Health

Obesity prevalence among US adults falls slightly to 40%, remains higher than 10 years ago: CDC

bymuratdeniz/Getty Images

(NEW YORK) — The prevalence of obesity among adults has slightly decreased in the United States but remains higher than 10 years ago, new federal data shows.

Among adults aged 20 and older, about 40.3% were estimated to be obese between August 2021 and August 2023, according to a report released early Tuesday from the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics.

This is lower than the 41.9% estimated to be obese between 2017 and 2020 but higher than the 37.7% figure recorded from 2013 to 2014.

Meanwhile, rates of severe obesity increased from 9.2% between 2017 and 2020 to 9.7% between August 2021 and August 2023. Between 2013 and 2014, an estimated 7.7% of adults were severely obese.

This means more than 100 million American adults have obesity, and more than 20 million adults have severe obesity, according to figures from the U.S. Census Bureau.

Dr. John Brownstein, an epidemiologist and chief innovation officer at Boston Children’s Hospital, and an ABC News contributor, said that although the data show a short-term slowdown of obesity rates, the prevalence is still quite high and higher than seen 10 years ago.

“The latest data reveals a persistent challenge with obesity rates holding steady at 40.3% among adults,” he said. “While this does not represent an increase, it is important to recognize that these rates are still alarmingly high — higher than they were a decade ago — underscoring the urgent need for targeted public health strategies.”

The prevalence of severe obesity was higher among women at 12.7% compared to 6.7% for men.

Among age groups, the prevalence of obesity was highest among adults between ages 40 and 59 at 46.4%. By comparison, the prevalence in adults between ages 20 and 39 was 35.5% and among those aged 60 and older was 38.9%. This pattern was seen in both men and women, according to the report.

Severe obesity prevalence was also highest among those aged 40 to 59 at 12% compared to 9.5% for those aged 20 to 29 and 6.6% for those aged 60 and older.

When it came to prevalence by education level, those with a bachelor’s degree or more had the lowest prevalence of obesity at 31.6% between August 2021 and August 2023.

There were no significant differences between men and women in obesity prevalence by education level, the report found.

Adults with obesity are at high risk of other chronic diseases. About 58% of obese adults in the U.S. have high blood pressure and about 23% have diabetes, according to the CDC.

Additionally, obesity can put a strain on the health care system. In 2019, the annual medical costs for adults with obesity were $1,861 higher per person than for adults with healthy weight. For those with severe obesity, excess costs were $3,097 per person, the CDC said.

“While there are some differences across demographics, this work really highlights that obesity is a broad health issue in the U.S. and that men, women, young and old are all affected,” Brownstein said. “Comprehensive approaches are essential to support individuals and communities in achieving healthier lifestyles.”

Copyright © 2024, ABC Audio. All rights reserved.

Health

New York reports death from EEE after 1st case diagnosed in nearly a decade

mrs/Getty Images

(NEW YORK) — The first person in New York state to be diagnosed with eastern equine encephalitis (EEE) in nearly a decade has died, Gov. Kathy Hochul’s office announced Monday.

The case was confirmed on Sept. 20 in Ulster County — located along the Hudson River — by the state Department of Health. It is currently being investigated by the county Department of Health.

State Health Commissioner Dr. James McDonald previously issued a Declaration of an Imminent Threat to Public Health after the EEE diagnosis, which allows the state to deploy resources including mosquito spraying efforts from Sept. 30 to Nov. 30, 2024.

“Eastern equine encephalitis is different this year. While we normally see these mosquitoes in two to three counties each year, this year they have been in 15 counties so far, and scattered all over New York State,” McDonald said in a statement. “This life-threatening mosquito-borne disease has no commercially available human vaccine and must be taken seriously. Mosquitoes, once a nuisance, are now a threat.”

“I urge all New Yorkers to prevent mosquito bites by using insect repellents, wearing long-sleeved clothing and removing free-standing water near their homes. Fall is officially here, but mosquitoes will be around until we see multiple nights of below freezing temperatures,” the statement continued.

The New York case is likely at least the eleventh case of EEE so far this year, according to an ABC News tally. This also includes the 10 known cases listed on the Centers for Disease Control and Prevention’s (CDC) website.

Beyond New York, cases have been reported in Massachusetts, with four; New Hampshire, with two; and in New Jersey, Rhode Island, Vermont and Wisconsin, with one each.

Between 2003 and 2023, there have been at least 196 EEE cases reported in the U.S., including 176 hospitalizations and 79 deaths, CDC data shows.

Most people who are infected with EEE show either mild symptoms or no symptoms at all, according to the CDC. However, severe cases usually present with fever, headache, chills and vomiting before progressing to the more serious encephalitis, which is inflammation of the brain, or meningitis, which is inflammation of the membranes that surround the brain and spinal cord.

About one-third of all people who develop severe EEE die from the illness, the CDC says, while survivors can experience ongoing physical and neurological problems, including seizures, paralysis, cranial nerve dysfunction, personality disorders, and intellectual disabilities that can range from mild to severe.

There are no vaccines for EEE and health officials say the best protection is to prevent mosquito bites.

Health officials recommend wearing long-sleeve shirts and long pants, and tucking shirts into pants and pants into socks, at dusk or dawn, which are times of day when mosquitoes are most active.

Additionally, it is recommended to use insect repellent with DEET, to use screens on windows and doors, and to eliminate all standing water around the home where mosquitoes can breed.

ABC News’ Youri Benadjaoud and Meredith Deliso contributed to this report.

Copyright © 2024, ABC Audio. All rights reserved.

Health

Lactaid milk recalled in 27 states due to potential for undeclared almonds

FDA.Gov

(NEW YORK) — Lactaid milk is being recalled due to the potential presence of almonds, a common tree nut allergen.

The Food and Drug Administration and HP Hood LLC announced the voluntary recall Sept. 20.

HP Hood said it discovered the potential almond contamination following a “routine maintenance” review but also said they have not received any reports of any illnesses so far.

Five varieties of refrigerated Lactaid milk in 96-ounce containers are included in the recall – whole milk, 2% milk, 1% milk, fat-free milk, and calcium-enriched milk – for potentially having trace amounts of almonds, which are undeclared in the recalled milk products’ ingredients list.

The recalled milk products were shipped to retailers and wholesalers in 27 states in September.

A list of Lactaid milk containers affected by the recall and their best by dates, product names and expiration dates can be found on FDA’s website.

Customers with the recalled Lactaid milk, which doesn’t contain the lactase sugar found in traditional cow’s milk, are advised to return the product to the place of purchase for a full refund or exchange. Impacted customers can also reach out to Hood Consumer Affairs at 800-242-2423. The call line is available on weekdays between 9 a.m. ET and 5:00 p.m. ET.

In a statement Monday, HP Hood LLC told “Good Morning America,” it was recalling the 96-ounce containers of Lactaid milk “out of an abundance of caution because the product may contain trace amounts of almond, which is not listed on the label.”

“HP Hood, the manufacturer of Lactaid Milk products, has long recognized consumer and public health concerns related to the potential presence of undeclared allergens in food products. Hood’s allergen and sanitation management programs are aligned with all regulatory and industry standards,” the company said.

Copyright © 2024, ABC Audio. All rights reserved.

Health

New York state reports 1st human case of EEE in nearly a decade

Jon Cherry/Getty Images

(NEW YORK) — New York state reported its first case of eastern equine encephalitis in nearly a decade on Friday.

The rare mosquito-borne virus was detected in Ulster County, the New York State Department of Health said. The individual is hospitalized, it said.

The Ulster County Department of Health is currently investigating the case, which marks the first case of EEE confirmed in New York state since 2015, health officials said.

“Eastern equine encephalitis is a serious and fatal mosquito-borne disease with no vaccine,” New York State Health Commissioner Dr. James McDonald said in a statement. “Even though temperatures are getting cooler, mosquito-borne illnesses are still a risk and New Yorkers must be cautious.”

The human case comes after a case of EEE was confirmed in a horse in Ulster County in August, the state health department said. Earlier this month, two emus in New York’s Rensselaer County also tested positive for the virus, which does not spread directly from birds to humans, the department said.

The latest human EEE case in New York brings the national tally to at least 11 so far this year, according to an ABC News tally. The national yearly average is 11, with most cases occurring in eastern or Gulf Coast states.

Beyond New York, cases have been reported in at least six other states so far this year: Massachusetts, with four; New Hampshire, with two; and, with one each, New Jersey, Rhode Island, Vermont and Wisconsin.

Between 2003 and 2023, there have been at least 196 EEE cases reported in the U.S., including 176 hospitalizations and 79 deaths.

The best way to prevent infection from the disease is to protect yourself from mosquito bites, including by using insect repellant, wearing long-sleeved shirts and pants, treating clothing and gear and taking steps to control mosquitoes indoors and outdoors.

“With the first confirmed human case of eastern equine encephalitis in Ulster County, I urge residents to take the recommended precautions to prevent mosquito bites and the risk of infection,” Ulster County Executive Jen Metzger said in a statement.

Most people infected with EEE do not develop symptoms. For those who do, symptoms can include fever, headache, vomiting, diarrhea, seizures, behavioral changes and drowsiness, according to the U.S. Centers for Disease Control and Prevention.

Approximately a third of all people who develop severe cases die, according to the CDC.

Copyright © 2024, ABC Audio. All rights reserved.

Health

What to know about body roundness index, an alternative to BMI

Halfpoint Images/Getty Images

(NEW YORK) — While body mass index (BMI) has long been a go-to measure of a person’s health, used by doctors and health insurers alike, a new approach is taking hold.

Body roundness index, or BRI, is gaining prominence as a way of predicting one’s health risk by taking into account more than just a person’s height and weight, which are the sole factors used to determine BMI, according to the National Institutes of Health.

Here are five questions answered about BRI and why it’s being used with increasing frequency.

1. What is body roundness index?

Body roundness index takes into account a person’s height and waist circumference to determine whether they are in a healthy or unhealthy sphere, according to Maya Feller, a registered dietitian and nutritionist.

A study published in June in JAMA Network Open described BRI as an evidence-backed tool for more accurately determining a person’s mortality risk.

2. How do I calculate my own BRI?

BRI is calculated using a mathematical formula: 364.2 − 365.5 × √(1 − [waist circumference in centimeters / 2π]2 / [0.5 × height in centimeters]2, according to the study.

There are online calculators where you can enter your height and waist and hip measurements to determine your BRI.

Once your measurements are entered, you will see a number and whether that puts you in or out of the “healthy zone.”

3. What are the criticisms of BRI?

According to Feller, one criticism of BRI is that it favors a certain body type.

“The challenge with the BRI is that it really favors more slender bodies, and it says that, okay, rounder bodies are not as ‘healthy,'” Feller said.

4. What is wrong with using BMI?

BMI is still a go-to determinant of health used by medical providers.

Some critics, though, argue that BMI does not take into account a person’s body composition because it only measures weight and height, according to Feller.

With BMI, a person is categorized as either underweight, normal weight, overweight or obese.

Last year, the American Medical Association said in a policy announcement that BMI does not account for racial, sex, age ethnic and gender diversity.

“It doesn’t take body composition into consideration,” Feller said. “So someone who’s very muscular might wrongly be put in the overweight or obese category, and that’s just not okay.”

5. What are other ways to check my health status?

Feller noted that while BRI and BMI can be useful, she recommends relying on tests that measure a person’s internal health rather than their weight or measurements.

“I always like to check the insides,” Feller said. “You can look as wonderful as you want on the outside, but what’s happening with your lipids? What’s happening with your blood pressure, your blood sugars? Those are the things that I want to see.”

Copyright © 2024, ABC Audio. All rights reserved.

Health

Overdose deaths have continued to drop, now at their lowest level in three years, data shows

In this Jan. 25, 2024, file photo, a used Narcan brand Naloxone nasal spray rests on the street after paramedics and police responded to a suspected fentanyl drug overdose in Portland, Oregon. — Patrick T. Fallon/AFP via Getty Images, FILE

(ATLANTA) — The estimated number of drug overdose deaths in the U.S. have been dropping for months and are now at their lowest levels in three years, according to data from the Centers for Disease Control and Prevention (CDC).

Deaths from overdoses dropped for the first time in five years in 2023, following a steady rise during the pandemic. However, the current number of overdose deaths still remains higher than pre-pandemic levels.

In April 2024, the latest month with data, the estimated number of deaths in the past 12 months was 101,168, according to the CDC. The last month with figures that low was in May of 2021, with 100,997 deaths.

Data from other sources, such as emergency department visits and calls to EMS, support the downward trend, according to an analysis led by Dr. Nabarun Dasgupta, a senior scientist at the Injury Prevention Research Center at the University of North Carolina at Chapel Hill. He tells ABC News that the data may point to 20,000 fewer deaths annually, or more.

While experts continue to explore possible reasons driving the decline, there are a few public health initiatives to curb drug overdoses that may be showing signs of success.

“Enhanced access to naloxone, expanded treatment programs for opioid use disorder, and increased public awareness about the dangers of synthetic opioids like fentanyl are likely playing significant roles in saving lives,” said Dr. John Brownstein, chief innovation officer at Boston Children’s Hospital and an ABC News medical contributor.

Another potential explanation for the downturn, Dasgupta says, may be related to changes in the drug supply, such as more people using xylazine, a dangerous, non-opioid animal sedative that’s often mixed with other illicit drugs, including fentanyl.

“Xylazine makes people use less fentanyl, is the bottom line,” Dasgupta told ABC News, while citing research that showed that those who overdosed and tested positive for xylazine had less severe health outcomes than those who did not have xylazine in their system. This could be due to the fact that those who used illicit substances, like fentanyl, mixed with xylazine may be using those substances less often, Dasgupta said.

“We’re seeing this pattern kind of happening that looks a lot like a change in the drug supply, more so than just explained by all the interventions in the public health space,” Dasgupta added. “It’s probably a mix of all these things at the end of the day, but something really changed in the third quarter of last year.”

Within each state, however, the decline in overdose deaths is not uniform among all people. Maryland, for example, experienced a decline in deaths among white populations, yet an increase among Black populations, Dasgupta points out.

Changes in drug overdose deaths also vary greatly by state, with some still experiencing increases in the past 12 months, CDC data shows. States with the greatest dips in overdose deaths over the past year, according to the same data, were Nebraska, North Carolina, Vermont, Ohio, and Pennsylvania, in that descending order.

While the national downward trend may continue, experts told ABC News it may not be permanent.

“We’ve seen dips that have been erased a year later. So, I’m cautious. I feel like things really haven’t cooled down yet,” Dasgupta said. “It feels like we’ve put the lid on the pot, but we’re still at a rolling boil. There’s still a lot of people dying of overdose.”

“It’s crucial that we continue to intensify our efforts to address the root causes of the opioid epidemic,” Brownstein said. “We need to continue investing in comprehensive strategies that address the complex factors driving the opioid crisis.”

Jake Goodman, MD, MBA is a psychiatry resident physician and a member of the ABC News Medical Unit.

Copyright © 2024, ABC Audio. All rights reserved.

Health

3D mammography better at detecting early-stage cancer with fewer false positives, study finds

Isaac Lane Koval/Corbis/VCG/Getty Images

(NEW YORK) — Newer three-dimensional imaging is more effective at detecting breast cancer and may improve long-term outcomes, according to a new study led by researchers at the Yale School of Medicine.

The study, which analyzed more than 272,000 breast cancer screenings over 13 years, showed that 3D mammography, known as digital breast tomosynthesis, or DBT, identified breast cancer at higher rates and earlier stages when compared to traditional 2D mammograms.

3D mammography also reduced the number of false positive results, leading to fewer unnecessary tests after initial screening, according to the study, published Tuesday in the medical journal Radiology.

The study builds on a growing body of research suggesting 3D mammography could offer benefits over 2D imaging.

According to lead co-author Dr. Liane Philpotts, this is the first study on 3D mammography of its scale, with 10 years’ worth of 3D screening data.

“It confirms some of what we knew from earlier … and shows the sustainability of these benefits,” Philpotts told ABC News. “But the big take-home point is that the advanced cancer rate was less [with 3D mammography]. That is the most significant finding from this.”

While 2D mammography is still accepted as a gold standard for breast cancer screening, an increasing number of health centers are incorporating this 3D technology.

Here are five questions answered about 3D mammography:

1. What is 3D mammography?

While traditional mammography involves a two-dimensional X-ray image, three-dimensional mammograms use a rotating “X-ray arc” that takes X-rays from multiple angles to create a detailed 3D representation of breast tissue.

This allows radiologists to scroll through 1-millimeter slices to obtain a more comprehensive view of the tissue.

2. Practically speaking, what are the benefits of 3D mammograms compared to 2D, according to the latest research?

3D mammograms may be able to detect breast cancers more frequently and at earlier stages. Earlier detection means earlier treatment and a higher chance of a cure.

In addition, 3D mammograms were associated with fewer false positive results, reducing the burden of unnecessary follow up testing. This could mean less time, money and stress for patients.

“It gives us … a better chance of finding things, and also a reduced chance of having to call people back unnecessarily,” Philpotts said. “So, it’s kind of a win-win from that point of view.”

3. What do current guidelines say about 2D vs. 3D mammograms?

According to the U.S. Preventive Services Task Force guidelines — an influential group of experts whose guidelines help determine government insurance coverage — 2D and 3D mammography are both effective forms of breast cancer screening.

Right now, one is not recommended over the other.

4. Is it covered by insurance?

Many insurance providers, including Medicare, cover 3D mammography.

However, coverage varies depending on insurance company and state of residence, as 3D mammograms are more expensive than 2D.

In some cases, only a portion is covered, or patients must meet a deductible first. Patients may need to call their insurance provider to understand what their individual plan covers.

5. Can I request it during my next screening?

More than likely, if you are due for breast cancer screening, you could receive a 3D mammogram.

3D breast mammography is offered at 90% of certified breast imaging centers. However, 3D imaging may not be necessary for everyone. It is a good idea to speak with your provider about whether it’s right for you.

Copyright © 2024, ABC Audio. All rights reserved.

Health

Los Angeles County reports a rare handful of local dengue cases

Gerard Rivest/500px/Getty Images

(LOS ANGELES) — While Los Angeles County is reporting three locally acquired cases of dengue this year — which is rare for the region — there have been at least 3,085 cases nationally of locally acquired virus so far this year, according to data from the Centers for Disease Control and Prevention.

There has been about double the number of locally acquired dengue cases so far this year nationally compared to last year, according to the CDC. Puerto Rico currently makes up the bulk of those cases – with over 2,960 reported. The U.S. territory declared a public health emergency back in March.

“The City of Baldwin Park is aware of the recent cases of locally acquired dengue in our community. While the risk of transmission remains low, we must take this situation seriously and act proactively,” said Mayor Emmanuel J. Estrada.

Dengue viruses spread through mosquito bites. The most common symptom is a fever with aches and pains, nausea, vomiting and rash. Symptoms usually begin within two weeks after being bitten by an infected mosquito and last 2-7 days. Most people recover after about a week.

Locally acquired cases mean that the people infected have no history of traveling to an area where dengue normally spreads. Local dengue transmission is typically common in tropical and subtropical areas of the world – including Florida, and U.S. territories in the Caribbean.

Last year, there were only two locally acquired cases reported in the state of California, the first local cases in the state reported in over a decade, according to CDC data.

The CDC issued a health alert in June warning health care providers of an increased risk of dengue virus infection this year. Globally, new cases of dengue have been the highest on record, according to the CDC. The agency also noted that cases are likely to increase as global temperatures increase.

The best way to prevent dengue is to avoid mosquito bites, according to the CDC.

Copyright © 2024, ABC Audio. All rights reserved.

Health

Man left paralyzed at 19 drives car again for first time

Courtesy Ryley Hopper

(NEW YORK) — A man who was left paralyzed after diving into a swimming pool as a teenager was recently able to drive again for the first time, eight years after his injury.

Ryley Hopper, 27, got behind the wheel of a specially equipped van on Aug. 14, his first time driving since he was paralyzed from the chest down at the age of 19.

“It’s a very empowering, independent thing,” Hopper told ABC News’ Good Morning America, about reclaiming the freedom to drive again. “I wanted to want something … to find a purpose to attack head on.”

Hopper was a college freshman at the University of North Carolina Wilmington and enjoying a summer swim in his friend’s pool in 2016 when he flipped into the shallow end, hit the bottom and lost consciousness.

His friend, trained as a lifeguard, performed CPR on Hopper to keep him stable until the ambulance arrived.

The accident left Hopper with a life-altering C5-C7 spinal cord injury that resulted in paralysis from the chest down.

He spent nearly a month at Duke University Hospital, including four days in a medically induced coma, before being transferred to the Shepherd Center in Atlanta for two months of intensive inpatient rehabilitation.

“In the beginning, I was figuring out what the future would look like … my first goal was to get back to school,” said Hopper, who prioritized returning to UNCW the following fall semester to complete his undergraduate and graduate finance degrees.

With his mother as his caretaker and a supportive community behind him, a couple years after entering the workforce, Hopper said he was ready to “attack this driving thing … and be more in control of my life.”

“It took a while to reset my mindset,” he said, but “minutes after being in the car, the butterflies went away.”

Hopper attributes spending time outside as a factor in his post-injury progress, and for him, driving is an extension of that.

“A lot of healing is done indoors — in and out of physicians’ offices — and the natural world isn’t always accessible,” said Hopper, who said he aspires to one day create a space for people with disabilities to participate in accessible outdoor activities and reconnect with nature.

When setting spinal cord injury recovery milestones, Hopper also underscores the importance of mental health and striving for personal growth.

“I’ve been given a unique perspective because of my injury, and I wouldn’t be where I am today if it wasn’t for the struggle I’ve been through,” he said.

For others dealing with a spinal cord injury, Hopper reminded them to not forget to find the silver lining.

“Find peace and serenity,” he said. “Once you realize that you’re in a position that grants you a unique perspective on life … it’s a kind of superpower in itself.”

Copyright © 2024, ABC Audio. All rights reserved.

Health

Polio vaccinations wrap up in Gaza as officials try to inoculate 90% of children under age 10

Majdi Fathi/NurPhoto via Getty Images

(TEL-AVIV, Israel) — The last day of the polio vaccination campaign is wrapping up in Gaza, the World Health Organization (WHO) said Thursday.

The campaign was launched after the first case of polio in Gaza in more than 25 years was recently detected. Health officials from the WHO, the Hamas-run Gaza Ministry of Health and partner organizations said they would be vaccinating children in three-day phases starting in central Gaza, then in southern Gaza, and ending in the north.

As of Thursday morning, more than 552,000 children under age 10 out of 640,000 have been vaccinated in Gaza, according to the WHO. The organization said at least 90% coverage is needed to stop a potential outbreak in Gaza, and the campaign may be extended if that 90% figure isn’t achieved on Thursday.

Poliovirus was first detected in sewage samples from the cities of Deir al-Balah and Khan Younis – in central and southern Gaza, respectively – in mid-July, in tests conducted by the Gaza Ministry of Health in coordination with the UN.

In mid-August, the Ministry of Health reported the first case of polio in Gaza in 25 years, in a 10-month-old child who had not been vaccinated. Doctors suspected polio after symptoms resembled the virus, which was confirmed in test conducted in Amman, the capital of Jordan, according to the WHO.

Children are receiving two drops of novel oral polio vaccine type 2 (nOPV2), which has been used for outbreak response under the WHO’s Emergency Use Listing approval since March 2021. A second dose is typically given four weeks after the first.

“We want to protect our children from diseases and give them the necessary vaccines because prevention is better than cure,” Islam Saleh, a mother in northern Gaza, said in a video issued by the United Nations (UN) on Wednesday.

“I fear for my son because there is no cure for polio. This dose he received will protect him, and it is safe,” Saleh added.

Officials have said that the vaccination operation is complicated by access restrictions, evacuation orders and fuel shortages. Israel has agreed to “temporary” pauses in fighting each day in order for the vaccinations to be administered.

Earlier this week, a convoy of UN vehicles in northern Gaza was stopped and questioned by Israeli Security Forces before being released, the Israel Defense Forces (IDF) said in a statement.

Polio largely affects children under age 5 and can lead to paralysis or death. According to the Palestinian Central Bureau of Statistics, there are about 341,000 children under the age of five in Gaza.

Children in the U.S. are recommended to get the inactivated polio vaccine as part of routine childhood immunization, according to the Centers for Disease Control and Prevention (CDC). It consists of four doses in total administered first at 2 months of age, then at 4 months, 6-18 months, and 4-6 years.

“It has been heartening to see the response to the campaign,” the WHO said in comments released after a press briefing on Thursday. “Everywhere the team has gone, parents are doing all they can to ensure their child does not miss vaccination. Many vaccination sites received more than expected crowds. Special coordinated missions were also conducted to reach children in insecure and heard to reach areas.”

ABC News’ Jordana Miller and Dana Savir contributed to this report.

Copyright © 2024, ABC Audio. All rights reserved.