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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.
Barbara Crampton Will Face THE KENTUCKY GOBLINS In New Festive Found-Footage Creature Feature
She's taken on zombies, killer robots, cursed puppets, and a whole lot more, but now genre icon and Fango fave Barbara Crampton will face her trickiest foe yet with a starring role in The Kentucky Gob...
Laramie County health and food inspections (9/11/26–9/17/26)
CHEYENNE, Wyo. — The Cheyenne-Laramie County Health Department inspects restaurants, bars, convenience stores, delis, grocery stores, bed and breakfasts
Conectando Dreamers: The Three Cities of Ross Mintzer
A bright red full moon hung low over Nahuel Huapi Lake one night in 2026, as hundreds gathered beneath Patagonia’s stars for the second Conectando Dreamers festival in San Carlos de Bariloche, Argenti...
MS NOW, CNN and Politico say their journalists were denied access to White House after Trump ban
Reporters from CNN, MS NOW and Politico have been denied access to the White House. Reporters from the two cable networks both went live to report they’d been barred following
Confirmed: Barcelona suffer Andreas Christensen injury blow after Sevilla win
Barcelona have confirmed an injury setback for Andreas Christensen, with the experienced defender suffering a left thigh strain during the 3-1 victory over Sevilla.The Dane had to be withdrawn in the ...
Christensen facing several weeks out with muscle injury
LeadBarcelona beat Sevilla 3-1 at the Ramon Sanchez-Pizjuan on Saturday, but the result was followed by an injury update on Andreas Christensen. Hansi Flick confirmed after the game that the defender ...
Downtown Bethlehem sports bar, restaurant up for sale
Located at 515 Main St., the restaurant and bar is listed for $799,000 and features a full menu, sports viewing and established clientele.
A kid’s right to bodily integrity at heart of why I’m voting for Prop. 135
Proposition 135 on this fall’s ballot would prohibit sex-change surgery on minors. Call it “gender-affirming surgery” if that makes the amputation sound more compassionate. I’ll admit, I struggled with how to vote. Not because I think children should undergo these surgeries, but because I’m suspicious whenever government barges into a family’s decisions. The question is […]
Confirmed 2. Bundesliga lineups: Hannover 96 vs. VfL Bochum
Interim head coach Lars Barlemann makes two changes from the defeat in Nürnberg. Franz Roggow and Benjamin Källman replace Waniss Taïbi and Benedikt Pichler. Uwe Rösler makes one change from the ...
Texas A&M stock report, from Saturday’s game against Kentucky
Texas A&M’s Week 3 Stock Report: After the embarrassing loss to Kentucky, who’s rising, who’s slipping?
‘Crisis even bigger than Covid’: American business owners are barely getting by
The historic supply chain struggles that America’s business owners face show why resurgent inflation will not be easily resolved – even if the war ended.
'Trespasses' review: Come for the romance, stay for the historical drama
This adaptation of Louise Kennedy's 2022 debut novel on PBS follows a clandestine affair between a young Catholic schoolteacher and a Protestant barrister during the Troubles in Ireland.
Under pressure, Tottenham boss lays into his team
The atmosphere at Tottenham grew even heavier after Saturday’s 3-2 defeat to Aston Villa (19). Under serious risk of being sacked, coach Roberto De Zerbi laid bare the crisis by harshly criticizing ...
Deco outlines Barcelona’s three-player renewal plan
Barcelona sporting director Deco told the club’s General Assembly that agreements are close to being finalised on new contracts for Raphinha, Marc Bernal and Xavi Espart. Raphinha’s proposed exten...
🗞️ Front pages: King Raphinha reigns on derby Sunday
Sunday’s front pages are split between an immeasurable Brazilian and an elite derby.Raphinha scored a hat-trick in Seville, taking his tally to twelve goals in seven matchdays, and Barça head into ...
Betts' Offensive Barrage Leads Dodgers to Series Win Over Giants
Mookie Betts continues his hot hitting for the Los Angeles Dodgers with a four-hit day in the win against the San Francisco Giants.
‘Skyrocketing’ diesel prices impacting area businesses
The average price of diesel fuel in the Scranton/Wilkes-Barre/Hazleton market rose to $6.52 as of Thursday — up about $2.50 from last year and nearing the record high of $6.62 set in May 2022.
Tight end Baron Naone unlocking Washington offense early in season
Washington Huskies tight end Baron Naone had 103 yards on Saturday against Eastern Washington, flashing his potential as an elite contributor.
Fiesta de Salud brings free health resources, culture, community to Austin
Families gathered at the Emma S. Barrientos Mexican American Cultural Center on Saturday for Fiesta de Salud, a free community health fair aimed at helping Central Texans start the school year healthy and informed. READ MORE: https://www.kxan.com/news/local/austin/fiesta-de-salud-brings-free-health-resources-culture-community-to-austin/
Biljon has ambitions to coach at top level
ROTHERHAM director of rugby Harvey Biljon believes he’s shown he has what it takes to coach at the very top level after an extraordinary last four years has seen him win three different leagues. ■By LUKE JARMYN The former Wasps and Barbarians scrum-half has overcome both professional and personal adversity to win the Championship title […] The post Biljon has ambitions to coach at top level appeared first on The Rugby Paper .
Bikini barista shop coming to Sulphur despite pushback
A bikini barista shop is coming soon to Sulphur, but the store’s owners are already facing pushback from the local community. Married couple Kloey and Hunter Machulski expect to begin […]
‘Outstanding’ – Rodri singles out three Barcelona players after Sevilla win
The Spain star was happy with the three points.
One arrested after attempted burglary at Colorado Springs business, according to police
One person was arrested after an attempted burglary, according to Colorado Springs police.
Melissa Barrera Says Ed Sheeran Could Have Rebooked His Shows and “People Would Have Rallied Behind Him”
Melissa Barrera was fired from the Scream franchise in 2023 over social media posts criticizing Israel and praising Ed Sheeran’s decision to remove himself from the U.S. leg of his… The post Melissa B...
D-backs vs. Yankees discussion
Today’s Lineups YANKEES DIAMONDBACKS Ben Rice – DH Lars Nootbaar – LF Cody Bellinger – LF Ketel Marte – 2B Luis Garcia – 1B Gabriel Moreno – C Heliot Ramos – RF Geraldo Perdomo – SS George Lombard – SS Corbin Carroll – RF Austin Wells – C Nolan Arenado – 3B Anthony Volpe – […]
MLT’s new family-focused indoor entertainment complex open for business
Just in time for the rainy season, Monster Mini Golf opens its doors in Mountlake Terrace, across the street from the Grocery Outlet and Cinebarre. The 18-hole, glow-in-the-dark, mini golf […]
MLT’s new family-focused indoor entertainment complex open for business
Just in time for the rainy season, Monster Mini Golf opens its doors in Mountlake Terrace, across the street from the Grocery Outlet and Cinebarre. The 18-hole, glow-in-the-dark, mini golf […]
News Outlets Express Solidarity After Trump Bars Some Reporters
Some Democrats said President Trump’s ban was an attempt to control the press and distract voters as Republicans face deep challenges in the midterm elections.
Arsenal may move for Endrick in January
Barcelona may launch a huge offer for Haaland, Arsenal are interested in struggling Endrick, and Liverpool insist on keeping Wirtz
Brazil's new 9️⃣? Raphinha bags another hat-trick for Barcelona
It’s not “old” news.Raphinha bagged ANOTHER hat-trick in a Barcelona shirt.This time, the feat came this Saturday (19).He scored ALL of Barça’s goals in the 3-1 win over Sevilla right at the ...
Raphinha 10, Yamal 9 | Sevilla 1-3 Barcelona: Player Ratings
Barcelona did not have it easy against a spirited Sevilla last night, and the Ramon Sanchez Pizjuan made sure that the Catalans were made to suffer for every bout of possession.For the first time this...
Barcelona star limps off with injury vs Sevilla
La Liga champions Barcelona have on Saturday been dealt a potential setback on the personnel front. This comes after Andreas Christensen was forced into an early departure from the club’s latest out...
La Liga: Barcelona visit Sevilla bidding to maintain perfect start
Follow live text coverage as La Liga leaders Barcelona visit Sevilla looking to maintain their perfect start.
Fiesta de Salud brings free health resources, culture, community to Austin
Families gathered at the Emma S. Barrientos Mexican American Cultural Center on Saturday for Fiesta de Salud, a free community health fair aimed at helping Central Texans start the school year heal…
Fiesta de Salud brings free health resources, culture, community to Austin
Families gathered at the Emma S. Barrientos Mexican American Cultural Center on Saturday for Fiesta de Salud, a free community health fair aimed at helping Central Texans start the school year healthy...
The race to build a pandemic-proof world
Six years after COVID-19 killed millions, battered health systems, disrupted lives and brought the global economy to a virtual standstill, the world is still grappling with how we can prepare better for the next pandemic.
Sevilla vs Barcelona, La Liga: TV & Streaming, Live Thread
Join us for another Barcelona La Liga adventure!
Raphinha gives Barcelona clear signal on his long-term future
Raphinha has told RAC1 he would be happy to extend his Barcelona contract beyond its current 2028 expiry and finish his career at the club, according to Barca Blaugranes. The Brazilian is currently ti...
Harvey Barnes makes Newcastle history with quickfire assists ⚡️
Newcastle have jumped out to a lightning-fast start against Hull City on Saturday, taking a 2-0 lead inside seven minutes.And while he isn't on the scoresheet, you have to give credit to Newcastle win...
Ensuring Continuity in Science Education for Bar Harbor Students
Parents express concerns over Bar Harbor's science curriculum continuity post-pandemic, urging reevaluation of the current instructional model.
Bar Harbor Parents Again Raise Concerns About How Some Science Education In Sixth Grade.
The Bar Harbor Story is generously sponsored by Restaurant Barn. BAR HARBOR—Parents again raised concerns this week about how Bar Harbor students receive science instruction after fifth grade, months after the same issue came before the Bar Harbor School Board. The concern centers on a past scheduling change at Conners Emerson School that gives fifth graders a full year of science rather than switching between science and social studies at midyear. Principal Dr. Heather Weir Webster told the board that the school has been monitoring test scores, teacher feedback, and the experience of students as it considers whether the current approach is working. If it is not, the approach may be changed, but that would not likely occur this school year. In fifth and sixth grade, the school used to have one semester of social studies and one of science in each year. That schedule shifted because switching at midyear often broke up the learning units. So, approximately two-three years ago, they decided to shift that a bit. Science became a dedicated focus in fifth grade. Social studies was the dedicated focus in sixth grade. The school staff members are hoping to dive deeply into the data and see if the students are having a more quality experience throughout their time in those grades when it comes to science and social studies. If not, things could shift again. This year, Dr. Webster said at the September meeting, potential changes to curricula have been a bit complicated by moving into the school’s new building in late October and early November. “There have been no changes this year because it’s hard enough to handle the move. That allows them to have consistency,” Dr. Webster said. Dr. Webster said that after the Covid pandemic which prevented students from attending school in person, many fifth graders were struggling. “We tried several different configurations,” she said, including a co-teaching model to help with that struggle, but to also see how to best schedule and support those students. “We found that a January switch” where classes switched from social studies to science was really difficult. Part of the decision making stemmed from science being more hands-on and accessible to fifth graders. Social studies was a bit more abstract content, which was why the school tried the current configuration. In a letter submitted as public comment, parent Beth Dumont wrote, “In May 2026, I wrote to express my concern that our middle school students are not receiving consistent instruction in science and social studies. I appreciate that the Board took this concern seriously and requested a presentation from Principal Webster. I am also grateful for the opportunity to meet with Principal Webster and Julie Keblinsky in July to learn more about the current curriculum and scheduling. “During that meeting, I learned that the current model is intended to integrate science and social studies into other subjects during the years or semesters when they are not offered as standalone courses. “While I appreciate the intent behind this model, I remain concerned about its premise. Science and social studies are core academic disciplines that provide students with essential knowledge, skills, and ways of thinking. Yet under the current schedule, students are not guaranteed consistent instructional time in these subjects. Instead, exposure to content in these disciplines may depend on whether opportunities for integration arise within other classes. “To be clear, I strongly support interdisciplinary learning. Integrating science and social studies across the curriculum can enrich students’ educational experiences and help them make meaningful connections across subject areas. My concern is not with integration itself, but with relying on integration as a substitute for dedicated instruction in core disciplines.” Dr. Webster said that they’ve been monitoring test scores, talking to teachers, seeing how the pilot program works. It’s in its third year now of this schedule. One science teacher, she said, told her he’d seen positive outcomes with full year science and that there was a stronger classroom community. Another science teacher had concerns over the readiness last year, but she isn’t feeling that way about this year’s current class. A third teacher for social studies said he loves the full year. A fourth teacher of social studies hasn’t said that anything has changed. For the three fathers who spoke at the school committee meeting, the fractured science curriculum caused concerns. One father said that when he spoke to others, “all were surprised and confused as to why there was no dedicated, continuous science education,” at the school. Though students are testing well in science and math, he worried that without continuity in education, learning is lost. “We shouldn’t have to choose between key learning disciplines,” he said. Matthew Bergin, another father, agreed, adding, “I’m just a little concerned.” In her letter, Dumont wrote, “As the parent of a recent sixth grader who completed an entire year without a dedicated science course, I saw very little evidence that this integration was occurring in a consistent, systematic, or readily identifiable way. This is not a criticism of our middle school teachers, who have been uniformly excellent. Rather, it is a structural criticism of the current schedule.” Dr. Webster gave an update about all aspects of the schedule and how it’s created and she also spoke to social and emotional learning (SEL) in middle school. It’s explicitly taught but also embedded. Science is embedded as well and explicitly taught at all but that one grade. The school schedule is built from lunch out, then electives like art and physical education are placed, before going into the instruction time, teacher planning time, multi-tier support systems (MTSS), and then social and emotional learning. Teachers have to have 250 minutes a week of planning time per their contracts. That’s the minimum and occurs when their students are at specials. “The schedule is really not the purview of the board,” School Board Chair Marie Yarborough reminded the other board members and the public and thanked Dr. Webster for the presentation. The parents were also thanked for coming. LINK TO LEARN MORE [ ](https://barharborstory.substack.com/p/despite-strong-rankings-some-bar) [ Despite Strong Rankings, Some Bar Harbor Parents Raise Concerns About School's Science Education ](https://barharborstory.substack.com/p/despite-strong-rankings-some-bar) Carrie Jones · Jun 4 [ Read full story ](https://barharborstory.substack.com/p/despite-strong-rankings-some-bar) HELP SUPPORT THE BAR HARBOR STORY When we started The Bar Harbor Story, we didn’t know if anyone would read it. But you showed up. You shared. You sent tips. Now—over 400,000 views every month later—it’s clear: people here care about their community and each other. We’ve kept everything free because news should never be out of reach, but every one of our stories takes time to write, and your support keeps The Bar Harbor Story going. If you value our work, please consider a paid subscription, a founding membership, or a sponsorship. It truly helps us cover one more meeting, tell one more story, shine one more light. Even $5 a month makes a difference. Click here to become a one-time supporter now. Thank you so much for being here. Founding member information can be found here. Have questions about sponsorships? Just send Shaun an email at sfarrar86@gmail.com, he’d love to hear from you. Subscribe Share Bar Harbor Story Share Leave a comment
🤝 Deco: Raphinha, Bernal and Espart extensions agreed
As a warm-up to tonight’s match against Sevilla, FC Barcelona held its ordinary assembly of delegate members, featuring noteworthy remarks from president Laporta and also from Deco. The latter took ...
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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Using data collected from internal payroll, financial and capital reports, the report estimates that Novant Health Coastal Region pays approximately $1.15 billion in total compensation to its employees. According to the study, the provider’s annual operating expenditures, or direct economic impact, total $2.36 billion. That direct impact ripples through the regional economy through spending at its suppliers, or indirect impact, and household spending by staff and its suppliers’ workers, or induced impact. The report estimates the Novant Health Coastal Region’s indirect economic impact is $786 million, reflecting the multiplying effect of the provider’s operating expenses on expenditures like medical supplies, facilities, food, IT and professional services. Because 86.9% of Novant Health Coastal Region employees live within the tri-county region, the report estimates that wages paid by Novant circulate into the regional economy, creating an induced economic impact of $1.17 billion. “That money just doesn’t go into thin air,” Guettabi said of the wages paid to Novant Health Coastal Region employees. “Some of that money is being re-spent, and therefore it’s supporting grocery stores, hiring, restaurants and bars, and there are a lot of other companies or organizations whose employment, whose activity partially depends on that.” The combination of direct ($2.36 billion), indirect ($786 million), and induced ($1.17 billion) impacts totals an estimated $4.33 billion, according to the report. A study commissioned by Novant Health in 2024 and conducted by FTI Consulting’s Center for Healthcare Economics and Policy found that Novant Health generated nearly $2 billion of direct impact, with $628 million in indirect impact and $857 million in induced impact. Healthcare investments in the pipeline for Brunswick County Additionally, the study found that while healthcare employment has kept pace with population growth in New Hanover and Pender counties, it lags in Brunswick County. “Once you go below the metro level and you decompose the three counties that make up the Wilmington Metro,” Guettabi said, “it becomes fairly clear that Brunswick is the standout. And not only that, but clearly the growth there is fully domestic migration and largely retiree-driven migrants.” Using data from the Centers for Medicare and Medicaid Services on per-capita healthcare spending among age groups, Guettabi estimates that adults aged 65 and older demand 2.44 times the healthcare of working-age adults. “The share of the population in Brunswick County that’s over the age of 65 is 33%,” Guettabi said, “which is so much higher than the average share of people over the age of 65 within the state or within the country.” The report emphasizes that Brunswick County is the “strongest candidate” for new healthcare investment, adding that patient discharge records show Brunswick residents rely heavily on facilities in New Hanover County for inpatient care. “Investments in Brunswick County would not only meet the demand for those residents, but it would also relieve pressure for New Hanover County residents,” Guettabi said. Laurie Whalin, president of the Novant Health Coastal Region, told the Business Journal Friday that the provider plans to expand services at Novant Health Brunswick Medical Center, in addition to other investments in the area. In April, the state granted conditional approval to both Novant Health and Columbus Regional Healthcare System to build new hospitals, just miles apart, on either side of the Columbus County and Brunswick County borders. Columbus Regional’s $214 million 30-bed hospital would be located at the former Acme-Delco Middle School in Delco, according to the application. The project’s approved timetable has construction slated to finish in May 2029, with the hospital open for service by October 2029. The Whiteville-based provider, which Atrium Health manages, broke ground on an Advanced Care facility in December 2025 and operates four specialty clinics in Leland. Meanwhile, Novant Health’s proposed $251 million 20-bed hospital would be built just miles from Columbus Regional’s proposed hospital, near the Compass Pointe community in Leland. The provider estimates the hospital will open by 2030. State officials also approved Novant Health in March to build a freestanding emergency department in Carolina Shores, near U.S. 17. The project is estimated to cost $24 million, according to the application, and will operate under the Novant Health Brunswick Medical Center license. Additionally, Novant Health’s 16,000-square-foot ambulatory surgery center is slated to open in Leland by year’s end, officials said.
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