Palestinian Rockets Kill Three Israelis and Trigger Air Sirens in Tel Aviv

KIRYAT MALACHI, Israel — Israel and Hamas widened their deadly conflict over Gaza on Thursday, as militants fired dozens of rockets — including one that killed three civilians in an apartment block in this small southern Israeli town — and two longer-range rockets aimed at Tel Aviv, causing no harm but triggering the first air raid warning there set off by incoming fire from Gaza. The death toll in Gaza from Israeli airstrikes rose to at least 19, including five children and a pregnant teenager.

There was no sign that either side was prepared to dial back the confrontation that has threatened a new war in the Middle East, despite entreaties for restraint by world leaders including President Obama and Ban Ki-moon, the United Nations secretary general, who planned a visit there in coming days. If anything, the Israelis intensified their attacks on Gaza after the Tel Aviv scare and made new moves toward a possible ground invasion.

The Israeli deaths were the first since Israel’s military launched ferocious aerial assaults on Wednesday to stop the chronic rocket fire from Gaza, the Palestinian coastal enclave controlled by Hamas, the militant Palestinian group.

The Israel Defense Forces said in a cryptic statement that one of the two longer-range rockets aimed at Tel Aviv landed but did not hit the ground — meaning that it likely crashed into the Mediterranean Sea — and that the other appeared to have landed far outside the city. Exact locations were not specified.

But the Tel Aviv air raid warnings — which residents of Israel’s largest metropolis had not heard except for drills or malfunctions since Saddam Hussein’s Scuds threatened them in the first Persian Gulf War, more than two decades ago — were a reminder of their vulnerability to an attack from Gaza, less than 40 miles away. They also underscored Israel’s stated reason for seeking to destroy the missile-launching sites in Gaza.

Ehud Barak, the minister of defense, said the targeting of Tel Aviv and the scope of the Palestinian rocket fire “represents an escalation, and there will be a price for that escalation that the other side will have to pay.”

Mr. Barak also dropped a further hint that planning for a ground invasion of Gaza had begun, saying he had instructed the army to broaden its draft of reservists to “be prepared for any kind of development if and when it will be required.” Israeli officials said 30,000 reservists could be called, and heavy machinery and tanks rumbled south along Israeli roads leading to Gaza on Thursday in preparation for a possible invasion.

The Israel Defense Forces said that within hours of the Tel Aviv air raid warning, they had attacked 70 underground rocket-launching sites in Gaza, and “direct hits were confirmed.” There were also unconfirmed reports that Israeli rockets had struck near Gaza’s Rafah crossing into Egypt, forcing the Egyptians to close it.

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Brig. Gen. Yoav Mordechai, a spokesman for the Israel Defense Forces, said its aerial assaults had hit more than 200 sites in Gaza by late Thursday, and “we’ll continue tonight and tomorrow.” He also said militants in Gaza had fired about 300 rockets into southern Israel and at least 100 more had been intercepted by Israel’s Iron Dome antimissile defense system.

The Israeli aerial assault on Gaza that began on Wednesday was the most intense military operation by Israel in Gaza since an invasion four years ago.

The regional perils of the situation sharpened as President Mohamed Morsi of Egypt warned that his country stood by the Palestinians against what he termed Israeli aggression, echoing similar condemnation on Wednesday.

“The Egyptian people, the Egyptian leadership, the Egyptian government and all of Egypt is standing with all its resources to stop this assault, to prevent the killing and the bloodshed of Palestinians,” Mr. Morsi said in nationally televised remarks before a crisis meeting of senior ministers. He also instructed his prime minister to lead a delegation to Gaza on Friday and said he had contacted President Obama to discuss strategies to “stop these acts and doings and the bloodshed and aggression.”

Isabel Kershner reported from Kiryat Malachi, Israel, and Rick Gladstone from New York. Reporting was contributed by Fares Akram from Gaza, Rina Castelnuovo from Kiryat Malachi, Mayy El Sheikh and David D. Kirkpatrick from Cairo, Gabby Sobelman from Jerusalem and Alan Cowell from Paris.

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Miguel Cabrera, Buster Posey win MVP awards

NEW YORK (AP) — Detroit's Miguel Cabrera has won the American League's Most Valuable Player award after becoming baseball's first Triple Crown winner in 45 years, and San Francisco's Buster Posey has been voted the National League honor.

Cabrera received 22 of 28 first-place votes and 362 points from the AL panel of Baseball Writers' Association of America. Los Angeles Angels rookie center fielder Mike Trout had six firsts and 281 points.

Posey got 27 of 32 firsts and 422 points from the NL panel, outdistancing 2011 winner Ryan Braun of Milwaukee, who was second with 285 points.

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I Was Misinformed: The Time She Tried Viagra

I have noticed, in the bragging-rights department, that “he doesn’t need Viagra” has become the female equivalent of the male “and, I swear, she’s a real blonde.” Personally, I do not care a bit. To me, anything that keeps you happy and in the game is a good thing.

But then, I am proud to say, I was among the early, and from what I gather, rare female users.

It happened when the drug was introduced around 1998. I was 50, but after chemotherapy for breast cancer — and later, advanced ovarian cancer — I was, hormonally speaking, pretty much running on fumes. Whether this had diminished my sex drive I did not yet know. One may have Zorba-esque impulses when a cancer diagnosis first comes in; but a treatment that leaves you bald, moon-faced and exhausted knocks that out of your system pretty fast.

But by 1998, the cancer was gone, my hair was back and I was ready to get back in the game. I was talking to an endocrinologist when I brought up Viagra. This was not to deal with the age-related physical changes I knew it would not address, it was more along the feminist lines of equal pay for equal work: if men have this new sex drug, I want this new sex drug.

“I know it’s supposed to work by increasing blood flow,” I told the doctor, “But if that’s true for men, shouldn’t it be true for women, too?”

“You’re the third woman who asked me that this week,” he said.

He wrote me a prescription. I was not seeing anyone, so I understood that I would have to do both parts myself, but that was fine. I have a low drug threshold and figured it might be best the first time to fly solo. My memory of the directions are hazy: I think there was a warning that one might have a facial flush or headaches or drop dead of a heart attack; that you were to take a pill at least an hour before you planned to get lucky, and, as zero hour approached, you were supposed to help things along by thinking beautiful thoughts, kind of like Peter Pan teaching Wendy and the boys how to fly.

But you know how it is: It’s hard to think beautiful thoughts when you’re wondering, “Is it happening? Do I feel anything? Woof, woof? Hello, sailor? Naaah.”

After about an hour, however, I was aware of a dramatic change. I had developed a red flush on my face; I was a hot tomato, though not the kind I had planned. I had also developed a horrible headache. The sex pill had turned into a bad joke: Not now, honey, I have a headache.

I put a cold cloth on my head and went to sleep. But here’s where it got good: When I slept, I dreamed; one of those extraordinary, sensual, swimming in silk sort of things. I woke up dazed and glowing with just one thought: I gotta get this baby out on the highway and see what it can do.

A few months later I am fixed up with a guy, and after a time he is, under the Seinfeldian definition of human relations (Saturday night date assumed) my official boyfriend. He is middle aged, in good health. How to describe our romantic life with the delicacy a family publication requires? Perhaps a line from “Veronika, der Lenz ist da” (“Veronica, Spring Is Here”), a song popularized by the German group the Comedian Harmonists: “Veronika, der Spargel Wächst” (“Veronica, the asparagus are blooming”). On the other hand, sometimes not. And so, one day, I put it out there in the manner of sport:

“Want to drop some Viagra?” I say.

Here we go again, falling into what I am beginning to think is an inevitable pattern: lying there like a lox, or two loxes, waiting for the train to pull into the station. (Yes, I know it’s a mixed metaphor, but at least I didn’t bring in the asparagus.) So there we are, waiting. And then, suddenly, spring comes to Suffolk County. It’s such a presence. I’m wondering if I should ask it if it hit traffic on the L.I.E. We sit there staring.

My reaction is less impressive. I don’t get a headache this time. And romantically, things are more so, but not so much that I feel compelled to try the little blue pills again.

Onward roll the years. I have a new man in my life, who is 63. He does have health problems, for which his doctor prescribes an E.D. drug. I no longer have any interest in them. My curiosity has been satisfied. Plus I am deeply in love, an aphrodisiac yet to be encapsulated in pharmaceuticals.

We take a vacation in mountain Mexico. We pop into a drugstore to pick up sunscreen and spot the whole gang, Cialis, Viagra, Levitra, on a shelf at the checkout counter. No prescription needed in Mexico, the clerk says. We buy all three drugs and return to the hotel. I try some, he tries some. In retrospect, given the altitude and his health, we are lucky we did not kill him. I came across an old photo the other day. He is on the bed, the drugs in their boxes lined up a in a semi-circle around him. He looks a bit dazed and his nose is red.

Looking at the picture, I wonder if he had a cold.

Then I remember: the flush, the damn flush. If I had kids, I suppose I would have to lie about it.

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DealBook: In a Switch, Investors Are Buying European Bank Bonds

LONDON — European bank debt, once an investment pariah, is suddenly popular.

In recent weeks, money managers have been readily buying the new bonds of the region’s financial institutions, deals that just months ago would have seemed unpalatable. Bank of Ireland, which received a bailout in 2010, sold $1.3 billion of bonds on Tuesday and found strong demand. It was the largest offering by an Irish bank without a government guarantee in almost three years.

The gradual thawing of the capital markets is a good sign for the region’s banks. In the midst of the crisis, institutions, especially in troubled economies like Ireland and Portugal, have been struggling to raise money from private investors. The latest deals will help bolster banks’ capital levels and strengthen their balance sheets.

But the bonds could leave investors exposed, especially given the precarious situation in Europe. The sovereign debt crisis continues to weigh on the economy. The financial markets remain volatile. And profit at the region’s banks is flagging.

“It’s a great time to be issuing high-yield debt but not to be investing in it,” said Robin Doumar, managing partner at the private equity firm Park Square Capital.

For now, bondholders are taking comfort in the policy makers’ response to the sovereign debt crisis.

In late August, the European Central Bank began an unlimited bond-buying program aimed at lowering countries’ borrowing costs and breathing life into local economies. By essentially offering a blank check to help Europe’s troubled governments, policy makers calmed short-term fears that some of the region’s banks might need to be bailed out, reviving interest in the companies’ bonds.

“The biggest driver of demand has been the policy responses from the European Central Bank,” said Melissa Smith, head of European high-grade debt capital markets at JPMorgan Chase in London. “It’s provided stability as policy makers have stated their commitment to preserving the euro zone.”

With interest rates at record lows, European bank debt looks especially appealing to investors.

On Thursday, the British bank Barclays sold $3 billion of 10-year bonds at 7.6 percent. The Portuguese lender Banco Espírito Santo recently issued $958 million worth of debt at 5.9 percent.

By comparison, a 10-year Treasury is paying 1.8 percent. Germany has offered a negative yield on some of its sovereign debt maturities this year.

Even the yields on junk bonds, the risky corporate debt that pays high interest rates, are coming down as investors pile into such securities. The average yield is now just 5.8 percent, according to a Bank of America Merrill Lynch index. Historically, they have paid 10 percent or even more.

“There’s been a huge contraction,” said Robert Ellison, head of European debt capital markets for financial institutions at UBS in London.

The industry has been quick to capitalize on investors’ desperate hunt for returns. Banks in Europe have issued a combined $318 billion of unsecured debt so far this year, almost triple the amount raised by their American counterparts, according to the data provider Dealogic.

The capital markets are being discerning. This year, well-financed companies in Northern Europe, like Nordea Bank of Sweden, have been able to sell the largest lots of bonds at relatively reasonable rates. Smaller banks, particularly in Southern Europe, have had to offer investors better rates to win support for their bond deals.

Even so, it is a stark contrast from almost a year ago. With the capital markets paralyzed, the European Central Bank then had to step in to stabilize the banks, offering $1.3 trillion in short-term, low-cost loans to financial companies.

As they find renewed interest from private investors, European banks can more easily raise money, fortifying their balance sheets in case of unexpected losses. At regulators’ behest, financial institutions in the region have been increasing their capital levels.

But bond investors, in their thirst for yield, may be overlooking signs of potential trouble.

Barclays, for instance, sold a controversial type of debt, known as contingent convertible bonds. With these so-called CoCo bonds, investors can be wiped out if the bank’s capital falls below a certain threshold. While Barclays’ balance sheet is in good shape, bondholders’ willingness to accept such conditions highlights the risks in the market. Traditional bondholders can usually recoup at least some of their principal even if a company goes bankrupt.

At the same time, many European financial institutions are still in fragile shape. The Bank of Ireland, in which the Irish government still has a small stake, is struggling to divest itself of many risky loans that it made before the financial crisis. Portugal’s economy is also expected to contract 3 percent this year, which will probably depress the earnings of Banco Espírito Santo.

The question for investors is whether the reward is worth the risk.

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Israelis Launch Major Assault on Gaza, Killing Hamas Commander

GAZA — Israel on Wednesday launched one of the most ferocious assaults on Gaza since its invasion four years ago, hitting at least 20 targets in aerial attacks that killed the top military commander of Hamas, drew strong condemnation from Egypt and escalated the risks of a new war in the Middle East.

The Israelis coupled the intensity of the airstrikes with the threat of another ground invasion and warnings to all Hamas leaders in Gaza to stay out of sight or risk the same fate as the Hamas military commander, Ahmed al-Jabari, who was killed in a pinpoint airstrike as he was traveling by car down a Gaza street. “We recommend that no Hamas operatives, whether low level or senior leaders, show their faces above ground in the days ahead,” the Israel Defense Forces said in a Twitter message.

The ferocity of the airstrikes, which Israel called Operation “Pillar of Defense” in response to repeated rocket attacks by Gaza-based Palestinian militants, provoked rage in Gaza, where Hamas said the airstrikes amounted to war and promised a harsh response. It quickly launched dozens of rockets into southern Israel, including several that struck the city of Beersheba, shattering windows and damaging cars but causing no injuries.

Civil-defense authorities in Israel, anticipating retaliation, raised alert levels early in the day and told residents in southern Israel to take precautions. Many remained indoors or congregated in bomb shelters.

The Hamas-run Health Ministry in Gaza said the Israeli attacks had killed at least five others besides Mr. Jabari, including a baby and a 7-year-old girl, and had wounded at least 40.

The abrupt escalation in hostilities between Israel and Hamas, the militant organization regarded by Israel as a terrorist group sworn to Israel’s destruction, came amid rising tensions between Israel and all of its Arab neighbors. Israel has faced growing lawlessness on its border with the Sinai, including cross-border attacks. It recently fired twice into Syria, which is caught in a civil war, after munitions fell in the Israeli-occupied Golan Heights, and it has absorbed rocket fire from Gaza, which has damaged homes and frightened the population.

Israeli officials had promised a robust response to the rocket fire, but for the moment, at least, opted against a ground invasion and instead chose airstrikes and targeted killings.

The Israeli attacks especially threatened to further complicate Israel’s fragile relations with Egypt, where the Islamist-led government of President Mohamed Morsi, reversing a policy of ousted predecessor Hosni Mubarak, had established closer ties with Hamas and had been acting as a mediator to restore calm between Israel and Gaza-based militant groups.

In the first crisis in Israeli-Egyptian relations since Mr. Morsi came to power, he called the Israeli actions “wanton aggression on the Gaza Strip.” He ordered Egypt’s ambassador to Israel to return home, summoned the Israeli ambassador to protest, and called for emergency meetings of both the United Nations Security Council and the Arab League over the Gaza attacks. Egyptian state media said Foreign Minister Mohamed Amr had “warned Israel against the consequences of escalation and the negative reflections it may have on the security and stability of the region.”

Mr. Morsi’s Freedom and Justice Party, which was founded by the Muslim Brotherhood, posted a video on its Web site of what was described as the burned body of a Palestinian child said to have been killed in the Israeli attacks, in what appeared to be a deliberate attempt to inflame passions. His party also issued a statement saying: “The wanton aggression against Gaza proves that Israel has yet to realize that Egypt has changed and that the Egyptian people who revolted against oppression will not accept assaulting Gaza.”

A spokesman for Hamas, Fawzi Barhoum, said the Israelis had “committed a dangerous crime and broke all redlines,” and that “the Israeli occupation will regret and pay a high price.”

Military officials in Israel, which announced responsibility for the death of Mr. Jabari, later said in a statement that their forces had carried out additional airstrikes in Gaza targeting what they described as “a significant number of long-range rocket sites” owned by Hamas that had stored rockets capable of reaching 25 miles into Israel. The statement said the airstrikes had dealt a “significant blow to the terror organization’s underground rocket-launching capabilities.”

Yisrael Katz, a minister from Israel’s governing Likud Party, issued a statement saying that the operation had sent a message to the Hamas political leaders in Gaza “that the head of the snake must be smashed. Israel will continue to kill and target anyone who is involved in the rocket attacks.”Hamas and medical officials in Gaza said both Mr. Jabari and a companion were killed by the airstrike on his car in Gaza City. Israeli news media said the companion was Mr. Jabari’s son, but there was no immediate confirmation.

Fares Akram reported from Gaza, and Isabel Kershner from Jerusalem. Reporting was contributed by Mayy El Sheikh and David D. Kirkpatrick from Cairo, Gabby Sobelman in Jerusalem, Rina Castelnuovo in Beersheba, Israel, and Rick Gladstone from New York.

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Price edges Verlander for AL Cy Young Award

NEW YORK (AP) — David Price of the Tampa Bay Rays won the AL Cy Young Award on Wednesday in one of the closest votes ever.

Price beat out 2011 winner Justin Verlander by only four points in balloting by the Baseball Writers' Association of America. Other than a 1969 tie between Mike Cuellar and Denny McLain, it was the tightest race in the history of the AL award.

Runner-up two years ago, Price was the pick this time for the league's top pitching prize. He received 14 of 28 first-place votes and finished with 153 points. Verlander was chosen first on 13 ballots.

Rays closer Fernando Rodney got the other first-place vote and came in fifth.

Price went 20-5 to tie Jered Weaver for the American League lead in victories and winning percentage. The 27-year-old lefty had the lowest ERA at 2.56 and finished sixth in strikeouts with 205.

Verlander, also the league MVP a year ago, followed that up by going 17-8 with a 2.64 ERA and pitching the Detroit Tigers to the World Series. He led the majors in strikeouts (239), innings (238 1-3) and complete games (six).

Price tossed 211 innings in 31 starts, while Verlander made 33. One factor that might have swung some votes, however: Price faced stiffer competition in the rugged AL East than Verlander did in the AL Central.

Weaver came in third with 70 points, but was listed second on a pair of ballots. The right-hander threw a no-hitter and had a 2.81 ERA in his first 20-win season but missed time with injuries and totaled only 188 2-3 innings for the Los Angeles Angels.

The top pick in the 2007 amateur draft out of Vanderbilt, Price reached the majors the following year and has made three straight All-Star teams.

Despite going 19-6 with a 2.72 ERA in 2010, he finished a distant second in Cy Young voting to Felix Hernandez, who won only 13 games for last-place Seattle but dominated most other statistical categories that year.

Verlander was trying to become the first AL pitcher to win back-to-back Cy Youngs since Boston's Pedro Martinez in 1999 and 2000. San Francisco right-hander Tim Lincecum did it in the National League in 2008-09.

The NL Cy Young winner was to be announced later Wednesday.

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Personal Health: Quitting Smoking for Good

Few smokers would claim that it’s easy to quit. The addiction to nicotine is strong and repeatedly reinforced by circumstances that prompt smokers to light up.

Yet the millions who have successfully quit are proof that a smoke-free life is achievable, even by those who have been regular, even heavy, smokers for decades.

Today, 19 percent of American adults smoke, down from more than 42 percent half a century ago, when Luther Terry, the United States surgeon general, formed a committee to produce the first official report on the health effects of smoking. Ever-increasing restrictions on where people can smoke have helped to swell the ranks of former smokers.

Now, however, as we approach the American Cancer Society’s 37th Great American Smokeout on Thursday, the decline in adult smoking has stalled despite the economic downturn and the soaring price of cigarettes.

Currently, 45 million Americans are regular smokers who, if they remain smokers, can on average expect to live 10 fewer years. Half will die of a tobacco-related disease, and many others will suffer for years with smoking-caused illness. Smoking adds $96 billion to the annual cost of medical care in this country, Dr. Nancy A. Rigotti wrote in The Journal of the American Medical Association last month. Even as some adult smokers quit, their ranks are being swelled by the 800,000 teenagers who become regular smokers each year and by young adults who, through advertising and giveaways, are now the prime targets of the tobacco industry.

People ages 18 to 25 now have the nation’s highest smoking rate: about 34 percent, according to the 2010 National Survey on Drug Use and Health. I had to hold my breath the other day as dozens of 20-somethings streamed out of art gallery openings and lighted up. Do they not know how easy it is to get hooked on nicotine and how challenging it can be to escape this addiction?

Challenging, yes, but by no means impossible. On the Web you can download a “Guide to Quitting Smoking,” with detailed descriptions of all the tools and tips to help you become an ex-smoker once and for all.

Or consult the new book by Dr. Richard Brunswick, a retired family physician in Northampton, Mass., who says he’s helped hundreds of people escape the clutches of nicotine and smoking. (The printable parts of the book’s provocative title are “Can’t Quit? You Can Stop Smoking.”)

“There is no magic pill or formula for beating back nicotine addiction,” Dr. Brunswick said. “However, with a better understanding of why you smoke and the different tools you can use to control the urge to light up, you can stop being a slave to your cigarettes.”

Addiction and Withdrawal

Nicotine beats a direct path to the brain, where it provides both relaxation and a small energy boost. But few smokers realize that the stress and lethargy they are trying to relieve are a result of nicotine withdrawal, not some underlying distress. Break the addiction, and the ill feelings are likely to dissipate.

Physical withdrawal from nicotine is short-lived. Four days without it and the worst is over, with remaining symptoms gone within a month, Dr. Brunswick said. But emotional and circumstantial tugs to smoke can last much longer.

Depending on when and why you smoke, cues can include needing a break from work, having to focus on a challenging task, drinking coffee or alcohol, being with other people who smoke or in places you associate with smoking, finishing a meal or sexual activity, and feeling depressed or upset.

To break such links, you must first identify them and then replace them with other activities, like taking a walk, chewing sugar-free gum or taking deep breaths. These can help you control cravings until the urge passes.

If you’ve failed at quitting before, try to identify what went wrong and do things differently this time, Dr. Brunswick suggests. Most smokers need several attempts before they can become permanent ex-smokers.

Perhaps most important is to be sure you are serious about quitting; if not, wait until you are. Motivation is half the battle. Also, should you slip and have a cigarette after days or weeks of not smoking, don’t assume you’ve failed and give up. Just go right back to not smoking.

Aids for Quitting

Many if not most smokers need two kinds of assistance to become lasting ex-smokers: psychological support and medicinal aids. Only about 4 percent to 7 percent of people are able to quit smoking on any given attempt without help, the cancer society says.

All 50 states and the District of Columbia have free telephone-based support programs that connect would-be quitters to trained counselors. Together, you can plan a stop-smoking method that suits your smoking pattern and helps you avoid common pitfalls.

Online support groups and Nicotine Anonymous can help as well. To find a group, ask a local hospital or call the cancer society at (800) 227-2345. Consider telling relatives and friends about your intention to quit, and plan to spend time in smoke-free settings.

More than a dozen treatments can help you break the physical addiction to tobacco. Most popular is nicotine replacement therapy, sold both with and without a prescription. The Food and Drug Administration has approved five types: nicotine patches of varying strengths, gums, sprays, inhalers and lozenges that can curb withdrawal symptoms and help you gradually reduce your dependence on nicotine.

Two prescription drugs are also effective: an extended-release form of the antidepressant bupropion (Zyban or Wellbutrin), which reduces nicotine cravings, and varenicline (Chantix), which blocks nicotine receptors in the brain, reducing both the pleasurable effects of smoking and the symptoms of nicotine withdrawal. Combining a nicotine replacement with one of these drugs is often more effective than either approach alone.

Other suggested techniques, like hypnosis and acupuncture, have helped some people quit but lack strong proof of their effectiveness. Tobacco lozenges and pouches and nicotine lollipops and lip balms lack evidence as quitting aids, and no clinical trials have been published showing that electronic cigarettes can help people quit.

The cancer society suggests picking a “quit day”; ridding your home, car and workplace of smoking paraphernalia; choosing a stop-smoking plan, and stocking up on whatever aids you may need.

On the chosen day, keep active; drink lots of water and juices; use a nicotine replacement; change your routine if possible; and avoid alcohol, situations you associate with smoking and people who are smoking.

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This post has been revised to reflect the following correction:

Correction: November 14, 2012

An earlier version of this column misstated the rate of smoking among young adults. According to the 2010 National Survey on Drug Use and Health, about 34 percent of people ages 18 to 25 smoke cigarettes, not 40 percent. (That is the share of young adults who use tobacco products of any kind, according to the survey.)

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5-Hour Energy Is Cited in 13 Death Reports

Federal officials have received reports of 13 deaths over the last four years that cited the possible involvement of 5-Hour Energy, a highly caffeinated energy shot, according to Food and Drug Administration records and an interview with an agency official.

The disclosure of the reports is the second time in recent weeks that F.D.A. filings citing energy drinks and deaths have emerged. Last month, the agency acknowledged it had received five fatality filings mentioning another popular energy drink, Monster Energy.

Since 2009, 5-Hour Energy has been mentioned in some 90 filings with the F.D.A., including more than 30 that involved serious or life-threatening injuries like heart attacks, convulsions and, in one case, a spontaneous abortion, a summary of F.D.A. records reviewed by The New York Times showed.

The filing of an incident report with the F.D.A. does not mean that a product was responsible for a death or an injury or contributed in any way to it. Such reports can be fragmentary in nature and difficult to investigate.

The distributor of 5-Hour Energy, Living Essentials of Farmington Hills, Mich., did not respond to written questions about the filings, and its top executive declined to be interviewed. Living Essentials is a unit of the product’s producer, Innovation Ventures.

However, in a statement, Living Essentials said the product was safe when used as directed and that it was “unaware of any deaths proven to be caused by the consumption of 5-Hour Energy.”

Since the public disclosure of reports about Monster Energy, its producer, Monster Beverage of Corona, Calif., has repeatedly said that its products are safe, adding that they were not the cause of any of the health problems reported to the F.D.A.

Shares of Monster Beverage, which traded above $80 earlier this year, closed Wednesday at $44.74.

The fast-growing energy drink industry is facing increasing scrutiny over issues like labeling disclosures and possible health risks. Some lawmakers are calling on the F.D.A. to increase its regulation of the products and the New York State attorney general is investigating the practices of several producers.

Unlike Red Bull, Monster Energy and some other energy drinks that look like beverages, 5-Hour Energy is sold in a two-ounce bottle referred to as a shot. The company does not disclose the amount of caffeine in each bottle, but a recent article published by Consumer Reports placed that level at about 215 milligrams.

An eight-ounce cup of coffee, depending on how it is made, can contain from 100 to 150 milligrams of caffeine.

The F.D.A. has stated that it does not have sufficient scientific evidence to justify changing how it regulates caffeine or other ingredients in energy products. The issue of how to do so is complicated by the fact that some high-caffeine drinks, like Red Bull, are sold under agency rules governing beverages, while others, like 5-Hour Energy and Monster Energy, are marketed as dietary supplements. The categories have differing ingredient rules and reporting requirements.

In an interview Wednesday, Daniel Fabricant, the director of the agency’s division of dietary supplement programs, said the agency was looking into the death reports that cited 5-Hour Energy. He said that while medical information in such reports could rule out a link with the product, other reports could contain insufficient information to determine what role, if any, a supplement might have played.

Mr. Fabricant said that the 13 fatality reports that mentioned 5-Hour Energy had all been submitted to the F.D.A. by Living Essentials. Since late 2008, producers of dietary supplements are required to notify the F.D.A. when they become aware of a death or serious injury that may be related to their product.

Currently, the agency does not publicly disclose adverse event filings about dietary supplements like 5-Hour Energy. Companies that market energy drinks as beverages are not required to make such reports to the agency, although they can do so voluntarily, Mr. Fabricant said.

Along with caffeine, 5-Hour Energy contains other ingredients, like very high levels of certain B vitamins and an amino acid called taurine.

Reached by telephone, the chief executive of the Living Essentials, Manoj Bhargava, declined to discuss the filings and said he believed an article about the reports would cast the company in a negative light.

“I am not interested in making any comment,” Mr. Bhargava said.

Subsequently, the company issued a statement, that said, among other things, that it took “reports of any potential adverse event tied to our products very seriously,” adding that the company complied “with all of our reporting requirements” to the F.D.A.

The company also stated that it marketed 5-Hour Energy to “hardworking adults who need an extra boost of energy.” The product’s label recommends that it not be used by woman who are pregnant or by children under 12 years of age.

The number of reports filed with the F.D.A. that mention 5-Hour Energy appears particularly striking. In 2010, for example, the F.D.A. received a total of 17 fatality reports that mentioned a dietary supplement or a weight loss product, two broad categories that cover more than 50,000 products, according to Mr. Fabricant, the F.D.A. official.

He added that it was difficult to put the volume of 5-Hour Energy filings into context because he believed that some supplement manufacturers were probably not following the mandated reporting rules and that consumers and doctors might also be unaware that they can file incident reports with the agency. Last year, the F.D.A. received only 2,000 reports about fatalities or serious injuries that cited dietary supplements and weight loss products, he said.

Another federal agency, the Substance Abuse and Mental Health Services Administration, reported late last year that more than 13,000 emergency room visits in 2009 were associated with energy drinks alone.

Along with Living Essentials, The Times sent queries last week to several producers asking whether they had received reports linking fatalities or serious injuries to their products.

Representatives for two of those companies — Red Bull and Coca-Cola, which sells NOS and Full Throttle — said they were unaware of any such reports. A representative for PepsiCo, which makes Amp, also said it was unaware of any such reports.

In addition to Red Bull, NOS, Full Throttle and Amp are also marketed as beverages, rather than as dietary supplements.

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White House Supports Top U.S. Commander in Afghanistan

President Obama has faith in Gen. John R. Allen, the top American and NATO commander in Afghanistan, the White House spokesman said on Tuesday, after it was disclosed that the general was under investigation for what the Pentagon called “inappropriate communication” with the woman whose complaint to the F.B.I. set off the scandal involving David H. Petraeus’s extramarital affair.

“The president thinks very highly of General Allen,” the spokesman, Jay Carney, said at a White House news briefing. “He has faith in General Allen,” and believes that he has done “an excellent job” as commander in Afghanistan, Mr. Carney added. General Allen’s recent nomination to become the supreme allied commander in Europe, Mr. Carney said, is delayed at the request of Defense Secretary Leon E. Panetta pending the investigation’s outcome.

Mr. Panetta and other officials disclosed overnight the investigation into General Allen’s e-mails with Jill Kelley, the woman in Tampa, Fla., who was seen by Paula Broadwell, Mr. Petraeus’s lover, as a rival for his attentions.

Mr. Petraeus’s affair led to his resignation as head of the C.I.A. on Friday, and the F.B.I.’s investigations into e-mails in the matter apparently led in turn to General Allen’s correspondence.

In a statement released to reporters on his plane en route to Australia early Tuesday, Mr. Panetta said the F.B.I. on Sunday had referred “a matter involving” General Allen to the Pentagon.

Mr. Panetta turned the matter over to the Pentagon’s inspector general to conduct an investigation into what a defense official said were thousands of pages of documents, many of them e-mails between General Allen and Ms. Kelley.

A senior law enforcement official in Washington said on Tuesday that F.B.I. investigators, looking into Ms. Kelley’s complaint about anonymous e-mails she had received, examined all of her e-mails as a routine step.

“When you get involved in a cybercase like this, you have to look at everything,” the official said, suggesting that Ms. Kelley may not have considered that possibility when she filed the complaint. “The real question is why someone decided to open this can of worms.”

The official would not describe the content of the e-mails between General Allen and Ms. Kelley or say specifically why F.B.I. officials had decided to pass them on to the Defense Department. “Generally, the nature of the e-mails warranted providing them to D.O.D.,” he said.

Under military law, adultery can be a crime.

The defense official on Mr. Panetta’s plane said that General Allen, who is also married, told Pentagon officials that he had done nothing wrong. Neither he nor Ms. Kelley, who is also married with children, could be reached for comment early Tuesday. Mr. Panetta’s statement praised General Allen for his leadership in Afghanistan and said, “He is entitled to due process in this matter.”

A senior Defense Department official said General Allen had denied having an extramarital affair with Ms. Kelley. But the official said the content of some of the e-mails “was of a flirtatious nature.”

“Some were of an affectionate nature,” the official said, adding that it was unclear whether the flirtatiousness expressed was from General Allen to Ms. Kelley, from Ms. Kelley to General Allen, or mutual.

“That is what makes the e-mails potentially inappropriate,” he said.

The official said that he had not read the e-mails, but had been briefed on the content, and that they did not contain anything inappropriate regarding operations or security.

But there were conflicting assessments of the content of the e-mails. Associates of General Allen said that the e-mails were of an innocuous nature. Some of the e-mails, these associates said, used terms of endearment, but not in a flirtatious way.

Pentagon officials cautioned against making too much of the number of documents, since some might be from e-mail chains, or brief messages printed out on a whole page.

The Pentagon inspector general’s investigation opens up what could be a widening scandal into two of the most prominent generals of their generation: Mr. Petraeus, who was the top commander in Iraq and Afghanistan before he retired from the military and became director of the C.I.A., only to resign on Friday because of the affair, and General Allen, who also served in Iraq and now commands 68,000 American troops in Afghanistan.

Although General Allen will remain the commander in Afghanistan, Mr. Panetta said that he had asked President Obama to delay the general’s nomination to be the commander of American forces in Europe and the supreme allied commander of NATO, two positions he was to move into after what was expected to be easy confirmation by the Senate. Mr. Panetta said in his statement that Mr. Obama agreed with his request.

Scott Shane and Thom Shanker contributed reporting from Washington.

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RIM sees BB10 devices in stores soon after launch

WATERLOO, Ontario (Reuters) – Research In Motion is confident its new BlackBerry 10 devices will be 100 percent ready for the January 30 launch and available in stores “not too long after” that, Chief Operating Officer Kristian Tear said on Tuesday.

“We’re working hard right now to make sure all the bits and pieces and all the details are in place for the date, when the devices will be available for consumers and enterprises,” Tear told Reuters in an interview.

RIM, which virtually invented the concept of mobile email with its first line of BlackBerry devices more than a decade ago, was roundly criticized for the botched 2011 launch of its PlayBook tablet computer, which RIM had hoped would compete with Apple’s blockbuster iPad.

The PlayBook looked pretty and had top-of-the-line hardware. But its software was far from complete at the launch and needed multiple updates.

The device also lacked the library of apps available on the iPad and on devices that run on Google Inc’s competing Android operating system.

RIM says its the new devices will be faster and smoother than its existing phones and have a large catalog of applications that are crucial to the success of any smartphone.

The company hopes the new devices will allow it to claw back some of the market share it has lost to Android and Apple phones.

Tear said RIM has used input from current BlackBerry users to influence the design of the new devices, The new phones both build on the strengths of RIM’s existing operating system and improve on its weak points, he said.

RIM last month began carrier testing on the new devices, with an initial rollout to more than 50 carriers. Tear, who joined RIM a few months ago from Sony Mobile Communications, said RIM was expanding that to a wider group of carriers across the globe.

“We submitted to 50 carriers to begin with, and obviously that number is increasing as we move forward,” he said. “Our ambition is to make this a global launch, everything will not happen at the same time, but it will be a global launch.”

RIM has said it initially plans to roll out a high-end touchscreen version of the device. Phones with the mini QWERTY keyboards that many long-time BlackBerry users adore will come a few weeks later, while lower-end versions of both devices will be launched later in the year.

The company has yet to say exactly when the devices will be available in stores worldwide or how much they will cost.

“We have to agree with carriers as well on what they want to announce when, so it’s not absolutely to our own discretion,” Tear said.

COST CUTTING

RIM, whose share price has fallen more than 90 percent from a 2008 peak around $ 148, is part way through a major restructuring, as it seeks to trim costs in the run-up to the launch of the new devices.

The company, which has also said it is examining its strategic options, is lowering operating costs by about $ 1 billion and cutting about 5,000 jobs, or about 30 percent of its workforce, by the time its fiscal year ends in early March.

“We are on track to deliver on that,” said Tear. “It is an ongoing process, when it comes to efficiencies and costs.”

RIM’s Chief Legal Officer Steve Zipperstein said the company is pushing ahead with its strategic review.

“The process is ongoing and it continues to be a focus on RIM’s senior management, but we have nothing to report at this moment,” said Zipperstein.

RIM shares, which have risen slightly over the last couple of months in the run-up to the launch of BB10 devices, closed 4.7 percent lower at $ 8.40 on Nasdaq. RIM’s Toronto-listed shares fell by a similar margin to C$ 8.40.

(Reporting by Euan Rocha; Editing by Janet Guttsman, Leslie Adler and Tim Dobbyn)

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