Tag Archives: worrying

The Fargo shooter used a binary trigger. Here’s what to know about the device that’s worrying police – The Associated Press

  1. The Fargo shooter used a binary trigger. Here’s what to know about the device that’s worrying police The Associated Press
  2. Fargo shooter who killed a police officer used ‘binary trigger’ device, had stockpile of weapons at home CNN
  3. North Dakota AG: Fargo shooter searched for ‘crowds’ Associated Press
  4. Forum Editorial: Fargo mourns a fallen police officer and struggles to understand an incomprehensible tragedy INFORUM
  5. First responders receiving mental health support following Friday’s deadly shooting KVLY
  6. View Full Coverage on Google News

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Worrying signs that your fatty liver is getting worse | Health

Fatty liver often appears harmless and has rarely any symptoms in the initial stages. It all starts with a build-up of fat in liver that is not broken down properly due to consuming too many calories or diseases like diabetes, high cholesterol among others. In the initial stages, there is hardly any inflammation of damage to the liver and many people may not reach advanced stages of fatty liver disease where the risks of liver cirrhosis and liver cancer goes up. Fatty liver in many people goes undiagnosed in the early stages because it’s most asymptomatic. However, as the disease progresses one may start to notice yellowing of skin, dull ache in the lower right side of the ribs, swelling in abdomen, legs, weight loss among many other symptoms. (Also read: 8 fruits you must eat to reverse fatty liver disease)

“Fatty liver is on the rise due to lifestyle and diet changes. A sedentary lifestyle and excess intake of processed and high-calorie diet are some of the major causes of this condition. Though alcohol tops the chart as an etiology for fatty liver, non-alcoholic fatty liver is equally on the rise due to this,” says Dr Amol Dahale, Consultant, Gastroenterology, Manipal Hospitals, Baner-Pune.

“Mostly detected in asymptomatic patients, few people can develop symptoms like upper abdominal pain, nausea, fatigue, decreased appetite even jaundice in a few cases. Though look benign initially, few people develop cirrhosis and even liver cancer which can be fatal,” says Dr Dahale.

Dr. Pratik Tibdewal, Consultant Gastroenterologist, Wockhardt Hospitals, Mira Road explains in detail the four stages of fatty liver disease and when should one start worrying.

FIRST STAGE: NO RED FLAGS

There are four stages of Non-Alcoholic Fatty Liver Disease (NAFLD) which determine the progression of the disease. The first stage is simple fatty liver or steatosis. This happens when the liver cells start to build-up fat, but without inflammation or scarring at this stage. There are no red flags in this stage and a large number of people don’t even know they have fatty liver. Not everyone with fatty liver will get non-alcoholic steatohepatitis (NASH) which is the second stage.

SECOND STAGE: INFLAMMATION

The second stage of NAFLD is non-alcoholic steatohepatitis (NASH). Here, there is a build-up of fat in the liver cells along with inflammation as the liver is repairing damaged tissue. If the damaged tissue is more then there can be scarring of the liver leading to fibrosis

THIRD STAGE: FIBROSIS

The third stage of NAFLD is fibrosis. It is seen when the scar tissue is there in the liver and in the blood vessels around the liver. Thus, treating inflammation may prevent further progression or even reverse some of the damage. However, if not tackled at the right time, it can lead to cirrhosis.

FOURTH STAGE: CIRRHOSIS

The fourth stage of NAFLD is cirrhosis. At this stage, the liver will completely stop working and there can be signs and symptoms such as yellowing of the skin and a dull ache in the lower right side of the ribs and one will suffer from liver damage which can lead to Ascites (abnormal swelling), leg swelling, bleeding from vomiting or altered consciousness which will require hospitalisation and may require a liver transplantation.

Dr Shankar Zanwar Consultant Gastroenterologist, Wockhardt Hospital, Mumbai Central shares fatty liver danger signs that nobody should ignore.

– If the patient starts getting fatigue in activities which are not usually tiresome

– Loss of desire to eat food

– Yellowish discolouration of eyes and urine

– Fullness of abdomen typically due to fluid accumulation

– Blood vomiting

– Black coloured stools

– Leg swelling

– Weight loss

– Abnormal mental activity in form of disturbed sleep and wake cycle, irrelevant talking, disorientation

– Easy bruisability meaning bleeding under skin with trivial injuries

“As the dictum goes that prevention is better than cure, early diagnosis and treatment can lead to a complete reversal of the disease. Today with the availability of multiple detection tools like ultrasound, fibro scan, blood tests, early diagnosis is possible. Regular exercise, dietary and lifestyle changes along with medicines can help us to cure fatty liver,” says Dr Dahale.

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COVID, RSV, sickness worrying CDC Director Walensky ahead of Philadelphia visit

Federal and local health departments must invest in better data tracking technology to quickly respond to viral outbreaks, such as COVID-19 and the ”tridemic” of influenza, RSV, and COVID currently straining hospitals, CDC Director Rochelle Walensky said in Philadelphia on Tuesday.

Walensky’s remarks at the Bloomberg American Health Summit, held at Loews Hotel Philadelphia, came a day after she urged Americans during a CDC news conference to be proactive in protecting themselves and others by wearing a mask indoors and on public transportation.

She also recommended that people see a doctor if they have symptoms and that they get vaccinated.

“The past several years have certainly not been easy, and now we face another surge of illness, another moment of overstretched capacity, and one of tragic and often preventable sadness,” Walensky said during a CDC briefing Monday.

The CDC has recorded at least 8.7 million cases of flu, including 78,000 hospitalizations and 4,500 deaths, since October, the Washington Post reported.

Children’s hospitals have been flooded with cases of RSV, a flulike virus that can cause severe respiratory problems among very young children and those with underlying health conditions.

“Our hospital is filling up with young babies that are struggling to breathe,” James Reingold, chair of the department of emergency medicine at St. Christopher’s Hospital for Children in Philadelphia, told The Inquirer in early November.

» READ MORE: As respiratory virus cases surge among kids in Philly region, children’s hospitals filling up

COVID cases and hospitalizations are also rising in Pennsylvania and New Jersey but remain within the range the region has seen over the last two months.

On Tuesday, Walensky focused on what the CDC and public health agencies can do to be better prepared for future outbreaks — namely, modernizing data-gathering operations.

The pandemic exposed how insufficient the CDC’s system of gathering health data was, Walensky said, noting at the beginning of the pandemic the agency did not have the ability to track COVID test results.

The CDC has little power to compel local or state health agencies to share data. Information can arrive incomplete and months or even years late — too late to be useful for policymaking.

“The challenges of the COVID-19 pandemic made us acutely aware of the urgent need to create public health culture that is nimble,” Walensky said.

Health agencies need to do more than just speed up data delivery, she said. Each municipality, county, and state has a different system for gathering and sharing data, making it difficult to make comparisons and standardize data. The CDC has struggled to gather standardized data about firearms-related injuries and deaths, diabetes, and hypertension, among other health concerns, Walensky said.

“Some are still working on 1980s fax machines,” she said.

Walensky promoted a bill in Congress that would create a data center that local health entities could enter information into, ensuring standardization. She said efforts to improve data sharing have led to more than 20,000 health-care facilities nationwide participating in an automated program that aggregates patient data nearly in real time.

Still, those participating represent just 22% of hospitals registered for Medicaid and Medicare services and 9% of rural health providers.

Other conference speakers included Pennsylvania’s incoming governor, Josh Shapiro, who discussed his commitment to working on public health issues such as violence, the environment, and drug addiction. Philadelphia has one of the worst big-city overdose crises in the country: A record 1,276 people died of overdoses here in 2021.

After his public remarks, Shapiro told The Inquirer that he remains opposed to efforts to open a place in Philadelphia where people with addiction can use drugs under medical supervision. The federal government on Monday asked for more time to respond to a lawsuit over a proposed supervised injection site in the city.

Staff writer Aubrey Whelan and the Washington Post contributed to this article.

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How I Learned to Stop Worrying and Love Uncertainty

Like most physicists, I spent much of my career ignoring the majority of quantum mechanics. I was taught the theory in graduate school and applied the mechanics here and there when an interesting problem required it … and that’s about it.

Despite its fearsome reputation, the mathematics of quantum theory is actually rather straightforward. Once you get used to the ins and outs, it’s simpler to solve a wide variety of problems in quantum mechanics than it is in, say, general relativity. And that ease of computation—and the confidence that goes along with wielding the theory—mask most of the deeper issues that hide below the surface.

Deeper issues like the fact that quantum mechanics doesn’t make any sense. Yes, it’s one of the most successful (if not the most successful) theories in all of science. And yes, a typical high school education will give you all the mathematical tools you need to introduce yourself to its inner workings. And yes, for over a century we have failed to come up with an alternative theory of the subatomic universe. Those are all true statements, and yet: Quantum mechanics doesn’t make any sense.

Instead of trying to make sense of the quantum world, let’s use the quantum world to make sense of ours.

The statements that quantum mechanics makes about the subatomic world fly in the face of our natural intuition about the macroscopic world. If I throw a ball at you, you have a decent shot of catching it because you know it will only take a single path. If we make plans for dinner, we don’t need to worry about what the Andromeda Galaxy is doing right now because it’s very far away and thus very unlikely to interfere with our plans. If you see someone walk through your doorway, then you can say with confidence that they did, if fact, walk through your doorway.

And yet all these very reasonable statements break down when we examine the subatomic world. Particles can exist in multiple states at once. They can travel multiple paths at once. Particles can suddenly appear in unexpected places. Particles can maintain a phantom-like connection to each other, known as entanglement, regardless of the distance of their separation. We can’t make confident predictions about the outcomes of experiments, but instead have to rely only on fuzzy probabilities. There are fundamental limits to what we can know.

When I first learned the full extent of quantum weirdness, in school, my brain broke, along with my expectations of how the world works. My first reaction was amazement and wonder at the richness and complexity of the subatomic world. And then … dismay. Heartbreak. Confusion. Torment. A storm of emotions poured over me as I tried, in vain, to go from awestruck wonder to considered understanding.

While my undergraduate and graduate courses on modern physics and quantum mechanics were teaching me these fundamental statements, they didn’t discuss to any significant degree the deep philosophical problems that those statements entail. That kind of reckoning, in my case, didn’t come until over a decade post-Ph.D. As I struggled with the philosophical side of quantum theory, many years after I should have, I discovered to my surprise (and relief) that my struggles were mirrored in the very historical development of the theory itself.

Quantum mechanics is confusing, nonintuitive, and seemingly nonsensical. What I found through my journey is that this confusion and senselessness isn’t a bug, but a feature, and creates a new way to see our everyday life. Instead of interpreting quantum mechanics, I ultimately realized, maybe we should just submit to it—and let quantum mechanics interpret our own lives.

But in order to arrive at this, somewhat unorthodox but ultimately liberating, vantagepoint, I had to journey through the four stages of what I have come to call “quantum grief.”

Stage One: Confusion

The first mystery I encountered, as an undergraduate, of the hidden secrets of the subatomic realm was the bizarre feature of reality called wave-particle duality. In the macroscopic world described by classical physics (the physical view of the world prior to the invention of quantum mechanics) there are two kinds of objects: waves and particles. Particles are generally small, well localized in space, and have a defined, measurable position. If you wanted to, you could point to a particle, and everyone would know that you’re picking out that particle and not another one.

Waves, on the other hand, without a particular place in space, are just kind of … over there, vaguely. It’s much more difficult to point to a wave. Waves also don’t zoom from one place to another, but instead slosh around in complicated patterns.

In this classical view of the world, all fundamental entities are either one or the other. To my undergraduate brain, this simply made sense. But in the quantum view, all objects have properties of both. A single object can sometimes act like a particle or sometimes act like a wave, having wavelike properties in one moment (say, when an electron scatters off of an obstacle, it acts like a wave would) and a particle-like property in another (when that electron finally hits a detection screen, it deposits all its energy in a specific location, much like a particle).

PAGING DOCTORS SCHRÖDINGER AND HEISENBERG: Quantum theory can bring an unexpected peace in the chaos of physics—and the world at large—if we can learn to live our own lives within a quantum framework. Illustration by Zenobillis / Shutterstock.

I had read about this in books as a teenager, but in college I had to confront it head-on in a formal, impossible-to-ignore setting … and it blindsided me. The only response I could conjure was a simple: How?

The wavelike nature of matter doesn’t manifest itself at macroscopic scales, which is why physicists didn’t notice this until they started playing around with subatomic particles at the beginning of the 20th century.

Much like my first taste of the phenomenon, when the early quantum pioneers initially encountered wave-particle duality, their first response was complete and total confusion. What exactly is a wave of matter? How are we supposed to interpret this now-experimentally undeniable aspect of reality?

I would look at my own face in the mirror. Quantum mechanics taught me that what I saw had some very tiny but very real wave nature. But a wave nature of what? My reflection couldn’t give me an answer.

Physicists like Erwin Schrödinger, working in the first half of the 20th century, argued that at tiny scales matter was literally smeared out over space like a wave. He believed that if we could crack open an atom and look at its bits and pieces, we would see tiny little waves wiggling about. Schrödinger would use this insight to develop a wave-based theory of quantum phenomena that was astoundingly successful in describing a wide variety of otherwise perplexing experimental results.

But Schrödinger was not alone amongst the explorers of the unknown quantum land. Other physicists like Werner Heisenberg, working around the same time, argued that we shouldn’t bother even trying to build up a mental picture of what subatomic particles are up to, and should instead just focus on experimental results. He developed a completely different paradigm for answering quantum problems. His method was based on much more difficult mathematics but was nonetheless equally successful.

Cue heated debate, with Schrödinger snubbing Heisenberg’s approach as nonsense, because what good is a physical theory if it can’t paint a picture of the world, and Heisenberg slamming Schrödinger, saying that subatomic physics is so far beyond the realm of human perception that our normal classical thinking is obsolete.

Stage Two: Orthodoxy

Eventually Schrödinger’s idea fell out of favor, as experiment after experiment revealed that subatomic objects, like electrons, while they had wavelike properties, most definitely did not extend through space. By the 1930s, the initial confusion over the onslaught of experimental evidence and theoretical tools eventually gave way to a sort of quantum orthodoxy.

This mirrored my own experience, beginning in graduate school. Aspects of the quantum world, beginning with wave-particle duality, fly in the face of common sense, logic, and our natural intuitions about the world. But then, just when the confusion reaches a crescendo, and it seems like the feeble human intellect will be swallowed by the quantum tempest, comes sweet conceptual deliverance: a formalism.

The relief I felt when I finally learned the postulates and mathematical framework of quantum mechanics is nearly indescribable. It’s like this wonderful escape hatch, liberating yourself of the mental burden of trying to untangle the Gordian knots of quantum reality, set free to dance through the blissful fields of getting work done.

This confusion and senselessness isn’t a bug, but a feature, and creates a new way to see our everyday life.

In the 1930s, physicists like John von Neumann would take the various initial attempts at quantum mechanics and craft it into a cohesive, rigorous whole. Finally, after decades of study, we had a firm physical theory based on a limited set of founding postulates, a full mathematical language for writing down problems and finding their solutions, and a wide variety of interesting applications to tackle with the theory: the nature of atomic absorption and emission, the building blocks of chemical and nuclear physics, the creation and manipulation fundamental particles, and so much more. We had a physics of the subatomic world.

The interpretation of what the mathematics said about the world slid away from the hopes of Schrödinger and fell firmly into the Heisenberg camp: Don’t worry about the details, and just focus on solving problems. The wavelike nature of particles was demoted into a mere mathematical trick, a way of calculating probabilities rather than an extant property of nature. Other results of the wave-nature of matter, like entanglement or “spooky action at a distance,” were accepted as straightforward facts without any deeper discussion about what that entailed.

Quantum mechanics was weird and made no sense, but it worked, dang it.

And in that work I found safety. I didn’t have to worry about mysterious quantum this-or-that, about what was actually happening, as long as I could keep putting the mathematical pieces together. It felt good to solve problems, to find interesting applications. As a physicist, I developed a new kind of intuition, one not based on growing up a living, thinking, macroscopic creature, but an instinctual grasp of the symbols and machinery of quantum mechanics. I began to intuit which problems were well suited to the theory, and which ones were not. I found myself able to cast meaningful physical questions about the real world into the language of von Neumann—and, amazingly, get an answer, a result that I could test against experiment (as I and my classmates did, in the lab sections of our classes).

I began to believe that I finally—finally—had a firm grip on understanding quantum mechanics.

Stage Three: Rebellion

That is, as long as I didn’t think too hard about what it all means. The siren song of quantum formalism, the raw math, was all too tempting. But follow it too far and you are bound to crash into the sharp unyielding rocks of a deceptively simple question: What does quantum mechanics actually mean?

Schrödinger had his doubts. So did Einstein. So, even, did Heisenberg and Bohr and Dirac and von Neumann and all the other founders of quantum theory. The difference is that Schrödinger and Einstein would go to their graves believing that quantum mechanics was incomplete, while the others held on to the slim comfort that our physical theories had finally taken us to a place that we could not otherwise mentally comprehend … but at least we could get answers and validate against experiment, which was good enough.

The dominant interpretation of quantum mechanics is called the Copenhagen interpretation. If you’ve ever done any reading on the subject, you’ve probably encountered it already. It’s the default assumption of how quantum theory should be viewed, and it’s the default treatment given in a typical physics education, including mine. At its highest level the Copenhagen interpretation instructs us to not sweat the small stuff and just focus on the math. Matter has a wavelike property that maps out probabilities for the outcomes of experiments. When we perform an observation, that wave and all those probabilities snap out of existence, to be replaced with a single result in our apparatus. Aspects like fundamental uncertainty principles and non-local entanglement are simply facets of the full theory.

Quantum mechanics doesn’t make any sense.

How does it all work? Why do the waves snap out of existence upon measurement? How can two distant particles be aware of their entangled partner without exchanging information? What is the state of reality when we’re not observing it? These are all questions that the Copenhagen interpretation ignores, because it says that they’re not important: What matters is results, results, results.

And so I, ever the lifelong student, had to eventually confront the Copenhagen interpretation and its explicit lack of desire to explain anything further. Some physicists are fine with this, choosing to “shut up and calculate” and accept that our puny human brains can’t possibly imagine or envisage what’s happening at the subatomic level. And many I know find a sort of comfort in that.

Other physicists are less fine with this. Thankfully for them, there are plenty of other interpretations to choose from. Some elevate the wavelike nature of matter to a real entity. Some claim that consciousness plays a critical role in the measurement process. Some say that it’s all an illusion of shifting information. There are … more. Dozens of potential interpretations, all selecting some parts of quantum theory to be true and other parts to be mere mathematical artifacts.

For some physicists dissatisfied with the aloofness of the Copenhagen interpretation, they find refuge in these alternative interpretations.

I did not. The interpretations of quantum mechanics try to make sense out of the nonsense by applying a layer of rationality on top of the bare mathematics of the theory—a bedtime story to help us sleep at night when we can’t stop thinking about how strange the subatomic world is. I myself tried to find salvation in interpretations, years after learning the theory itself in graduate school, hopping from paper to paper like a neophyte trying out different religions.

Ultimately, I couldn’t find any interpretations that were satisfying. The classic Copenhagen left a sour taste in my mouth for its refusal to paint a picture of subatomic processes—I believe that humanity is smarter and cleverer than Heisenberg gave us credit for. But the other interpretations have their own shortcomings. For example, if you follow the logic of making the wave-nature real, you end up with parallel universes constantly splitting into existence … with no further explanation of how that’s supposed to work. And so on and so on. For every interpretation, there are some attractive features to it, and some parts of its own theory that it fails to explain.

Stage Four: Acceptance

So what was I to do if none of the interpretations seemed to satisfy that deeper craving to live in an understandable universe? One answer is to retreat back to the safety of the Copenhagen interpretation, finding solace in the mathematics and giving up on the dream of visualizing subatomic processes. Another is to dig deep into one of the alternative interpretations, believing that with enough work and enough cleverness, I could overcome their shortcomings and build a coherent, consistent, complete model of the universe.

There is another way, one that I found after years of frustration, and that is to completely subsume myself into the weird and wonderful quantum world, embracing the ultimate lessons of the theory. We have tried for over a hundred years to force an interpretation on the theory, to no avail. So perhaps that’s nature trying to tell us something: that no interpretations are available to us.

The experimentally verified reality of quantum mechanics is, indeed, that classical thinking, based on our intuitions of the macroscopic world, is inadequate to describe every aspect of the cosmos. And trying to create an interpretation and insist that it’s the correct one—even the Copenhagen interpretation—is precisely the trap of classical, binary, yes/no thinking that the subatomic world is trying to tell us to avoid.

Here’s the mental model I eventually settled on, after years of apathy and antipathy: Instead of trying to make sense of the quantum world, let’s use the quantum world to make sense of ours. Thinking about quantum behavior seems absurd, but that’s only because we live and breathe in a classical world. So what if we tried to live in a fully quantum one, even in our everyday lives?

When I released myself from interpretation, I found the freedom to see the fundamental lessons of quantum mechanics: probabilities, uncertainties, non-locality, entanglements, and so much more, and apply those lessons to my life.

For example, I could begin to live my life truly accepting the uncertainty of the future, setting goals and visions without the burden of concrete expectations. I could acknowledge that my actions had influence across the globe, with even small gestures of kindness or charity making an impact. I accepted that I can’t know everything as well as I wish I could. I stopped myself from falling into binary, either/or choices, allowing situations, choices, and even people to be more complex than that. As I continued to put these thoughts into daily practice, I found that Schrödinger, Heisenberg, and the rest sounded less and less like physicists and more and more like therapists (indeed, nothing I had learned was a new revelation to mental health professionals). These were useful lessons that enriched and informed my daily life: Through a quantum lens, I found happiness, contentment, satisfaction, and a better sense of my own humanity.

It wasn’t easy—and it still isn’t. I still feel the occasionally classical tug to insist on an interpretation, or to finally get to the bottom of all this quantum nonsense. Every day I have to wake up and resist those temptations and remind myself that the quantum world—the real world—is so much more rich and vibrant and wonderful than that.

Paul M. Sutter is a research professor in astrophysics at the Institute for Advanced Computational Science at Stony Brook University and a guest researcher at the Flatiron Institute in New York City. He is the author of Your Place in the Universe: Understanding our Big, Messy Existence.

Lead image: Mentalmind / Shutterstock




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What’s behind worrying RSV surge in US children’s hospitals?

Children’s hospitals in parts of the U.S. are seeing a surge in a common respiratory illness that can cause severe breathing problems for babies.

RSV cases fell dramatically two years ago as the pandemic shut down schools, day cares and businesses. With restrictions easing in the summer of 2021, doctors saw an alarming increase in what is normally a fall and winter virus.

Now, it’s back again. And doctors are bracing for the possibility that RSV, flu and COVID-19 could combine to stress hospitals.

“I’m calling it an emergency,” said Dr. Juan Salazar of Connecticut Children’s Hospital, where RSV has caused a shuffling of patients into playrooms and other spaces not normally used for beds. The institution explored using a National Guard field hospital, but has set aside that option for now.

A look at RSV and what the recent surge may mean:

WHAT IS RSV?

It stands for respiratory syncytial virus, a common cause of mild cold-like symptoms such as runny nose, cough and fever. Nearly all U.S. children normally catch an RSV infection by age 2.

People infected are usually contagious for three to eight days. Babies and people with weakened immune systems can spread RSV for up to four weeks. There is no vaccine for it, though several candidates are in testing.

WHO DOES IT AFFECT?

Everyone can get RSV. But it causes the most threat to infants, older adults and other vulnerable people, who can get serious airway and lung infections.

Among U.S. kids under age 5, RSV typically leads to 58,000 hospitalizations and up to 500 deaths in a year.

For adults 65 and older, RSV causes 177,000 hospitalizations and 14,000 deaths yearly.

For babies, the struggle to breathe can interfere with eating. “And that’s really when we start to worry,” said Dr. Melanie Kitagawa of Texas Children’s Hospital in Houston, where more than 40 children have RSV.

“They’re breathing fast, breathing deep. We see them using muscles in their chest to help them breathe,” Kitagawa said. “These are kids who are having difficulty taking a bottle because their breathing is being impacted and they can’t coordinate both at once.”

WHY IS THERE AN INCREASE NOW?

The virus is encountering a highly vulnerable population of babies and children who were sheltered from common bugs during the pandemic lockdowns.

Immune systems might not be as prepared to fight the virus after more than two years of masking, which offered protection, according to Dr. Elizabeth Mack of Medical University of South Carolina.

“South Carolina is drowning in RSV,” Mack said in a news release. The surge arrived earlier this year than normal, she said.

For babies, their mothers may not have been infected with RSV during pregnancy, which could have given the children some immunity.

U.S. health officials have noted a rise this month in national reports of respiratory illnesses, which they say is at least partly due to the early spread of flu in much of the South.

Last week, more than 7,000 tests came back positive for RSV, according to CDC figures. That’s more than in previous surges.

IS THERE A TREATMENT?

There’s no specific treatment, so it’s a matter of managing symptoms and letting the virus run its course. Doctors may prescribe oral steroids or an inhaler to make breathing easier.

In serious cases, patients in the hospital may get oxygen, a breathing tube or a ventilator.

WHAT DO DOCTORS RECOMMEND?

Prevent the spread of viruses by washing hands thoroughly and staying home when you’re sick.

During RSV season, an injection of an antibody-based medicine is sometimes prescribed to protect premature infants and other very vulnerable babies.

If you’re worried your child is having a severe breathing problem, “do not hesitate” to go to an emergency department or call 911, said Dr. Russell Migita of Seattle Children’s Hospital, where RSV is on the rise.

For less severe medical problems, Migita said, call your regular health care provider for advice, use telehealth or go to urgent care.

In Chicago on Saturday, Dr. Juanita Mora saw a family of five kids all with RSV, ranging from a 3-year-old to a teenager. Fearing what’s ahead this winter, she’s telling everyone to get a flu shot and a COVID-19 booster.

“We don’t want a triple whammy, a triple pandemic,” Mora said.

___

Associated Press/Report for America reporter James Pollard contributed from Columbia, South Carolina. AP Medical Writer Mike Stobbe contributed.

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

Read original article here

What’s behind worrying RSV surge in US children’s hospitals?

Children’s hospitals in parts of the U.S. are seeing a surge in a common respiratory illness that can cause severe breathing problems for babies.

RSV cases fell dramatically two years ago as the pandemic shut down schools, day cares and businesses. With restrictions easing in the summer of 2021, doctors saw an alarming increase in what is normally a fall and winter virus.

Now, it’s back again. And doctors are bracing for the possibility that RSV, flu and COVID-19 could combine to stress hospitals.

“I’m calling it an emergency,” said Dr. Juan Salazar of Connecticut Children’s Hospital, where RSV has caused a shuffling of patients into playrooms and other spaces not normally used for beds. The institution explored using a National Guard field hospital, but has set aside that option for now.

A look at RSV and what the recent surge may mean:

WHAT IS RSV?

It stands for respiratory syncytial virus, a common cause of mild cold-like symptoms such as runny nose, cough and fever. Nearly all U.S. children normally catch an RSV infection by age 2.

People infected are usually contagious for three to eight days. Babies and people with weakened immune systems can spread RSV for up to four weeks. There is no vaccine for it, though several candidates are in testing.

WHO DOES IT AFFECT?

Everyone can get RSV. But it causes the most threat to infants, older adults and other vulnerable people, who can get serious airway and lung infections.

Among U.S. kids under age 5, RSV typically leads to 58,000 hospitalizations and up to 500 deaths in a year.

For adults 65 and older, RSV causes 177,000 hospitalizations and 14,000 deaths yearly.

For babies, the struggle to breathe can interfere with eating. “And that’s really when we start to worry,” said Dr. Melanie Kitagawa of Texas Children’s Hospital in Houston, where more than 40 children have RSV.

“They’re breathing fast, breathing deep. We see them using muscles in their chest to help them breathe,” Kitagawa said. “These are kids who are having difficulty taking a bottle because their breathing is being impacted and they can’t coordinate both at once.”

WHY IS THERE AN INCREASE NOW?

The virus is encountering a highly vulnerable population of babies and children who were sheltered from common bugs during the pandemic lockdowns.

Immune systems might not be as prepared to fight the virus after more than two years of masking, which offered protection, according to Dr. Elizabeth Mack of Medical University of South Carolina.

“South Carolina is drowning in RSV,” Mack said in a news release. The surge arrived earlier this year than normal, she said.

For babies, their mothers may not have been infected with RSV during pregnancy, which could have given the children some immunity.

U.S. health officials have noted a rise this month in national reports of respiratory illnesses, which they say is at least partly due to the early spread of flu in much of the South.

Last week, more than 7,000 tests came back positive for RSV, according to CDC figures. That’s more than in previous surges.

IS THERE A TREATMENT?

There’s no specific treatment, so it’s a matter of managing symptoms and letting the virus run its course. Doctors may prescribe oral steroids or an inhaler to make breathing easier.

In serious cases, patients in the hospital may get oxygen, a breathing tube or a ventilator.

WHAT DO DOCTORS RECOMMEND?

Prevent the spread of viruses by washing hands thoroughly and staying home when you’re sick.

During RSV season, an injection of an antibody-based medicine is sometimes prescribed to protect premature infants and other very vulnerable babies.

If you’re worried your child is having a severe breathing problem, “do not hesitate” to go to an emergency department or call 911, said Dr. Russell Migita of Seattle Children’s Hospital, where RSV is on the rise.

For less severe medical problems, Migita said, call your regular health care provider for advice, use telehealth or go to urgent care.

In Chicago on Saturday, Dr. Juanita Mora saw a family of five kids all with RSV, ranging from a 3-year-old to a teenager. Fearing what’s ahead this winter, she’s telling everyone to get a flu shot and a COVID-19 booster.

“We don’t want a triple whammy, a triple pandemic,” Mora said.

___

Associated Press/Report for America reporter James Pollard contributed from Columbia, South Carolina. AP Medical Writer Mike Stobbe contributed.

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

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There Are Worrying New Reports About Cara Delevingne Amid Fan Concerns

According to a new report from TMZ on Friday (September 16), friends claim that she is struggling with issues beyond substance abuse.

One of her closest friends, Margot Robbie, was seen visibly distraught this week leaving Cara‘s house in Los Angeles.

“We’re told Cara‘s been struggling for a while now, initially with mental health issues, but now the people closest to her believe she needs rehab too. We’re told Margot and other friends are advocating for Cara to immediately get into a treatment program that includes mental therapy as well as substance abuse treatment,” the outlet reports.

Last week, Cara was seen appearing seemingly confused after initially boarding one of Jay-Z‘s private jets in Los Angeles. The flight never took off, and she got off it 45 minutes later.

Cara is reportedly not opposed to treatment, but is “dragging her feet” and is struggling.

We are wishing the best to Cara Delevingne at this time.



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Stop scolding people for worrying about monkeypox

In the past few weeks, more than 350 cases of monkeypox — a viral disease that’s a much milder cousin of smallpox — have been reported in more than 20 countries worldwide. That’s a surprise, and an unpleasant one. Monkeypox has surfaced periodically in the Congo Basin and in West Africa since its discovery in the 1950s, but past outbreaks haven’t involved cases in this many countries, or this degree of apparent person-to-person spread.

Still, because as far as we know from past outbreaks monkeypox usually isn’t very contagious and a good vaccine already exists, it ought to be possible to contain even this apparently larger outbreak. Hence many public health officials have emphasized, in their communications about monkeypox, that people shouldn’t worry or overreact.

Panic is never a good public health strategy, but in attempting to preemptively tamp down public fear, I think experts are failing to learn one of the most important lessons of Covid-19: that we’re too afraid of “alarmism” when outbreaks hit, and should spend less time telling people not to overreact and more time telling them what’s actually going on.

The impulse on the part of the public health community to try to manage public emotion — rather than provide the public with facts — has dogged us throughout the pandemic, often making it harder to make good decisions. Assurances that people didn’t need masks, meant to protect the supply for health care workers, lastingly damaged trust and masking rates. The CDC’s initial decision not to track breakthrough infections — seemingly meant to show confidence in the vaccines — made it harder to tell how long vaccine-based immunity lasted.

There are some solid epidemiological reasons to conclude that monkeypox doesn’t pose the same threat to the world that Covid-19 did in 2020. But instead of condemning alarmism, experts should acknowledge the many reasons for that alarm. The world is horribly vulnerable to the next pandemic, we know it will hit at some point, and the undetected spread of monkeypox around the world until there were dozens of cases in non-endemic countries — despite the fact it typically has low transmissibility — shows how profoundly we’ve failed to learn the lessons from Covid-19 we need to avoid a catastrophic repeat.

Experts should focus more on communicating what they know about monkeypox, pandemics, and the fragility of our current system, aiming to tell people what they can do and the policies they can support in response to their justified fear — instead of preemptively warning against “panic.”

Monkeypox, explained

Monkeypox was first identified in research animals in the 1950s, and can cause flu-like symptoms and a characteristic rash with round red blisters all over the body when it infects unprotected humans. The fatality rate has historically ranged from zero to 11 percent, according to the World Health Organization.

For decades, outbreaks among humans were rare, in significant part because the smallpox vaccine protects against monkeypox, and smallpox vaccination was common. In recent years, though, monkeypox cases have been on the rise as vaccination against smallpox, which was eradicated in 1979, began to wane. According to the CDC, Nigeria has reported 450 monkeypox cases since 2017 — not a lot, but a significant increase from case rates in previous decades.

Despite that rise and the more recent spread to new countries, there’s reason for optimism that we can prevent a large-scale pandemic of monkeypox. While the variant causing the current outbreaks isn’t fully understood, and we should not rule out that the virus is substantially more transmissible than we’re used to, the disease in general is a known quantity. Even under pessimistic assumptions about the transmissibility of this new variant, it is much less transmissible than the coronavirus that causes Covid-19, which originally had an R0 of 2-3 and now has an R0 of 8-10 for people without preexisting immunity. Unlike Covid-19, monkeypox is thought to be only contagious while patients are symptomatic, which provides additional reason for optimism about containment.

But optimism should not equal complacency.

A large international outbreak of a disease that was previously thought to be very hard to transmit person-to-person is bad news, period. There are still a lot of unknowns here, and until we know exactly what happened and have slowed the growth of new cases, the chance of this variant of monkeypox being substantially more transmissible — and hard to contain — is not so low that we can confidently assert that everything will be fine.

The lessons of Covid-19

Writing this article, I had an eerie sense of déjà vu. I wrote a similar one in early February of 2020, when Americans were just starting to hear about Covid-19. In that article, I rounded up some takes on the then very novel coronavirus that were in the headlines at the time:

“Don’t worry about the coronavirus. Worry about the flu,” BuzzFeed argued. The flu “poses the bigger and more pressing peril,” the Washington Post said. “Why should we be afraid of something that has not killed people here in this country?” an epidemiologist argued in the LA Times. Other outlets have agreed. An ex-White House health adviser has told Americans to “stop panicking and being hysterical.”

Bad call, I argued at the time. We didn’t know yet how transmissible the coronavirus was. We didn’t know if the early numbers out of China, where the first cases were recorded, were misleading. (It’s now believed they almost certainly were.) “That’s just far too much uncertainty to assure people that they have nothing to worry about,” I wrote. “And misleadingly assuring people that there’s nothing to worry about can end up doing harm.”

Obviously, Covid-19 has done quite a lot of harm, to the tune of more than 1 million dead in the US alone. But we’re at risk of forgetting some of those major lessons from early 2020.

Last week, CNN quoted the CDC’s Jennifer McQuiston, deputy director of the Division of High Consequence Pathogens and Pathology, as saying: “There really aren’t that many cases that are being reported — I think maybe a dozen, a couple dozen — so, the general public should not be concerned that they are at immediate risk for monkeypox.”

This seems true, technically. Most Americans are not at immediate risk of exposure to monkeypox, just like in early February 2020 they weren’t at immediate risk of exposure to the coronavirus (there may have only been a few dozen cases in the US at that time). But this neglects the factor of exponential growth. The thing that’s scary about infectious disease is that a few cases can rapidly become more cases, and eventually become lots of cases. Monkeypox probably isn’t very transmissible, but until we’ve actually contained it, we don’t know how easy it will be to contain, and the fact there aren’t very many cases yet just isn’t that reassuring.

“‘No reason for alarm’ is bad science as well as bad risk communication,” I quoted risk communications expert Peter Sandman as saying in that 2020 story. “Telling people not to worry about an emerging infectious disease because it isn’t a significant risk here and now is foolish. We want people to worry about measles when there’s very little measles around, so they will take the precaution of vaccinating their children before it’s imminently necessary. We want people to worry about retirement when they’re years away from retiring, so they will start saving now.”

Yet the impulse to focus on assuring Americans they shouldn’t panic about monkeypox is very much on display.

“There’s certainly no reason to panic,” Daniel Bausch, president of the American Society of Tropical Medicine & Hygiene, told CNN. Reason ran an article titled Don’t Panic Over Monkeypox. “Don’t worry — at least about this,” Geoffrey Smith, a University of Cambridge poxvirus virologist, told the Washington Post.

I agree with the more nuanced opinions each of these experts share when they’re given a bit more space to expound on their views. It’s straightforwardly true that monkeypox should be easier to contain with contact tracing and vaccination than Covid-19 was.

But everyone’s insistence on prefacing that nuance by telling me not to worry drives me nuts, and I think reflects a mistake in our thinking about pandemics.

Being alarmed about pandemics is completely reasonable

A fact that should not need saying in 2022: Pandemics cause immense human suffering and death. Even if a disease kills only one in 1,000 people who get sick with it, if it hits a billion people worldwide, that’s a million dead. Infectious disease has killed more people than any war in history, and experts keep on warning us that a pandemic much, much worse than Covid-19 is very much possible and really could happen.

The 1918 flu was deadlier than Covid-19, and deadly in particular to healthy young people. A repeat would be devastating, and the world isn’t particularly prepared. Smallpox, when it existed, had an estimated 30 percent mortality rate. The US has vaccines stockpiled in case a lab accident, terrorist act, or bioweapon ever unleashes it on the world again, but vaccinating the whole world against a disease — as we’ve seen with Covid-19 — is hard to do as quickly as a contagious disease can move.

It’s not just diseases from nature, either. With rapid advances in biological engineering, it’s now entirely possible to make diseases that could put smallpox and the flu to shame. “Gain of function” work on making deadly diseases deadlier is ongoing. A small group of bad actors could unleash a virus that kills millions of people — and the systems in place to prevent that are limited, underresourced, and inadequate for the stakes.

In that light, all the focus on telling people not to worry about monkeypox seems a little silly. There are genuine concerns about not crying wolf, about preserving credibility so that when you tell people ‘this is the big one’, they listen. But institutions that initially failed to say “this is the big one” about Covid-19 in February 2020 — and told us, instead, to worry about the flu — aren’t going to repair their damaged credibility by maintaining the same course.

The course I’d like to see them take instead is the one Sandman, the risk communications expert, recommended with Covid-19: “Instead of deriding people’s fears about the Wuhan coronavirus,” he wrote, “I would advise officials and reporters to focus more on the high likelihood that things will get worse and the not-so-small possibility that they will get much worse.”

Taking “worry” off of center stage

Many of the biggest missteps of the last few years have happened when our public health and communications institutions have tried to manage public reactions to what they have to say: from Fauci saying that he dismissed mask-wearing early on in the pandemic out of fears of causing mass panic, to worries that endorsing booster shots (even as the evidence grew they were needed) would make the vaccines look bad, to the FDA’s earlier seeming reluctance to authorize vaccines for children under age 5, despite data justifying it, out of concerns that authorizing Pfizer and Moderna at different times would confuse the public.

In general, I’d like to see public health officials step back entirely from trying to manage our feelings about outbreaks. Don’t tell us to worry or not to worry, or not to worry yet. Don’t tell us to worry about something else instead. Tell us what measures are being taken to contain the monkeypox outbreak, and prevent the next monkeypox outbreak, and prevent the next outbreak of something much, much worse than monkeypox. By all means, explain the reasons to think monkeypox is likely not very transmissible; that’s important information you have relevant expertise on, unlike trying to manage the public’s feelings.

And for its part, the media should stop asking public health officials “should I worry?” instead of asking them the questions they are much more equipped to answer: What policies would have prevented this outbreak? What measures need to be in place to contain it? What scenarios are plausible from here?

In many cases, “don’t worry” is just being used as shorthand for “there’s good reason to think monkeypox won’t cause a global pandemic” — which, to be clear, is a true claim. But I think it’s worth spelling out the longer claim, rather than treating worry as the key consideration. People shouldn’t be encouraged to view outbreaks through the lens of “should I be scared?” but rather through the lens of “will this be contained, what will it take to contain it, and if it’s not contained, what effects will it have on the world?”

Once you have the accurate facts about monkeypox — and about the risk of pandemics generally — whether you’re worried by those facts isn’t really a question for the CDC.

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Why more COVID-19 in Salt Lake County wastewater isn’t worrying officials

COVID-19 risk levels in the areas served by both the South Valley and Jordan Basin water reclamation facilities have moved up enough to make the state’s watch list, but a Salt Lake County Health Department official said that doesn’t mean another virus surge is coming.

“I don’t think we have a reason to think that transmission is going to explode like it did in January,” Kylie Sage, the county health department’s data and surveillance manager said, citing still low rates of emergency room visits for the virus and the availability of more vaccinations and treatments.

“People have more options for protection and so those three indicators together don’t necessarily spark immediate concern,” Sage said, even though the county, like the state, is now relying on a measure of the presence of COVID-19 in feces samples collected at sewage treatment plants to monitor outbreaks rather than case counts.

“Wastewater tells us what we might be able to expect, but it’s just one tool in the surveillance toolbox. And because of that, we shouldn’t necessarily react to every fluctuation in the data. We know that COVID is still spreading in our communities,” Sage said, so some ups and downs are likely.

COVID-19 cases are climbing in other parts of the country as so-called “stealth omicron” sweeps through the United States. According to theCenters for Disease Control and Prevention, the even more highly transmissible subvariant of omicron, which drove Utah’s case counts to record highs in January, now dominates this region.

But Salt Lake County’s wastewater surveillance levels are comparable to the same point last year, Sage said. Since then, children have become eligible for COVID-19 vaccinations and booster doses have become available, including a second booster dose for those 50 and older or who are immunocompromised.

Utah has just moved to a new “steady state” pandemic response announced earlier this yearby Gov. Spencer Cox. The governor said by March 31, the state would end most testing and treatment and begin dealing with COVID-19 more like the flu or other endemic disease that, while still deadly, isn’t a constant threat.

Under the new response, the Utah Department of Health has replaced daily reports on COVID-19 with a single update posted online Thursdays at coronavirus.utah.gov that includes data from the state’s twice-weekly analysis of wastewater samples gathered from 32 sites around the state.

While Thursday’s update showed increases in the virus at just six sites, a map on another state website, wastewatervirus.utah.gov, on Friday showed nine sites have higher levels of COVID-19 but still puts the South Valley facility in the unchanged category.

Sage said both South Valley and Jordan Basin don’t just have more COVID-19 being detected, but she said it’s enough that the state has now deemed them sites to watch. The state defines the level as “of potential concern, but not high enough to be considered elevated.”

Nathan LaCross, the state health department wastewater surveillance manager, said after the state’s weekly update came out Thursday, new data has moved sites in Moab and Park City to the highest risk level, elevated, and four sites — the two in Salt Lake County, one in Davis County and another in Hyrum — to the watch list.

He said even though the Moab and Park City systems have been determined to have elevated levels of COVID-19, no one there should be “incredibly alarmed, but they should be aware that there are strong indications we’re seeing more transmission in some areas and take appropriate measures,” such as social distancing.

There’s no such red flag in Salt Lake County yet, but Sage offered similar suggestions.

“My advice would be to stay diligent in the really simple ways that you can protect yourself — washing your hands, staying home if you’re sick, getting vaccinated if you’re not, or boosted if you’re eligible,” she said. “Really, just abiding by those hygiene practices we’ve all become so familiar with in the past two years.”

Most people don’t need to wear masks or social distance, Sage said, unless they are at high risk for severe illness from COVID-19 or regularly interact with someone who is. The COVID-19 vaccine still offers the best protection against hospitalization or death, said.

And COVID-19 isn’t the only virus on the upswing in Salt Lake County — so is the flu, Sage said.

“It’s still low but it is unusual that at this point in the year, flu activity is going up. Normally spring is the end of our flu season,” she said. Flu had all but disappeared during the first winter of the pandemic, but now many people are more relaxed about the hygiene habits they adopted against COVID-19.

“I think that’s the most likely cause” of the increase in the flu, she said, urging those who have not done so to get a flu shot. “More or less, everybody’s gone back to their quote-unquote normal lives and as we see more people and do more things, that just gives us more potential to spread different viruses.”

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Artificial sweeteners cause cancer in mice. Here’s worrying data from humans.

Since the 1940s, studies have linked the wide use of artificial sweeteners to cancer in lab mice. In the 1970s, this led the U.S. to put cigarette package-like warning labels on anything containing saccharin. But in recent decades, scientists have mostly written off mice studies as inconclusive. Research on rodents cannot say anything definitive about to the risk for people.

Now a new study, published Thursday in PLOS Medicine, presents some troubling data from humans.

What’s New — Researchers combed through more than a decade of health data from 102,865 French volunteers. They found that consumption of artificial sweeteners was associated with an increased risk of cancer. Specifically, the researchers found that those who consumed any kind of artificial sweetener had a 13-to-14 percent higher probability of developing cancer than those who did not.

Artificial sweeteners are chemical creations that have almost no calories, making them seem like a healthy alternative to sugar.

The researchers looked at three common sweeteners individually: aspartame, acesulfame potassium, and sucralose. Acesulfame potassium is sold in the U.S. under the brand names Sunett and Sweet One. Aspartame is sold as NutraSweet or Equal. Sucralose you may know as Splenda.

  • Cancer rates were 15 percent greater for higher consumers of aspartame and 12 percent greater for lower consumers. More than the others, aspartame intake was associated with an increased risk of breast cancer, with a 22-percent greater chance for higher consumers.
  • Cancer rates were 13 percent greater for higher consumers of acesulfame potassium and 12 percent for lower consumers.
  • Sucralose seemed to have the least association with cancer: Rates were not greater for higher consumers and 3 percent greater for low consumers.

Because artificial sweeteners differ vastly in how much of each is needed for desired sweetness, researchers calculated individual measurements of high and low for each one.

As is common in such studies, all these numbers were the result of adjustments to account for some factors relevant to cancer risk, including age, gender, and tobacco use, to make them more representative to the entire French population.

How They Did It — The researchers used data from the NutriNet-Santé study for which more than 170,000 French citizens have agreed to submit information about their habits and health outcomes for decades for researchers to mine for correlations. The study started in 2009. The researchers looked at data from then until January of 2021.

Every six months, volunteers get an alert to keep a diet diary, recording all foods and beverages they consumed that day, even taking photographs and keeping containers to establish serving sizes. Because of this, researchers got a decent record of which artificial sweeteners a person consumed on an average day and how much.

Why It Matters — Artificial sweeteners — also called sugar substitutes, non-nutritive sweeteners, and high-intensity sweeteners — are chemical creations that have almost no calories, making them seem like a healthy alternative to sugar. (The whole idea of diet soda was replacing the natural sugar that was once used in Coca-Cola with a no-calorie replacement.)

The FDA currently allows six artificial sweeteners in the U.S. and they are in wide usage in processed foods:

  • Saccharin was discovered in 1879 and is still found in fruit juices, candies, jams, jellies, and cookies, particularly those with a “low fat” label.
  • Aspartame was approved by the FDA in 1981 and often added to sodas, energy drinks, desserts, candy, chewing gum, and weight control products.
  • Acesulfame potassium, approved in 1988, is used in sodas and protein shakes and added to medicines to make them more pleasant to taste.
  • Sucralose was approved in 1998 and used for many of the same purposes as aspartame.
  • Neotame and advantame, approved in 2002 and 2014, respectively, and not commonly used yet.

The first four are also allowed in the European Union.

Almost as soon as Johns Hopkins University chemists discovered saccharin, debate raged about the safety of artificial sweeteners.

A product of the 80s fitness craze, diet soda replaced sugar with artificial sweeteners to create a low-calorie soda.Jonathan Brady – PA Images/PA Images/Getty Images

After the Pure Food and Drug Act was passed in 1906, amid fears about the “adulteration” of food, the newly created Food and Drug Administration considered banning saccharin altogether. President Theodore Roosevelt, who was on a sugar-free diet, intervened and even called his public health advisor “an idiot” over the issue.

Studies showing that saccharin caused bladder cancer in mice led to its labeling in the U.S., banning in Canada, and a worldwide decline in its use. Starting in 1978, every packet of Sweet ’N Low and countless cans of diet soda cautioned that they contained a product that caused cancer in lab animals.

Scientists came to see this reasoning as flawed, even panicked; the mechanism by which saccharin caused cancer in mice did not apply to humans and one would have to drink hundreds of twelve-ounce saccharin-infused diet sodas daily to reach the doses fed to lab mice. The U.S. removed warning labels in 2000 and Canada reversed its ban in 2011.

After all this, many are now confused if they are “better” than sugar.

The researchers say that this is the first study to evaluate artificial sweeteners directly and not soda as a proxy. Research like this could settle the debate over artificial sweeteners, but will probably first reignite it.

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