Does 'cycle syncing' your workouts give you better results? We asked the experts

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(NEW YORK) -- If you're a female who loves fitness you may have heard the term "cycle syncing," the idea that you should change up your workouts based on where you are in your menstrual cycle.

The impact of the menstrual cycle in women's sports has been prominent among professional athletes over the last few years with the U.S. Women's National Soccer Team tracking their periods ahead of their 2018 World Cup win as a strategy to maximize performance. This year, Orlando Pride, a National Women's Soccer League team based in Florida, changed their uniforms from white shorts to black shorts to help players feel more "comfortable and confident" while playing on their periods.

Now, curiosity over how the menstrual cycle impacts performance has gone mainstream. The hashtag #cyclesyncing has been used more than 280 million times on TikTok with millions of women sharing how changing their workouts each month based on where they are in their menstrual cycle has benefited their personal health.

Cycle syncing focuses on four main phases of the menstrual cycle: the menstrual phase, follicular phase, ovulatory phase and luteal phase. This training regimen recommends doing different types of workouts for the four different stages of your cycle.

The breakdown of the average cycle syncing training regimen, according to Nike trainer Lauren Schramm, looks like this:

  • Menstrual phase: Lasts three to seven days. Rest on days one and two of your period, then use optimal movement for when energy levels are low and rest needed is high with activities such as yoga, walking, and barre.
  • Follicular phase: Lasts around seven days. Focus on speed, power and optimal movement for when energy levels are low to moderate and rest needed is moderate with activities such as heavy lifting, HIIT, boxing, dance and track workouts.
  • Ovulatory phase: Lasts around three to seven days. Focus on aerobic, endurance and optimal movement for when energy levels are the highest and rest needed is low with activities such as a group fitness classes, long runs, cycling and hot yoga.
  • Luteal phase: Lasts around seven days. Focus on mobility, recovery and optimal moment for when energy levels are low to moderate and rest needed is moderate to high. Activities can include mobility training, stretching, breath work, yoga and massage.

Does cycle syncing your workouts really help your performance? How can you effectively track your cycle? Is it one size fits all? We asked the experts.

What experts know about cycle syncing

Dr. Ellen Casey, a sports medicine physician from the Department of Physiatry and the Women's Sports Medicine Center at the Hospital for Special Surgery in New York City, spoke with ABC News' Good Morning America about her thoughts on the science of cycle syncing.

While your menstrual cycle will impact your physical performance and energy levels, Casey, who has been researching this topic since 2009, says there are benefits for female athletes to track their cycles, but adds there is not enough scientific evidence to show this structured "cycle syncing" method works for everyone.

"I do think it's very important for female athletes to track their cycles," Casey says. "It's when you try to give a sort of group recommendation that I think [is] where we're falling short to date in the literature, and where I worry that there may be some overselling of cycle tracking and conforming that to your workouts, because we don't have the data to support that as a group effect at this time."

Casey said that everyone's cycle is different -- things like the length of phases and estrogen levels vary for every person. This makes it difficult to track the change in phases without using an ovulation stick every morning, which she said can be expensive and time consuming.

"Even if we know exactly that everybody's on day 10 of their follicular phase, it's still going to be different, because my level of estrogen might be totally different than yours," Casey said.

While the cycle syncing method can be used as a baseline, Casey said without proper equipment, like using an ovulation stick each day, there is no sure, scientific way to tell what phase of your cycle your body is in.

"What would be nice is for everybody to be like, 'Cool, this is where I'm really going to push my strength gains, and this is where I'm going to do endurance work.' I think at some point you know, when we can check these markers in saliva or whatever ... [but] we're not there yet with the science," she said.

How tracking your period can influence your workouts

While Casey said the science is not there for a one size fits all cycle syncing program just yet, she does recommend tracking your cycle to figure out how to get best results for yourself.

"I do think there's value in individual following," she said.

Referring to cycle syncing, she added, "I think it's such a fascinating area and I love that people are thinking of it. So, embrace that interest."

Schramm said she began tracking her cycles when she noticed she wasn't able to train in the same way and get the same consistent results that her male coworkers and clients were getting.

"I believe cycle-syncing is something that can be taken as far as you desire, and if it's of interest to begin experimenting with yourself, after clearance from your doctor is obtained, then I think it's an ideal approach to movement as someone with monthly hormonal fluctuations," Schramm said.

Schramm said she has seen improvements in her own training by tracking her cycle and following the cycle syncing method of training.

"Understanding the hormonal fluctuations … has clarified why some days I feel my strongest, have unlimited energy and could workout for hours and then the following week, it's a struggle to get through my warmup," Schramm said.

Where to start

If you'd like to start monitoring your cycle in relation to your workouts, here several ways you can get started:

  • Consult with a doctor or trainer: If you are looking to begin a cycle syncing-type process, start by making observations regarding your own menstrual cycle, then consult with a trainer or doctor about the best ways to be active while still respecting your body's needs for rest and energy.
  • Track your cycle with apps: Start tracking your cycles. The FitrWoman app, designed by Dr. Georgie Bruinvels, breaks down the four phases of the menstrual cycle and uses evidence-based research to match symptoms and solutions to each phase. This app was used by the U.S. Women's National Team when training for the World Cup. Other period tracking apps such as MyFlo, Cycles and Period Tracker Lite will help you track your cycle and follow how you feel turning workouts at different points of your cycle.
  • Use cycle-friendly training tools: More and more fitness brands are adding cycle syncing training as an option in their training programs. Nike has started a "NikeSync" training program with physiologist Stacy Sims, Ph.D., which includes training plans and nutrition suggestions for every phase of the menstrual cycle. Fitness membership program Les Mills + contains a cyclical training guide that includes four workouts to match each week of cycle. Adidas also offer a free "PE(riod)" lesson plan online developed by Buinvels that helps you better understand working out during your menstrual cycle and gives recommendations for each of the four phases.

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Tennessee woman gets emergency hysterectomy after doctors deny early abortion care

Courtesy Mayron Hollis

(NEW YORK) -- Mayron Hollis said she had just started taking contraceptives when she found out she was pregnant again a few months after giving birth in February 2022. Despite the surprise, Hollis and her husband say they were excited about the pregnancy and eager to add another child to their growing family.

Hollis, 32, had no idea the excitement would turn into a fight for her baby's life and her own.

The Tennessee woman would end up needing a lifesaving emergency hysterectomy, ending her opportunity to give birth to more children, after she says she was denied medically necessary abortion care at a hospital in her home state for life-threatening complications earlier in her pregnancy.

"[My doctor] told me I needed to do the surgery. If I didn't, I could die; the baby could die," Hollis said.

Because she had delivered by cesarean section and the two pregnancies were so close together, Hollis' OB-GYN was worried she could develop a cesarean scar pregnancy, a type of ectopic pregnancy where the fertilized egg is implanted in the cesarean scar after a previous C-section, which can cause the uterus to rupture, leading to excessive bleeding and even death, according to the National Institutes of Health.

In August, Hollis found out that she did have a cesarean scar pregnancy, with the pregnancy bulging out of her uterus, and a placenta accreta -- a serious pregnancy complication in which the placenta grows too deeply into the uterine wall and part or all of the placenta then remains attached to the uterine wall during delivery. The condition can cause severe blood loss after delivery, according to the Mayo Clinic.

"I [could] hemorrhage, because that was already bulging out," Hollis said. "It was scary."

Hollis was eight weeks pregnant when she met with a maternal fetal medicine specialist, who confirmed that she had a cesarean scar pregnancy and sent her back to Vanderbilt University Medical Center for care.

Vanderbilt University Medical Center said it would not comment on the case.

Because she wanted the baby, Hollis said it took her and her husband time before they were able to decide that they wanted to end the pregnancy because the risk it posed to her life was too high.

Hollis said she was unaware of the changing landscape in Tennessee after the U.S. Supreme Court overturned Roe v. Wade, ending federal protections for abortion rights. A trigger ban prohibiting nearly all abortions went into effect in Tennessee on Aug. 24, 2022.

Hollis said her doctor did not explain to her that there was a narrow window in which she could receive care before the ban went into effect.

One day before the ban went into effect, medical records show that in the early weeks of her pregnancy, Hollis' placenta accreta had progressed and was "concerning," according to her medical records. She was 11 weeks pregnant at the time.

"It was a hard pregnancy. It was scary the whole time," Hollis said.

"They thought they were gonna have to reconstruct my bladder. They didn't know if it was gonna touch any other organs -- if they could even stop the bleeding if I did start to hemorrhage," Hollis said.

When the couple realized how big the risk was to Hollis' life, they decided it was best to end the pregnancy.

Hollis had been offered abortion care since the ban had not yet gone into effect. But when she reached out to her OB-GYN to ask for the care on Aug. 24, it was too late. That was the day Tennessee's trigger ban prohibiting all abortions went into effect.

The ban criminalizes performing an abortion, making it a felony. An exception to save the life of the mother or prevent serious and permanent bodily injury only comes into play when a physician is defending themselves in court after they have been charged with the felony. A separate so-called "heartbeat ban" that prohibited all abortions after fetal cardiac activity is detected was also in effect.

Physicians told ABC News the exception is unclear and many worry about the consequences they could face for providing essential care.

The procedure Hollis needed was complex and required a number of physicians from different specialties to perform. Not enough physicians were willing to provide the care with the ban in effect, according to Hollis.

A specialist would have needed to inject the pregnancy with something to stop the heart before physicians from other specialties could provide abortion care that would preserve Hollis' fertility, Dr. Sarah Osmundson, a maternal fetal medicine specialist in Tennessee who treated Hollis later in her pregnancy, told ABC News.

There is a very narrow window in which pregnancies with placenta accreta can be terminated without the need for a hysterectomy, due to the excessive bleeding that the condition causes, according to Osmundson. The window generally closes at around 12 weeks of pregnancy, Osmundson said.

Few facilities would have been able provide the complex care needed to preserve her fertility, according to Osmundson.

Hollis was recommended a facility in Pittsburgh, but she said traveling for care wasn't an option because Hollis and her husband both needed to work and couldn't afford to take time off.

Under the ban, Hollis was told the only way doctors could intervene was if her life was in danger, so she had to continue her pregnancy.

"Because of everything that was going on, they didn't know what was the right thing to do was. So the only way to save me was for something bad to happen to me," Hollis said. "That's how it felt anyways."

"They really had no answer for me the whole time I was pregnant. It was the scariest thing I ever did. [Doctors were] telling me that my pregnancy wasn't viable, but we can't send you anywhere and we can't do anything to help you. So it's just a lot of prayers for me. Reading up and just having a lot of faith," Hollis said.

Procedure to deliver and save her life

As her pregnancy progressed, it had gradually attached to her bladder and her accreta progressed to placenta percreta -- meaning her placenta grew through the uterine wall and attached to surrounding organs, Hollis said.

At one point she had to be put on bedrest because doctors were worried her uterus could rupture, Hollis said.

Hollis was admitted to the hospital at 25 weeks pregnant after she began excessively bleeding, according to medical records. After staying in the hospital for four days, Hollis said she went home. It was almost Christmas.

One day after returning home, Hollis was taken back to the hospital after she began significantly bleeding again, according to medical records.

Before she had the hysterectomy, Hollis said she had to write a will and tell doctors whose life to prioritize if they could only save her or the baby.

She had a cesarean delivery and an emergency hysterectomy in one procedure, according to medical records.

"I didn't want the hysterectomy. But they said that was the only way that they could stop the bleeding to help me, so I didn't have a choice," Hollis said.

Hollis said she lost so much blood that doctors set up IV lines in both arms, both legs and her neck, allowing for a large transfusion of blood. Medical records show she was given eight units of packed red blood cells and six units of fresh frozen plasma. Hollis probably lost at least 2 liters of blood, Osmundson said.

"She could have easily died at another institution," Osmundson said.

By the time Hollis was 26 weeks along, there was no other option than to perform an emergency hysterectomy to be able to stop the bleeding, Osmundson said.

An amendment was recently added to the Tennessee ban allowing abortions for ectopic pregnancies, so physicians are now able to treat patients with complications similar to Hollis, but Osmundson said there are still other cases where doctors are unsure how to act.

"So much of medicine is gray areas," Osmundson said. "Regulating these complex decisions will result in people getting hurt and will result in people dying."

Hollis' baby, whom she named Alayna, was delivered so premature she was in an incubator for a month, Hollis said. She slowly graduated to different beds at the hospital. The baby was delivered on Dec. 13, but she was only able to go home on Feb. 23, needing oxygen and other interventions at the hospital.

Since the newborn returned home in February, she has been taken back to the hospital five times, Hollis said. The longest she has been at home since February was for two weeks.

"I thought I lost her one time for like five minutes. She turned colors and I had to wait on the ambulance to get here, doing CPR and an off-duty cop showed up," Hollis said. "He did CPR on the hood of his car and saved her life."

Hollis said the baby's lungs are not fully formed and she is not growing as fast as she could be. She had only been eating through a feeding tube through her nose, but just started taking food by mouth, according to Hollis.

"[I've] just been stressed out a little bit not knowing what's going to go on with my daughter, how I'm gonna get her what she needs and what's gonna happen next. So I'm just trying to hang in there," Hollis said.

"I'm very adamant to make sure that I'm on top of her care," Hollis said. "It's been really hard to go back to work because I don't have the means to pay for the adequate care that she needs. So I've been trying to get help."

Copyright © 2023, ABC Audio. All rights reserved.

While COVID and RSV rates were decreasing this spring, a lesser-known virus was on the rise

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(NEW YORK) -- While cases of COVID-19 and RSV were decreasing across the United States this spring, infections linked to another lesser-known respiratory virus were increasing.

The percent of tests positive for human metapneumovirus (hMPV) surged to 19.6% for antigen tests and 10.9% percent for PCR tests at the beginning of March, according to data from the Centers for Disease Control and Prevention.

During the four years before the pandemic, the weekly percentage of positive tests never reached higher than 7.7%, data shows.

Meanwhile, during the beginning of March, the percentage of tests positive for COVID and RSV were at 7% and 2%, respectively, according to the CDC.

The virus causes mild symptoms for most people and typically goes away on its own, but health experts say the data is a reminder about staying vigilant regarding all types of respiratory infections and not just the ones getting the most attention.

"There's a number of different respiratory viruses that haven't gotten much attention and human metapneumovirus is one of them," Dr. Bruce Y. Lee, a professor of health policy and management at City University of New York School of Public Health, told ABC News.

What is hMPV?

HMPV was discovered in 2001 and is in the same family of viruses as RSV, according to the CDC. It can cause upper and lower respiratory infections, but younger children, older adults and immunocompromised people are at higher risk of severe disease.

The virus is most commonly spread from person to person and can be transmitted through droplets from coughing and sneezing, personal contact such as shaking hands and or touching surfaces with the virus on them and then touching the eyes, nose or mouth, the CDC said.

What are the symptoms?

Symptoms can take between three to six days to appear after infection and resemble those of the common cold and include cough, nasal congestion, fever and shortness of breath.

Surveillance data shows that it tends to be more active in the late winter and spring, similar to other seasonal viruses like the flu, but has surged this year.

"That peak itself is about 36% higher than what is normally seen before the pandemic," Lee said. "So, it's an indirect way of getting a sense of the prevalence of hMPV infections out there. It does suggest that there is at least significant activity."

Lee says that although testing for hMPV has become broader, people are not routinely tested for it, so the true percentage could be even higher than what is reported.

How is hMPV treated and prevented?

There are no antiviral therapies to treat hMPV so those infected can treat their disease with over-the-counter medications including pain relievers or decongestants.

No vaccines are available to prevent the disease so prevention measures including washing hands with warm soap and water, cleaning surfaces and staying home when ill, according to the CDC.

Lee said the lessons learned from the pandemic about the importance of mitigation can be applied here as well.

"Early on [in the pandemic] there was a lot of realization that a lot of the precautions that you should normally take to prevent the transmission of respiratory viruses weren't in place," he said. "So the best way to really constructively move from the pandemic is to think about what are some of the precautions that we should be putting in place just in general to prevent the spread of these respiratory viruses."

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More than 40% of restaurant foodborne illness outbreaks caused by sick workers: CDC


(ATLANTA) -- Sick workers were behind a plurality of foodborne illness outbreaks and caterers in the U.S., new federal data shows.

In a report published Tuesday afternoon, the Centers for Disease Control and Prevention looked at outbreaks across 25 state and local health departments from 2017 to 2019.

They found that among outbreaks where a contributing factor was identified, four in 10 -- or 41% -- were caused by food contamination from ill or infectious employees.

This included handlers, workers or preparers making either gloved or barehanded contact with food.

"If a food worker stays on the job while sick and does not wash his or her hands carefully after using the toilet, the food worker can spread germs by touching food,' the CDC writes on its website.

Of managers who were interviewed, 91.7% said their restaurant or establishment had policies requiring food workers to notify their manager when they were ill.

However, "often these policies were missing components intended to reduce foodborne illness risk," the CDC said.

For example, 66% of managers said they had a written policy about workers notifying superiors regarding illness.

Only 69.5% specifies symptoms that would lead to restricting or excluding ill workers from working. But just 23% said their policy specified the five symptoms of foodborne illness workers needed to report to their manager including vomiting, diarrhea, jaundice, sore throat with fever and lesions with pus.

The report also found that under half -- 43.6% -- of managers interview said their establishments provided paid sick leave to any workers.

"Contamination of food by ill food workers is a top contributing factor to foodborne outbreaks in retail food establishments; therefore, identifying gaps in these establishments' ill worker policies is important to outbreak prevention," the authors wrote in the report.

"Health departments responsible for ensuring food safety in retail food establishments can use the findings in this report to assess their food safety priorities and guide their outbreak investigations and routine (i.e., preventive) inspections," they continued.

The report also found that 17.6% was caused by contaminated food that was meant to be consumed raw, undercooked or underprocessed.

Another 10.6% of outbreaks were caused by improper or slow cooling of food and 6.6% were caused by either insufficient time, temperature or both during the cooking or heating process.

What's more, when it came to what bacteria or viruses led to the outbreaks, norovirus was the most commonly identified cause at 47%.

Norovirus is a highly contagious virus that is the most common cause of viral gastroenteritis, which is an inflammation of the inside lining of the gastrointestinal tract. In fact, it is the leading cause of foodborne illness in the United States, causing 58% of foodborne illnesses each year, according to the CDC.

This was followed by salmonella -- a bacteria that lives in the intestinal tract of animals -- accounting for 18.6% of outbreaks.

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What is fungal meningitis after two Americans die from the infection contracted in Mexico


(NEW YORK) -- At least two Americans have died and 17 have suspected or probable cases of a potentially deadly infection linked to an outbreak at cosmetic surgery clinics in Mexico.

The infected patients contracted fungal meningitis after having procedures under epidural anesthesia in Matamoros, Mexico -- just across the border from Brownsville, Texas -- according to the state’s Department of Health Services.

More than 200 people across the U.S. who underwent operations between Jan. 1 and May 13 of this year may be at risk, according to the Centers for Disease Control and Prevention.

Despite the closure of River Side Surgical Center and K3 Clinica, people developed symptoms of fungal meningitis weeks later.

Here are the signs to look for and how the infection can be treated before it’s too late:

What is fungal meningitis?

Meningitis is a type of infection and inflammation affecting the fluid and three meninges -- or membranes -- that protect the brain and spinal cord.

Fungal meningitis specifically occurs after someone contracts a fungal infection that spreads to the brain or spinal cord, according to the CDC.

Signs and symptoms can appear weeks after initially developing the infection and include headache, fever, nausea, vomiting, stiff neck, sensitivity to light and an altered mental state.

How do people contract fungal meningitis?

Many fungi are too small to see with the naked eye so it’s easy for people to breathe in or ingest microscopic spores, the CDC says.

Fungal meningitis is not contagious and cannot spread from person to person.

"While rare, outbreaks of fungal meningitis following medical and surgical procedures have occurred," the CDC says on its website. "Healthcare providers can find information on testing and treatment options for patients with suspected or confirmed fungal meningitis. These options are applicable to patients regardless of where exposure occurred."

How is fungal meningitis treated?

To be diagnosed with fungal meningitis, a patient gives samples of blood or cerebrospinal fluid that are tested for the presence of fungi.

If results are positive, patients are then given high doses of antifungal medications intravenously, according to the CDC, which may include amphotericin B -- a medication that stops the growth of fungi.

Next, patients are given antifungal medications by mouth, the health agency said, which may include itraconazole or fluconazole.

There is no specific timeline for how long a patient takes these medications; it will depend on the patient’s immune system. For example, those with underlying conditions weakening the ability of the body to fight infections, including cancer or HIV/AIDS, may have a longer course of treatment.

Is fungal meningitis deadly?

There is no data on the number of deaths per year from fungal meningitis but public health experts say it can turn deadly if not identified and treated quickly.

A 2017 study on an outbreak in Virginia found that 9.678% of the people who developed fungal meningitis died even after receiving treatment and 100% with fungal meningitis who did not receive treatment died.

One of the two patients who died in this current outbreak is Shyanne Medrano, a 31-year-old mother from Houston, according to local ABC affiliate KRGV-TV.

She began to feel sick not long after visiting K3 Clinica in March to receive a Brazilian butt lift.

Weeks later, Medrano was admitted to a hospital with symptoms of the infection. She later developed a blood clot, a family member told KRGV. On May 16, two months after the procedure, Medrano died.

Can I prevent fungal meningitis?

There are no vaccines that protect against fungal meningitis. The CDC does recommend several prevention measures.

These include avoiding areas that contain a lot of dust, staying inside during dust storms, avoiding activities that involve close contact to dirt and cleaning skin injuries with warm water and soap to avoid the odds of developing an infection.

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New study shows benefits of afternoon exercise for Type 2 diabetes

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(NEW YORK) -- For people with Type 2 diabetes, could the time of day when you exercise have an impact on your blood sugar averages?

A new study seems to suggest so.

After studying more than 2,400 adults over a four-year period, researchers suggest that patients with Type 2 diabetes who exercise in the afternoon instead of in the morning may have better control of their A1C levels.

ABC News' Erielle Reshef appeared on Good Morning America Monday to discuss the study's findings:

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Mom says infant got 'margarita burn' from eating celery outside: What to know as summer approaches

Courtesy Reanna Bendzak

(NEW YORK) -- A mom in Canada is sharing a warning about eating and drinking outdoors as summer approaches.

Reanna Bendzak said she, her husband and their two children were at an outdoor barbecue in March when she gave her then-7-month-old daughter a piece of celery to chew on.

"Our daughter was cutting her second tooth, so we gave her a piece of celery to chew on, just to help soothe those gums," Bendzak, who asked that her daughter's name not be used, told ABC News' Good Morning America. "It wasn't warm by any means, but it was sunny so she was covered neck-to-toe in a onesie and we had a sun hat on her, so we thought she was fairly well-protected."

Bendzak said she and her husband wiped their daughter's face multiple times throughout the afternoon with a cloth, but didn't at the time wash her face with soap and water.

The next morning, Bendzak said her daughter woke up with a rash around her mouth, which later in the day worsened into blisters.

Bendzak said her daughter was ultimately diagnosed with a condition she had never heard of, phytophotodermatitis, a skin reaction that can happen after touching certain plants while out in the sun, according to research published in the journal Canadian Family Physician and available in the National Library of Medicine.

Celery is among the plants that can cause phytophotodermatitis, Bendzak said she and her husband learned. The condition is also commonly called "margarita burn" because limes and other citrus fruits are also culprits.

"As any parents out there would know, your first reaction is just like, 'Oh my gosh, what did I do? And how could I have prevented that,'" Bendzak said. "But you're only as good of a parent as the knowledge you have, and we did what we thought was best at the time."

She continued, "Now in retrospect, of course, we would have done things differently and made an intentional effort to go inside and wash with soap and water."

Bendzak said her daughter, who is now 9 months old, experienced blisters on her mouth area for about 10 days, and some scarring and hyperpigmentation for about six weeks, but now is "doing great."

She said she and her husband estimate their daughter was only exposed to direct sunlight for about 20 minutes total that afternoon, but that was enough time to cause damage.

Once her daughter had recovered, Bendzak shared her family's story on Facebook in hopes of spreading awareness of phytophotodermatitis.

"I had no idea that it was even a possibility until this experience," Bendzak said. "Hopefully this story can help others learn from our experience and they can make better decisions for their own personal lives moving forward as well."

How to treat and prevent phytophotodermatitis

Dr. Jennifer Ashton, ABC News' chief medical correspondent and a board-certified OB-GYN, said the summer season is a time to be acutely aware of phytophotodermatitis as people are often outside cooking, eating and making drinks.

"Citrus is definitely the most common, and lime is the most common amongst the citrus," Ashton said. "So, that's why it's gotten this name, 'margarita burn.' People are making or drinking margaritas, touching limes outside in the summer months, and that can be an exposure."

In addition to celery and citrus, other plants and fruits that can cause phytophotodermatitis include carrots, peppers, dill, fennel, mustard, parsley and parsnip.

Ashton said the best prevention method is to wash your skin with soap and water if you are handling food and drinks while outside in the sun.

Another important prevention method, according to Ashton, is to wear sunscreen daily.

"If you are going to be outside in the summer months, make sure you're reapplying that SPF every two hours," she said, adding, "But to be crystal clear, [SPF] should be used 365 days a year, on your face, hands and neck, people of all skin colors, all skin types. So make it part of your day-to-day routine."

If a person notices changes on their skin, Ashton said they should contact a healthcare provider.

She noted that phytophotodermatitis can present from mild to severe symptoms.

"It really is a spectrum of severity in terms of mild, moderate to severe," Ashton said. "In mild cases, where someone has touched a lime or the citrus, you could just see some itching, some inflammation. You could see some some redness or pinkish discoloration depending on skin color, and then you could see a full spectrum of severity, ranging in more moderate cases to discoloration that may persist longer, and in severe cases, even some small blistering."

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Map: How abortion access has shifted in 11 months since Roe v. Wade was overturned

ABC News

(NEW YORK) -- The landscape of abortion rights has shifted dramatically in the 11 months since the U.S. Supreme Court overturned Roe v. Wade, ending federal protections for abortion rights.

The decision left it up to states to decide how to regulate abortion services.

States in the West and Northeast have since taken steps to expand and protect abortion rights, while states across the South, Great Plains and Midwest have moved to ban or restrict abortion care.

Sixteen states have ceased nearly all abortion services.

South Carolina became the latest state to greatly restrict abortion access this week after its governor signed a six-week ban into law.

Florida could be the next state to severely restrict abortion services. If a state court upholds a 15-week abortion ban, a new six-week abortion ban will go into effect.

The ban would prohibit all abortions after fetal cardiac activity is detected, which generally occurs around six weeks of pregnancy, before most women know they are pregnant. The ban makes exceptions for when the woman's life or health is at risk and cases of rape or incest, under certain conditions.

If allowed to go into effect, the ban will limit access to many women in the South who live in areas where Florida would have been the closest state where they could access care.

Medication abortions

Meanwhile, a court case in Texas is seeking to revoke the Federal Drug and Food Administration's approval of one of the medications used in chemical abortions -- mifepristone -- across the country, even in states where abortion is protected.

The case is currently before the Fifth Circuit Court of Appeals but is expected to reach the U.S. Supreme Court. Mifepristone remains available while the case continues.

Wyoming became the first state to ban medication abortions in March.

How abortion bans largely work

Nearly all bans throughout the country target physicians, making it illegal for them to provide abortion services punishable by fines, jail time and their medical licenses being revoked.

Some bans -- modeled after a Texas law -- make it a crime to aid women in accessing abortion care and establish civil liability against individuals who violate state bans.

Texas, which has several abortion bans in place, allows people to sue anyone who "aids or abets" an illegal abortion, to collect a bounty of at least $10,000.

Physicians warn that the anti-abortion landscape in some states will discourage doctors and future doctors from moving to states banning or restricting abortion. This could also have implications for reproductive and female health care in the states.

Residency programs in states with bans in place saw a drop in the number of OB-GYN residency applications, according to recent data from the Association of American Medical Colleges. While there was an overall decrease in the number of all residency applications submitted in 2023, the decrease was sharper in states with complete bans compared to states without restrictions, according to the data.

There was a 10.5% decrease in OB-GYN applicants in states with complete bans in 2023 compared to 2022 residency applications, according to the study. In states without restrictions, the decrease was only 5.3%, data shows.

How pregnant women are being affected

Some women have come forward with stories about how abortion bans have impact them and their access to reproductive health care. In a first since Roe was overturned, 15 Texas women filed a lawsuit against the state, saying that its near-total ban put their lives in danger.

Abortion ban challenges in other states face legal challenges from abortion providers, on behalf of their patients, abortion clinics and pro-abortion rights groups.

Kylie Beaton, a woman in Texas, told ABC News she was forced to carry a nonviable pregnancy to term, watching her son die days after he was born. Beaton was unable to access care in New Mexico because she was too far along when she received her diagnosis -- past the facility's cutoff point -- despite the state allowing abortion at all stages of pregnancies.

The only other option was a facility in Colorado that provided late-term care, but Beaton and her husband could not afford the $10,000 to $15,000 it would have cost. Beaton has since joined other women suing Texas over its ban.

Women forced to travel to receive abortion care also risk having to continue further along into their pregnancies. The further along a pregnancy, the more complex, risky and expensive the abortion care.

Even with exceptions to abortion bans, women have reported having to wait until their health deteriorates or until their life is in danger before they could get care in states with near-total or total bans.

"Heartbeat" laws which prohibit abortions when cardiac activity can be detected have in some cases complicated care for women whose water breaks before their pregnancy is viable.

Kristen Anaya, who lives in Texas, told ABC News she had to wait until she went into sepsis before she could get abortion care because her fetus still had a heartbeat, despite her high fever and shaking uncontrollably for hours — both signs of an infection.

In Florida, Anya Cook was sent home from a hospital after losing nearly all her amniotic fluid because she wasn't at a high risk for any complications, despite the risk that she could go into sepsis without delivering the fetus—which can be fatal. She later delivered in the bathroom of a hair salon, bleeding so much she lost half the blood in her body and had to be hospitalized for six days, she told ABC News.

She needed two subsequent procedures to remove the remainder of her placenta. This pregnancy was her 17th miscarriage in just two years, she told ABC News.

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South Carolina six-week abortion ban signed into law, providers file lawsuit

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(COLUMBIA, S.C.) -- South Carolina Gov. Henry McMaster signed a six-week abortion ban into law Thursday, with it going into effect immediately. The new ban prohibits all abortions after fetal cardiac activity is detected, which generally occurs at six weeks of pregnancy, with limited exceptions, according to the ban.

"With my signature, the Fetal Heartbeat and Protection from Abortion Act is now law and will begin saving the lives of unborn children immediately," McMaster said. "This is a great day for life in South Carolina, but the fight is not over. We stand ready to defend this legislation against any challenges and are confident we will succeed. The right to life must be preserved, and we will do everything we can to protect it."

Abortion providers Planned Parenthood and Greenville Women's Clinic have filed a lawsuit challenging the state's ban and seeking a temporary restraining order that would prevent enforcement of the law.

"Abortion providers have asked a state trial court to block S. 474 on the grounds that it violates South Carolinians' constitutional rights to privacy, equal protection, and substantive due process by banning abortion, providing inadequate protections for patients' health, conditioning sexual assault survivors' access to abortion on the disclosure of their personal information to law enforcement, violating the Medicaid Act, and improperly targeting Planned Parenthood through an unconstitutional bill of attainder," Planned Parenthood said in a statement.

White House press secretary Karine Jean-Pierre said in a written statement Thursday evening that South Carolina's "extreme and dangerous" ban on abortions past six weeks " will criminalize health care providers and cause delays and denials of health and life-saving care."

"South Carolina's ban will cut off access to abortion for women in the state and those across the entire region for whom South Carolina is their closest option for care," Jean-Pierre said.

McMaster signed a previous so-called "heartbeat ban" into law in 2021, but it was struck down by the state's Supreme Court in January.

Fifteen states have ceased nearly all abortion services since the U.S. Supreme Court overturned Roe v. Wade, ending federal protections for abortion rights.

Under the new ban, abortions are permitted to prevent the death of the pregnant woman, to prevent the serious risk of a substantial and irreversible impairment of a major bodily function, in cases of rape and incest and if the fetus has a fatal anomaly, according to the ban. The exception does not include psychological and emotional conditions.

Conditions listed under the exception include molar pregnancy, partial molar pregnancy, blighted ovum, ectopic pregnancy, severe preeclampsia, HELLP syndrome, abruptio placentae, severe physical maternal trauma, uterine rupture, intrauterine fetal demise and miscarriage, according to the bill.

Anyone who violates the ban is guilty of a felony and, upon conviction, must be fined $10,000, face prison time of up to two years or both. Physicians or medical providers found guilty of performing illegal abortions will also have their licenses revoked.

Planned Parenthood said, along with its partners, that it is prepared to challenge the ban in court.

"Abortion is already difficult to access in South Carolina, with only three abortion clinics in the state and a range of limitations on access imposed by state lawmakers. South Carolina ranks 43rd -- in the bottom 10 of all states -- with the highest maternal mortality rates. Women here are three times more likely to die during pregnancy or childbirth than the average U.S. woman," Planned Parenthood said in a statement.

'Sister senators' fight against ban

A group of five women senators, the only five in the legislative body, has fought against the bill. The group, who've adopted the term "sister senators," told ABC News that a short holiday week near the end of the legislation session would be the time the men would "shove it down our throats."

Even before the vote they had a sense that a back-room deal had been made to get it through. After three attempts, the senators' filibuster failed to block the bill from passing.

"Women are 51% of the South Carolina population [but hold] only 14% of the General Assembly and even less than that in the Senate. What I believe is that women are going to show up at the ballot box," state Sen. Sandy Senn said.

The group of women are very different -- three Republicans, one Democrat and one independent -- but they are all religious mothers who are certain this bill passing in the state Senate would be bad for women in the state. None of them viewed themselves as women's rights advocates or feminists and they all said they were "pro-life."

"We all believe in life. We believe in life for the woman as well as a life for the child," state Sen. Margie Bright-Matthews told ABC News.

They needed two men to cross over to vote with them on Tuesday to block the ban, but one of their previous allies had gone dark, which they knew wasn't a good sign.

Abortion options for women in the Deep South are now closing fast, with Florida's six-week ban awaiting a court ruling soon and North Carolina's 12-week ban taking effect.

What is in the ban?

Women will be required to have to in-person doctors appointments before they can receive an abortion.

Under the ban, pregnant women cannot be criminally prosecuted or face civil liability for violations of the ban.

If the fetus is alive in utero, physicians are required to make reasonable efforts to preserve the life of the unborn child, provided that does not pose a risk to the health of the pregnant women, according to the bill. Entities that violate this will be fined up to $50,000, according to the bill.

Physicians who perform abortions under the health exceptions have to rationalize why they believe the woman qualifies for the exception in her medical records, according to the bill.

Abortions performed under the rape and incest exceptions must report it to the sheriff in the county in which the abortion was performed within 24 hours. Physicians must tell the patient they will report the rape before the abortion is performed.

Physicians are also required to maintain a copy of the patient's records for seven years after an abortion is performed under the exception. Failing to do so would be a felony with up to two years of imprisonment and a $10,000 fine on the physician, according to the bill.

Pregnant women upon whom an abortion is performed in violation of the law can seek actual and punitive damages against the violator.

ABC News' Ben Gittleson contributed to this report.

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Artificial intelligence used in medical procedure to help paralyzed man walk

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(NEW YORK) -- A man left paralyzed by a motorcycle crash over a decade ago is walking again after a surgical procedure aided by artificial intelligence.

Gert-Jan Oskam, 40, said he dreamt of walking again after being paralyzed from the waist down in the 2011 crash.

"I tried everything at home," Oskam told ABC News. "I tried standing up and making steps, but it wasn't enough."

It was not until last year that Oskam, working with researchers in Switzerland, experienced a breakthrough.

In 2022, researchers at Lausanne University Hospital surgically inserted electronic implants in the areas of Oskam's brain and spinal cord that control movement.

Then, with the help of AI, the researchers built what they call a "digital bridge" between his brain and spine, bypassing his injuries, and essentially putting his thought into action.

"Thanks to algorithms based on adaptive artificial intelligence methods, movement intentions are decoded in real time from brain recordings," one of the researchers, Guillaume Charvet, said in a statement, noting that the technology allows the patient to "move around independently."

Oskam said that now he can think about moving, and his body follows his thoughts.

"I think about moving my leg and then the stimulation gives me a pulse to make the step," Oskam said, noting that even when the sensors are turned off, he can still walk with the help of crutches.

Although this type of AI has been used in medicine for decades, researchers say Oskam's case is the first successful procedure of its kind.

Researchers describe the breakthrough as using AI as a thought-decoder that processes what the neurons in the brain region are trying to do, and sending that signal to the spine.

Details of the accomplishment were published Wednesday in the medical journal Nature.

The technology that enabled Oskam to walk is still in the preliminary stages, the researchers acknowledged. Oskam was the first human to undergo this procedure.

While the technology is not widely available to patients, the researchers said their mission is to "bring it to other people."

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Salmonella outbreak linked to raw cookie dough sickens 18 across six states

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(ATLANTA) -- The Centers for Disease Control and Prevention said it is investigating reports of 18 salmonella infections across six states -- California, Idaho, Missouri, Oregon, Utah and Washington. Two people have been hospitalized but no deaths have been reported in connection with the outbreak.

Multiple cases have been linked back to Papa Murphy's raw chocolate chip cookie dough and s'mores bars dough that are sold at Papa Murphy's Take 'N' Bake Pizza stores, according to the CDC.

Nine of the sickened people reported that they ate Papa Murphy's raw cookie dough in the week before they got sick. Papa Murphy's has temporarily stopped selling the two types of dough, according to the CDC.

At least two sick people said they did not eat at Papa Murphy's. Investigators are working to identify the contaminated ingredient in the cookie dough, the CDC said.

The true number of sick people is likely higher than the number reported, and the outbreaks may not be limited to the states with known illnesses. Some people recover without medical care and are not tested for salmonella, according to the CDC.

Most people infected with salmonella experience symptoms including diarrhea, fever and stomach cramps, which usually start between six hours to six days after ingesting the bacteria, according to the CDC.

Anyone experiencing more severe symptoms -- including diarrhea and a fever higher than 102 degrees; diarrhea for more than three days that is not improving; bloody diarrhea; so much vomiting that you cannot keep liquids down or signs of dehydration -- should call their health care provider.

Most people recover without treatment after four to seven days, according to the CDC.

Some may experience more severe illness that requires medical treatment or hospitalization, including those with weakened immune systems, children under 5 and adults 65 years and older, the CDC said.

Anyone with Papa Murphy's chocolate chip cookie dough or s'mores bars dough in their freezer or refrigerator should throw it out, even if they didn't get sick after eating some of it, the CDC said.

Items and surfaces that may have touched the dough should be washed using hot, soapy water or a dishwasher. Papa Murphy's chocolate chip cookie dough and s'mores bars dough are not meant to be eaten raw, according to the CDC.

Most raw cookie dough is made with unpasteurized eggs or raw flour and can have germs like salmonella and E. coli, according to the CDC.

There are some other cookie dough options that do not need to be baked because they are made with heat-treated flour and pasteurized eggs or no eggs, which is noted on the label, according to the CDC.

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Woman shares yearslong experience with PCOS to spotlight the impact on South Asian women

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(NEW YORK) -- A woman is sharing her experience with polycystic ovary syndrome, or PCOS, to put a spotlight on a community at greater risk of the condition: women of South Asian descent.

Varsha Singh of Pennsylvania told ABC News' Good Morning America that she struggled with symptoms for over a decade before being diagnosed with PCOS in her mid-20s.

"My hair was shedding more over time, and coupled with having an irregular period, I knew something was off," Singh said, adding, "I was not given any kind of support that I wish I had."

The condition Singh, 31, was ultimately diagnosed with, PCOS, is a female hormone imbalance in which the ovaries produce excessive amounts of testosterone and, in some cases, form small ovarian cysts, according to the U.S. Office on Women's Health.

Symptoms of PCOS can include everything from irregular or absent periods to excessive facial hair, acne and obesity. The exact cause of PCOS is not known.

The condition affects 1 in 10 women of childbearing age, according to the Office on Women's Health.

People of South Asian descent are at even higher risk for PCOS, multiple studies show.

One study, based in the United Kingdom, estimated nearly 50% of South Asians had polycystic ovaries (PCO), which is one criteria of PCOS.

Another study published in 2021 found that the prevalence of PCOS in South Asian women was 3.3%, compared to 1% for Chinese women and 1.5% for Filipina women.

"People who are of South Asian descent tend to present with symptoms at a younger age and have more severe hirsutism, or that high level of male hormone in the body," Dr. Fatima Daoud Yilmaz, a New York-based, board-certified OB-GYN, told GMA, adding that there is a need for more research and visibility on people of South Asian descent with PCOS.

"We shouldn't be comparing everyone to a default of a Caucasian person, but rather comparing you to people who have a similar origin that you do," Daoud Yilmaz said.

A diagnosis of PCOS requires two of three criteria: Irregular ovulation, which is usually indicated by an irregular menstrual cycle or a lack of a cycle; increased androgen levels; and multiple small cysts on the ovaries.

After she was diagnosed, Singh started chronicling her journey with PCOS online, in the hopes that she might help other people.

She said for her, lifestyle changes including diet and exercise made a difference in treating the condition.

"I had more time to learn how to work out the right way for me and how to meal prep and cook healthy foods," Singh said. "Within three months, my body was showing improvements."

She continued, "I'm doing yoga and meditating. Now it's a lifestyle practice for me."

Other treatment options to manage PCOS symptoms include hormonal birth control and anti-androgen medicines as well as weight loss, according to the Office on Women's Health.

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Social media could have a 'profound risk' on kids and teens, US surgeon general warns

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NEW YORK -- U.S. Surgeon General Vivek Murthy warned in a new advisory Tuesday that excessive social media use can be a “profound risk” to the mental health of youth in the United States.

“I’m very concerned that social media has become an important contributor to the pain and the struggles that many of our young people are facing,” Murthy said in an interview on ABC News Live.

A surgeon general’s advisory is “reserved for significant public health challenges that require the nation’s immediate awareness and action,” according to the report released by the surgeon general’s office.

The surgeon general said that while we’re in the “middle of a youth mental health crisis” it’s important to identify possible causes. The advisory recognizes that social media has both positive and negative effects on young people, but that ultimately there’s not enough “research and clear data” to determine if it’s “safe” for adolescents to use.

Ninety-five percent of teens are on social media. Although age 13 is commonly the required minimum age for users of social media platforms, nearly 40% of children ages 8 through 12 still use the platforms, according to the Federal Trade Commission.

Children and teen users are not only scrolling on these accounts, but are also becoming hooked. Young people on average report spending three and a half hours per day engaging in or creating social media content, according to a study referenced in the advisory.

Murthy calls this “deeply concerning,” as the studies he points to indicate that at least three hours on social media a day doubles a young person’s risk of developing depression and anxiety disorders. The advisory also highlights social media’s negative impact on body image and disordered eating behaviors.

Not only is it “chipping away at their self esteem,” the U.S. surgeon said, but that these platforms are also “taking time away from activities that are critical for health and development.”

On a typical weekday, nearly one in three adolescents report using screen media until midnight or later, the surgeon general told us.

“Poor sleep has been linked to altered neurological development in adolescent brains, depressive symptoms and suicidal thoughts and behaviors,” according to a study referenced in the advisory.

Murthy also highlighted the harmful content children are being exposed to on social media, including violence, sexual content, harassment and bullying.

The entire burden of managing social media use in children is currently being placed on parents, according to Murthy, who is also a parent to young children.

“It can’t be on parents alone to manage this,” Murthy told ABC News, detailing why he’s calling for “immediate action” on policymakers and technology companies.

The advisory has a number of suggestions for actions technology companies can take: conducting independent assessments of the impact of their products on adolescents, disclosing findings with researchers, creating effective systems to address complaints and requests from users and their families, as well as prioritizing health and safety while designing products.

“We’ve got to make sure these platforms are actually safe for our kids,” said Murthy. “The way we do with other products that children use, whether it’s medications, cars, car seats, infant formula, we make sure that these are safe so that parents have the support that they need to make the best decisions for their kids.”

The surgeon general’s advisory asks policymakers to create “age-appropriate health and safety standards,” require higher standards for privacy protection, fund future research, support implementation of digital literacy education in schools and require tech companies to share health-related data.

Earlier this month, a bipartisan pair of lawmakers introduced the Kids Online Safety Act, focused on protecting children online and holding social media companies accountable.

Though the bill failed last year, Sen. Richard Blumenthal, after conversations with Senate Majority Leader Chuck Schumer, said he has “hope” and expects to have a vote this session.

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US surgeon general issues major advisory on social media use and teens' mental health

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(NEW YORK) -- A new advisory from the U.S. surgeon general warns of an urgent public health issue regarding social media usage and youth mental health.

In the new advisory, released Tuesday, Dr. Vivek H. Murthy calls for more research to determine the extent of mental health impacts on young people, including the type of content generating the most harm, societal factors that could protect youth and ways in which social media can be beneficial.

"To date the burden of protecting youth has fallen predominantly on children, adolescents and their families," Murthy writes. "The entire burden of mitigating the risk of harm of social media cannot be placed on the shoulders of children and parents."

Murthy claims in the advisory that technology companies' "lack of transparency" has created "barriers to understanding the full scope and scale of the impact of social media on mental health and well-being."

He calls on social media companies to prioritize safety and privacy in their product designs and ensure minimum age requirements are enforced.

Most social media platforms have a minimum user age of 13, which Murthy says he believes is "too early" for kids to be on social media, describing the age as a "time when kids are developing their identity, their sense of self."

Murthy says the ages of 10 to 19 are a sensitive time, when youth identities are forming, leaving them susceptible to social pressure and peer opinion.

The advisory also outlines how policymakers can enact change in three ways: creating policies limiting access to potentially harmful content, developing curricula about digital and media literacy in schools, and increasing funding for related research.

Murthy also calls on parents to model responsible social media behavior, in addition to the changes recommended for policymakers and social media companies.

He says parents should create family media plans, establish tech-free zones and encourage children to foster in-person friendships.

The advisory comes just weeks after the American Psychological Association issued sweeping recommendations intended to help teenagers use social media safely.

Psychologists say that adolescent brain development starts around age 10 and continues through early adulthood. The APA cautions that sites that use "like" buttons and artificial intelligence to encourage excessive scrolling "may be dangerous for developing brains" and recommends limiting social media use on these types of platforms through phone settings.

Research shows frequent social media use may be associated with distinct changes in the developing brain, including in areas necessary for emotional learning, regulation and impulse control.

Mitchell Prinstein, Ph.D., chief science officer of the APA, told ABC News that as it stands now, the time in life that kids' brains develop the most is also when they are most exposed to social media.

"The time when most kids get access to social media is actually one of the most sensitive periods of neural development in our lifetimes," he said.

On average, teens report using social media for 3.5 hours a day, with many spending more than seven hours a day on these platforms, according to Tuesday's surgeon general's advisory.

Time is a key component when it comes to assessing social media and mental health risks, as teens who spend more than three hours a day on social media may unknowingly double their risk of poor mental health outcomes, according to the advisory.

Dr. Colette Poole-Boykin, a child psychiatrist and assistant professor at Yale University, told ABC News that the reality may be worse than data shows because children may underestimate the time they report spending on social media.

"Children have difficulty estimating how much time they spend on social media," she said. "When this happens, it is almost always that they spend far too much unrestricted time on their devices."

Poole-Boykin noted that cyberbullying can also be an issue for teens on social media, saying, "I have treated multiple patients for mood disorders and concern for suicidality due to bullying and the sharing of intimate information on social media."

According to the surgeon general's advisory, 75% of teens say social media sites are only doing a fair to poor job of addressing the issues of cyberbullying and online harassment.

While social media has some benefits, particularly for minority youth who find community, identity-affirming content and other social support online, experts say there is still not enough evidence to say social media is safe for children and teens.

Dr. Neha Chaudhary, child and adolescent psychiatrist at Massachusetts General Hospital and Harvard Medical School, said she has seen benefits for teens when working in "moderated groups."

"There's a power in feeling less alone," she said, describing "moderated groups" as places where "people can come together to validate one another, share advice and support, and uplift one another, especially if they are facing a common challenge."

Copyright © 2023, ABC Audio. All rights reserved.

Girl, 12, saves twin brother's life after he chokes in school cafeteria

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(NEW YORK) -- A 12-year-old Massachusetts girl is being credited with helping save her twin brother's life.

Amelia Loverme was eating lunch with her twin brother Charlie and their classmates in the school cafeteria this month when Charlie began choking on a slice of cheese.

"I was just really scared because I didn't know if I would be able to get it out of my throat or if it would just be stuck there," Charlie told ABC News' Good Morning America. "I thought I was going to pass out, or like die."

Surveillance video from the cafeteria shows Charlie stumbling and pointing to his mouth as he seeks help.

As other students back away, seemingly unsure of what to do, Amelia runs in to help her brother, wrapping her arms around him and performing the Heimlich maneuver.

"I just knew that I needed to help him, or try and help him," Amelia told GMA. "I didn't know how to do it either. I just did what I thought was right."

The Heimlich maneuver is designed to be used on people ages 1 and older, specifically when a person is not able to speak, cough or breathe, according to the American College of Emergency Physicians.

When performing the maneuver, the ACEP says to first reach around the waist of the person who is choking, placing one clenched fist above the navel and one below the rib cage.

Then, holding the two fists together, push "backward and upward under the rib cage six to 10 times quickly," according to the ACEP.

In the surveillance video of Charlie and Amelia, Charlie is able to remove the cheese from his mouth after just a few abdominal thrusts.

Christy Ruth, Charlie and Amelia's mom, said she is "grateful" that Amelia was looking out for her brother.

"This is the stuff you hope and pray never, ever to happens to one of your children," Ruth said. "Kids need to pay attention and look out for one another, and I'm just grateful that Amelia did."

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