Most prenatal supplements lack the quantity of omega-3 fatty acids that would help prevent premature birth, i.e. delivery before 37 weeks of pregnancy. That is a Key finding of a brand new studypublished by my team, within the American Journal of Perinatology.

Omega-3 fatty acids are essential nutrients that are mainly present in fatty fish. They help prevent inflammation and thus reduce the danger of premature birth.

However, our study showed that roughly one in six pregnancy supplements containing omega-3 fatty acids available in the marketplace within the United States provide the quantity most pregnant women need.

My colleagues and I used information from the US Department of Agriculture Database of dietary complement labels to discover prenatal supplements that contained omega-3 fatty acids. We then compared the quantity of omega-3 fatty acids listed on the product labels with that recommended amounts in the brand new guidelines published within the American Journal of Obstetrics and Gynecology Maternal-Fetal Medicine by a team of experts representing international obstetric and child health organizations.

The guidelines recommend different dosages of omega-3 fatty acids depending on whether a lady's baseline intake before pregnancy was sufficient or inadequate.

We found that 70% of prenatal supplements containing omega-3 fatty acids provided the quantity advisable for ladies to devour adequately. However, previous research has shown that only 5% of pregnant women and ladies of childbearing age Consume enough omega-3 fatty acids. Therefore, prenatal supplementation with the next amount of omega-3 fatty acids can be helpful for ladies with inadequate intake.

Why it matters

Premature birth is the most important reason behind this Child mortality worldwide. It can be probably the most common reason behind childhood illnesses, resulting in costly hospital stays Neonatal intensive care units. And then there's the hard part emotional toll that it impacts parents and families.

Premature birth also increases a baby's risk of long-term health consequences reminiscent of: mental disabilitychronic illnesses reminiscent of hypertension, diabetes and psychiatric illnesses in maturity.

And yet there are some few treatment options for premature births.

This is where omega-3 fatty acids come into play. They reduce the danger of premature birth by reducing the production of those fatty acids Signaling molecules that trigger labor.

A Cochrane review of 26 randomized controlled trials showed that 1,000 milligrams of additional omega-3 fatty acids per day can reduce the danger of preterm birth by 11% and the danger of early preterm birth (delivery before 34 weeks of pregnancy) by 42%.

Considering that prenatal supplements often don’t contain the required amount of omega-3 fatty acids, one option is to easily take a further omega-3 complement along with a prenatal vitamin to make up the difference and get the profit.

However, omega-3 supplements will not be all the time mandatory. The recent guidelines recommend that every one women of childbearing age devour 250 milligrams of omega-3 fatty acids per day. This amount may be obtained from about two 3-ounce servings per week of fatty fish reminiscent of salmon, mackerel, herring, sardines and anchovies.

If women increase their intake of omega-3 fatty acids before pregnancy, the advisable intake levels while pregnant are lower. This is one option to eliminate the necessity for supplements in the primary place.

However, because of this, women of childbearing age also need to think about the mercury content in fish negative effects on the neurological development of the fetus. While most forms of salmon are low in mercury, certain fish wealthy in omega-3 fatty acids could also be moderately high mercury content. It is significant to seek the advice of local health guidelines regarding mercury levels in fish to make sure secure consumption levels.

What will not be yet known

Omega-3 fatty acids are chemically unstable molecules that are inherently fragile and subsequently prone to oxidation, a process during which oxygen breaks down the molecule and renders it ineffective. Studies have shown large variation within the oxidation states In commercial omega-3 supplements. Worse still, there are few predictors of the standard of omega-3 supplements.

However, despite their high risk of oxidation, commercially available omega-3 supplements have shown an increased risk of oxidation proven advantages in clinical trials.

What's next?

Considering the inconsistent amounts of omega-3 fatty acids in prenatal supplements, their instability, and the likelihood that pre-pregnancy dietary sources offset complement needs, further research is required to grasp how increased omega-3 intake helps Women of childbearing age may be motivated.

Given that many ladies proceed to require omega-3 fatty acids from supplements, longitudinal studies to watch omega-3 levels in prenatal supplements will probably be critical.

Furthermore, ongoing efforts are needed to advertise the implementation of this information in clinical settings to make sure that pregnant women and the health care professionals who look after them can make the most of the good potential of omega-3 fatty acids in pregnancy prevention of preterm birth.

An old-school World War II drama, a quietly powerful Irish drama, a Christmas story and a fantasy anime hit theaters this week.

Additionally, the brilliantly creepy horror film “Heretic” hits theaters this week.

Here is our summary.

“Flash”: Award-winning filmmaker Steve McQueen goes old skool, so to talk, along with his breathtakingly filmed World War II adventure story. The story revolves around nine-year-old boy George (impressive newcomer Elliott Heffernan), who someday faces disaster throughout the air raid on London in order that he can see his mother Rita (Saoirse Ronan) and grandfather (Paul Weller) again. True to McQueen standards, “Blitz” is polished and crafted to perfection. It's also very paying homage to Forties Britain – the garments, the streets, the homes, the hairstyles, the racism and the results of war – which is powerfully captured in Yorick Le Saux's gritty cinematography.

“Blitz” will not be revolutionary and tells an old-fashioned story like lots of us have seen before. But it goes a special way and features one other great acting turn from Ronan, who conveys the love and panic a mother feels when she realizes her son will not be where he must be – on this case, in a rustic house where He might be gone. Damage is the way in which.

The all-too-precocious George jumps off the train into the countryside and, in true Dickens style, meets some helpful people in addition to some shady characters on his treacherous journey home.

While fans may long for an edgier McQueen à la “12 Years a Slave,” “Shame” or “Hunger,” there is no such thing as a doubt that the author directing this epic film still thinks outside the box.

His story addresses the racism of the time (George is of mixed race) and the fate that his father suffered partly because of this. But the film stands out more for its impressively staged motion scenes, one in a subway that recalls elements of James Cameron's “Titanic,” and the opposite with haunting brilliance that mixes the enjoyment of a giant party and a jazz performance with destruction and Death contrasts left lying within the rubble after an air raid.

Both scenes are unforgettable and breathtaking in a solid, unremarkable film that warms the unwavering love between a mother and son and the courage and bravado of Londoners throughout the Blitz. Expect greater than that and also you will probably be dissatisfied. Details: 3 out of 4 stars; hits theaters November eighth and will probably be available to stream on Apple TV+ November twenty second. (Note: It can be a shame to not see this on a giant screen.)

“Little things like this”: Cillian Murphy delivers one of the crucial acclaimed performances of 2024. He is ideal in every scene. The awards likely won't occur, nonetheless, because the talented actor nabbed an Oscar last yr for the far more visible “Oppenheimer.” In this small but big Irish indie based on one other wistful and achieved novella by Claire Keegan, Murphy will rip your heart out as compassionate, low-earning Irish coal merchant Bill Furlong, an insomniac with five daughters and one hardened man. The working woman (Eileen Walsh) desires to recuperate from her meager existence. Bill finds himself in an ethical crisis when he crosses paths with a miserable head nun (Emily Watson) in a convent that is a component of the infamous Magdalene Laundries – a spot where women are severely mistreated. Bill is dead drained most of his waking hours and has difficulty respiration as a result of his work. In the lean days before Christmas, Bill struggles with what to do after encountering a desperate, abused woman on the convent. The associated horrific events behind the monastery partitions awaken memories of Bill's past and the way another person's altruistic actions have influenced his life. Irish playwright Enda Walsh adapts Keegan's sophisticated work with grace, while director Tim Mielants draws top-notch performances from his forged. But it's Murphy's sensitive and impeccable performance and Bill's weathered face and people small but meaningful gestures that make “Small Things Like These” such a quietly big film about extending a helping hand to those in need. It's a message for all seasons. Details: 3½ stars; in theaters November eighth.

“The Best Christmas Contest Ever”: Desiring to turn into an annual holiday watch tradition, Dallas Jenkins' endearing, faith-filled adaptation of Barbara Robinson's Chestnut has the true meaning of Christmas and takes greater than a number of references from Bob Clark's 1983 classic “A Christmas Story.” , to the nostalgic drunken narration by “The Gilmore Girls” actress Lauren Graham. The screenplay by Ryan Swanson, Platte F. Clark and Darin McDaniel could have used a bit of more eggnog-like spice when coping with the rude and rowdy behavior of the six poor Herdman children who sneak right into a snoozer at a church pageant within the town of Then turn it over. Still, his earnest messages that churches have to be more inclusive so we are able to create healthy communities couldn't be more priceless in these difficult times. Judy Greer stands out from the forged as a nervous but patient assistant festival director and mother who learns to talk as much as support the kids the church desires to shun and leave behind. Details: 3 stars; hits theaters on November eighth.

“Overlord: The Holy Kingdom”: Anyone not aware about the intricacies of a multi-episode anime series – let alone a series that has resulted in 4 popular seasons – would jump in fear right into a pre-existing world and hope to know what the hell is happening goes. Overall, I got it, even when I didn't know anything in regards to the backstory of the character Momonga, the protagonist who gets sucked right into a video game. In the world of this film, where demigods, power struggles and hidden traitors lurk, Momonga has transformed into Ainz Ooal Gown, a sorcerer king who plays a vital role within the fight against the Demon Emperor Jaldabaoth, a power-obsessed being who desires to rule every part and anything everyone – living or dead – within the Holy Kingdom. Director Naoyuki Itô obviously enjoys classic world-building elements and takes care of some pretty amazing visual set pieces. All the essential elements are there too: bloody battles, surprising revelations and latent powers in unlikely sources. I’ll not have caught all of the references, but I'm determined to see what happens next after this film's cliffhanger ending. You could say I'm addicted. I believe you will probably be too. Details: 3 stars; in theaters November eighth.

“Weekend in Taipei”: Luc Besson might be counted on to end up crazy time-wasters that defy logic but look implausible and draw strength from tongue-in-cheek motion sequences. You get all that on this full-on popcorn fun co-written and co-produced by the French filmmaker. Luke Evans suits perfectly into the role of brash Minneapolis DEA agent John Lawler, who goes rogue after a bloody raid and flies to Taipei to take down a mega-heroin ring run by wickedly wealthy businessman Kwang (Sung Kang). Fifteen years earlier, Lawler went undercover in Taiwan and fell in love with spirited Joey (Gwei Lun-mei), now mother to environmentally conscious 13-year-old Raymond (Wyatt Yang). Oh yes, she happens to be Ms. Kwang. From there, the plot becomes increasingly ridiculous, but everyone within the forged – especially Evans – sells it with a wink as director/co-screenwriter George Huang stages martial arts brawls and shootouts. There are two breathtaking sequences – one which begins within the kitchen of a restaurant and extends to the front of the home, and one other in a Marriott hotel room that’s destroyed. “A Weekend in Taipei” loses its unbroken charm toward the top, but there’s good enough occurring — including a humorous nod to Audrey Hepburn and “Breakfast at Tiffany’s” — to make it value a visit to the cinema. Check your brain on the door. Details: 3 stars; in theaters November eighth.

“Black Taxi”: Most can relate to a foul rideshare experience. Not-so-happy couple Anne (Synnøve Karlsen) and Patrick (Luke Norris) embark on the final word hellish ride with a gregarious, over-sharing driver (Nick Frost, living it up here). He has ulterior motives that lead to them being held hostage in his taxi. Director Bruce Goodison uses the stress well in the primary two-thirds of this efficient Shudder release, but then the plot hits a dead end in the ultimate act. There's some great things here; foggy, dense English backroad atmosphere and a dose of bloody punishment, however the story simply runs out of fuel and we're left stranded on the side of the road. Details: 2½ stars; available November eighth on Shudder.

Originally published: November 7, 2024 at 1:18 pm PST

Many Americans will discover a place on their November 2024 ballot to vote for a very important office: that of local sheriff. Although there are exceptions, sheriffs have long used their power to keep up a certain, unequal balance of power in society, often along racial and sophistication lines.

A recent example of this occurred on September 13, 2024, when Bruce Zuchowski, Sheriff of Portage County, Ohio, posted a message on a Facebook page captioned with a graphic which contained his official portrait and was inscribed together with his official titleZuchowski called on the general public to put in writing down the addresses of individuals whose front yards have campaign signs supporting Democratic vice presidential candidate Kamala Harris.

That way, he said, when immigrants arrive and wish accommodation, “we will already have the addresses of the … families … who supported their arrival.”

The post, which Zuchowski said later appeared on his “personal Facebook page,” included derogatory terms for immigrants and for Harris. It also included screenshots of two Fox News reports on migrants in Aurora, Colorado, and Springfield, Ohio. Both places had been falsely identified by former President Donald Trump, the Republican nominee, and his running mate JD Vance as sites of dangerous immigrant activity.

Sheriffs within the United States do rarely receive national attention within the news, but Zuchowski’s application was The Washington Post, NBC News And The Guardianamongst other things.

There are greater than 3,000 county-level elected sheriffs within the United States, each with the authority and autonomy to set and implement law enforcement policy. For example, sheriffs in lots of states can resolve whether their deputies wear body cameras and what happens to footage captured during routine stops.

In our book “The Power of the Badge: Sheriffs and Inequality in the USA” we provide a comprehensive have a look at this office and detail the history of sheriffs enforcing inequality each through using formal powers of their office, similar to Cooperation with federal immigration authoritiesand with informal powers, similar to communicating who belongs to their community.

Zuchowski's post demonizing immigrants and targeting individuals who advocate for immigrant rights is, as we document in our book, just a part of an extended history of sheriffs using their power as a tool of social control.

Throughout American history, various sheriffs have participated in social control. In the 18th century, for instance, An Alabama sheriff held slave auctions and Georgia's sheriffs played a central role in Enforcement of slave codesIn the nineteenth century A sheriff in Pennsylvania blocked the union's efforts to guard employees' rights against exploitative corporations. In the twentieth century The role of sheriffs within the South in voter suppression throughout the civil rights movement are well documented. In the twenty first century Racial profiling was an issue within the Enforcement of traffic laws of sheriffs in Arizona and California, amongst others. Zuchowski is just certainly one of the twenty first century sheriffs who’ve been Debate on immigration policy And Immigrant rights.

Personal views affect public service

Following Zuchowski’s post, The Portager, a news website for his community, reported that residents said the The position of sheriff was a voter intimidationSome residents have demanded investigations of the Sheriff's Office by local, state and national authorities, including the Civil Rights Division of the Department of Justice.

So far, in response to the Ohio Department of State, the sheriff has no laws broken.

Both in our book and previous workswe document through two national surveys how sheriffs' differing views on race and ethnicity can influence the policies and practices of their office.

Zuchowski’s comments about immigrants, including calling them “illegal human locusts,” denies their humanity from Comparing immigrants with animals.

In our research, we found that sheriffs’ negative attitudes toward immigrants were statistically correlated with Anti-immigration sentimentFor example, sheriffs with more negative attitudes usually tend to have an official policy to ascertain the immigration status of crime victims and witnesses. This association remained even after we controlled for the potential influence of other aspects similar to political party affiliation and the proportion of the native-born population in a sheriff's district.

Likewise, as we show in our book, sheriffs with racist views were less prone to tell us that their deputies were trained to cut back racial and ethnic bias in traffic enforcement. This issue is an issue in Portage County, in response to the local NAACP, which released a report in 2023 claiming that the sheriff's office unfairly targets black drivers.

Politics plays a job

Since his first post, Zuchowski defended himself on social media, writing:

“If the citizens of Portage County If you want to vote for someone who supports open borders (which I have personally visited twice!) and has failed to enforce the laws of our country…that is your right. Elections have consequences. That being said…I believe that those who vote for individuals with liberal policies must take responsibility for their actions! I am a law enforcement officer…not a politician!”

Despite Zuchowski's claims, he is definitely a politician. Like other sheriffs across the United States, he was elected by voters. He was the Republican nominee in 2020 and is running for re-election in 2024.

Like sheriffs across the country, Zuchowski had extensive law enforcement experience, including working within the Portage County Sheriff's Office before running to steer the office. We found that greater than 85% of sheriffs worked for the previous sheriff before running for election. And like most other sheriffs, Zuchowski is white. republican Man. We and Miscellaneous find that over 90% of sheriffs are white and over 98% are male.

Across America, sheriffs can be asking voters for his or her support this fall to remain in office. In most counties, these elections are usually not competitive: Sheriffs normally either without opposition or against weak candidates.

In this respect, Portage County is an exception. Zuchowski’s first selection was a tough fight for a vacant seatand he faces a challenger for re-election within the 2024 election. His Democratic opponent, Jon Barber, can be a white man with a police background.

But Barber's Campaign website highlights one other common challenge for voters: learn how to select a great sheriff. His website talks about transparency, accountability and community policing, but doesn't discuss immigration. Voters aren't given a transparent message about any substantive differences between the 2 candidates.

Will Zuchowski’s comments matter to voters? Elsewhere within the country, voters have re-elected sheriffs who anti-immigration And racist Comments.

As the presidential campaign heats up, media coverage suggests that Americans are hopelessly divided and headed for a difficult fall—and maybe a tense January as well.

But that is just not the entire story, in response to reports and survey results from the American Communities Projecta journalism and research project we lead at Michigan State University that analyzes the country through 15 different community types.

In fact, a 2023 American Communities Project (ACP) survey found that there is powerful agreement across the 15 community types we studied on the subject of issues and policies wherein government plays a very important role, akin to taxes, immigration, the economy, and even abortion.

But when it got here to problems with the “culture war” (religion, gender identity, weapons, family values), big differences became apparent.

This gap between the discussion of “politics” and the discussion of “culture” — between the discussion of “what we want” and “who we are” — is having a tremendously divisive effect on the nation. And if politics and government are to turn into more productive, Americans must discover a method to move beyond the problems of cultural identity.

Broad agreement on policy

We saw the difference between politics and culture in our 2023 survey.

The 15 community types within the ACP vary greatly from each other demographically, geographically and politically. The deeply rural, predominantly white community type that we call “Ageing arable land” – small rural counties spread across the Great Plains – gave 79% of their votes to Donald Trump in 2020. The densely populated and diverse group we call “Big cities“ – counties that include many of the country’s 50 largest cities – gave 66% of their votes to Joe Biden.

And yet there was broad agreement on various issues referring to politics or the state of the nation.

For example, in every community type, greater than 60 percent of respondents said they consider “the American economy is rigged to benefit the rich and powerful.” In no community did greater than 38 percent agree with the statement “The U.S. government should cut social programs to lower taxes” – a matter we explored in a panel discussion with voters in Florida.

Even on the sensitive issue of abortion, there was agreement on the statement: “Abortion should be a decision made by the woman in consultation with her doctor, without government involvement.” More than 50% in each community type agreed with this. Many polls show high support for legalizing abortion, however the agreement between different ACP types surprised us.

To be clear, not all areas of agreement favored Democrats' positions. The statement “America would be better off if we allowed more immigrants into the country” didn’t reach 30% agreement in any community. And “The government should play a more active role in monitoring the behavior of the private sector” didn’t reach greater than 45% agreement anywhere.

Regardless, for a rustic that usually feels hopelessly divided, this represents an ideal deal of agreement on statements that, in a technique or one other, concern the federal government's actions.

Questions of culture

But when cultural issues became the main target of the survey, familiar divisions in our communities emerged.

The largest divide within the poll was on the statement, “The right to own a firearm is central to what it means to be an American.” Overall, 49% of Americans agreed with this statement, but there have been large differences across community types and geography.

In rural “Evangelical Centers”, within the South and Midwest, 71% agreed that owning a gun is a central a part of being an American, while within the “Ageing arable land”, concentrated within the Central Plains and Great Plains, it was 73%. In the “Big cities” And “Urban suburbs“, outside the cities the centrality of this right fell to 30% and 34% respectively.

There were similar disagreements regarding gender identity.

Respondents were asked whether or not they agreed or disagreed with the statement “People should have the freedom to express their gender identity in the way that works best for them.” Gender expression was rather more accepted in diverse communities, akin to “Big cities” “Urban suburbs” and rural “Native American lands,” with 61%, 60% and 60% respectively. In rural working-class areas “Country of the working class” And “Evangelical Centers“, the figures were 37% and 32% respectively.

Faith and Religion

At the national level, a sort of consensus emerged regarding the importance of religion and religion.

Overall, 58% agreed with the statement that “faith and religion are important parts of American life.” But here, too, there have been large differences depending on the sort of church.

In the “Ageing arable land”, the importance of religion and religion reached 77%, within the “Native American lands”, 73 %, while within the “Evangelical Centers”, which is dominated by Christian evangelicals, it was 70%. For comparison: In theBig cities” And “Urban suburbs”, it was 47%, a difference of greater than 20 points in comparison with these rural communities.

And there was sharp disagreement over the statement “Traditional family structures with an income-earning father and a stay-at-home mother best equip children for success.” The percentages who agreed with this statement were highest within the group “Native American lands”, with 59 %, and in the agricultural communities of “Christian faith”LDS enclaves”, at 55% and “Evangelical Centers”, at 54%. The “Big cities”, “Urban suburbs” And “University cities“ were at the opposite end of the spectrum at 33%, 36% and 36% respectively.

Culture wars abuse political debates

These issues – guns, gender, faith and family – are obviously very necessary to many Americans. But how much do they should do with politics?

People will maintain their views on gender issues or live by their personal ideals about faith and family no matter who sits within the White House. The government cannot realistically monitor every bedroom and kitchen table in America. The issue of guns will be debated as each a matter of constitutional interpretation by the U.S. Supreme Court and a matter of private belief, but this issue too could be very personal, as now we have learned. after we talked to people in Michigan about it.

In some ways, these culture wars have hijacked the political debate, although there’s broader agreement on issues where the state does play a very important role.

Of course, agreement on the importance of key issues is just not the identical as agreement on what needs to be done about them.

We know from our work with people in these diverse communities that their respective answers to questions like easy methods to take care of a “rigged” system, or with taxes, abortion, or immigration, would likely vary. But these conversations are about give and take, about negotiating answers. That is the purpose of politics, and different from the culture wars that dominate our discussions.

In a rustic of 330 million people, there won’t ever be easy answers to the query “Who are we?” In fact, the country was designed to go away this query largely open inside broad parameters.

But unless politicians address the more necessary query: “What should we do?” the stalemate and tensions Americans feel within the 2024 election are unlikely to vary.

politics

WASHINGTON (AP) — President Joe Biden warned Monday that a Supreme Court ruling granting presidents broad immunity from prosecution would further embolden unbridled Republican Donald Trump “to do whatever he wants” if he wins back the White House in November’s election.

Biden, who’s under enormous pressure following his disastrous performance in the controversy against Trump last week, urged Americans to rigorously consider their voting decision and signaled that he has no intention of dropping out of the race.

Biden criticized the court's conservative majority's decision – which virtually guarantees that Trump is not going to face trial in Washington before the November election for his conduct throughout the violent riots on January 6, 2021 – and said it was now as much as the American people “to do what the courts would have been willing to do but are not doing.”

“The American people must judge Donald Trump’s conduct.”

Biden's efforts to refocus his campaign after the controversy, which spooked donors and sparked deep fear amongst Democrats, closely resemble his previous attempts to focus entirely on Trump's misdeeds and inadequacies. During his transient address on Monday, he made no mention of last week's debate or his performance and didn’t take questions, delivering an unusually political message from the White House.

“I know I will respect the limits of the president's power, as I have for three and a half years, but any president, including Donald Trump, will now have the freedom to ignore the law,” Biden said.

Biden appeared relaxed and assured, had a crisp, clear tone of voice, and looked tanned and rested – all in stark contrast to his often halting performance during last week's debate, when his face was strikingly pale. The president also had the good thing about a teleprompter for his remarks concerning the court, something he didn’t have at his disposal when sparring with Trump.

There were private discussions inside Biden's camp about what more the president could do to counteract what Americans saw throughout the debate, when he gave muddled answers, paused at times, occasionally stared into space and sounded croaky. The conversations also touched on whether Biden ought to be more visible in public, resembling at town hall-style events or interviews and press conferences, which he has generally avoided during his time in office.

But most of those near him are waiting for more meaningful poll results to evaluate the extent of the damage before changing course in any significant way, based on 4 Biden advisers who weren’t authorized to talk publicly about internal discussions and spoke to The Associated Press on condition of anonymity.

Biden's team may not change anything in any respect. Many imagine – or hope – that the awkward moment will pass, especially after Biden's family encouraged him at a gathering at Camp David on Sunday to remain within the race and keep fighting.

Campaign officials said Monday that that they had no latest events to announce. Biden will run his campaign as before and address the swing states as he has been doing for months.

An ad released Monday was titled “I Know” and used clips from Biden's post-debate rally in North Carolina, where he said, “When you get knocked down, you get back up.”

Quentin Fulks, Biden's deputy campaign manager, turned the main focus to Trump in a phone call with reporters, saying: “When you see President Biden on the campaign trail, he will talk about the reasons why Americans should be afraid of Donald Trump, just as he has been doing for months.”

Even before the controversy, the 81-year-old Democratic president's age was an obstacle with voters, and the prime-time debate brought the problem into focus, before perhaps the most important audience he can have within the 4 months until Election Day. CNN, which hosted the controversy, said greater than 51 million people watched.

“I think his age was a big factor, and I know he can do better than he did Thursday night. I expected more. I'm not sure that was the case for other voters,” said Jennifer Palmieri, White House communications director throughout the Obama administration and spokeswoman for Hillary Clinton's 2016 campaign.

She added that the campaign has responded tactically by supporting Biden's strong speech in North Carolina on Friday and continuing to publicize high fundraising numbers. Palmieri also said Biden can also need to undergo more interviews to proceed to point out that the controversy was an anomaly.

“Their focus needs to be on getting him in front of the voters who matter most, and more interviews should be part of that. Don't be like Trump in your own little universe,” she said. “Right now, it's early days, but what they're doing is working.”

One gets the sensation that voters are actually watching Biden more closely, searching for signs that may reveal, a technique or one other, whether his debate debacle was only a slip-up—whether, as he himself says, he’s fit for the job.

Alan Kessler, a lawyer and member of the Biden campaign's national finance team, has spent days reassuring nervous donors by telling them what he said he personally experienced when he saw the president – that he was “clear-headed and strong as ever.”

“I reassure people as necessary,” Kessler said.

Biden expressed interest in at the very least one interview. At a fundraiser Saturday in East Hampton, New York, Biden said he spoke with radio host Howard Stern, who interviewed him in April, answering open-ended questions that mostly related to his early years.

The president told the gang that he was ready for an additional conversation with Stern: “I had a great time on his show. And I'm actually going to take a chance and come back.”

Meanwhile, senior Biden campaign officials, including Fulks and Jen O'Malley Dillon, sought damage control by making calls Monday evening with about 500 members of the campaign's National Finance Committee and other donors, based on an individual acquainted with the private call who spoke to AP on condition of anonymity.

They downplayed potential consequences of the controversy, blamed the media for concerns about Biden's popularity and reiterated that Biden is fit for office. But the decision did little to allay the concerns of many supporters, the person said.

Campaign officials said there had been “no discussions whatsoever” about Biden dropping out of the race or any personnel restructuring after the controversy.

The window of opportunity is getting smaller and smaller anyway. The Democratic National Committee has announced that it’s going to officially nominate him because the nominee in a virtual vote before the party convention begins in Chicago on August 19. But when that may occur and what it’s going to seem like continues to be unclear.

___

Associated Press writers Josh Boak and Michael Rubinkam in Scranton, Pennsylvania, and Thomas Beaumont in Des Moines, Iowa, contributed to this report.