title: Ye (album)

text: "Ye" was released for digital download and streaming worldwide on June 1, 2018, through West's labels GOOD Music and Def Jam. The album was later released as a CD in various countries by the aforementioned labels on July 20, 2018. On June 8, it was revealed that "Ye" was slated to be released on vinyl in the summer of 2018 and pre-orders were made available simultaneously, while the vinyl release ultimately occurred in various countries on July 27, 2018, through West's labels. This marked the first official vinyl release for an album by West since his collaborative studio album "Watch the Throne" with Jay-Z in 2011. However, West's previous two albums "Yeezus" and "The Life of Pablo" were heavily bootlegged on vinyl.


title: Ye (album)

text: A two-hour listening party took place for "Ye" on the night of May 31, 2018, in Jackson Hole, with West broadcasting a livestream of the party through the WAV app. West invited a variety of guests to the listening party, including Ty Dolla Sign, Kid Cudi, Nas, Pusha T, Desiigner, 2 Chainz, Big Sean, Cyhi the Prynce, among others. Members of Def Jam's staff mobilized and organized people from various locations around the world for the party, though the number of people originally planned to fly out for it was 300 until it was ultimately halved. At the location of the listening party, the album's title was announced as being "Ye" by American comedian Chris Rock, shortly before the party began.


title: Ye (album)

text: By June 6, 2018, West's official website had been updated to include footage from the listening party for "Ye". A promotional video of the listening party was played on the website, set to the album tracks "I Thought About Killing You" and "Ghost Town". Rock provided narration for the video. West's website was later updated on October 22, 2019, in promotion of his ninth studio album "Jesus Is King".


title: Ye (album)

text: There weren't any music videos released for "Ye", but lyric videos for the tracks "All Mine" and "Violent Crimes" were officially released simultaneously on June 19, 2018. Both of the tracks were treated as singles from the album with the promotion, despite not having been released as such at the time, though "All Mine" later experienced a single release. The videos include the lyrics being written out on the same Wyoming mountain range displayed on the artwork for "Ye", while the lyrics are in the same font used for the text on the artwork.


title: Ye (album)

text: West initially debuted "Ye" on June 1, 2018, without any singles, as is popular among musicians using the sudden release option that don't want a big marketing roll out. On June 8, "Yikes" was released to UK mainstream radio stations by West's labels as the lead single from the album. Three days later, it was revealed that West had to choose a lead single in the United States for promotion. Simultaneously, the song was revealed to have been selected by West for release as a single in the US. It was serviced to US radio stations through West's labels as the lead single on June 11, 2018. Prior to release as a single, the song charted at number eight on the US "Billboard" Hot 100, standing as West's first solo track to enter the top 10 of the Hot 100 since the single "Heartless" in 2008 and becoming his 16th top 10 single on the chart. After having been released as a single, the song made its debut at number 10 on the UK Singles Chart, standing as West's 19th top 10 single on the chart. On August 14, 2019, "Yikes" was certified platinum in the US by the Recording Industry Association of America (RIAA) for sales of 1,000,000 certified units. The song was later certified gold in the United Kingdom by the British Phonographic Industry (BPI) for selling 200,000 units.


title: Ye (album)

text: West went on to select "All Mine" for release as the second single from "Ye" on July 20, 2018, which features vocals by Ty Dolla Sign and Clemons. This decision was made by West due to his labels preparing a track for such a release to block a momentum loss for the album after "Yikes" experienced a lack of success on record charts. However, the track's lyric video had been released in promotion over a month before it was selected for release as a single. On July 24, 2018, the track was sent to US rhythmic contemporary radio stations through West's labels as the second single. The track entered at number 11 on the "Billboard" Hot 100, prior to being released as a single. That same week, the track debuted at an identical position on the UK Singles Chart. "All Mine" was certified double platinum in the US by the RIAA for pushing 2,000,000 certified units on June 28, 2021. On March 6, 2020, the track was certified silver in the UK by the BPI for sales of 200,000 units.


title: Ye (album)

text: Both of the singles stood as West's first entries in the top 10 of the US Hot R&B/Hip-Hop Songs chart since "All Day" reached number six in 2015. "Yikes" and "All Mine" gave West his 25th and 26th tracks to attain top 10 positions on the chart, entering at number seven and nine, respectively. Though "Yikes" charted higher than "All Mine", the latter remained on the "Billboard" Hot 100 longer; it spent nine weeks on the chart, while the former only remained on the Hot 100 for five weeks.


title: Ye (album)

text: The artwork for "Ye" was revealed by Kardashian to have been taken by West on his iPhone on their way to the listening party on May 31, 2018, hours before the release of the album. It features a view of the Teton Range from Jackson Hole, the mountain range where the album was recorded and produced. The mountainous terrain photographed is natural, though it is questionable whether the artwork includes a skyline or not within the area that the terrain is present on it. The text on the artwork reads: "I hate being / Bi-Polar / its awesome," which is scribbled in neon green over the mountain range. With the inclusion of the phrase on the artwork, West confirmed his bipolar disorder.


title: Ye (album)

text: In an interview conducted with Big Boy during the listening party for the album, West explained the title, which is a diminutive of his own name commonly used in his songs, by stating: "I believe 'ye' is the most commonly used word in the Bible, and in the Bible it means 'you.' So, I'm you, I'm us, it's us. It went from Kanye, which means 'the only one,' to just "Ye" – just being a reflection of our good, our bad, our confused, everything." West went on to tweet in June 2018 that without his ego, he is "Just "Ye"," a potential point of reference for the album title.


title: Ye (album)

text: In October 2022, CNN cited anonymous sources as saying that West originally suggested calling the album "Hitler" after the Nazi dictator, alleging that West had displayed a fascination with Hitler and his rise to power, would talk about the "great things he and the Nazi Party achieved for the German people", openly read Hitler's book "Mein Kampf" (1925), and expressed admiration for Hitler and the Nazis' use of propaganda. West later drew international condemnation for publicly making comments that were and . It subsequently emerged that West had reputedly promoted such views in his inner circle for nearly two decades.


title: Ye (album)

text: "Ye" was met with generally favorable reviews from music critics. At Metacritic, which assigns a normalized rating out of 100 to reviews from professional publications, the album received an average score of 64, based on 34 reviews. Aggregator AnyDecentMusic? gave it 6.1 out of 10, based on their assessment of the critical consensus.


title: Ye (album)

text: Alexis Petridis for "The Guardian" stated the album doesn't feel slight but opined that it is exhausting. Petridis wrote: "Substantially more focused than its predecessor, it packs a lot into 23 minutes. It is bold, risky, infuriating, compelling and a little exhausting: a vivid reflection of its author." Jones looked at "Ye" as "an album about Kanye's state of mind, his family, and a narration of what's been going on in his 'shaky-ass year.' The beats are great. Lyrically, it's fine. Whatever you think of his politics, his songwriting, sample-hunting and beat-making remain dynamic, surprising and ballsy." Purdom claimed that West "can still create thunderous blasts of sound on par with anyone on the planet, and "Ye"s best moments are reminders of that. It's a prismatic album, reflecting its creator's entire body of work—and also whatever you think about him going in." Writing for "Time", Maura Johnston compared West's previous projects to the album, saying that "the one thing they've consistently focused on is contrast: light and dark, ugly and beautiful, self-aggrandizing and self-loathing." She added that it "resembles his last album, "The Life of Pablo" in which "Ye" doesn't deviate too much from the lyrical concepts of "Pablo"; it blends the trivial and the life-or-death, like on the darkened-club 'Yikes,' on which he declares his bipolar syndrome to be his 'superpower' and compares the U.S.-North Korea tensions to his long-simmering beef with Wiz Khalifa." Kyle Mullin from "Exclaim!" wrote that "if West had better delved into his emotional and psychological turmoil in "Ye"s lyrics, instead of getting bogged down with click-baity asides, then this LP would've been a classic."


title: Ye (album)

text: Eric Brown was less enthusiastic in "Billboard", stating: "It's tough to ignore "Ye"s musical stasis; known for his forward motion, on this set, West remains mired in the past," also commenting that "It's a missed opportunity in the sense that it fails to measure up to his previous work and change the conversation around him." For AllMusic, Neil Z. Yeung expressed mixed feelings, writing that the album "can feel uneven, sometimes boring, and more indulgent than usual, but it's a fascinating peek into West's psyche." Similarly, Wren Graves of "Consequence" believed that "on "Ye", he's consolidating old skills, not testing out new ones," adding that "the lack of wow-factor, combined with the short length, makes the album feel somewhat slight." Rob Sheffield of "Rolling Stone" described the album as "wildly uneven" with "enough sporadic flashes of brilliance to make you hungry for much, much more." "Slant Magazine"s Zachary Hoskins viewed the album as what "just feels unfinished, as if he wanted to avoid another debacle like the rollout of the also-unfinished "The Life of Pablo"" and called it "a mix of the weakest moments from "The Life of Pablo"." Horton wrote negatively of the album, claiming that "there's no through-line. No concept. No consistency. There's certainly no quality control." Robert Christgau gave the album a in a capsule-review column for "Vice", calling it a "half-assed attempt to make asshattery germane again."


title: Ye (album)

text: "Ye" appeared on year-end best album lists for 2018 by multiple publications. On the "Pitchfork" Readers' Poll: Top 50 Albums of 2018, the album was voted in at number 37. "Ye" was listed at number four on the website's polls for most underrated and most overrated album of the year, respectively. It was ranked at the same position on "GQ" Russia's list of 2018's best albums. "The Edge" and Jon Caramanica of "The New York Times" both listed the album as the seventh best of the year. "Ye" was ranked by "NME" as the 34th best album of 2018, with the staff writing that "there's plenty in this experimental, weird little album that suggests Kanye has very much still got it." "411Mania" named "Ye" the 42nd best album of the year, with David Hayter of the website claiming that despite the "serious faults" of the album, it is an "endlessly listenable collection," calling the music "too coherent and sonically satisfying to quibble over." "Ye" was ranked as the 30th best hip hop album of 2018 by "Rolling Stone" even though the staff viewed it as West's worst album, writing that "West, at his worst, is still making more fascinating music than almost anyone else," and the staff elaborated, calling the album "a dense and, at times, brilliant piece of music."


title: Ye (album)

text: On April 25, 2018, West tweeted out: "I'm turn the Grammys into the Yammys," predicting success for himself at the 2019 Grammy Awards. West's work on "Ye" and other projects earned him a nomination for Producer of the Year, Non-Classical at the ceremony. However, the album marked West's first to not be nominated for Best Rap Album at the Grammys, with the lack of a nomination being viewed as a snub by multiple publications. In an article for "Consequence", Lake Schatz was surprised by West being snubbed even though he called "Ye" "hardly the best in his catalog" and questioned "whether the lack of even a nomination has to do partially with the MC's especially divisive nature in 2018." At the 2019 Fonogram Hungarian Music Awards, the album earned a nomination for Best Foreign Rap or Hip-Hop Album of the Year.


title: Ye (album)

text: "Ye" debuted at number one on the US "Billboard" 200 with 208,000 album-equivalent units, of which 85,000 were pure album sales, becoming the fifth-largest weekly units for an album in 2018. The album was West's eighth consecutive chart topper on the "Billboard" 200, tying him with Eminem's streak from 2000 to 2018 and English band the Beatles' streak from 1965–1968 as one of only three acts to accumulate eight consecutive number one albums. West also became the only other act apart from Eminem to achieve eight consecutive number one debuts, since none of the albums from the Beatles' streak debuted atop the "Billboard" 200. The sales surpassed the first week projections of 175,000 to 190,000 album-equivalent units and up to 80,000 pure sales. "Ye" recorded the second largest per-track streaming average ever, receiving 25.7 million on-demand audio streams. The seventh-largest streaming debut week ever was experienced with 120,000 streaming equivalent albums, with the streams being counted at over 180 million.


title: Ye (album)

text: The album descended four places to number five in its second week on the "Billboard" 200 and dropped 65% in sales, moving 74,000 album-equivalent units. This became the second highest decrease in sales for an album's second week of 2018, standing behind the 73% decline of American musician J. Cole's fifth studio album "KOD"; however, the second week sales for "KOD" were higher than those of "Ye", with 105,000 units having been pushed. The album also entered atop the US Top R&B/Hip-Hop Albums chart, giving West his eighth consecutive number one debut on the chart. In 2018, it was ranked as the 50th and 30th most popular album of the year on the "Billboard" 200 and Top R&B/Hip-Hop Albums charts, respectively. On September 30, 2021, "Ye" received a platinum certification from the RIAA for amassing 1,000,000 certified units in the US.


title: Ye (album)

text: "Ye" debuted atop the ARIA Albums chart, giving West his second chart-topping album in Australia and replacing fellow rapper Post Malone's second studio album "Beerbongs & Bentleys" at the top position. This made West the third major hip hop act to have an album reach the top 10 of the chart in 2018, joining J. Cole with "KOD" and ASAP Rocky with his third studio album "Testing". A Streaming Equivalent Album Value being taken into account for the Album Chart calculations in Australia helped "Ye" top the ARIA Albums chart, since the value counts the streams for all tracks of albums 10 tracks or less, rather than the two most streamed tracks as done for longer albums. The album was also a chart topper on the Irish Albums Chart, giving West his first number one album in Ireland. By reaching the same position on the New Zealand Albums chart, "Ye" became West's second number one album in the country. The following week, it remained at the top position. The album also debuted at number one on the Canadian Albums Chart, with 16,000 total consumption units, though it reached the second highest album sales and on-demand streams of the week. This became West's sixth chart-topping album in Canada, while also standing as his first since "Yeezus". In Estonia, "Ye" entered at number one on the Albumid tipp-40 and remained atop the chart the following week.


title: Ye (album)

text: "Ye" entered at number two on the UK Albums Chart, being held off the top spot by "", which denied West a number one album on the issue that coincided with his 41st birthday. However, the album was the most played album of the week on streaming services, and it was reported that 80% of sales came from streams. On May 21, 2021, "Ye" was certified gold in the UK by the BPI for sales of 100,000 units. The album also attained the chart position of number two on both the Danish Albums Chart and Norwegian Albums Chart. Similarly, "Ye" reached number three on the Czech Albums, Icelandic Albums, and Netherlands' Dutch Album Top 100 charts. On the Swedish Albums chart, the album reached number five.


title: Ye (album)

text: All seven tracks from "Ye" debuted in the top 40 of the "Billboard" Hot 100, with lead single "Yikes" charting the highest at number eight. The tracks entering the Hot 100 lead to West's total number of top 40 entries amounting to 48, placing him joint-10th with fellow rapper Jay-Z on the list for most top 40 entries on the chart, and also making West the 11th act with as many as seven simultaneous top 40 Hot 100 entries. West topped the US "Billboard" Artist 100 for the first time in his career, partially as a result of the entries from the album, surpassing his previous peak position of number three that was attained as a result of "The Life of Pablo". The two tracks "Ghost Town" and "All Mine" charted in the top 40 of the UK Singles Chart, along with "Yikes"; the latter of the three was the highest charting from "Ye" at number 10.


title: Salvia divinorum

text: Salvia divinorum (Latin: "sage of the diviners"; also called ska maría pastora, seer's sage, yerba de la pastora, magic mint or simply salvia) is a plant species with transient psychoactive properties when its leaves are consumed by chewing, smoking, or as a tea. The leaves contain opioid-like compounds that induce hallucinations. Because the plant has not been well-studied in high-quality clinical research, little is known about its toxicology, adverse effects, or safety over long-term consumption.


title: Salvia divinorum

text: Its native habitat is cloud forest in the isolated Sierra Mazateca of Oaxaca, Mexico, where it grows in shady, moist locations. The plant grows to over a meter high, has hollow square stems like others in the mint family Lamiaceae, large leaves, and occasional white flowers with violet calyxes. Botanists have not determined whether "Salvia divinorum" is a cultigen or a hybrid because native plants reproduce vegetatively and rarely produce viable seed.


title: Salvia divinorum

text: Mazatec shamans have a long and continuous tradition of religious use of "Salvia divinorum" to facilitate visionary states of consciousness during spiritual healing sessions.


title: Salvia divinorum

text: Its chief active psychoactive constituent is a structurally unique diterpenoid called "salvinorin A", a potent κ-opioid agonist. Although not thoroughly assessed, preliminary research indicates "Salvia divinorum" may have low toxicity (high ). Its effects are rapid but short-lived.


title: Salvia divinorum

text: "Salvia divinorum" is legal in some countries including the U.S., although many states have passed laws criminalizing it.


title: Salvia divinorum

text: The genus name, "Salvia", was first used by Pliny for a plant that was likely "Salvia officinalis" (common sage) and is derived from the Latin "salvere". The specific epithet, "divinorum", was given because of the plant's traditional use in divination. It is often loosely translated as "diviner's sage" or "seer's sage". Albert Hofmann, who collected the first plants with Wasson, objected to the new plant being given the name "divinorum": "I was not very happy with the name because "Salvia divinorum" means "Salvia of the ghosts", whereas "Salvia divinatorum", the correct name, means "Salvia of the priests". It is now in the botanical literature under the name "Salvia divinorum" due to priority rules.


title: Salvia divinorum

text: There are many common names for "S. divinorum", including "sage of the diviners", "ska maría pastora", "seer's sage", "yerba de la pastora", simply "salvia" also "sally-d" and "magic mint".


title: Salvia divinorum

text: "Salvia divinorum" is native to the Sierra Mazateca in Oaxaca, Mexico, where it is still used by the Mazatec, primarily to facilitate shamanic visions in the context of curing or divination. "S. divinorum" is one of several species with hallucinogenic properties that are ritually used by Mazatec shamans. In their rituals, the shamans use only fresh "S. divinorum" leaves. They see the plant as an incarnation of the Virgin Mary, and begin the ritual with an invocation to Mary, Saint Peter, the Holy Trinity, and other saints. Ritual use traditionally involves being in a quiet place after ingestion of the leaf—the Maztec shamans say that "La Maria ("S. divinorum") speaks with a quiet voice."


title: Salvia divinorum

text: It is also used remedially at lower dosages as a diuretic, and to treat ailments including diarrhea, anemia, headaches, rheumatism, and a semi-magical disease known as "panzón de borrego", or a swollen belly (literally, "lamb belly").


title: Salvia divinorum

text: The history of the plant is not well known, and there has been no definitive answer to the question of its origin. Speculation includes "Salvia divinorum" being a wild plant native to the area; a cultigen of the Mazatecs; or a cultigen introduced by another indigenous group. Botanists have also not been able to determine whether it is a hybrid or a cultigen.


title: Salvia divinorum

text: "Salvia divinorum" was first recorded in print by Jean Basset Johnson in 1939 while he was studying Mazatec shamanism. He later documented its usage and reported its effects through personal testimonials. It was not until the 1990s that the psychoactive mechanism was identified by a team led by Daniel Siebert.


title: Salvia divinorum

text: Gordon Wasson tentatively postulated that the plant could be the mythological "pipiltzintzintli", the "Noble Prince" of the Aztec codices. Wasson's speculation has been the subject of further debate amongst ethnobotanists, with some scepticism coming from Leander J. Valdés, and counterpoints more supportive of Wasson's theory from Jonathan Ott.


title: Salvia divinorum

text: The identity of another mysterious Aztec entheogen, namely that of "poyomatli", has also been suggested as being "Salvia divinorum".


title: Salvia divinorum

text: Here too there are other candidate plants, notably Cacahuaxochitl ("Quararibea funebris"), again suggesting that there is no consensus.


title: Salvia divinorum

text: "Salvia divinorum" has large green ovate (often also dentate) leaves, with a yellow undertone that reach long. The leaves have no hairs on either surface, and little or no petiole. The plant grows to well over in height, on hollow square stems which tend to break or trail on the ground, with the plant rooting quite readily at the nodes and internodes.


title: Salvia divinorum

text: The flowers, which bloom only rarely, grow in whorls on a inflorescence, with about six flowers to each whorl. The flowers are white, curved and covered with hairs, and held in a small violet calyx that is covered in hairs and glands. When it does bloom in its native habitat, it does so from September to May.


title: Salvia divinorum

text: Early authors erred in describing the flowers as having blue corollas, based on Epling and Játiva's description. The first plant material they received was dried, so they based the flower color on an erroneous description by Hofmann and Wasson, who didn't realize that their "blue flowers, crowned with a white dome" were in fact violet calyces with unopened white corollas.


title: Salvia divinorum

text: "Salvia divinorum" is endemic to the Sierra Mazateca in the state of Oaxaca in Mexico, growing in the primary or secondary cloud forest and tropical evergreen forest at elevations from . Its most common habitat is black soil along stream banks where small trees and bushes provide an environment of low light and high humidity.


title: Salvia divinorum

text: "Salvia divinorum" produces few viable seeds even when it does flower—no seeds have ever been observed on plants in the wild. For an unknown reason, pollen fertility is also comparatively reduced. There is no active pollen tube inhibition within the style, but some event or process after the pollen tube reaches the ovary is aberrant. The likeliest explanations are inbreeding depression or hybridity, although the latter was rejected in 2010. All of the Mazatec populations appear to be clonal. The plant's square stems break easily and tend to trail on the ground, rooting easily at the nodes and internodes.


title: Salvia divinorum

text: "Salvia divinorum" was first documented in 1939, but it was many years before botanists could identify the plant due to Mazatec secrecy about the growing sites. Flowers were needed for a definitive identification of the species. In 1962, the Swiss chemist Albert Hofmann, and ethnomycologist R. Gordon Wasson, traveled throughout the Sierra Mazateca researching Mazatec rituals and looking for specimens of the plant. They were unable to locate live plants. Eventually, the Mazatec provided them some flowering specimens. These specimens were sent to botanists Carl Epling and Carlos D. Játiva, who described and named the plant as "Salvia divinorum", after its use in divination and healing by the Mazatec. By 1985, up to fifteen populations of the plant had been found.


title: Salvia divinorum

text: Until 2010, there were differing opinions on whether "Salvia divinorum" is an interspecific hybrid. The plant's partial sterility was suggestive of a hybrid origin, though no two parent species have been found with an obvious affinity to "Salvia divinorum". One other possibility for the plant's partial sterility is that long-term cultivation and selection have produced an inbred cultigen.


title: Salvia divinorum

text: In 2010, a molecular phylogenetic approach by DNA sequencing of "Salvia divinorum" and a number of related species suggest that the species is not a hybrid. One earlier proposed parent was "Salvia cyanea" (a synonym for "Salvia concolor"), which Epling and Játiva believed to be closely allied to "Salvia divinorum". The 2010 study demonstrated "Salvia divinorum"s closest relative to be "Salvia venulosa"—a rare and endemic "Salvia" that is native to Colombia, growing in shaded, wooded gullies at elevation. It also showed that "Salvia divinorum" does not belong to the "Salvia" section "Dusenostachys", as believed earlier. The genetic study also indicated that "Salvia venulosa" was likely misplaced into "Salvia" section "Tubiflorae", and that it may not be related to other Colombian "Salvia" species, though further tests are needed. A 2013 follow-up analysis of more "Salvia" species reports the same result.


title: Salvia divinorum

text: The origin of "Salvia divinorum" is still a mystery (as of 1993), one of only three plants in the extensive genus "Salvia" (approximately 900 species) with unknown origins—the other two are "Salvia tingitana" and "Salvia buchananii".


title: Salvia divinorum

text: There are two commonly cultivated strains which are known to be distinct. One is the strain that was collected in 1962 by ecologist and psychologist Sterling Bunnell (the "Bunnell" strain), colloquially mis-attributed as the "Wasson-Hofmann strain". The other was collected from Huautla de Jiménez in 1991 by anthropologist Bret Blosser (the "Blosser" or "Palatable" strain). There are other strains that are not as well documented, such as the "Luna" strain (possibly "Bunnell") isolated from a Hawaiian patch of "Salvia divinorum" clones, featuring unusually serrated and rounded rather than ovate leaves.


title: Salvia divinorum

text: "Salvia divinorum" is usually propagated through vegetative reproduction. Small cuttings, between long, cut off of the mother plant just below a node, will usually root in plain tap water within two or three weeks.


title: Salvia divinorum

text: Blooms occur when the day length becomes shorter than 12 hours (beginning in mid-October in some places), necessitating a shade cloth in urban environments with exposure to light pollution (HPS). Siebert and hobbyist literature report that viable seeds can (rarely) form in cultivation after manual or hummingbird pollination.


title: Salvia divinorum

text: The known active constituent of "Salvia divinorum" is a "trans"-neoclerodane diterpenoid known as salvinorin A (chemical formula CHO). This compound is present in the dried plant at about 0.18%.


title: Salvia divinorum

text: Salvinorin A is not an alkaloid, (meaning it does not contain a basic nitrogen), unlike most known opioid receptor ligands. Salvinorin A is the first documented diterpene hallucinogen.


title: Salvia divinorum

text: Similar to many psychoactive herbs, "Salvia divinorum" synthesizes and excretes its active constituent (salvinorin A) via trichomes, of the peltate-glandular morphology, located just beneath the cuticle (subcuticular) layer.


title: Salvia divinorum

text: By mass, salvinorin A "is the most potent naturally occurring hallucinogen." It is active at doses as low as 200 µg. Synthetic chemicals, such as LSD (active at 20–30 µg doses), can be more potent. Research has shown that salvinorin A is a potent and selective κ-opioid (kappa-opioid) receptor agonist. It has been reported that the effects of salvinorin A in mice are blocked by κ-opioid receptor antagonists. However, it is an even more potent D receptor partial agonist, and it is likely this action plays a significant role in its effects as well. Salvinorin A has no actions at the 5-HT serotonin receptor, the principal molecular target responsible for the actions of 'classic' hallucinogens, such as mescaline and LSD, nor is it known to have affinity for any other sites to date.


title: Salvia divinorum

text: Salvinorin's potency should not be confused with toxicity. Rodents chronically exposed to dosages many times greater than those to which humans are exposed show no signs of organ damage.


title: Salvia divinorum

text: Other terpenoids have been isolated from "Salvia divinorum", including other salvinorins and related compounds named divinatorins and salvinicins. None of these compounds has shown significant (sub-micromolar) affinity at the κ-opioid receptor, and there is no evidence that they contribute to the plant's psychoactivity.


title: Salvia divinorum

text: Salvinorin A is capable of inhibiting excess intestinal motility (e.g. diarrhea), through a combination of κ-opioid and cannabinoid (mainly CB receptor) receptors in "inflamed" but not normal gut "in vivo". The mechanism of action for Salvinorin A on ileal tissue has been described as 'prejunctional', as it was able to modify electrically induced contractions, but "not" those of exogenous acetylcholine. Results from a study at the University of Iowa indicate that it may have potential as an analgesic and as a therapeutic tool for treating drug addictions.


title: Salvia divinorum

text: A pharmacologically important aspect of the contraction-reducing (antispasmodic) properties of ingested Salvinorin A on gut tissue is that it is only pharmacologically active on "inflamed" and "not" normal tissue, thus reducing possible side-effects.


title: Salvia divinorum

text: There are a few ways to consume "Salvia divinorum". In traditional Mazatec ritual, shamans use only fresh "Salvia divinorum" leaves. Modern methods have been developed to more effectively absorb the active principle, salvinorin A. If enough salvinorin A is absorbed, an altered state of consciousness can occur. The duration of experience varies with the method of ingestion and the amount of salvinorin A absorbed.


title: Salvia divinorum

text: Mazatec shamans crush the leaves to extract leaf juices from about 20 to 80 or more fresh leaves (i.e. about ). They usually mix these juices with water to create an infusion or 'tea' which they drink to induce visions in ritual healing ceremonies.


title: Salvia divinorum

text: Chewing and swallowing a large number of fresh leaves is the other Mazatec method. Oral consumption of the leaf makes the effects come on more slowly, over a period of 10 to 20 minutes. The experience, from the onset of effects, lasts from about 30 minutes up to one and a half hours.


title: Salvia divinorum

text: Doses for chewing vastly exceed doses used for smoking. By calculating the concentrations per leaf ("an average concentration of 2.45 mg per gram" of leaf), the average weight per leaf ("about 50 g" per 20 leaves, or 2.5 g/leaf), and the standard dose for chewing (about 8–28 leaves), the doses can range from about 50 mg to 172 mg.


title: Salvia divinorum

text: Modern methods of ingestion include smoking or chewing the leaf, or using a tincture, as described in the following sections.


title: Salvia divinorum

text: Dry leaves can be smoked in a pipe, or through the use of a water pipe to cool the smoke. The temperature required to release salvinorin from the plant material is quite high (about 240 °C). A cooler flame will work, but the direct application of a more intense flame, such as that of a torch lighter, is often preferred.


title: Salvia divinorum

text: Some find that untreated dry leaf produces unnoticeable or only light effects. Concentrated preparations or extracts which may be smoked in place of untreated leaves, have become widely available. This enhanced (or "fortified") leaf is described by a number followed by an x (e.g. "5x", "10x"), the multiplicative factors being generally indicative of the relative amounts of leaf concentrate, though there is no accepted standard for these claims. Other sources may use a system of color codes to form their own standards of potency; for example, "green", "yellow", and "red."


title: Salvia divinorum

text: These grades of potency may be roughly indicative of the relative concentration of the active principle, (salvinorin A), but the measure should not be taken as absolute. Overall extract potency will depend on the (naturally varying) strength of the untreated leaf used in preparing the extract, as well as the efficiency of the extraction process itself. Extracts reduce the overall amount of inhalations needed to ingest a given amount of active principle, thus facilitating more powerful experiences.


title: Salvia divinorum

text: If salvia is smoked, then the main effects are experienced quickly. The most intense 'peak' is reached within a minute or so and lasts for 1–5 minutes, followed by a gradual tapering off. At 5–10 minutes, less intense yet still noticeable effects typically persist, giving way to a returning sense of the everyday and familiar until back to baseline after about 15 to 20 minutes.


title: Salvia divinorum

text: The traditional method of chewing the leaves has continued in modern use. However, salvinorin A is generally considered to be inactive when orally ingested, as salvinorin A is effectively deactivated by the gastrointestinal system. Therefore, in what's understood to be a modern innovation, the 'quid' of leaves is held in the mouth as long as possible in order to facilitate absorption of the active constituents through the oral mucosa. 'Quid' refers to the fact that at the end of this method the user spits out the leaves rather than swallowing them because ingesting the leaves has no known effect. Chewing consumes more of the plant than smoking, and produces a longer-lasting experience.


title: Salvia divinorum

text: Less commonly, some may ingest salvia in the form of a tincture. This is administered sublingually, usually with the aid of a glass dropper. It may be taken diluted with water just before use, which may slightly reduce the intensity of its effects, but can also serve to lessen or avoid a stinging sensation in the mouth caused by the presence of alcohol. Tinctures vary in potency, and the effects can range from inducing a mild meditative state to bringing about a more intense hallucinatory one.


title: Salvia divinorum

text: When taken as a tincture the effects and duration are similar to other methods of oral ingestion, though they may be significantly more intense, depending on extract potency.


title: Salvia divinorum

text: Aside from individual reported experiences, there has been a limited amount of published work summarising salvia divinorum effects. A survey of salvia users found that 38% described the effects as unique in comparison to other methods of altering consciousness. 23% said the effects were like yoga, meditation or trance. Users have written prose about their experiences; some describing their visions pictorially, and there exist examples of visionary art which are 'salvia-inspired'. Others claim musical inspiration from the plant.


title: Salvia divinorum

text: A 2019 large-scale study found that ketamine, "Salvia divinorum", and DMT (and other classical psychedelic substances) are linked to near-death experiences.


title: Salvia divinorum

text: Dale Pendell expressed some concerns about the use of highly concentrated forms of salvia. In its natural form, salvia is more balanced and benevolent and quite strong enough, he argues. High strength extracts on the other hand can show "a more precipitous, and more terrifying, face" and many who try it this way may never wish to repeat the experience.


title: Salvia divinorum

text: Ethnobotanist Daniel Siebert cautions that inhaling hot air can be irritating and potentially damaging to the lungs. Vapor produced by a heat gun needs to be cooled by running it through a water pipe or cooling chamber before inhalation.


title: Salvia divinorum

text: An ABC news report said excitement over research into "Salvia" "could vanish overnight if the federal government criminalized the sale or possession of salvia, as the Drug Enforcement Agency [sic] is considering doing right now." A proposed Schedule I classification would mean (among other things) that there is no "currently accepted medical use" as far as the United States government is concerned. Scientists worry that such legislation would restrict further work. Mendelsohn said scheduling salvia could scare away a great deal of research and development into salvia's therapeutic promise.


title: Salvia divinorum

text: The relatively recent emergence of "Salvia divinorum" in modern Western culture, in comparison to its long continuing traditions of indigenous use, contrasts widely differing attitudes on the subject.


title: Salvia divinorum

text: Opinions range from veneration of the plant as a spiritual sacrament or "a gift from the gods", to a "threat to society", to be banned as quickly as possible in order to "spare countless families the horror of losing a loved one to the relentless tentacles of drug abuse".


title: Salvia divinorum

text: Interest in "Salvia divinorum" has been escalating in the news media, particularly in the United States, where an increasing number of newspaper reports have been published and television news stories broadcast.


title: Salvia divinorum

text: These stories generally raise alarms over salvia's legal status, for example comparing it to LSD, or describing it as "the new pot", with parental concerns being raised by particular focus on salvia's use by younger teens.


title: Salvia divinorum

text: Story headlines may also include 'danger' keywords, such as "Dangerous Herb is Legal..." or "Deadly Dangers Of A Street Legal High".


title: Salvia divinorum

text: Mainstream news coverage and journalistic opinion has widely been negative on the subject. In a local news report aired on ABC affiliate WJLA in Washington, DC on July 11, 2007, the anchors are seen to exchange expressions of incredulity when referring to a salvia story with the following introduction "Now, an exclusive I-Team investigation of a hallucinogenic drug that has begun to sweep the nation. What might amaze you is that right now the federal government is doing nothing to stop it".


title: Salvia divinorum

text: In March 2008 a Texas news report aired with the story "A legal drug that teenagers are now using to get high could soon be banned here in San Antonio - all because of a Fox News 4 investigation", going on to say, "The drug is legal in Texas, at least for now. But a News 4 investigation could lead to a new ordinance to protect your kids."


title: Salvia divinorum

text: Many salvia media stories headline with comparisons to LSD. However, while LSD and salvinorin A may have comparative potencies, in the sense that both can produce their effects at low dosages, they are otherwise quite different. The two substances are not chemically similar or related, as salvinorin A is found naturally in a single plant while LSD is chemically semisynthesized from lysergamides like ergotamine. They are ingested in different ways and produce different effects, which manifest themselves over different timescales. For example, the effects of salvia when smoked typically last for only a few minutes as compared to LSD, whose effects can persist for 8–12 hours.


title: Salvia divinorum

text: A particular focus of many US media stories is the long-running coverage of the case of Brett Chidester, a 17-year-old Delaware student who committed suicide in January 2006 by carbon monoxide poisoning.


title: Salvia divinorum

text: Reportedly, some months before this, Brett's mother Kathleen Chidester had learned about his salvia use and questioned him about it. Brett said that he had ceased his experimentation, but his parents did not believe that he was telling the truth. They have instead argued that salvia-induced depression was largely to blame for his death. Some of Brett's earlier writings about his salvia experiences have been used to suggest that it made him think "existence in general is pointless." Some media stories have referred to these earlier written experience reports as if they were part of Brett's suicide note. A law was soon passed in Delaware classifying the herb as a Schedule I controlled substance in that state. This legislation was nicknamed Brett's law (formally referred to as Senate bill 259).


title: Salvia divinorum

text: Although the Chidester story has been given continued exposure by US media, there has not been anywhere else, either before or since this controversial incident, any other reported cases involving or alleging "Salvia divinorum" as a serious factor in suicide, overdose, accidental, or any other kind of death. Regarding this, San Francisco attorney Alex Coolman has commented, "It's remarkable that Chidester's parents, and "only" Chidester's parents, continue to be cited over and over again by the mainstream media in their coverage of the supposed 'controversy' over the risks of "Salvia divinorum"."


title: Salvia divinorum

text: Kathleen Chidester has continued campaigning for "Schedule I"-like legislation beyond their home state of Delaware. For example, three years after Brett's death, in written testimony in support of Senator Richard Colburn's proposed Senate Bill to the Maryland State Legislature, saying, "My hope and goal is to have salvia regulated across the US. It's my son's legacy and I will not end my fight until this happens."


title: Salvia divinorum

text: In 2007, videos were shared on YouTube of alleged salvia users laughing uncontrollably, apparently unable to perform simple tasks or to communicate. In an interview published in the San Francisco Chronicle in June 2007, Daniel Siebert said that the videos "make salvia look like some horrible drug that makes people nuts and dangerous ..." and that it stops people from realizing "there are sensible ways to use something like this."


title: Salvia divinorum

text: Waco Representative Charles Anderson (R), who is sponsoring one of several bills to ban salvia in Texas, told colleagues at a legislative hearing about a video that depicts a salvia user behind the wheel of a car. "What we really worry about, is youngsters doing this and then getting in a vehicle or getting on a motorcycle or jumping in a pool somewhere."


title: Salvia divinorum

text: Michigan Representative Michael Sak (D) submitted a bill which proposed Schedule I classification of "Salvia divinorum" and salvinorin A. He said that if people had questions about the deleterious effects of salvia, they should go on YouTube to watch the videos. A reporter questioned Sak as to whether he had ever seen a "Girls Gone Wild" video, and whether that would incite him to make alcohol illegal (Sak replied that he hadn't yet had a chance to review the material).


title: Salvia divinorum

text: Nebraska Senator Vickie McDonald responded with "Anytime anything's on YouTube it's an issue," and "Legislators, parents, grandparents, we need to be on top of these things," McDonald proposed Schedule I listing "Salvia divinorum" as part of their Controlled Substances Act, under which possession of salvia would have been considered a Class IV felony with a penalty of up to five years and trafficking would have fallen under a Class III felony with up to a 20 year penalty.


title: Salvia divinorum

text: In Massachusetts, YouTube videos were shown by a retired police officer to public health and judiciary committees as evidence in favor of outlawing it there.


title: Salvia divinorum

text: The issue has been raised of whether the salvia videos are in breach of YouTube's own community guidelines, which ask users not to "cross the line" and post videos showing "bad stuff" like "drug abuse". The question is considered as particularly problematical as the videos may be something of an enforcement grey area.


title: Salvia divinorum

text: Many countries control "Salvia divinorum" in some manner. As of 2015, it is illegal in Australia, Belgium, Canada, Croatia, Czech Republic, Denmark, Germany, Hong Kong, Italy, Japan, Latvia, Lithuania, Poland, Portugal, Republic of Ireland, Romania, South Korea, Sweden, and Switzerland. It is legal to possess and grow in Chile, France and Spain, but not to sell. In Russia, it is legal to possess, but not grow or sell. Estonia, Finland, Iceland, and Norway treat it as a medicinal herb that requires a prescription.


title: Salvia divinorum

text: The prohibitive degree of "Salvia divinorum" legislation varies widely from country to country. Australia has imposed its strictest 'schedule 9' (US Schedule I equivalent), and Italy has also placed salvia in its 'Table I' of controlled substances (also US Schedule I equivalent). In Spain, there are controls focusing only on the commercial trade of "Salvia divinorum", personal cultivation (i.e. for non-commercial use) is not targeted.


title: Salvia divinorum

text: Legislation may prove difficult to enforce. The plant has a nondescript appearance; unlike many other drug plants, the leaves are non-descript, and without a detectable odour. "Salvia divinorum" can be grown as an ordinary houseplant without the need of special equipment such as hydroponics or high-power lights.


title: Salvia divinorum

text: In the United Kingdom, following a local newspaper story in October 2005, a parliamentary Early Day Motion was raised calling for "Salvia divinorum" to be banned there. However, it only received 11 signatures. A second motion raised in October 2008 attracted 18 signatures, and it was reported that Mann had also written to Jacqui Smith, then Home Secretary. The Advisory Council on the Misuse of Drugs, the independent body that advises UK government on drugs, was asked to investigate further.


title: Salvia divinorum

text: On the 28 January 2016, the Psychoactive Substances Act 2016 was passed. The act came into force on 26 May 2016, across the entire United Kingdom, making "S. divinorum" illegal to possess with intent to supply, possess on custodial premises, import for human consumption, or produce for human consumption. The two sponsors for the bill were Conservative House of Lords member Michael Bates and Conservative MP Theresa May.


title: Salvia divinorum

text: "Salvia divinorum" is considered a Schedule 9 prohibited plant in Australia under the Poisons Standard (October 2015). A schedule 9 drug is outlined in the Poisons Act 1964 as "Substances which may be abused or misused, the manufacture, possession, sale or use of which should be prohibited by law except when required for medical or scientific research, or for analytical, teaching or training purposes with approval of the CEO."


title: Salvia divinorum

text: National legislation for amendment of the Controlled Substances Act to place salvinorin A and "Salvia divinorum" in Schedule I at the federal level in the United States was proposed in 2002 by Representative Joe Baca (D- California). Those opposed to bill HR 5607 include Daniel Siebert, who sent a letter to Congress arguing against the proposed legislation, and the Center for Cognitive Liberty and Ethics (CCLE), who sent key members of the US Congress a report on "Salvia divinorum" and its active principle, along with letters from an array of scientists who expressed concern that scheduling "Salvia divinorum" would negatively impact important research on the plant. The bill did not pass.


title: Salvia divinorum

text: Although salvia is not regulated under the Controlled Substances Act, as of 2009, it had been made illegal in 13 states. Delaware banned it after salvia use was reported to have played a role in the suicide of a teenager. Alabama, Delaware, Illinois, Louisiana, Michigan, Missouri, Ohio, Texas, and other states have passed their own laws. Several other states have proposed legislation against salvia, including Alaska, California, Florida, Iowa, Maryland, New Jersey, New York, Oregon, and Pennsylvania. Many of these proposals have not made it into law, with motions having failed, stalled or otherwise died, for example at committee review stages.


title: Salvia divinorum

text: Where individual state legislation does exist, it varies from state to state in its prohibitive degree.


title: Salvia divinorum

text: Legal consequences may also exist even in states without bans on salvia in particular. Christian Firoz, a Nebraska store owner, was charged for selling salvia, but not under the auspices of any specific law against "Salvia divinorum". Firoz was instead charged under a general Nebraskan statute where it is illegal to sell a product to induce an intoxicated condition. See also the legal status of salvia in North Dakota and Nebraska.


title: Salvia divinorum

text: Some internet vendors will not sell live "salvia" cuttings, leaf, or leaf products to states where its use is restricted or prohibited. Per their drugs and drug paraphernelia policy, eBay does not permit sale of "Salvia divinorum" or derived products (despite legality in most areas).


title: Salvia divinorum

text: Concerns expressed by some politicians on the subject of salvia reflect those of the media, with comparisons to LSD and particular focus on "protecting our children" being echoed; and with legislative proposals following soon after news stories breaking.


title: Salvia divinorum

text: Some arguments against salvia have been of a preventative nature, "We need to stop this before it gets to be a huge problem not after it gets to be a huge problem," or of an imitative nature, "The Australians have clearly found a problem with it. There's obviously a risk in people taking it." Concerns about driving while under the influence of salvia have also been expressed.


title: Salvia divinorum

text: Opponents of more prohibitive measures against salvia argue that such reactions are largely due to an inherent prejudice and a particular cultural bias rather than any actual balance of evidence, pointing out inconsistencies in attitudes toward other more toxic and addictive drugs such as alcohol and nicotine. While not objecting to some form of legal control, in particular with regard to the sale to minors or sale of enhanced high-strength extracts, most salvia proponents otherwise argue against stricter legislation.


title: Salvia divinorum

text: Those advocating consideration of "Salvia divinorum"s potential for beneficial use in a modern context argue that more could be learned from Mazatec culture, where salvia is not really associated with notions of drug taking at all and it is rather considered as a spiritual sacrament. In light of this it is argued that "Salvia divinorum" could be better understood more positively as an entheogen rather than pejoratively as a hallucinogen.


title: Salvia divinorum

text: Despite its growing notoriety in some circles, media stories generally suggest that the public at large are still mostly unaware of salvia, with the majority perhaps having never even heard of it.


title: Salvia divinorum

text: Although published responses may not necessarily be representative of public opinion as a whole, some news agencies generally support reader and viewer feedback in connection with their stories.


title: Ketchup

text: Ketchup or catsup is a table condiment with a sweet and tangy flavor. The unmodified term ("ketchup") now typically refers to tomato ketchup, although early recipes used egg whites, mushrooms, oysters, grapes, mussels, or walnuts, among other ingredients.


title: Ketchup

text: Tomato ketchup is made from tomatoes, sugar, and vinegar, with seasonings and spices. The spices and flavors vary, but commonly include onions, allspice, coriander, cloves, cumin, garlic, and mustard, and sometimes include celery, cinnamon, or ginger. The market leader in the United States (60% market share) and the United Kingdom (82%) is Heinz Tomato Ketchup. Tomato ketchup is most often used as a condiment to dishes that are usually served hot and are fried or greasy: french fries and other potato dishes, hamburgers, hot dogs, chicken tenders, hot sandwiches, meat pies, cooked eggs, and grilled or fried meat. Ketchup is sometimes used as the basis for, or as one ingredient in, other sauces and dressings, and the flavor may be replicated as an additive flavoring for snacks, such as potato chips.


title: Ketchup

text: In the United Kingdom, ketchup was historically prepared with mushrooms as a primary ingredient, rather than tomatoes. Ketchup recipes began to appear in British and then American cookbooks in the 18th century. The term ketchup first appeared in 1682. In the United States, mushroom ketchup dates back to at least 1770, and was prepared by British colonists in the Thirteen Colonies.


title: Ketchup

text: Many variations of ketchup were created, but the tomato-based version did not appear until around a century after other types. An early recipe for "Tomata Catsup" from 1817 includes anchovies:


title: Ketchup

text: James Mease published another recipe in 1812. In 1824, a ketchup recipe using tomatoes appeared in "The Virginia Housewife" (an influential 19th-century cookbook written by Mary Randolph, Thomas Jefferson's cousin). American cooks also began to sweeten ketchup in the 19th century.


title: Ketchup

text: As the century progressed, tomato ketchup began its ascent in popularity in the United States. Ketchup was popular long before fresh tomatoes were. People were less hesitant to eat tomatoes as part of a highly processed product that had been cooked and infused with vinegar and spices.


title: Ketchup

text: Tomato ketchup was sold locally by farmers. Jonas Yerkes is credited as the first American to sell it in a bottle. By 1837, he had produced and distributed the condiment nationally. Shortly thereafter, other companies followed suit. F. & J. Heinz launched their tomato ketchup in 1876. Heinz Tomato Ketchup was advertised: "Blessed relief for Mother and the other women in the household!", a slogan which alluded to the lengthy process required to produce tomato ketchup in the home. With industrial ketchup production and a need for better preservation there was a great increase of sugar in ketchup, leading to the typically sweet and sour formula of today. In Australia, it was not until the late 19th century that sugar was added to "tomato sauce", initially in small quantities, but today it contains just as much as American ketchup and only differed in the proportions of tomatoes, salt and vinegar in early recipes.


title: Ketchup

text: The "Webster's Dictionary" of 1913 defined "catsup" as: "table sauce made from mushrooms, tomatoes, walnuts, etc. [Also written as ketchup]."


title: Ketchup

text: Modern ketchup emerged in the early years of the 20th century, out of a debate over the use of sodium benzoate as a preservative in condiments. Harvey W. Wiley, the "father" of the Food and Drug Administration in the US, challenged the safety of benzoate which was banned in the 1906 Pure Food and Drug Act.


title: Ketchup

text: In response, entrepreneurs including Henry J. Heinz, pursued an alternative recipe that eliminated the need for that preservative. Katherine Bitting, a bacteriologist working for the U.S. Department of Agriculture, carried out research in 1909 that proved increasing the sugar and vinegar content of the product would prevent spoilage without use of artificial preservatives. She was assisted by her husband, Arvil Bitting, an official at that agency.


title: Ketchup

text: Prior to Heinz (and his fellow innovators), commercial tomato ketchups of that time were watery and thin, in part due to the use of unripe tomatoes, which were low in pectin. They had less vinegar than modern ketchups; by pickling ripe tomatoes, the need for benzoate was eliminated without spoilage or degradation in flavor. But the changes driven by the desire to eliminate benzoate also produced changes that some experts (such as Andrew F. Smith) believe were key to the establishment of tomato ketchup as the dominant American condiment.


title: Ketchup

text: In fast-food outlets, ketchup is often dispensed in small sachets or tubs. Diners tear the side or top and squeeze the ketchup out of the ketchup packets, or peel the foil lid off the tub for dipping. In 2011, Heinz began offering a new measured-portion package, called the "Dip and Squeeze" packet, which can be opened in either way, giving both options.


title: Ketchup

text: Some fast food outlets previously dispensed ketchup from hand-operated pumps into paper cups. This method has made a comeback in the first decades of the 21st century, as cost and environmental concerns over the increasing use of individual plastic ketchup tubs were taken into account.


title: Ketchup

text: In October 2000, Heinz introduced colored ketchup products called EZ Squirt, which eventually included green (2000), purple (2001), mystery (pink, orange, or teal, 2002), and blue (2003). These products were made by adding food coloring to the traditional ketchup. these products were discontinued.


title: Ketchup

text: The term used for the sauce varies. "Ketchup" is the dominant term in American English and Canadian English, although "catsup" is commonly used in some southern US states and Mexico.


title: Ketchup

text: "Tomato sauce" is more common in English-speaking countries outside North America. In Canada and the US, "tomato sauce" is not a synonym for ketchup but is a sauce made from tomatoes and commonly used in making sauce for pasta.


title: Ketchup

text: A popular folk etymology is that the word came to English from the Cantonese "keh jup" (茄汁 "ke2 zap1", literally meaning "tomato sauce" in Cantonese). The word "keh" (茄) means "eggplant";"Tomato" in Cantonese is 番茄, which literally translates to "foreign eggplant".


title: Ketchup

text: Another theory among academics is that the word derives from one of two words from Hokkien of the Fujian region of coastal southern China: "kôe-chiap" (in Xiamen and Quanzhou) or "kê-chiap" (in Zhangzhou). Both of these words (膎汁, kôe-chiap and kêchiap) come from either the Quanzhou dialect, Amoy dialect, or Zhangzhou dialect of Hokkien, where it meant the brine of pickled fish (膎, meat; 汁, juice) or shellfish. There are citations of "koe-chiap" in the "Dictionary of the Vernacular or Spoken Language of the Amoy" (London; Trudner) from 1873, defined as "brine of pickled fish or shell-fish".


title: Ketchup

text: Ketchup may have entered the English language from the Malay word "kicap" (pron. "kichap", sometimes spelled "kecap" or "ketjap"). Originally meaning "soy sauce", the word itself derives from the Chinese terms.


title: Ketchup

text: In Indonesian cuisine, which is similar to Malay, the term "kecap" refers to fermented savory sauces. Two main types are well known in their cuisine: "kecap asin" which translates to 'salty kecap' in Indonesian (a salty soy sauce) and "kecap manis" or "sweet kecap" in Indonesian. Kecap manis is a sweet soy sauce that is a mixture of soy sauce with brown sugar, molasses, garlic, ginger, anise, coriander and a bay leaf reduced over medium heat until rather syrupy. A third type, "kecap ikan", meaning "fish kecap" is fish sauce similar to the Thai "nam pla" or the Philippine "patis". It is not, however, soy-based.


title: Ketchup

text: American anthropologist E. N. Anderson relies on Elizabeth David to claim that "ketchup" is a cognate of the French , meaning "food in sauce". The word also exists in Spanish and Portuguese forms as "escabeche", "a sauce for pickling", which culinary historian Karen Hess traced back to Arabic "Kabees", or "pickling with vinegar". The term was anglicized to "caveach", a word first attested in the late 17th century, at the same time as "ketchup".


title: Ketchup

text: The word entered the English language in Britain during the late 17th century, appearing in print as "catchup" (1690) and later as "ketchup" (1711). The following is a list of early quotations collected by the "Oxford English Dictionary".


title: Ketchup

text: U.S. Heinz tomato ketchup's ingredients (listed from highest to lowest percentage weight) are: tomato concentrate from red ripe tomatoes, distilled vinegar, high-fructose corn syrup, corn syrup, salt, spice, onion powder, and natural flavoring.


title: Ketchup

text: Some ketchup in the U.S. is labeled "Fancy". This is a USDA grade, relating to specific gravity. Fancy ketchup has a higher tomato solid concentration than other USDA grades.


title: Ketchup

text: The following table compares the nutritional value of ketchup with raw ripe tomatoes and salsa, based on information from the USDA Food Nutrient Database.


title: Ketchup

text: Commercial tomato ketchup has an additive, usually xanthan gum, which gives the condiment a pseudoplastic or "shear thinning" property – more commonly known as thixotropic. This increases the viscosity of the ketchup considerably with a relatively small amount added—usually 0.5%—which can make it difficult to pour from a container. However, the shear thinning property of the gum ensures that when a force is applied to the ketchup it will lower the viscosity enabling the sauce to flow. A common method to getting ketchup out of the bottle involves inverting the bottle and shaking it or hitting the bottom with the heel of the hand, which causes the ketchup to flow rapidly. Ketchup in plastic bottles can be additionally manipulated by squeezing the bottle, which also decreases the viscosity of the ketchup inside. Another technique involves inverting the bottle and forcefully tapping its upper neck with two fingers (index and middle finger together). Specifically, with a Heinz ketchup glass bottle, one taps the 57 circle on the neck. This helps the ketchup flow by applying the correct shearing force. These techniques work because of how pseudoplastic fluids behave: their viscosity (resistance to flow) decreases with increasing shear rate. The faster the ketchup is sheared (by shaking or tapping the bottle), the more fluid it becomes. After the shear is removed the ketchup thickens to its original viscosity.


title: Ketchup

text: Ketchup is a non-Newtonian fluid, meaning that its viscosity changes under stress and is not constant. It is a shear thinning fluid which means its viscosity decreases with increased shear stress. The equation used to designate a non-Newtonian fluid is as follows: formula_1. This equation represents apparent viscosity where apparent viscosity is the shear stress divided by shear rate. Viscosity is dependent on stress. This is apparent when you shake a bottle of tomato sauce/ketchup so it becomes liquid enough to squirt out. Its viscosity decreased with stress.


title: Ketchup

text: The molecular composition of ketchup is what creates its pseudoplastic characteristics. Small polysaccharides, sugars, acids, and water make up the majority of the metastable ketchup product, and these small structures are able to move more easily throughout a matrix because of their low mass. While exposed to shear stress, the molecules within the suspension are able to respond quickly and create an alignment within the product. The bonds between the molecules are mostly hydrogen bonds, ionic interactions, and electrostatic interactions, all of which can be broken when subject to stress. Hydrogen bonds are constantly rearranging within a product due to their need to be in the lowest energy state, which further confirms that the bonds between the molecules will be easily disrupted. This alignment only lasts for as long as shear stress is applied. The molecules return to their original disorganized state once the shear stress dissipates.


title: Ketchup

text: In 2017, researchers at the Massachusetts Institute of Technology reported the development of a bottle coating that allowed all the product to slip out without leaving a residue.


title: Ketchup

text: In 2022, researchers at the University of Oxford found that splatter from a near-empty bottle can be prevented by squeezing more slowly and doubling the diameter of the nozzle.


title: Ketchup

text: Ketchup is one of the many products that are leachable, meaning that the water within the product migrates together as the larger molecules within the product sediment, ultimately causing water to separate out. This forms a layer of water on top of the ketchup due to the molecular instability within the product. This instability is caused by interactions between hydrophobic molecules and charged molecules within the ketchup suspension.


title: Ketchup

text: Pectin is a polysaccharide within tomatoes that has the ability to bind to itself and to other molecules, especially water, around it. This enables it to create a gel-like matrix, dependent on the amount within the solution. Water is a large part of ketchup, due to it being 80% of the composition of distilled vinegar. In order for the water within the ketchup to be at the lowest possible energy state, all of the hydrogen bonds that are able to be made within the matrix must be made. The water bound to the polysaccharide moves more slowly within the matrix, which is unfavorable with respect to entropy. The increased order within the polysaccharide-water complex gives rise to a high-energy state, in which the water will want to be relieved. This concept implies that water will more favorably bind with itself because of the increased disorder between water molecules. This is partially the cause for water leaching out of solution when left undisturbed for a short period of time.


title: Asthma

text: Asthma is a long-term inflammatory disease of the airways of the lungs. It is characterized by variable and recurring symptoms, reversible airflow obstruction, and easily triggered bronchospasms. Symptoms include episodes of wheezing, coughing, chest tightness, and shortness of breath. These may occur a few times a day or a few times per week. Depending on the person, asthma symptoms may become worse at night or with exercise.


title: Asthma

text: Asthma is thought to be caused by a combination of genetic and environmental factors. Environmental factors include exposure to air pollution and allergens. Other potential triggers include medications such as aspirin and beta blockers. Diagnosis is usually based on the pattern of symptoms, response to therapy over time, and spirometry lung function testing. Asthma is classified according to the frequency of symptoms, forced expiratory volume in one second (FEV1), and peak expiratory flow rate. It may also be classified as atopic or non-atopic, where atopy refers to a predisposition toward developing a type 1 hypersensitivity reaction.


title: Asthma

text: There is no known cure for asthma, but it can be controlled. Symptoms can be prevented by avoiding triggers, such as allergens and respiratory irritants, and suppressed with the use of inhaled corticosteroids. Long-acting beta agonists (LABA) or antileukotriene agents may be used in addition to inhaled corticosteroids if asthma symptoms remain uncontrolled. Treatment of rapidly worsening symptoms is usually with an inhaled short-acting beta-2 agonist such as salbutamol and corticosteroids taken by mouth. In very severe cases, intravenous corticosteroids, magnesium sulfate, and hospitalization may be required.


title: Asthma

text: In 2019 asthma affected approximately 262 million people and caused approximately 461,000 deaths. Most of the deaths occurred in the developing world. Asthma often begins in childhood, and the rates have increased significantly since the 1960s. Asthma was recognized as early as Ancient Egypt. The word "asthma" is from the Greek , "âsthma", which means "panting".


title: Asthma

text: Asthma is characterized by recurrent episodes of wheezing, shortness of breath, chest tightness, and coughing. Sputum may be produced from the lung by coughing but is often hard to bring up. During recovery from an asthma attack (exacerbation), it may appear pus-like due to high levels of white blood cells called eosinophils. Symptoms are usually worse at night and in the early morning or in response to exercise or cold air. Some people with asthma rarely experience symptoms, usually in response to triggers, whereas others may react frequently and readily and experience persistent symptoms.


title: Asthma

text: A number of other health conditions occur more frequently in people with asthma, including gastroesophageal reflux disease (GERD), rhinosinusitis, and obstructive sleep apnea. Psychological disorders are also more common, with anxiety disorders occurring in between 16 and 52% and mood disorders in 14–41%. It is not known whether asthma causes psychological problems or psychological problems lead to asthma. Current asthma, but not former asthma, is associated with increased all-cause mortality, heart disease mortality, and chronic lower respiratory tract disease mortality. Asthma, particularly severe asthma, is strongly associated with development of chronic obstructive pulmonary disease (COPD). Those with asthma, especially if it is poorly controlled, are at increased risk for radiocontrast reactions.


title: Asthma

text: Cavities occur more often in people with asthma. This may be related to the effect of beta 2 agonists decreasing saliva. These medications may also increase the risk of dental erosions.


title: Asthma

text: Asthma is caused by a combination of complex and incompletely understood environmental and genetic interactions. These influence both its severity and its responsiveness to treatment. It is believed that the recent increased rates of asthma are due to changing epigenetics (heritable factors other than those related to the DNA sequence) and a changing living environment. Asthma that starts before the age of 12 years old is more likely due to genetic influence, while onset after age 12 is more likely due to environmental influence.


title: Asthma

text: Many environmental factors have been associated with asthma's development and exacerbation, including, allergens, air pollution, and other environmental chemicals. Smoking during pregnancy and after delivery is associated with a greater risk of asthma-like symptoms. Low air quality from environmental factors such as traffic pollution or high ozone levels has been associated with both asthma development and increased asthma severity. Over half of cases in children in the United States occur in areas when air quality is below the EPA standards. Low air quality is more common in low-income and minority communities.


title: Asthma

text: Exposure to indoor volatile organic compounds may be a trigger for asthma; formaldehyde exposure, for example, has a positive association. Phthalates in certain types of PVC are associated with asthma in both children and adults. While exposure to pesticides is linked to the development of asthma, a cause and effect relationship has yet to be established.


title: Asthma

text: The majority of the evidence does not support a causal role between acetaminophen (paracetamol) or antibiotic use and asthma. A 2014 systematic review found that the association between acetaminophen use and asthma disappeared when respiratory infections were taken into account. Acetaminophen use by a mother during pregnancy is also associated with an increased risk of the child developing asthma. Maternal psychological stress during pregnancy is a risk factor for the child to develop asthma.


title: Asthma

text: Asthma is associated with exposure to indoor allergens. Common indoor allergens include dust mites, cockroaches, animal dander (fragments of fur or feathers), and mold. Efforts to decrease dust mites have been found to be ineffective on symptoms in sensitized subjects. Weak evidence suggests that efforts to decrease mold by repairing buildings may help improve asthma symptoms in adults. Certain viral respiratory infections, such as respiratory syncytial virus and rhinovirus, may increase the risk of developing asthma when acquired as young children. Certain other infections, however, may decrease the risk.


title: Asthma

text: The hygiene hypothesis attempts to explain the increased rates of asthma worldwide as a direct and unintended result of reduced exposure, during childhood, to non-pathogenic bacteria and viruses. It has been proposed that the reduced exposure to bacteria and viruses is due, in part, to increased cleanliness and decreased family size in modern societies. Exposure to bacterial endotoxin in early childhood may prevent the development of asthma, but exposure at an older age may provoke bronchoconstriction. Evidence supporting the hygiene hypothesis includes lower rates of asthma on farms and in households with pets.


title: Asthma

text: Use of antibiotics in early life has been linked to the development of asthma. Also, delivery via caesarean section is associated with an increased risk (estimated at 20–80%) of asthma – this increased risk is attributed to the lack of healthy bacterial colonization that the newborn would have acquired from passage through the birth canal. There is a link between asthma and the degree of affluence which may be related to the hygiene hypothesis as less affluent individuals often have more exposure to bacteria and viruses.


title: Asthma

text: Family history is a risk factor for asthma, with many different genes being implicated. If one identical twin is affected, the probability of the other having the disease is approximately 25%. By the end of 2005, 25 genes had been associated with asthma in six or more separate populations, including GSTM1, IL10, CTLA-4, SPINK5, LTC4S, IL4R and ADAM33, among others. Many of these genes are related to the immune system or modulating inflammation. Even among this list of genes supported by highly replicated studies, results have not been consistent among all populations tested. In 2006 over 100 genes were associated with asthma in one genetic association study alone; more continue to be found.


title: Asthma

text: Some genetic variants may only cause asthma when they are combined with specific environmental exposures. An example is a specific single nucleotide polymorphism in the CD14 region and exposure to endotoxin (a bacterial product). Endotoxin exposure can come from several environmental sources including tobacco smoke, dogs, and farms. Risk for asthma, then, is determined by both a person's genetics and the level of endotoxin exposure.


title: Asthma

text: A triad of atopic eczema, allergic rhinitis and asthma is called atopy. The strongest risk factor for developing asthma is a history of atopic disease; with asthma occurring at a much greater rate in those who have either eczema or hay fever. Asthma has been associated with eosinophilic granulomatosis with polyangiitis (formerly known as Churg–Strauss syndrome), an autoimmune disease and vasculitis. Individuals with certain types of urticaria may also experience symptoms of asthma.


title: Asthma

text: There is a correlation between obesity and the risk of asthma with both having increased in recent years. Several factors may be at play including decreased respiratory function due to a buildup of fat and the fact that adipose tissue leads to a pro-inflammatory state.


title: Asthma

text: Beta blocker medications such as propranolol can trigger asthma in those who are susceptible. Cardioselective beta-blockers, however, appear safe in those with mild or moderate disease. Other medications that can cause problems in asthmatics are angiotensin-converting enzyme inhibitors, aspirin, and NSAIDs. Use of acid suppressing medication (proton pump inhibitors and H2 blockers) during pregnancy is associated with an increased risk of asthma in the child.


title: Asthma

text: Some individuals will have stable asthma for weeks or months and then suddenly develop an episode of acute asthma. Different individuals react to various factors in different ways. Most individuals can develop severe exacerbation from a number of triggering agents.


title: Asthma

text: Home factors that can lead to exacerbation of asthma include dust, animal dander (especially cat and dog hair), cockroach allergens and mold. Perfumes are a common cause of acute attacks in women and children. Both viral and bacterial infections of the upper respiratory tract can worsen the disease. Psychological stress may worsen symptoms – it is thought that stress alters the immune system and thus increases the airway inflammatory response to allergens and irritants.


title: Asthma

text: Asthma exacerbations in school‐aged children peak in autumn, shortly after children return to school. This might reflect a combination of factors, including poor treatment adherence, increased allergen and viral exposure, and altered immune tolerance. There is limited evidence to guide possible approaches to reducing autumn exacerbations, but while costly, seasonal omalizumab treatment from four to six weeks before school return may reduce autumn asthma exacerbations.


title: Asthma

text: Asthma is the result of chronic inflammation of the conducting zone of the airways (most especially the bronchi and bronchioles), which subsequently results in increased contractability of the surrounding smooth muscles. This among other factors leads to bouts of narrowing of the airway and the classic symptoms of wheezing. The narrowing is typically reversible with or without treatment. Occasionally the airways themselves change. Typical changes in the airways include an increase in eosinophils and thickening of the lamina reticularis. Chronically the airways' smooth muscle may increase in size along with an increase in the numbers of mucous glands. Other cell types involved include T lymphocytes, macrophages, and neutrophils. There may also be involvement of other components of the immune system, including cytokines, chemokines, histamine, and leukotrienes among others.


title: Asthma

text: While asthma is a well-recognized condition, there is not one universal agreed upon definition. It is defined by the Global Initiative for Asthma as "a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role. The chronic inflammation is associated with airway hyper-responsiveness that leads to recurrent episodes of wheezing, breathlessness, chest tightness and coughing particularly at night or in the early morning. These episodes are usually associated with widespread but variable airflow obstruction within the lung that is often reversible either spontaneously or with treatment".


title: Asthma

text: There is currently no precise test for the diagnosis, which is typically based on the pattern of symptoms and response to therapy over time. Asthma may be suspected if there is a history of recurrent wheezing, coughing or difficulty breathing and these symptoms occur or worsen due to exercise, viral infections, allergens or air pollution. Spirometry is then used to confirm the diagnosis. In children under the age of six the diagnosis is more difficult as they are too young for spirometry.


title: Asthma

text: Spirometry is recommended to aid in diagnosis and management. It is the single best test for asthma. If the FEV1 measured by this technique improves more than 12% and increases by at least 200 milliliters following administration of a bronchodilator such as salbutamol, this is supportive of the diagnosis. It however may be normal in those with a history of mild asthma, not currently acting up. As caffeine is a bronchodilator in people with asthma, the use of caffeine before a lung function test may interfere with the results. Single-breath diffusing capacity can help differentiate asthma from COPD. It is reasonable to perform spirometry every one or two years to follow how well a person's asthma is controlled.


title: Asthma

text: The methacholine challenge involves the inhalation of increasing concentrations of a substance that causes airway narrowing in those predisposed. If negative it means that a person does not have asthma; if positive, however, it is not specific for the disease.


title: Asthma

text: Other supportive evidence includes: a ≥20% difference in peak expiratory flow rate on at least three days in a week for at least two weeks, a ≥20% improvement of peak flow following treatment with either salbutamol, inhaled corticosteroids or prednisone, or a ≥20% decrease in peak flow following exposure to a trigger. Testing peak expiratory flow is more variable than spirometry, however, and thus not recommended for routine diagnosis. It may be useful for daily self-monitoring in those with moderate to severe disease and for checking the effectiveness of new medications. It may also be helpful in guiding treatment in those with acute exacerbations.


title: Asthma

text: Asthma is clinically classified according to the frequency of symptoms, forced expiratory volume in one second (FEV), and peak expiratory flow rate. Asthma may also be classified as atopic (extrinsic) or non-atopic (intrinsic), based on whether symptoms are precipitated by allergens (atopic) or not (non-atopic). While asthma is classified based on severity, at the moment there is no clear method for classifying different subgroups of asthma beyond this system. Finding ways to identify subgroups that respond well to different types of treatments is a current critical goal of asthma research.


title: Asthma

text: Although asthma is a chronic obstructive condition, it is not considered as a part of chronic obstructive pulmonary disease, as this term refers specifically to combinations of disease that are irreversible such as bronchiectasis and emphysema. Unlike these diseases, the airway obstruction in asthma is usually reversible; however, if left untreated, the chronic inflammation from asthma can lead the lungs to become irreversibly obstructed due to airway remodeling. In contrast to emphysema, asthma affects the bronchi, not the alveoli. The combination of asthma with a component of irreversible airways obstruction has been termed the asthma-chronic obstructive disease (COPD) overlap syndrome (ACOS). Compared to other people with "pure" asthma or COPD, people with ACOS exhibit increased morbidity, mortality and possibly more comorbidities.


title: Asthma

text: An acute asthma exacerbation is commonly referred to as an "asthma attack". The classic symptoms are shortness of breath, wheezing, and chest tightness. The wheezing is most often when breathing out. While these are the primary symptoms of asthma, some people present primarily with coughing, and in severe cases, air motion may be significantly impaired such that no wheezing is heard. In children, chest pain is often present.


title: Asthma

text: Signs occurring during an asthma attack include the use of accessory muscles of respiration (sternocleidomastoid and scalene muscles of the neck), there may be a paradoxical pulse (a pulse that is weaker during inhalation and stronger during exhalation), and over-inflation of the chest. A blue color of the skin and nails may occur from lack of oxygen.


title: Asthma

text: In a mild exacerbation the peak expiratory flow rate (PEFR) is ≥200 L/min, or ≥50% of the predicted best. Moderate is defined as between 80 and 200 L/min, or 25% and 50% of the predicted best, while severe is defined as ≤ 80 L/min, or ≤25% of the predicted best.


title: Asthma

text: Acute severe asthma, previously known as status asthmaticus, is an acute exacerbation of asthma that does not respond to standard treatments of bronchodilators and corticosteroids. Half of cases are due to infections with others caused by allergen, air pollution, or insufficient or inappropriate medication use.


title: Asthma

text: Brittle asthma is a kind of asthma distinguishable by recurrent, severe attacks. Type 1 brittle asthma is a disease with wide peak flow variability, despite intense medication. Type 2 brittle asthma is background well-controlled asthma with sudden severe exacerbations.


title: Asthma

text: Exercise can trigger bronchoconstriction both in people with or without asthma. It occurs in most people with asthma and up to 20% of people without asthma. Exercise-induced bronchoconstriction is common in professional athletes. The highest rates are among cyclists (up to 45%), swimmers, and cross-country skiers. While it may occur with any weather conditions, it is more common when it is dry and cold. Inhaled beta2-agonists do not appear to improve athletic performance among those without asthma, however, oral doses may improve endurance and strength.


title: Asthma

text: Asthma as a result of (or worsened by) workplace exposures is a commonly reported occupational disease. Many cases, however, are not reported or recognized as such. It is estimated that 5–25% of asthma cases in adults are work-related. A few hundred different agents have been implicated, with the most common being: isocyanates, grain and wood dust, colophony, soldering flux, latex, animals, and aldehydes. The employment associated with the highest risk of problems include: those who spray paint, bakers and those who process food, nurses, chemical workers, those who work with animals, welders, hairdressers and timber workers.


title: Asthma

text: Aspirin-exacerbated respiratory disease (AERD), also known as aspirin-induced asthma, affects up to 9% of asthmatics. AERD consists of asthma, nasal polyps, sinus disease, and respiratory reactions to aspirin and other NSAID medications (such as ibuprofen and naproxen). People often also develop loss of smell and most experience respiratory reactions to alcohol.


title: Asthma

text: Alcohol may worsen asthmatic symptoms in up to a third of people. This may be even more common in some ethnic groups such as the Japanese and those with aspirin-induced asthma. Other studies have found improvement in asthmatic symptoms from alcohol.


title: Asthma

text: Non-atopic asthma, also known as intrinsic or non-allergic, makes up between 10 and 33% of cases. There is negative skin test to common inhalant allergens. Often it starts later in life, and women are more commonly affected than men. Usual treatments may not work as well. The concept that "non-atopic" is synonymous with "non-allergic" is called into question by epidemiological data that the prevalence of asthma is closely related to the serum IgE level standardized for age and sex (P<0.0001), indicating that asthma is almost always associated with some sort of IgE-related reaction and therefore has an allergic basis, although not all the allergic stimuli that cause asthma appear to have been included in the battery of aeroallergens studied (the "missing antigen(s)" hypothesis). For example, an updated systematic review and meta-analysis of population-attributable risk (PAR) of "Chlamydia pneumoniae" biomarkers in chronic asthma found that the PAR for "C. pneumoniae"-specific IgE was 47%.


title: Asthma

text: When queried, asthma patients may report that their first asthma symptoms began after an acute lower respiratory tract illness. This type of history has been labelled the "infectious asthma" (IA) syndrome, or as "asthma associated with infection" (AAWI) to distinguish infection-associated asthma initiation from the well known association of respiratory infections with asthma exacerbations. Reported prevalences of IA for adults range from around 40% in a primary care practice to 70% in a specialty practice treating mainly severe asthma patients. The true population prevalence of IA in adult-onset asthma is unknown because clinicians are not trained to elicit this type of history routinely, and recollection in child-onset asthma is challenging.


title: Asthma

text: Many other conditions can cause symptoms similar to those of asthma. In children, symptoms may be due to other upper airway diseases such as allergic rhinitis and sinusitis, as well as other causes of airway obstruction including foreign body aspiration, tracheal stenosis, laryngotracheomalacia, vascular rings, enlarged lymph nodes or neck masses. Bronchiolitis and other viral infections may also produce wheezing. In adults, COPD, congestive heart failure, airway masses, as well as drug-induced coughing due to ACE inhibitors may cause similar symptoms. In both populations vocal cord dysfunction may present similarly.


title: Asthma

text: Chronic obstructive pulmonary disease can coexist with asthma and can occur as a complication of chronic asthma. After the age of 65, most people with obstructive airway disease will have asthma and COPD. In this setting, COPD can be differentiated by increased airway neutrophils, abnormally increased wall thickness, and increased smooth muscle in the bronchi. However, this level of investigation is not performed due to COPD and asthma sharing similar principles of management: corticosteroids, long-acting beta-agonists, and smoking cessation. It closely resembles asthma in symptoms, is correlated with more exposure to cigarette smoke, an older age, less symptom reversibility after bronchodilator administration, and decreased likelihood of family history of atopy.


title: Asthma

text: The evidence for the effectiveness of measures to prevent the development of asthma is weak. The World Health Organization recommends decreasing risk factors such as tobacco smoke, air pollution, chemical irritants including perfume, and the number of lower respiratory infections. Other efforts that show promise include: limiting smoke exposure in utero, breastfeeding, and increased exposure to daycare or large families, but none are well supported enough to be recommended for this indication.


title: Asthma

text: Early pet exposure may be useful. Results from exposure to pets at other times are inconclusive and it is only recommended that pets be removed from the home if a person has allergic symptoms to said pet.


title: Asthma

text: Dietary restrictions during pregnancy or when breast feeding have not been found to be effective at preventing asthma in children and are not recommended. Omega-3 consumption, mediterranean diet and anti-oxidants have been suggested by some studies that might help preventing crisis but the evidence is still inconclusive.


title: Asthma

text: Reducing or eliminating compounds known to sensitive people from the work place may be effective. It is not clear if annual influenza vaccinations affects the risk of exacerbations. Immunization, however, is recommended by the World Health Organization. Smoking bans are effective in decreasing exacerbations of asthma.


title: Asthma

text: While there is no cure for asthma, symptoms can typically be improved. The most effective treatment for asthma is identifying triggers, such as cigarette smoke, pets, or aspirin, and eliminating exposure to them. If trigger avoidance is insufficient, the use of medication is recommended. Pharmaceutical drugs are selected based on, among other things, the severity of illness and the frequency of symptoms. Specific medications for asthma are broadly classified into fast-acting and long-acting categories. The medications listed below have demonstrated efficacy in improving asthma symptoms, however "real world" use-effectiveness is limited as around half of people with asthma worldwide remain sub-optimally controlled, even when treated. People with asthma may remain sub-optimally controlled either because optimum doses of asthma medications do not work (called "refractory" asthma) or because individuals are either unable (e.g. inability to afford treatment, poor inhaler technique) or unwilling (e.g., wish to avoid side effects of corticosteroids) to take optimum doses of prescribed asthma medications (called "difficult to treat" asthma). In practice, it is not possible to distinguish "refractory" from "difficult to treat" categories for patients who have never taken optimum doses of asthma medications. A related issue is that the asthma efficacy trials upon which the pharmacological treatment guidelines are based have systematically excluded the majority of people with asthma. For example, asthma efficacy treatment trials always exclude otherwise eligible people who smoke, and smoking blunts the efficacy of inhaled corticosteroids, the mainstay of asthma control management.


title: Asthma

text: Bronchodilators are recommended for short-term relief of symptoms. In those with occasional attacks, no other medication is needed. If mild persistent disease is present (more than two attacks a week), low-dose inhaled corticosteroids or alternatively, a leukotriene antagonist or a mast cell stabilizer by mouth is recommended. For those who have daily attacks, a higher dose of inhaled corticosteroids is used. In a moderate or severe exacerbation, corticosteroids by mouth are added to these treatments.


title: Asthma

text: People with asthma have higher rates of anxiety, psychological stress, and depression. This is associated with poorer asthma control. Cognitive behavioral therapy may improve quality of life, asthma control, and anxiety levels in people with asthma.


title: Asthma

text: Improving people's knowledge about asthma and using a written action plan has been identified as an important component of managing asthma. Providing educational sessions that include information specific to a person's culture is likely effective. More research is necessary to determine if increasing preparedness and knowledge of asthma among school staff and families using home-based and school interventions results in long term improvements in safety for children with asthma. School-based asthma self-management interventions, which attempt to improve knowledge of asthma, its triggers and the importance of regular practitioner review, may reduce hospital admissions and emergency department visits. These interventions may also reduce the number of days children experience asthma symptoms and may lead to small improvements in asthma-related quality of life. More research is necessary to determine if shared-decision-making is helpful for managing adults with asthma or if a personalized asthma action plan is effective and necessary. Some people with asthma use pulse oximeters to monitor their own blood oxygen levels during an asthma attack. However, there is no evidence regarding the use in these instances.


title: Asthma

text: Avoidance of triggers is a key component of improving control and preventing attacks. The most common triggers include allergens, smoke (from tobacco or other sources), air pollution, non selective beta-blockers, and sulfite-containing foods. Cigarette smoking and second-hand smoke (passive smoke) may reduce the effectiveness of medications such as corticosteroids. Laws that limit smoking decrease the number of people hospitalized for asthma. Dust mite control measures, including air filtration, chemicals to kill mites, vacuuming, mattress covers and others methods had no effect on asthma symptoms. There is insufficient evidence to suggest that dehumidifiers are helpful for controlling asthma.


title: Asthma

text: Overall, exercise is beneficial in people with stable asthma. Yoga could provide small improvements in quality of life and symptoms in people with asthma. More research is necessary to determine how effective weight loss is on improving quality of life, the usage of health care services, and adverse effects for people of all ages with asthma.


title: Asthma

text: Medications used to treat asthma are divided into two general classes: quick-relief medications used to treat acute symptoms; and long-term control medications used to prevent further exacerbation. Antibiotics are generally not needed for sudden worsening of symptoms or for treating asthma at any time.


title: Asthma

text: For children with asthma which is well-controlled on combination therapy of inhaled corticosteroids (ICS) and long-acting beta-agonists (LABA), the benefits and harms of stopping LABA and stepping down to ICS-only therapy are uncertain. In adults who have stable asthma while they are taking a combination of LABA and inhaled corticosteroids (ICS), stopping LABA may increase the risk of asthma exacerbations that require treatment with corticosteroids by mouth. Stopping LABA probably makes little or no important difference to asthma control or asthma-related quality of life. Whether or not stopping LABA increases the risk of serious adverse events or exacerbations requiring an emergency department visit or hospitalisation is uncertain.