the seizures, to improve quality of life. This at least opens the door to trying those things.”

Dr Anne O’Donell-Luria, co-director of the Center for Mendelian Genomics at the Broad Institute of MIT and Harvard, identified more than 10 families affected by the disorder after Whiffin shared details of the discovery. “As we reached out to other collaborating researchers, they also identified an unprecedented number of diagnoses including from many patients and families who have long been seeking answers,” she said.

“Not having a diagnosis or an explanation for why the medical problems are occurring leaves patients and their families without a community, not knowing what other complications might be coming, and unable to know what steps to take next.”

O’Donnell-Luria said that identifying the RNU4-2 diagnosis was an important first step towards a better understanding of the underlying biology of the condition, and provided hope and a potential research path towards a therapy.

The editorial board of the New York Times has declared that “Donald Trump is unfit to lead” in an urgently worded article published just ahead of the Republican convention, where Trump will once again be formally named the party’s choice for president.

Noting that the former president and convicted felon has now become the Republican nominee three times in eight years, the board said: “A once great political party now serves the interests of one man, a man as demonstrably unsuited for the office of president as any to run in the long history of the republic, a man whose values, temperament, ideas and language are directly opposed to so much of what has made this country great.”

It called the selection of Trump “a chilling choice against this national moment”.

On Monday the paper’s editorial board also made Joe Biden the subject of a piece, in which it insisted that “that the best hope for Democrats to retain the White House is for him to step aside”, given that the president “continued to appear as a man in decline” following Biden’s disastrous debate against Trump in Atlanta last month.

But the latest piece focuses squarely on the danger posed by Trump, 78, and questions about his own cognitive fitness.

Many voters, the Times argued, were “frustrated, even despondent”. On Thursday, a new survey from the Washington Post, ABC News and Ipsos said 67% of US adults (and 58% of Democrats) wanted Biden to step aside, while 50% of US adults (but only 11% of Republicans) said the same about Trump.

Saluting Republicans that it said “pursued electoral power in service to solutions for such problems”, such as Ronald Reagan, George HW Bush, John McCain and Mitt Romney, the Times board went on to say that “too many Republicans set aside their concerns about Mr Trump because of his positions on immigration, trade and taxes. But the stakes of this election … are more foundational: what qualities matter most in America’s president and commander-in-chief”.

Trump was convicted on 34 criminal charges concerning hush-money payments to a porn star that a jury agreed were designed to interfere with the 2016 election. He was originally slated to be sentenced today, with the possibility of jail time, but after the supreme court ruled that presidents have some immunity from prosecution the judge has delayed the sentencing until September to review the case.

Trump faces 54 other criminal charges, concerning election subversion and retention of classified documents, and in civil cases has been fined hundreds of millions of dollars for business fraud and millions more in a defamation suit arising from a rape allegation a judge called “substantially true”.

His attempts to overturn the 2020 election culminated in the January 6 attack on the US Capitol. Nine deaths, about 1,300 arrests and hundreds of convictions are linked to the riot. Trump was impeached a second time for inciting an insurrection but Republican senators acquitted him, leaving him free to run for office. Trump has promised to pardon rioters.

The Times editorial board said these events and other indicators – which it categorised as moral fitness, principled leadership, character, a president’s words and the rule of law – indicated that Trump had “shown a character unworthy of the responsibilities of the presidency.

“He has demonstrated an utter lack of respect for the constitution, the rule of law and the American people. Instead of a cogent vision for the country’s future, Mr Trump is animated by a thirst for political power: to use the levers of government to advance his interests, satisfy his impulses and exact retribution against those who he thinks have wronged him.

“He is, quite simply, unfit to lead.”

It added that while Democrats “are rightly engaged in their own debate about whether President Biden is the right person to carry the party’s nomination into the election, given widespread concerns among voters about his age-related fitness”, the importance of that debate was down to “legitimate concerns that Mr Trump may present a danger to the country, its strength, security and national character – and that a compelling Democratic alternative is the only thing that would prevent his return to power.

It said it was a “national tragedy that the Republicans have failed to … [set] aside their longstanding values” and ignoring what former Trump officials “have described as his systematic dishonesty, corruption, cruelty and incompetence”, and urged American voters to “perform a simple act of civic duty in an election year: listen to what Mr Trump is saying, pay attention to what he did as president and allow yourself to truly inhabit what he has promised to do if returned to office”.

A devastating population collapse that decimated stone age farming communities across northern Europe 5,000 years ago may have been driven by an outbreak of the plague, according to research.

The cause of the calamity, known as the Neolithic collapse, has long been a matter of debate.

Studies based on DNA from human bones and teeth excavated from ancient burial tombs in Scandinavia – seven from an area in Sweden called Falbygden, one from coastal Sweden close to Gothenburg and one from Denmark – now suggest that disease played a central role.

The remains of 108 people – 62 males, 45 females and one undetermined – were studied. Eighteen of them, or 17%, were infected with plague at the time of death.

The researchers were able to chart the family tree of 38 people from Falbygden across six generations, spanning about 120 years. Twelve of them, or 32%, were infected with plague. Genomic findings indicated that their community experienced three distinct waves of an early form of plague.

The researchers reconstructed full genomes of the different strains of the plague-causing bacterium Yersinia pestis responsible for these waves. They determined that the last one may have been more virulent than the others, and they identified traits indicating the disease could have spread from person to person to cause an epidemic.

“We learned that the Neolithic plague is an ancestor to all later plague forms,” said Frederik Seersholm, a geneticist at the University of Copenhagen and lead author of the research, published in the journal Science.

A later form of this same pathogen caused the Justinian Plague of the sixth century AD and the 14th-century Black Death that ravaged Europe, north Africa and the Middle East. Because the strains circulating during the Neolithic decline were much earlier versions, the plague may have produced different symptoms than those in the epidemics millennia later.

The study demonstrated that the plague was abundant and widespread in the area examined.

Martin Sikora, who is also a geneticist at the University of Copenhagen and a co-author of the report, said: “This high prevalence of plague indicates that plague epidemics played a substantial role in the Neolithic decline in this region.

“Indeed, it seems plausible that the decline seen in other parts of Europe was also in some way affected by plague. We do already have evidence for plague in other megalithic sites in different parts of northern Europe. And seeing how prevalent it was in Scandinavia, I would expect a similar picture to emerge once we study these other megaliths with the same resolution.”

The Neolithic or new stone age involved the adoption of farming and animal domestication in place of a roving hunter-gatherer lifestyle. The Neolithic population crash in northern Europe occurred from about 3300BC to 2900BC. By that time, cities and sophisticated civilisations had already arisen in places such as Egypt and Mesopotamia.

The populations of Scandinavia and north-western Europe ultimately disappeared entirely, replaced by people known as the Yamnaya who migrated from a steppe region spanning parts of present-day Ukraine. They are the ancestors of modern northern Europeans.

“Up until now, multiple scenarios have been suggested that might explain the Neolithic decline: war or simple competition with steppe-related populations who became prevalent after the Neolithic decline; an agricultural crisis leading to widespread famine; and various diseases, including plague,” Seersholm said. “The challenge was that only a single plague genome had been identified before, and it was not known whether the disease was able to spread within a population of humans.“

The DNA evidence also offered insight into the social dynamics of these communities, showing that men often had children with multiple women and that the women were brought in from neighbouring communities. The women appeared to be monogamous.

“Multiple reproductive partners could mean several wives. It could also mean men were allowed to find a new partner if they became widowers or they had mistresses,” Seersholm said.

A teenager has been reported to police after allegedly sneaking around Florence’s Cathedral of Santa Maria del Fiore overnight and climbing up to its Cupola del Brunelleschi to take a selfie.

Wearing a black hoodie, jeans and trainers, a person filmed himself walking up an inside stairwell of the world heritage site before reaching the dome level, stepping on to a small platform outside and taking a picture of himself.

Coverage of the stunt was posted on @dedelate, an Instagram account with more than 227,000 followers. It is believed the person had hidden in the cathedral before it closed. An accomplice filmed the alleged exploit from outside the cathedral, apparently capturing the protagonist fleeing the building.

The teenager has not been officially identified but reports in the Italian press said he was a 17-year-old from Lombardy who was known for taking on similar selfie-driven challenges, including one at Milan Cathedral in May, for which he was reportedly charged.

Luca Bagnoli, the president of the Opera di Santa Maria del Fiore, said a complaint had been made to police.

“We have learned about the unauthorised access to Brunelleschi’s dome,” he told La Nazione newspaper. “The cathedral of Florence is a sacred and monumental place, a world heritage site. But unfortunately for some it is also a playground, and this is saddening. The relevant authorities will take care of the rest.”

The suspect has previously allegedly recorded stunts on the roof of Milan’s San Siro stadium and the Ariston theatre in Sanremo, where the annual song festival is held.

Fabiola Minoletti, a vice-president of a Milan residents’ committee, told Il Giorno newspaper: “Dede continues his exploits. Why can’t we contain these people, with such arrogant attitudes? He not only risks his life each time, but [the stunts] could generate dangerous emulations.”

One of the suspect’s followers has now challenged him to climb to the top of St Peter’s Basilica at the Vatican.