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Democrats try to ride data center backlash to election victory in rural US Midwest
Mounting public anxiety about AI, cloud-computing infrastructure has transformed data center construction into a contentious midterm elections issue
Crime writer Kellye Garrett brings latest book to Coe series
Explore “Missing White Woman,” the latest suspense thriller by crime fiction author and former “Cold Case” writer Kellye Garrett, ahead of her talk at Coe College in Cedar Rapids.
Oklahoma County jail administrator on challenges of mental health care
Gary Peters to direct USC politics center in post-Senate role
Michigan's outgoing senior U.S. senator has secured a new job on the West Coast after his term ends in January.
He beat a political pillar in Pawtucket. Now he wants a shakeup
For the first time in nearly two decades, Pawtucket will have a new mayor. Adam Greenman talks about his winning strategy and top priorities.
Campaign cash from utility leaders prompts fight in governor's race
The candidates for Michigan governor vow cheaper energy bills and attack one another over utility leader and PAC campaign contributions.
How are the waves? UT Marine Science Institute shares live buoy data
The University of Texas Marine Science Institute will report water and wind data from buoys near Port Aransas online.
Lubbock Public Health Director gets statewide award for vaccine advocacy
Lubbock's public health director was honored for her leadership during the historic West Texas measles outbreak and her continuing work to protect communities from vaccine-preventable diseases.
Wayland Baptist School of Business celebrates arrival of Starnes Market Ticker
Wayland Baptist University’s School of Business celebrated the arrival of its new market ticker this month at its campus in Plainview.
Lee Health: The people who make the difference
As I prepare to retire as Lee Health’s president and CEO, I’ve spent a lot of time thinking about what I’ll remember most from my years serving.
Finland's president reflects on Furman roots, world challenges
Finland President Alexander Stubb returned to Furman, reflecting on his student days, global affairs and Greenville's growth.
Getting nonstop political texts? Here’s what you can do to stop them
Political campaigns and pollsters can fill your inbox ahead of an election. Here’s what federal and Ohio guidance says about opting out, blocking and reporting unwanted texts.
Michigan State football in need of a health check as Big Ten play hits
As Pat Fitzgerald starts his quest to return Michigan State football to the top of the Big Ten, the Spartans enter with some health questions.
Vote for the Houma Today/Daily Comet AOTW, sponsored by Thibodaux Regional Health System
The poll is back open for the Houma Today/Daily Comet Athlete of the Week, sponsored by Thibodaux Regional Health System. Vote now and vote often!
Vote for the Houma Today/Daily Comet AOTW, sponsored by Thibodaux Regional Health System
The poll is back open for the Houma Today/Daily Comet Athlete of the Week, sponsored by Thibodaux Regional Health System. Vote now and vote often!
What stores are currently inside of West Ridge Mall? More than 20.
West Ridge Mall is adding new local businesses to its directory. See the full list of stores currently open.
What events are happening in the South Bend area from Sept. 21 to 27?
From fall festivals to haunted parks and film screenings, here is a guide to events happening Sept 21 to Sept 27.
Celebrate Dolly Parton Day on 9/25 with parties, books and tattoos!
In honor of the iconic star and her song “9 to 5,” Sept. 25 has been dubbed “Dolly Parton Day.” Check out these Parton-inspired events to celebrate!
Retiring Lee Health CEO Antonucci looks back on COVID, Ian, growth
Dr. Larry Antonucci retires as Lee Health CEO after leading the system through COVID-19 and Hurricane Ian.
Through the years: Dr. Larry Antonucci, CEO of Lee Health
CEO of Lee Health retires; dealt with COVID, Hurricane Ian, conversion to nonprofit system, AI and growthLiz
Why the Academy of Natural Sciences named a fish after Ernest Hemingway
The author took scientists on fishing expeditions and mailed specimens to Philadelphia while he was between books.
Hoosiers need easy access to qualified health care providers
While physicians discuss the perceived threat of expanding professional roles, Hoosiers face a greater threat: inaccessible, unaffordable healthcare.
See Mamaroneck roadway where state DOT plans to add bike lanes
A Mamaroneck business owner believes that bike lanes on Boston Post Road will increase traffic backups and be dangerous for young cyclists.
The Recovery House by Derek Owusu review – a uniquely honest view of mental health
Writing from firsthand experience, the author offers an affecting meditation on art, mental fragility and faith
Whether you like it or not, celebrities have an impact on politics
The global groundswell of support for Macklemore’s pro-Palestinian advocacy serves to remind us that maybe celebrity activism really is that deep after all, writes Cheek’s Varsha Yajman. Subscribe In the last week, publications, podcasts, and influencers that have either rarely or never spoken about Israel’s genocide in Palestine have flooded my social feed. And it was all because singer Ed Sheeran and his team dropped Macklemore as his opener for saying “Free Palestine” on stage. Millions raised, millions speaking up in support of Palestine - all of this confirming my view that, whether I like it or not, celebrities do have an impact on political outcomes. And this is interesting when much of the time celebrity activism can induce an eye roll - I love to see Charli XCX pointing out a Palestinian flag in the crowd, but it’s hardly the bold symbol of allyship that some fans would make it out to be. But there’s a line between healthy scepticism and outright dismissal - and I’d argue that the latter lets the rich and powerful off far too easily. For instance, actress Jennifer Lawrence, once outspoken about her political views, last year told The Times she no longer believes celebrities have a role to play: “Celebrities do not make a difference whatsoever on who people vote for. So then what am I doing? I’m just sharing my opinion on something that’s going to add fuel to a fire that’s ripping the country apart.” While it’s a narrative she might find comfort in, it simply is not true. Grassroots movements often garner worldwide attention when celebrities and other high-profile spokespeople bring a mainstream platform to their causes. And this frustrates me. We have had three years of a live-streamed genocide. Macklemore himself has been calling for a Free Palestine long before he booked the Sheeran concert. Yet it’s the high-profile fallout of the last week that finally seems to have made saying “Free Palestine” socially acceptable in the mainstream. It feels like the collective mood has shifted, where calling out censorship is now the obvious response - not just the business of ‘radical’ activists. To recap, Sheeran’s decision followed an ultimatum from billionaire Robert Kraft, owner of Gillette Stadium, one of the venues Sheeran was scheduled to perform at: either drop Macklemore as your opener after only two of the eight scheduled shows, or you do not play at any stadiums. Sheeran’s disappointing decision to stand on the side of billionaire-led censorship has ultimately seen a surge in support for Free Palestine. It began when all his openers and his backing band pulled out of Sheeran’s tour, in solidarity with Macklemore and with the Palestinian cause. It was met with an uproar of support from those who had never or barely touched politics before: influencers lip-syncing to Macklemore’s music, singers like Jack Antonoff singing “Free Palestine,” and publications and podcasts standing with Macklemore. And finally, we saw material support: Macklemore donated $1 million in profits from his two nights opening for Sheeran’s tour to several Palestinian aid groups and called for Sheeran and Kraft to match it, which they have since promised to do. We’ve also seen children’s entertainer Ms Rachel follow suit with a $1 million donation to Palestinian aid, and publication PopBase has donated $10,000. Anera, a humanitarian aid group working in Palestine, Lebanon, and Jordan, said donations since Macklemore’s announcement were more than triple this month’s daily average. The group’s Instagram page has also gained 8,000 followers. Macklemore far from the first celebrity to speak and participate in politics in the Western World. In 1924, singer Al Jolson supported Republican candidate Warren G. Harding for president, and decades later, celebrities such as Harry Belafonte, Lena Horne, and Aretha Franklin voiced their public support for the Civil Rights movement. More recently, in the lead-up to the 2024 US election, ‘The Daily Show with Trevor Noah partnered with the organisation Power the Polls to recruit poll workers to address shortages- a problem disproportionately affecting voters of colour. The campaign saw 170,000 new sign-ups - 35,000 of which came directly through the TV show’s link - resulting in the recruitment of 713,000 total poll workers that year, an almost three-fold increase on the organisation’s goal. Alongside recruiting workers, celebrities in the US (where voting in elections is not compulsory) have made a huge difference by calling for people to register to vote. Taylor Swift’s endorsement of Kamala Harris in 2024 saw over 400,000 visitors on the voter registration site within 24 hours of her Instagram post. In 2023, Swift had urged her fans to register, resulting in 35,000 new voter registrations. Similarly, Ariana Grande promoted voter registration in 2019 by setting up booths at concerts on the American leg of her tour, resulting in over 33,000 voters registering. And the same thing is happening closer to home. This year, musician Jack River successfully called for government action to ensure creatives in Australia do not have their work scraped by generative AI companies. Celebrity as the mediator between the punter and the politician Celebrity activism isn’t just a feel-good news story - research tells us it actually makes a difference. By directing attention to issues affecting the average person, like voting inaccessibility or a lack of action on a genocide, researchers Alfred Archer and Amanda Cawston state that “celebrities can play a useful bridging role between political elites and the people they represent”. Alternatively, in a world where talking about politics is “not cool,” or where people lack exposure or knowledge to engage with politics, celebrities can act as an educational resource or an entry point into the political world - when they speak up about an issue, their audience gets exposed to it. Olivia Rodrigo’s Daisy Chain Fields festival is a perfect example. Rodrigo partnered with twelve organisations focused on women’s issues, such as reproductive rights. These organisations had stalls at the festival for people to meet them and were also featured heavily on social media, giving their issues global attention and raising $20 million for the organisations. We have also seen celebrities at award shows such as the Emmys wearing F*CK ICE pins, referring to the U.S. Immigration and Customs Enforcement’s treatment and detainment of people - generally people of colour. When celebrities speak up about political issues in public forums, they put the issue at the forefront of mainstream media, rally their supporters, and make it clear that, however much they disagree, the government cannot simply ignore it. Our over-reliance on celebrities versus our politicians As much as I love seeing my favourite celebrity use their platform for a good cause, there is an important question to ask: not whether celebrity activism is good or bad, but whether we should have to rely on celebrities. And the answer would, in an ideal world, be no. In an ideal world, or merely a just world, action on Palestine would’ve happened decades ago, climate change would be taken seriously, and most importantly, people would understand their democratic rights. However, that is not our reality. Only around 28 per cent of Australian Year 10 students reach proficiency in civics and citizenship. In the US, almost two-thirds of people under 30 say high school civics education didn’t prepare them to understand voting deadlines, how to research candidates, or how to vote by mail. When civics education is weak, our trust in these institutions and our understanding of change-making processes also decline. This is where celebrity steps in and becomes our main source of reliance. As Mary R. Connelly notes in _The Tartan, “_Celebrities will always be involved in campaigns in one form or another, but their presence is not what causes people to vote blindly. The lack of political engagement and literacy is what allows celebrities to wield their influence on the political sphere so impactfully.” About the author Varsha Yajman is the Digital Content Producer at Cheek Media. She is a youth advocate and lawyer with a background in climate litigation and is passionate about looking at the intersection between race, climate justice, and mental health. Thanks for reading Cheek Media Co. ! This post is public so feel free to share it. Share
Oregon Health Plan members to receive notices on changes to Medicaid
BEND, Ore. (KTVZ) -- About 600,000 Oregon Health Plan members are beginning to receive notices about federally required changes to Medicaid coverage, including new work or activity rules that will affect some adults beginning January 1st, 2027. The Oregon Health Authority said the notices being sent this month are informational only, and members do not
These races will decide whether Democrats or Republicans win House control
A handful of swing districts will determine which party wins control of the House of Representatives in 2026.
These races will decide whether Democrats or Republicans win House control
A handful of swing districts will determine which party wins control of the House of Representatives in 2026.
The most iconic MTV VMA red carpet looks of all time
Since the first ceremony in 1984, the VMAs has become known as the award show where stars aren’t afraid to take major fashion risks, turning the red carpet into the ultimate spectacle.
How Saudi oil scientists ended up working on the world’s most important climate reports
Guardian investigation reveals fossil fuel links of IPCC authors, with experts declaring the body’s conflict of interest policy ‘not fit for purpose’
Shopping around: How Detroit is trying to attract more retail
Detroit officials estimate residents spend over $3 billion a year in surrounding communities on goods and services they can't easily find in town.
Should you trust an AI doctor? Relying on Gemini for health advice could be fatal
A fake disease, complete with absurd clues and a fictional laboratory aboard the USS Enterprise, was enough to fool AI chatbots—and even find its way into the scientific literature. The hoax exposes a deeper problem: AI can sound authoritative without knowing whether the information it has absorbed is true.
High School Teacher Discovers First-Ever Adult T. Rex Trackway While Fossil Hunting In US
Hups, a teacher at Northglenn High School, also became a co-author of the study published in the Journal of Vertebrate Palaeontology.
Gary Peters, Michigan's senior U.S. senator, prepares to leave office
U.S. Gary Peters, D-Bloomfield Township, is leaving office at the end of 2026 after 12 years in the Senate.
California tightens disclosure rules for influencers who post political ads
A new law will allow authorities to impose administrative, criminal and civil penalties on social media users who don’t make clear when they’re paid to post.
Kate Beckinsale sparks concern with cryptic Instagram posts
Kate Beckinsale has sparked concern online with a pair of cryptic, since-deleted social media posts shared on Sunday, Sept. 20.
La Lew wins $15K in RIT business pitch competition
La Lew Public Relations won the $15,000 grand prize in RIT's ROC the Pitch competition, while Allergy Advocates NY received $10,000.
Top Senate Republican says 'we need to do more' on economy, affordability
John Barrasso, the influential No. 2 Senate Republican, said his party needs to "do more" on the economy as November's midterm elections approach.
El-Sayed condemns harassment of Haley Stevens after 'gallows' rhetoric
It follows an incident where an activist followed Haley Stevens to her car, calling her a war criminal and saying, "We will see you at the gallows."
Patients who fight health insurance denials often win
New data show how often insurers deny prior authorizations that can stall patients’ care — and how frequently those decisions get reversed.
'Rethink everything:' Local health leaders take pulse of challenges
Ventura County's biggest healthcare players examined the "big beautful bill," worker shortages and other challenges.
East Tennessee has more measles cases. Health officials won’t say where
East Tennessee measles cases tallied six last week, but the state’s health department isn’t disclosing which counties those with the virus live in.
Brown Health residents struggle with low pay, paid leave
A neurosurgery resident details the struggle of balancing medical training with low pay and lack of family leave.
Oklahoma ranks top 10 for business bankruptcies despite startup boom
Oklahoma ranks in the top 10 for business bankruptcies as interest rates rise, yet the state remains a top spot for startups.
Parental instincts are crucial. The internet is clouding them.
Parents have more access to health information than ever, but it is conflicting and erodes their confidence.
The iPhone 18 Pro isn't worth $1,200, and the Pixel 11 Pro proves it
The iPhone 18 Pro is an excellent flagship, but the Pixel 11 Pro offers a more compelling package — and with a lower price tag.
FSU students show interest in staying in Tallahassee
Nearly 900 FSU students attended a local career fair, challenging the idea that graduates always leave the city.
From vaudeville to Broadway, Palace Theatre has evolved for 100 years
The historic Palace Theatre is hitting the century mark this year! Celebrate with special events through early December.
Seafood Festival, Pensacola Beach Brawl among this week's big events
Seafood Festival, Pensacola Beach Brawl, Lionfish Invitational, and the Fall Big Book Sale are among this week's biggest events.
Byron Donalds emphasizes FSU roots for Florida governor bid
Byron Donalds is embracing his FSU alumni status as he campaigns to become the next governor of Florida.
Wilmington nurse's legacy lives on through new scholarships
Family and colleagues honored the late Freddie Simpson, a beloved rehab nurse manager, with a new scholarship.
Author Michael Clinton weighs in on the changing science of longevity
The author reconsiders aging.
Q&A: Detroit retail leader on attracting businesses, retail growth
Addofio Addo is tasked with helping guide efforts to bring more retailers to neighborhood commercial corridors.
Peoria celebrates German heritage at 30th annual Oktoberfest
Peoria celebrates its German heritage with lots of beer, brats and polka music Saturday at the annual Oktoberfest on the riverfront.
Alameda County health authorities alert of possible measles exposure
State and Bay Area health officials warned of a possible measles exposure Friday after a person infected with the disease traveled by train from the Midwest through California.
See how MS politicians are using Ole Miss-LSU game to campaign
Mississippi politicians are using the fanfare around the Ole Miss clash with former coach Lane Kiffin and LSU to their advantage.
California warns of measles exposure in six counties from unvaccinated train passenger
Health authorities work to notify people who were exposed to person who traveled through at least six counties
Research suggests some voters using AI to help with midterms information
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Great Lakes bind U.S., Canada trade imperiled by Trump tariffs
A rift between Ottawa and Washington threatens lasting damage to supply chains across land and water geared for free-flowing commerce.
Power & Politics: Voter registration hearing; New poll on NJ's 7th Congressional District; ICE accused of using Roxbury warehouse
Author of New Jersey Playbook and Politico Reporter Matt Friedman and Founder and Director of Stimsight Research Patrick Murray join the show this week.
Power & Politics: Dangers of AI; 'Pay The People!' author John Driscoll; Former Budget Deputy Kosta Diamantis flees the country
State Sen. James Maroney and author and University of Connecticut Health's Board of Directors Chairman John Driscoll join the show this week.
Carrot Top hospitalized after alleged suicide attempt: report
Scott "Carrot Top" Thompson is recovering in a Las Vegas hospital as of Sept. 18 after reports of the comedian's alleged suicide attempt.
The Big Holes in Wearable Heart Rate Variability And Readiness Scores
On September 9th, Apple announced it was revamping its Apple Watch Health Sensing System, rolling out a Readiness score (0 to 10), and increasing the frequency of heart rate variability (HRV) outputs 24-fold. This can be viewed as upping its competition with various other consumer wearable sensors. These “readiness scores” as a composite of multiple metrics, with heart rate variability (HRV) being front and center for most. The majority of Americans are now using wearable sensors, which equates to well over 100 million adults. HRV and Readiness scores are increasingly being marketed as a measurement of autonomic nervous system health, a digital marker for future disease, a clock for biological age, and a holistic metric to promote healthspan and even longevity. (Apple also introduced a new longevity tab and “Health Age”.) None of this has been proven. In this edition of Ground Truths I am going to review what we know about heart rate variability and readiness scores. Heart Rate Variability HRV is the variation in normal heart cycle timing. The variability of the heart rate, the barely perceptible millisecond changes in time between consecutive heart beats (see R-R intervals in the Figure below, left panel), is due to interplay between the sympathetic and parasympathetic (vagal nerve) inputs. Distinct from heart rate, individuals with the same heart rate can have very different HRVs. It is a rough reflection of the autonomic nervous system (ANS) activity, inadequate to say whether a person’s ANS function is abnormal. For more than three decades, heart rate variability (HRV) has been measured and several studies have found an association of low HRV and clinical outcomes, particularly a link with higher all-cause and cardiovascular mortality. There have also been less well established links of low HRV to risk of early cognitive impairment, dementia, mental illness, Type 2 diabetes and substance abuse. An important reminder is that HRV is a surrogate marker without any established cause-and-effect relationship. If you increase your HRV, that doesn’t mean it will improve health outcomes. In fact, there is no hard evidence for that. All that work linking to health outcomes was done with electrocardiogram (ECG) derived HRV. Now, in the era of consumer wearables, this is getting assessed differently, by optical pulse (yes, the lights you see) plethysmography (PPG) or what is called pulse rate variability (PRV). They are not the same, as shown below (right panel) and only concordant when the delay between the ECG and pulse is kept constant, which basically means at rest. I should mention there’s also what I will call MPV, a mattress mechanical movement sensor, a derived heart rate variability, that companies like Eight Sleep use, even further away from directly measuring HRV. HRV has not one uniform measurement but many different types of quantification, such as RMSSD, the magnitude of difference between successive R-R intervals of normal sinus beats (N-N) or SDNN, the standard deviation of NN intervals, both in milliseconds. SDNN is one of the so-called frequency domain HRVs (others are LF, HF, LF/HF). Different wearable sensors use different metics; Apple has relied on SDNN and nearly all of the others use RMSSD, which is generally considered the more accurate metric. There’s also the different length of time measured, such as for a matter of minutes, all day, or an overnight’s sleep. Short measurements are especially problematic since they don’t capture enough of respiratory modulation and other factors that influence HRV. Share Ground Truths How well does HRV correlate with PRV? There are very limited studies, especially independently done. One that is commonly cited was conducted by Air Force researchers in only 13 healthy adults assessing Oura ring 3 and 4, Whoop 4.0, and Garmin Fenix 6 and showed a correlation coefficient of 0.88 to 0.97 and a mean absolute percentage error from 6 to 10%. The correlation is not a perfect 1.0, but there’s at least a fairly high level of correlation. HRV is supposed to increase during the night due to takeover of the parasympathetic nervous system, and higher during deep sleep. A recent example of my 1 week, all day “HRV,” and one during sleep is shown below. As you can see, the N of 1 data are inconsistent for the same days from different sensors (Oura, AppleWatch, Fitbit Air, and Eight Sleep) by patterns, absolute numbers, and comparison with prior days and weeks. The largest study in over 8 million Fitbit users (the old version, not Google Fitbit Air, introduced in May 2026) gives you a sense of the effect of age, sex, and the 2 different main HRV (here PRV) metrics, with RMSSD on the left and SDRR (=SDNN) on the right below. That study, from data collected in 2018, is a major outlier, since all the more recent ones are tiny with respect to sample size. Many of the companies have not had independent evaluation of their HRV, such as Eight Sleep, but have published a low standard error on their website. There are some other published studies on the correlation between HRV and PRV, but they are all small and only in healthy adults. A scoping review emphasized the lack of study in underrepresented individuals, including the aged, people of color (which affects the PPG signal), and individuals who are underweight or obese. Add the typical adult age 60 plus with one or more chronic diseases. For example, one study in over 900 adults found poor correlation of HRV and PRV, non-uniformly underestimated across many chronic diseases (cardiovascular, endocrine, neurological, respiratory, and others), concluding PRV is “an invalid surrogate for HRV.” A recent systematic review of 43 studies comparing HRV and PRV found reasonable pooled absolute standardized error (HRV as gold standard) but only 10 of the studies provided quantitative synthesis in ideal conditions. Their main conclusion was similarly cautious: “PPG-derived HRV [PRV] should not be regarded as universally interchangeable with ECG-derived HRV across all devices, populations, and recording contexts.” Factors Affecting HRV and PRV That gets me to the long list of factors that affect HRV (and PRV) besides the device, the type of measurement (RMSSD, SDNN or others), the person’s signal, the sensor site, the duration of data capture, if weighting by sleep stage is used, how artifact is processed and corrected. And this list is not complete!: Oura puts out data from their community of users (who input data) on what affects their overnight HRV. The factors currently provided are: no alcohol (increase 8%), melatonin (increase 2%, float tank (increase 2%), wine (decrease 4%), and party (decrease 14%) in overnight HRV. Must be some big parties! Subscribe What is a PRV measurement good for? It has been falsely characterized as an index of “autonomic balance” and a specific indicator of stress. A 2018 review of the studies available for HRV and its relationship to stress, not using any of the current wearables, found that stress can lower HRV. But so can many other factors. The non-specificity of the signal, indexed to the table above, is striking. Evidence from a UK Biobank study of over 46,000 participants with actual HRV looked at genetically predicted HRV, a genetic risk score, that failed to show the expected HRV-mortality link, indicating that _HRV is likely not causa_l, but rather a reflection of person’s physiologic state. A review of consumer wearable HRV data from 5 longitudinal studies showed that nighttime PRV was not associated with perceived stress, and surprisingly higher HRV, in the largest cohort (N=717 participants), was correlated with higher stress. An Oura ring cohort of 525 first-year college students found a link between overnight PRV and perceived stress, but that was also seen with resting heart rate, sleep, and respiratory rate. Several very small studies have examined the relationship of HRV and athletic injuries or guiding training with mixed, and predominantly negative results. HRV biofeedback training with paced breathing had no significant effect on reducing stress or raising HRV, as demonstrated with sham controlled trials. When HRV for multiple days showed a decline in conjunction with body temperature, the Oura ring published data for prediction of Covid. The WHOOP company sponsored an observational study, published in 2026, of 30,000 users for 72 weeks, without a control group, that reported reduced alcohol intake (5.8 % points) by self-report. That doesn’t tell us much, and particularly about the merits of HRV for behavioral change. If you use the same device and conditions as longitudinal trends for multiple (at least 2-3) weeks that may be the one way to get something useful from the measurements. Data for overnight sleep with minimal motion and using RMSSD is the best proxy for real HRV. The reason to look at trends rather than any given night is that it more likely represents something, even though you won’t know with certainty what the “it” is. Keep in mind there are no data, no peer-reviewed evidence, to show that HRV fluctuation in-person has any correlation with health outcomes. Share Readiness Scores These are proprietary scores that integrate different metrics for each of the wearables: no algorithms have been disclosed. They are unvalidated against health outcomes. In a review of 14 composite health scores of readiness and recovery, HRV contributed 86% to the scores, followed by reading heart rate (79%), physical activity and sleep duration (both at 71%). That review noted the substantial variability in measurement protools and lack of standardization. Sleep staging is notoriously inconsistent and inaccurate by these sensors, which adds further to the HRV uncertainties for what the scores, which use sleep stage data, mean. Only resting heart rate has been shown consistently across devices to be extremely accurate. I’ve made a Table to summarize what we know about which metrics are included, the scores, any peer-reviewed studies that compared the readiness score with health outcomes, and the corresponding (if any, NA-not available) citation. You will note that some companies do not use the term “readiness," such as WHOOP for recovery, and Garmin, which has 2 different scores, one of which is Body Battery. Eight Sleep uses the term “Fitness Score.” They all include HRV; Apple includes a new metric they call “Recovery HRV” which among other components uses 7-days of sleep, but it is unclear what this means or how it is differentiated from other scores (there are clearly no data for outcomes). We have no knowledge of how the different components are weighted or whether any of these scores are better than resting heart rate, HRV alone, physical activity, or any other single metric. Since none of these are standardized, they are not interchangeable, so if you get a 90 for Oura that has no relationship to a 90 on a Google Fitbit Air. Notably, the company can update its algorithm for readiness score at any point without notification to device users. Without any useful evidence of actionability for these scores or established relationship with health outcomes, it is hard to make a case for their value. At the Apple recent announcement they showed their Readiness score (0-10) on the watch (Figure below) but there are no published data on this score, not even on their website. It’s available only on their new Watch Series 12 or Ultra 4 [of course, ;-)]. That exemplifies the problems with these scores, lack of data and evidence for being meaningful to promote health. Perhaps the best study (which isn’t saying much) is the WHOOP Recovery for golfer performance, because it did correlate with an objective outcome, even though there was no control group and the authors were all from the company. Among the 389 pro golfers, an absolute 10-per cent point increase in Recovery score was associated with about 0.5 fewer strokes per round. But that’s hardly a health outcome! WHOOP is also conducting a study in over 2,700 runners to see if their recovery score will be linked to less injuries and improved performance, but that is not yet published and has no control group or randomization. Putting This in Context For two decades I’ve been enthusiastic about the potential for digital health and particularly wearable biosensors. Over the years, we’ve seen some great progress for their ability to promote physical activity and accurately detect atrial fibrillation (the first FDA cleared deep learning AI for consumers). That work was the subject of rigorous research. But there are holes in the data and evidence for other metrics. One notable one is the “VO2 max” story that I wrote about earlier this year. At that time many subscribers asked me to cover heart rate variability, which I finally got to here. When I dived into the research and publication for HRV and readiness scores, I expected to find at least some that were of high quality and demonstrated their utility by linkage to health outcomes. To my surprise, I found none. The wearable sensor measurements for HRV (PRV) are, for the most part, accurate, but that validation work has only been done in small studies of healthy adults and does not take into account the long list of factors, from the device, software side, and the user side, that affect HRV measurements. Moreover, this metric chiefly relies on optical sensing and, as we have learned for heart rate PPG sensing, may be less accurate in people of color. Keep in mind that all of the health outcome association evidence comes from ECG-derived HRV; none are from wearable sensor data. I will repeat the key point: there's no peer-reviewed evidence to show that in-person HRV fluctuation—or efforts to raise your HRV— has any correlation with health outcomes. For those of you who look at your HRV on awakening, or even 2+ week trends of it being low, I hope this context helps to relieve any anxiety. Yes, low HRV (not PRV) has been shown to increase risk of some diseases as summarized above. But efforts to raise your HRV—a surrogate metric— has not been established for improving any health outcomes. HRV does not have any evidence of causality (the genetic evidence actually goes against this possibility). In this summary, I have not included data for other wearable sensors such as Polar, Samsung, Withings, Suunto, Amazfit, Coros, Ultrahuman, or additional mattress sensors. These are beyond my first-hand experience, and as far as I know from my in-depth review none have any peer-reviewed published data that differ from the 6 sensors I’ve reviewed here. From the points I’ve gone over above, we’re not ready for readiness scores. Besides being proprietary, they are predominantly based on metrics that have their own issues. It’s compounding the problem, like building a house without a solid foundation that has never undergone a rigorous inspection, and then selling it. Like I mentioned for PRV, you can look at trends over weeks rather than any single day, to get a handle, but even that may not be helpful. There’s simply no evidence that these scores meaningfully relate to health outcomes. I’d emphasize they might, but that requires doing prospective or randomized studies to prove it. None exist. There’s great promise for HRV/PRV utility_. For example**,**_ Prof Maiken Nedergaard, who discovered the brain glymphatics that are essential in eliminating metabolic waste products from the brain during sleep, has posited that HRV could be a non-invasive marker for neuromodulator oscillations, brain-body regulatory circuits, and brain clearance. That would be extremely useful, but like everything else on HRV and readiness scores it requires solid research and validation. The lay media isn’t helping much to get the story straight. Earlier this year The Economist published a piece entitled “The most useful indicator of your overall health” which ordained HRV as an “accumulated stress score.” That’s akin to the false assertion about VO2max: “V02 max is the singular most powerful marker for longevity.” As I’ve summarized here, that is not established. The fact is that so many things can lower HRV, including physical exercise (especially an intense workout), reduced sleep quality, stress, the list above, no less the device, signal, and software. Whatever fluctuations observed have not been correlated with any health outcome. Sadly, “datamaxxers” are widely using HRV and readiness scores that have never been validated to mean anything. We already know that for some people using the sensors for sleep metrics, it can induce “orthosomnia,” an obsession to get high sleep quality, with associated high levels of anxiety. In an experiment done by a company to promote sleep quality for its employees, “For those employees who did use the trackers, many reported feeling perfectly rested until their tracker told them they had had a terrible night. Others were told that they had slept like a baby when they had actually been lying awake worrying about the quality of their sleep. “ The same problem can result from preoccupation with HRV or readiness scores, with anxiety that would lead to further reduction in both. It you are using a wearable like >100 million American adults, it’s OK to look at these data, but contextualized with the major caveats reviewed here. If you are one to require evidence that HRV or readiness scores are linked to health outcomes, you may not even want to look. The companies make it hard to turn them off! Let me end with the companies that make and sell wearables. Apple’s doubling down on HRV (24-fold more reporting and heart rate very 5 seconds) and introduction of a Readiness score tells us that consumers have bought into these metrics and they are joining the club. However, all of this is occurring with a backdrop of tens millions of users, claims about the data that are not backed up by adequate evidence, marketing way out in front of whatever limited data exists, and not being transparent about their readiness score algorithms. The companies can well afford to do the research that is needed to connect these metrics with health outcomes show, once and for all, that increasing HRV or using readiness scores promotes our health. If they believed and invested in the products they are selling, we’d not be in this position of not knowing. That’s essentially where we are with HRV and readiness scores. Perhaps someday this will change and we’ll have good reason to embrace them. NB: I wrote this post. No AI. I have no conflicts of interest with any of its content. Loading... Ground Truths has 215,000 subscribers from every US state and 214 countries. There are over 300,000 followers of Ground Truths so more than 90,000 folks who can easily convert to be free subscribers. Your subscription to these free essays and podcasts makes my work in putting them together worthwhile. If you’re not a subscriber, please join! If you found this interesting PLEASE share it! Share Ground Truths The proceeds from all voluntary paid subscriptions go to support our summer internship program. It enabled us to accept and support a record number of 62 summer interns that joined us in 2026! These are high school, college and medical students selected from thousands of applicants. We couldn’t do this expanded program without the funds coming in through Ground Truths. Thank you!
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