• A task force of more than a dozen doctors warned against prescribing children weight-loss drugs like Ozempic.
• In 2023, the American Academy of Pediatrics suggested drug treatments for children with obesity in addition to lifestyle interventions.
• Health professionals continue to debate the safety and effectiveness of these drugs for adolescents.

With weight-loss drugs like WeGovy and Ozempic dominating many of today's consumer healthcare conversations, there's a mounting concern for a particularly vulnerable group: children.

Pharmaceutical giants Eli Lilly and Novo Nordisk have been running clinical trials on children with obesity who are as young as 6 to understand how this class of drugs, called GLP-1s, could affect their health, Business Insider's Hilary Brueck previously reported.

In January 2023, the American Academy of Pediatrics (AAP) recommended that healthcare providers offer weight-loss medications, in addition to lifestyle adjustments, to treat obesity in children 12 and older. However, not all health professionals agree with the AAP's recommendation.

The US Preventive Services Task Force — a panel of more than a dozen doctors and public health experts from various academic institutions — issued a statement pushing for drug-free weight-loss interventions for children who are 6 and older on Tuesday.

"We believe we need more evidence to be able to make a recommendation for or against medications in children and adolescents," Wanda Nicholson, the task force's chair and senior associate dean of diversity and inclusion at the George Washington University School of Public Health, told STAT.

"While there were trials evaluating the effectiveness of FDA-approved medications, there was a limited number of trials per medication from our review. And in addition, there was limited evidence on weight loss maintenance after medications were discontinued in children," Nicholson said.

Lifestyle interventions are still preferred by doctors over drugs

GLP-1 drugs like WeGovy and Ozempic contain semaglutide, a substance that increases a person's insulin, the natural hormone that regulates blood sugar and tells the body when it's full.

These injectable drugs have proven successful as weight-loss interventions for adults with obesity, early research shows.

However, this class of drugs has its limitations. Many GLP-1 users have reported weight gain after ceasing GLP-1 use, while others have mentioned side effects like diarrhea, "paralyzed" stomachs, hair loss, and nausea.

The US Preventive Services Task Force voiced concern for these potential side effects in children, as well as an excessive focus on weight instead of health.

Nicholson said clinicians have used lifestyle interventions, like nutrition and exercise plans, to help children with obesity lose weight and reduce risk factors like hypertension, diabetes, and liver disease.

However, the AAP's and the US Preventive Services Task Force's recommendations overlap, according to Amanda Staiano, an associate professor of pediatric obesity and health behavior at the Pennington Biomedical Research Center of Louisiana State University.

"The AAP explicitly states that drugs should not be a monotherapy. They are an adjunct to be used in combination with intensive health behavior and lifestyle treatment," Staino, who was on the AAP's clinical practice guideline authorship committee, told STAT.

• IVF is under increasing scrutiny by conservative groups after the fall of Roe v. Wade.
• They take particular issue with the treatment's destruction of embryos.
• One author and fertility expert explains why these views won't work in practice.

In 2020, a hospital patient in Alabama wandered into a storage room, removed embryos from tanks of liquid nitrogen, and dropped them on the floor. Couples sued over wrongful death.

In February, the Alabama Supreme Court sided with the couples, ruling that the frozen embryos could legally be considered children.

"Even before birth, all human beings have the image of God, and their lives cannot be destroyed without effacing his glory," Chief Justice Tom Parker wrote in a concurring opinion.

The ruling not only created chaos for the state's fertility doctors — it kicked off a national debate over access to IVF.

The treatment helps women get pregnant by combining eggs and sperm in a lab setting. The goal is to create multiple embryos, with the hope of creating just one successful pregnancy. The rest might be thrown away or stored for future use.

But in a world without the protections afforded by Roe v. Wade, many fear "fetal personhood" laws, which give fetuses and potentially embryos the legal rights of a person, could complicate the IVF process for patients by raising the question: does throwing away excess embryos constitute murder?

Solutions like making one embryo at a time, for example, won't work, Leslie Schrock, an investor, author, and fertility expert, told BI in an interview. IVF requires making several embryos at once, as it mimics the very inefficiency that takes place naturally in our own bodies.

Natural human biology isn't perfect

Last week, Senate Republicans voted against a bill that would protect IVF access. At the same time, Southern Baptists, at their national conference, voted to oppose the use of IVF, but the resolution didn't explicitly oppose the creation of embryos that way — just their destruction.

All of these organizations have signaled that they believe life begins when "sperm meets egg," Schrock said. If you look at IVF through that lens alone, you would naturally believe that discarding embryos isn't okay. "There's no way around that," she said.

But our natural biology discards embryos all the time.

Most embryos conceived naturally don't survive in the human body. Among those that become successful pregnancies, one in four end in miscarriage.

"The biology of creating humans is fundamentally flawed," Schrock said. "It's not perfect. It's not like every time a sperm and egg meets, you get a viable pregnancy, much less a live birth."

IVF mimics this natural funnel. Not every fertilized egg will turn into an embryo; not every embryo will show up normal in genetic testing; and even the embryos that make it that far don't always transfer into the uterus successfully, Schrock said.

Making one embryo at a time would decrease success rates, extend wait times, and put further demands on IVF's lab workers, which are already in short supply, per Schrock and BI's reporting.

"There's a lot of loss along the way," she said. "It's not purposeful loss, it's not wasteful, it's not on purpose."

People aren't really choosing IVF

In the US, the treatment, which usually isn't covered by insurance, costs more than a Toyota Corolla. Meaning most IVF patients are either wealthy or taking out loans. (Yes, we live in a society in which your ability to have a baby can depend on your credit score.)

Women usually have to undergo two or three cycles to become pregnant, extending the financial and emotional costs of being a fertility patient.

Conservative groups can misunderstand that people who take this treatment on, per Schrock, are doing so because it's medically necessary to start a family — not because they want to.

Schrock herself nearly pursued IVF after suffering a miscarriage and medically necessary abortion. In the latter case, the fetus had stopped growing at around twelve weeks. At that point, she hadn't had children yet, and the choice — or lack thereof, rather — blew her mind.

"It was not something I wanted, it was not something I had ever even imagined was possible, and it was the hardest experience of my life," she said. "It's still visceral to this day, but medically speaking, I didn't have another option."

Deeply personal challenges are often where the IVF journey begins — and, sadly, ends.

Earlier this year, one patient, who asked not to be named, described her experience with fertility care to BI as a never-ending series of arbitrary choices, marked by a miscarriage and the end of her relationship.

"People don't just go into the process because it's fun," Schrock told BI, adding: "It's hard, it's disruptive, it's emotional. It is painful in many cases. And it does not always end with a healthy pregnancy."

Schrock, who has written about her experiences in books, felt shame for years, wondering where she went wrong.

"But you know what, it's just biology at the end of the day," she said. "It's taken me years to get to that. But it wasn't my fault, though. It wasn't my fault that it happened."

• Owners of the popular cafe chain Maman brought in about $50 million last year
• They risked everything — including all their savings — to do it
• In a recent CNBC article, the couple explained how they did it 

What was once a pipe dream of opening a café has become a multimillion-dollar business and brand for a New York couple.

Maman — a café touted for its pastries, French-style dishes, and Instagram-worthy aesthetics — has opened 34 locations across the US and Canada since opening its first Manhattan location in 2014.

"It was a small little dream that we had to open one cute, quaint, cozy coffee shop and café," owner Elisa Marshall told CNBC.

According to CNBC, Maman made about $47.2 million in sales last year and hopes to bring in $65 million in total revenue by the end of 2024. But it wasn't an easy start — from draining their savings to expanding the brand, co-founders Marshall and her husband, Benjamin Sormonte, gave up a lot to get the business where it is today.

In an interview with CNBC Make It, they described how they spent the last decade making their Parisian fantasy into a lucrative reality.

Big sacrifices at the onset

As with many small businesses, starting up was not easy. Marshall and Sormonte gave up a lot — including money, jobs, and sleep — to pursue their dream of running a successful café in New York.

Even before opening, they took their first leap of faith by uprooting their lives to relocate. Marshall and Sormonte moved to New York in 2012 from Spain after running a beach club in Ibiza. Before that, they had corporate jobs in law and marketing.

When it came time to bring the cafe to life physically, Sormonte and Marshall became not only business owners but also painters, bakers, and waiters. When Maman opened its doors in October 2014, they spent upwards of 80 hours a week working at the downtown Manhattan spot.

It was "a lot of sacrifice," Sormonte told CNBC, and "a lot of sweat and tears and love."

The couple burned about $250,000 to open, including emptying their savings accounts and turning to friends and family to pitch in.

"It was one of the biggest financial risks we could ever take," said Marshall to CNBC. "We really took quite a risk in pouring not only all of our money into it but also all of our time and energy."

Finding their 'it' factor

Coffee shops are a dime a dozen these days — one 2023 report said there are now more than 40,000 in the US. But Maman and its owners have made it a standout by honing in on a few distinct factors.

Inspiration for Maman — the French word for "mother" — and its menu was born from the foods they ate as kids. Sormonte grew up in Southern France and Marshall in Toronto.

Marshall told CNBC that they chose the name with the intent to create "the feeling of warmth and home."

"When we asked ourselves, 'Who is your favorite chef?' We both said "Maman," in the sense that we both grew up in a kitchen with our mom," Sormonte said.

The aesthetic inside its locations matches, with its blue and white china, country wood furniture, and floral touches.

"You're coming here for the ambiance [and] for the vibe, for the beauty of the space," she said, adding: "Good food and coffee is easy to find in a lot of places. So you need that little something more."

A standout menu item

While they had breakfast dishes, coffee drinks, and Instagram-worthy aesthetics down, one item in their pasty case put Maman on the map in its early days: their "nutty chocolate chip cookie."

In their first month of being open, Maman was featured in a New York Magazine article that said it had "NYC's most impressive new chocolate-chip cookie."

The attention catapulted them into the spotlight and spread the word fast about their existence. In its first year, Maman made about $2 million in revenue, according to CNBC.

Diversifying the brand

By 2015, Sormonte and Marshall were "close to burnout" from their hectic schedules as new business owners. So, CNBC reported, they looked outward for help, hiring more staff members and attracting the attention of outside investors, including a $1.5 million investment from Sormonte's brother.

They struck a deal in 2020 with a private equity firm for "between $10 million and $20 million," CNBC reported.

They have also rolled out Maman-themed merchandise and related products for sale. It's all part of a larger plan to make themselves more than a café.

In 2021, they published a cookbook called "Maman: All Day Recipes to Warm Your Heart." They also do catering and rent their café spaces for events — which together account for about 20% of Maman's yearly revenue, Marshall told CNBC. And there are plans for more in the future, like candles and dishware.

"My vision for Maman is much more than just a brick-and-mortar, four-wall restaurant," Marshall told CNBC. "I really see us turning into a multifaceted lifestyle brand."

• Best Buy is hoping Microsoft's Copilot+ will help end its 10 quarters of declining comparable sales.
• More than 30,000 employees have been trained to help sell the new AI-enabled PCs.
• The company also created a new "AI skillset" for Geek Squad agents in a retooling of the team.

The last few years haven't been kind to Best Buy.

With 10 consecutive quarters of declining comparable sales in the rearview, the electronics retailer is hoping a partnership with Microsoft will help end the slump.

On Tuesday, Best Buy began selling the tech company's AI-enabled Copilot+ PCs in stores and online. The computers are touted as the "fastest, most intelligent Windows PCs ever."

In February, CEO Corrie Barrie blamed companies like Apple and Microsoft for Best Buy's sales struggles.

"Right now there isn't any massive current innovation that would spur you to go buy a new laptop," she said before hinting that next-gen offerings (like the one launching this week) were in the works.

Now, to help move product, Best Buy says it has up-skilled more than 30,000 employees to demonstrate the capabilities of these new AI-enabled Copilot+ PCs.

"When tech this groundbreaking is introduced, it's our job to bring it to life for you," the company said in a press release.

Among the 30,000-and-counting experts are a cohort of over 1,000 Geek Squad agents, for whom the company created a new "AI skillset."

As the business unit is retooled from support to sales, these agents will handle training sessions and showcases in hundreds of stores across the US.

Best Buy has laid off large numbers of Geek Squad workers in recent months, primarily in the unit's in-home tech installation and support division, as the company emphasizes enhancing the in-store customer experience.

• I tried making Ina Garten's five-star-rated simple steak recipe at home.
• Garten's recipe called for only five ingredients: filet mignon, oil, butter, salt, and pepper.
• The recipe was simple to execute and resulted in perfectly cooked filet mignon.

My family and I love going out to restaurants like The Capital Grille and Ruth's Chris for a steak dinner.

But, as a family of four, we know going out to eat can be pricey — the average monthly cost of dining out is nearly $170 per person. When my husband, two teenagers, and I go out to eat, we usually spend more than that each month.

To save some cash and try to replicate a high-end meal on my own, I made Ina Garten's recipe for restaurant-quality steaks, which requires filet mignon and a few simple ingredients.

Here's what it was like to make the simple filet-mignon recipe in my kitchen.

Garten's steak recipe uses just five ingredients.

The ingredient list for Garten's restaurant-quality steak recipe was simple: four pieces of filet mignon, four tablespoons of butter, and two tablespoons each of vegetable oil, fleur de sel, and black pepper.

For this recipe, I purchased two filets weighing about half a pound each. I couldn't find fleur de sel at my local grocery store, so I used flaky Maldon sea salt.

The difference? Fleur de sel is a type of sea salt that's hand-harvested in France, and Maldon sea salt is harvested in England. Both types of salt are light and flaky, so I figured this substitution would work well.

I tied my filet mignon to help the meat keep its shape.

Garten's recipe called for tying each filet mignon around its perimeter to keep the steaks in a traditional oval shape.

After some research online, I discovered tying filet-mignon steaks promotes even cooking and keeps all cuts the same size for an aesthetically pleasing presentation. I used butcher's twine to tie the steaks into an oval shape.

Next, I prepared to cook the steaks in a skillet.

A cast-iron pan is one of my favorite kitchen tools, so I was excited to bring it out for this meal. Though I was cooking only two filets, I thought my relatively large cast-iron pan would give each piece of meat plenty of room to cook.

While the skillet heated up, I patted the steaks dry and coated them with oil, salt, and pepper.

I preheated my cast-iron skillet over high heat for about five minutes. While the skillet was heating up, I patted the tied filet mignon dry and coated it in a thin layer of vegetable oil.

Using tongs to prevent my hands from getting messy, I dipped each steak in a salt-and-pepper mixture to add flavor.

Next, I seared the steaks on all sides.

I added the steaks once my pan was hot enough for water droplets to instantly evaporate. I seared them for about two minutes on each side, including the meat's outer edges.

The instructions said to keep the house well-ventilated, and I can see why.

Searing oiled cuts of steak at high heat created lots of smoke, so I was sure to open my patio door and use a portable fan to blow some of it out of the kitchen.

By taking these measures, my house didn't smell like smoky, cooked steak for days, and the air in my home was clear.

Once the steaks were seared, it was time to cook them in the oven with some butter.

After searing, it was time to put the steaks in the oven, which I'd preheated to 400 degrees Fahrenheit. I topped each filet with a tablespoon of butter, per Garten's recipe, and added fresh rosemary from my garden.

The recipe said to leave the steaks in the oven until they reached an internal temperature of 120 degrees (for rare) or 125 degrees (for medium-rare). My steaks took about 10 minutes to reach an internal temperature of 125 degrees.

When the filets were at the right temperature, I took them out of the oven to rest.

Once they were done, I removed the steaks from the oven, placed them on a cutting board, and covered them in aluminum foil.

I let the steaks rest for 10 minutes so the juices had time to evenly distribute through each cut of meat. Then, it was time to remove the butcher's twine, slice the filets, and serve.

The steaks came out perfectly medium-rare and were easy to slice.

The filets came out perfectly, slicing easily and appearing just as beautiful and pink as medium-rare filets I've ordered at steak houses. I served them alongside baked potatoes.

Besides the recipe's simplicity, I was most impressed with how tender each filet came out. The meat was flavorful and juicy, and each steak's salty exterior was savory and delicious.

Most filet mignons I've had at restaurants had similar crispy exteriors and buttery-soft centers. These homemade steaks provided restaurant-quality yumminess.

I'd follow Garten's method for cooking steak again.

Based on my experience trying Garten's recipe for restaurant-quality steaks, I'd definitely use this method again.

This process was quick and easy to follow, and the ingredients were so simple that I already had almost everything in my pantry and refrigerator.

I thought the finished steaks were truly as delicious as those I've had at restaurants. Paired with a good baked potato, I'd have thought I was dining at a steak house, not in my own home.

• A vast majority of US companies are adopting generative AI tools, according to a new Bain survey.
• Most are also not sure where the value of these tools will come from.
• Lack of internal expertise is a top obstacle to wider adoption by businesses.

Businesses are embracing generative AI at an unusually fast pace. Now comes the messy part: Making money from these big investments.

That's the main takeaway from a new survey of the corporate world by consulting firm Bain & Company.

It surveyed 200 US companies with at least $5 million in revenue. Half were tech companies while the rest were spread across retail and consumer goods, manufacturing, healthcare, and financial services. Here are the highlights:

• 85% of the companies said adopting AI was a top-five priority. 12% listed the technology as their top priority. Only 1% said it was not a priority.
• Language generation and software coding are the two most common AI applications across all types of businesses.
• The companies reported spending $5 million a year on generative AI, on average.
• A fifth of those surveyed said they are spending more than $50 million per year on generative AI.
• The average annual generative AI spend for companies with more than $5 billion in revenue was $13.1 million.
• Companies with $500 million or less annual revenue spent an average of $1.6 million a year on this technology.

The big ROI question

For the most part, the companies told Bain that generative AI has met or exceeded their expectations. However, they also said the business case for significant AI investment is not clear.

It's a crucial question yet to be answered by AI juggernauts, such as Nvidia, Microsoft, OpenAI, and Google. These tech giants are betting on heavy AI usage in the future, but their customers must find value in these new services if the boom is to continue.

Despite the early rush to embrace generative AI, only 11% of the businesses Bain surveyed had a clear vision for how they would use generative AI and how it would add value.

That could be an issue of vision, talent, or it could be an issue with the tools themselves. Though most respondents reported that the AI tech they've tried met their expectations, a significant minority found the tools fell short of expectations.

The top concerns

In the Bain survey, worries about the quality of generative AI outputs tied with data-privacy and security concerns as issues holding businesses back from moving faster to adopt the technology.

There's also a lack of internal expertise. Compared to a similar survey Bain conducted last year, expertise is a rising concern, while performance and security are waning worries.

Gene Rapoport, who leads Generative AI initiatives for Bain's Private Equity practice, said CEOs need to take more ownership of the implementation of AI tools. That's in part because most companies expect generative AI to bolster revenue and increase the productivity and efficiency of the employees they already have, but far fewer have a full understanding of how that will happen.

Driving costs down

Those in the trenches building AI tools may be less concerned, citing the power of the underlying tech and the path of past technological breakthroughs.

"There's a natural cycle where you invest in new technology and then you expect pay-off," said Oren Etzioni, an AI investor and professor emeritus at the University of Washington in Seattle. "I'm very optimistic about the ROI coming."

ROI can and must improve in two ways, he emphasized. An observable contribution to revenue is one, but costs coming down is another.

"As a field, computer scientists are so good at driving costs down. Even in the 19 months since it started, the cost per query has been documented to go down significantly and training is getting more efficient," Etzioni said.

Nvidia CEO Jensen Huang echoed this urgency in his Computex keynote speech in Taiwan earlier this month, decrying "computation inflation," wherein computing costs grow faster than AI model performance improves.

"This of course cannot continue," he said.

Got a tip or an insight to share? Contact Senior Reporter Emma Cosgrove at ecosgrove@businessinsider.com or use the secure messaging app Signal: 443-333-9088

• Filipino soldiers defended themselves against an attack by Chinese coast guard, a general said.
• One soldier reportedly lost a thumb while others were injured and boats were damaged.
• Beijing denied responsibility, but US and Philippines officials criticized China.

Filipino soldiers had to defend themselves with bare hands against Chinese coast guard armed with swords and knives, according to the Philippines.

The Chinese coast guard personnel reportedly rammed their vessels into boats belonging to the Philippines on Monday, and boarded and attacked them, the BBC reported, leaving some injured and one soldier having lost a thumb.

General Romeo Brawner, the Philippines' top military commander, criticized China for what he described as "reckless and aggressive" behavior while the Philippines navy and coast guard were delivering supplies to Filipino soldiers in the disputed South China Sea.

In a statement posted online, Brawner said: "The Chinese coast guard has no right or legal authority to interfere with our legitimate operations or damage our assets within our Exclusive Economic Zone."

He said the incident "constitutes a blatant violation of international maritime law, Philippine sovereignty, and sovereign rights."

The Filipino army shared photos of the incident, showing damaged boats and Chinese personnel with blades.

Brawner said the Chinese coast guard's actions posed "significant" risks to regional stability, but he added that the Philippines would work with its international partners to try to maintain peace in the region.

China's actions have been condemned by other nations

The encounter is seen as the latest escalation in the disputed waters.

In April, video emerged of a Chinese ship colliding with a Philippine vessel while firing water cannons at it, as Business Insider's Chris Panella reported at the time.

On Monday, US Ambassador to the Philippines MaryKay Carlson posted on X denouncing China's "aggressive, dangerous maneuvers."

A Philippine Coast Guard commodore, meanwhile, said that he believed China was trying to "provoke trouble."

"They clearly hope that the US will also be agitated to justify their false narrative that Washington really wants to go to war against Beijing," Jay Tarriela wrote.

However, Beijing denied taking "direct measures" against Filippino soldiers, and claimed the Philippines was responsible for the incident.

Chinese foreign ministry spokesman Lin Jian said China had acted in accordance with the law.

"The maneuvers at the scene were professional, restrained, justified and lawful," Lin said in a statement.

• As a frequent cruiser, I'm selective about how much I spend on onboard extras.
• But some things, like comfort, cute coffees, and crafted cocktails, warrant a splurge.
• As a parent, I'm also willing to pay up for some "me time" while at sea.

Cruises are so back, and they're only predicted to get more popular.

The global cruise market, valued at $7.25 billion in 2021, is expected to grow about 11% from 2022 to 2028, according to Forbes.

One huge perk of this travel style is that it's pretty all-inclusive. Things like Broadway-style shows, multicourse meals, buffets, pool access, and onboard activities are built into the price of a typical sailing.

But ships also upsell and charge extra add-ons, upgrades, and perks. As a frequent cruiser who's sailed alone over 50 times and with family more than 30, I've increasingly become less likely to pay for these upcharges.

Instead, I save my hard-earned money for the upgrades that are actually worth it. Here are upcharges my family thinks are worth the splurge.

I tend to book a cheaper cabin category, but I'm willing to pay a premium to choose a quiet stateroom location

I rarely pay extra for a balcony room as I find that I don't use this feature enough to warrant the added cost. Instead, I opt for porthole-view rooms, which are generally less expensive.

But when selecting a room category during the booking process, I will pay more for a cabin located in an ideal spot on the ship.

Modern cruise vessels are huge, and I like a room that's centrally located on the ship, giving me easy access to everything I want to see and do. I'm also willing to pay a little more to select a cabin far away from elevators and loud entertainment venues.

After all, I need a good night's sleep to make the most of my days at sea.

Room service offers a level of convenience that makes the delivery fee palatable

One of the best things about cruising is the food, and thankfully, most ships have tons of eateries onboard that don't cost extra. However, room service often comes with an additional fee.

Although I wish all cruise lines offered complimentary room service, it's so convenient I'm willing to pay extra for it — especially for an early breakfast or a snack after a long day of adventures.

I love bringing my son along, and paying for childcare allows me to make the most of my vacation

Cruise-ship kids' clubs are a great selling point for families, and access to them is almost always included in the cost of the trip.

However, the complimentary clubs are typically only open to potty-trained children. For younger kids, many cruise lines offer onboard nurseries for an added cost.

For my family, the nursery fees have proved well worth the investment. My son sailed on dozens of cruises as an infant and toddler, and these vacations produced some of my fondest travel memories.

By paying to use the onboard nursery, my husband and I were able to enjoy date nights and connect during our getaways.

I'm frugal when it comes to food, but I can't resist splurging on unique beverages

I'm not a fan of overpriced "all-inclusive" cruise drink packages, and I try to take advantage of included beverages like tea, juices, and enhanced water as much as possible.

Nonetheless, I'm happy to spend extra on premium cocktails, wine-tasting sessions with the onboard sommelier, and other unique drink experiences.

I'm a sucker for a concoction mixed up by a robot at Royal Caribbean's Bionic Bar or a latte with my favorite cartoon pal etched on top as served in Disney Cruise Line's Cove Café, and these liquid indulgencies often show up on my onboard cruise tab.

Onboard spa treatments get pricey, but the lush thermal suites are worth the added cost

Spa treatments can be far pricier at sea, so I'm particular about what I book.

I save basic treatments like massages and facials for when I'm back on land, where prices are more favorable, but I do try to book at least one day pass to the onboard thermal suite per cruise.

On many ships, these blissful retreats — which can have everything from heated loungers to aromatherapy showers — are a worthy investment for those seeking a quiet atmosphere.

They're the ideal spot to soak up some "me time."

As thrifty as I am, I never feel guilty blowing my budget on experiences in the cruise ports of call

By saving money at sea and not paying for unneeded extras, I can better allocate my vacation budget where it truly counts — in the cruise ports of call.

There's no shortage of memorable adventures to be found back on land: hiking in the Norwegian fjords, helicoptering to a glacier in Alaska, exploring Mayan ruins, and strolling through cobblestone streets in Italy

For my family, savoring authentic land-based experiences is our main priority, and I'm not afraid to spend a lot on these excursions.

• Cases of streptococcal toxic shock syndrome (STSS) have risen suddenly in Japan this year.
• The rare and deadly bacterial infection affects blood and tissue.
• STSS is treated with antibiotics and sometimes surgery. There is no vaccine for the infection.

In Japan, cases of an uncommon but deadly bacterial infection have spiked in recent months, concerning health officials, the Washington Post reported.

Since January 2024, officials from Japan's Health Ministry have reported 1,019 cases of streptococcal toxic shock syndrome (STSS), a bacterial infection without a vaccine and treated with antibiotics. At least 77 deaths have been reported due to these STSS infections, with most fatal cases occurring in people over 50.

Officials from Japan's Health Ministry said they are unsure what has caused the sudden increase in cases. But they find the surge alarming, considering that fewer than 1,000 cases of STSS were reported in the country in 2023.

STSS causes and symptoms

STSS is caused by bacteria called group-A Streptococcus (GAS), according to the CDC.

This particular bacteria also causes mild infections like strep throat since it is commonly found in the throat and on the skin.

But if GAS gets into a person's bloodstream or tissue through open wounds or sores, their organs may start to fail within 24 to 48 hours, as per the CDC website. GAS has also been linked to necrotizing fasciitis, an infection that causes a "flesh-eating" disease.

According to the CDC, three in 10 people who develop STSS are likely to die.

Flu-like symptoms such as chills, fever, and muscle aches are often the first signs someone has STSS. More severe symptoms that signal organ failure due to STSS include:

• Low blood pressure signs include dizziness, blurred vision, weakness, nausea, and headaches.
• An abnormally rapid heart rate
• Abnormally rapid breathing

If someone has these symptoms, they should go to the hospital right away, according to the CDC.

Treatment typically involves replacing bodily fluids and antibiotics. According to the CDC, surgery may be needed to remove tissue infected by the GAS bacteria in some cases.

Infections like STSS are on the rise globally

Steer told the Washington Post that "we've had streptococcal toxic shock syndrome and invasive strep A infection in the US for decades and decades and decades, hundreds of years."

However, it's an uncommon infection, and healthcare providers should take the sudden uptick in STSS cases in Japan as a cue to increase their awareness of potential symptoms among their patients, said Andrew Steer, director of infection, immunity, and global health at Murdoch Children's Research Institute in Melbourne, Australia.

Since the coronavirus pandemic, health officials worldwide have expressed concern about increasing bacterial and viral infection rates.

In 2022, UK health officials reported 19 child deaths due to group-A streptococcal infections, the same bacteria that causes STSS.

Vaccines could help prevent the spread of these rare but potentially deadly bacterial infections, health experts said. However, creating one has proven to be a decadeslong process that is still in progress due to financial and scientific hurdles.

• California fined Amazon $5.9 million, saying it failed to inform employees about work quotas.
• A state law requires written quota details to prevent pressure and injuries among workers.
• An Amazon spokesperson said it has disputed the allegations and appealed the fine.

California's Department of Industrial Relations announced Tuesday it had fined Amazon more than $5.9 million, saying the e-commerce giant had violated labor laws that require companies to inform warehouse employees of any quotas they must follow.

According to the state's Warehouse Quotas law, which went into effect in January 2022, those quotas must be provided to workers in written form. They could include things like the number of tasks employees are expected to perform in an hour and any potential consequences they could face if they do not meet expectations.

The fines center on Amazon's fulfillment centers in Moreno Valley and Redlands, where the state Labor Commissioner's Office found 59,017 violations between October 20, 2023, and March 9, 2024, it said in a press release.

"The peer-to-peer system that Amazon was using in these two warehouses is exactly the kind of system that the Warehouse Quotas law was put in place to prevent," California Labor Commissioner Lilia García-Brower said in the release. "Undisclosed quotas expose workers to increased pressure to work faster and can lead to higher injury rates and other violations by forcing workers to skip breaks."

Amazon spokesperson Maureen Lynch Vogel told Business Insider the company disagrees with the allegations and has appealed the fine. She added that Amazon does not have fixed quotas.

"Individual performance is evaluated over a long period of time, in relation to how the entire site's team is performing. Employees can — and are encouraged to — review their performance whenever they wish," she said. "They can always talk to a manager if they're having trouble finding the information."

Lynch Vogel also provided a link to an Amazon blog post that describes how it manages the performance of fulfillment center employees, including its communication of work expectations and its use of robots to improve worker safety.

Amazon operates a vast network of fulfillment centers where workers pick and pack orders before they are sent out to customers. Some are as large as 1 million square feet and employ more than 1,000 workers. The company has attracted the attention of regulators over allegations of low pay and stressful working conditions, and in 2022, workers at the company's fulfillment center in Staten Island, New York, voted to unionize.