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Beats 360 Pre-Orders Open at Amazon With Cushion Kits on Sale, Plus More Beats Deals
The new Beats 360 headphones were announced today, and can be pre-ordered on Amazon ahead of their launch on Thursday. They're available in Black, Cloud, plus a bundle where you can style the headphones however you'd like thanks to interchangeable ear cushions and headbands. Note: MacRumors is an affiliate partner with Amazon. When you click a link and make a purchase, we may receive a small payment, which helps us keep the site running.
GOP candidate for governor Rick Jackson drops lawsuits against Burt Jones
Jackson and Jones filed lawsuits against each other amid a bitter primary battle as both sought the Republican nomination for Georgia governor.
Haley Jones Joins Kaplan/Perrone Entertainment As Lit Manager
Haley Jones has joined Kaplan/Perrone Entertainment as lit manager after a little more than six and a half years at Artists First.
Newsom signs bill expanding mental health options for veterans
A state budget trailer bill with funding for psychedelic therapy research to help veterans has been signed into law by Gov. Gavin Newsom, Sen. Brian W. Jones, R-Santee, announced Tuesday.
Earth Science Tech’s (ETST) Uplist to OTCQB Venture Market Continues Series of Milestones in Fiscal 2027
Austin, Texas, September 22nd, 2026, FinanceWireEarth Science Tech (OTCQB: ETST), a strategic holding company in the healthcare, pharmacy, and telemedicine sector, successfully uplisted to the OTCQB Venture Market effective September 17, 2026. The listing on OTCQB, an established public market for…
Jewel on Emotional Inheritance, Mental Health, Motherhood, More
Singer-songwriter Jewel sits down with TODAY’s Jenna Bush Hager and Sheinelle Jones to talk about her nonprofit, Inspiring Children Foundation, and the #NotAloneChallenge. She opens up about growing up in Alaska and overcoming challenges from her childhood. Jewel also talks about motherhood: “I really love being a mom. I wanted to be a mom, and I was in a really privileged position that I could change a lot of my life to make sure my son was the center,” she shares.
What CDC's new teen health survey shows, and what it skips
Teen suicide risk hit a 10-year low in 2025. Guns, sexual violence, and self-harm. Where are the 2025 data on transgender teens? Missing data changes public health policy. Teen suicide risk hit a 10-year low in 2025. CDC asked more than 10,000 high school students over 100 questions in spring 2025. Yesterday, it published a report covering a fraction of them. The report focsed on five areas: diet, physical activity, sleep, digital behaviors, and mental health, reflecting the priorities of the Make America Healthy Again movement. There was good news. Fewer teens seriously considered suicide in 2025 than in any survey year since 2015: 14%, down from 20% in 2023. Sadness fell. Underlying Conditions is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe Sports participation, which dipped to 49% in 2021, is back to its 2015 level of 58%. Daily PE fell from 27% to 20% in two years, while fewer students eat breakfast daily than a decade ago. Guns, sexual violence, and self-harm. The questionnaire is public, and it goes well beyond those five areas. Students answered questions about sexual violence, self-harm, and whether they got help when they felt sad or anxious. They said how quickly they could get a loaded gun. They reported whether food ran out at home and whether they felt close to people at school. There were questions about sexual identity, including whether they were transgender. The report did not publish any of the answers students gave to those questions. CDC posts the raw survey data online, so anyone can see what the report left out. The report doesn’t cover the health of sexual minority students. Among students who identified as gay, lesbian, bisexual, questioning, or another non-straight identity, persistent sadness fell from 66% to 57% between 2023 and 2025. Serious thoughts of suicide fell from 41% to 30%. Those drops were bigger than the ones among straight students, although the gap remains wide: 28% of straight students reported persistent sadness, about half the rate of LGBQ+ students. About 1 in 7 girls reported sexual violence in the past year. One in 6 students hurt themselves on purpose. Among students who needed help for sadness or anxiety, half rarely or never got it. And among students who had seriously considered suicide, 43% said they could get a loaded gun without an adult’s permission. One protective factor rose sharply. In 2023, 55% of students said they felt close to people at their school; in 2025, 63% did. CDC’s earlier research ties that kind of connection to better mental health. Where are the 2025 data on transgender teens? In 2023, CDC's national survey asked high school students, for the first time, whether they were transgender. Their answers are the only nationally representative data on transgender teens, and their mental health is by far the worst of any demographic. That year, 71% of transgender students reported persistent sadness, 54% seriously considered suicide, and 26% attempted it, compared with 38%, 18%, and 8% of cisgender students. But we don’t have 2025 data. The timing matters because students took the survey in spring 2025, as federal policy toward transgender youth shifted. On January 28th, an executive order directed agencies to end federal support for gender-affirming care for people under 19, and several hospitals paused that care within days. In February, the CDC said it would no longer process transgender identity data. Later in 2025, the Supreme Court upheld Tennessee’s ban on gender-affirming care for minors, and HHS ended the 988 Lifeline’s dedicated line for LGBTQ+ youth. Researchers disagree about how much state policy shapes trans teens’ mental health. A 2024 Trevor Project study estimated that anti-trans laws increased suicide attempts among trans and nonbinary youth. Critics dispute its methods and its estimates. The 2025 survey could have added national evidence to that fight. CDC collected the data but hasn’t publicly released it. Missing data changes public health policy. Surveillance works as a feedback loop. It can show officials whether their policies help or hurt. The CDC didn’t provide data on the students most exposed to transgender policy shifts. The report kept measures that frame health as personal choice, like fruit, breakfast, and sports. It left out measures that track policy, like gun access, mental healthcare, food at home, and school climate, all of which respond to what legislators and agencies decide. HHS did not respond to questions that I sent on September 21st.
Beats 360 Headphones Review: Best-Performing Beats Yet, and They're Modular
If you prefer over-ear headphones to earbuds for sports and exercise, these Beats are worth the investment.
The Beats 360 are what I’d bring to the gym if I hated earbuds
They protect against sweat and talkative gym bros.
Apple Planning to Bring iPhone Duo Display Tech to Pro in 2029
Apple's 2029 "Pro" iPhones could adopt thinner and more power-efficient OLED screens, according to UBI Research. The technology, known as Color Filter on Encapsulation (CoE), removes the conventional polarizer from the OLED panel and places a color filter directly on top of its encapsulation layer. A polarizer helps suppress reflections from ambient light, but it also absorbs a significant portion of the light produced by the display.
I flew 11,000 miles with Sonos' brand-new Ace Ultra headphones, and their noise cancellation wowed me
The Sonos Ace Ultra headphones offer excellent ANC and comfort, while integrating wirelessly with other Sonos devices.
Sonos Ace Ultra review: Giving the people what they want
The Ace Ultra is an obvious upgrade over the original Ace headphones, with headphone linking performing reliably already, even in its early phase.
Why a food and drinks giant is betting big on crop science
At a multigeneration family farm in Alberta, drones and data are replacing guesswork—part of PepsiCo’s broader bet that healthier soil means a more resilient global supply chain
MIT’s tiny flying robot gets 450% faster with AI
A new AI control system lets MIT’s tiny flying robot move with insect-like agility, boosting its speed by about 450 percent and allowing it to pull off 10 somersaults in 11 seconds. The technology could eventually enable miniature robots to search earthquake rubble and navigate dangerous spaces that conventional drones cannot reach.
Inter Not Getting Much Contribution from EPL Signings
Inter based their summer strategy on bringing in players from the Premier League to try to get closer to those powerhouses in Europe, but the early returns have been paltry at best. Only Curtis Jones ...
Colts Signing New Receiver After Alec Pierce Update
The Indianapolis Colts are signing one of Daniel Jones' former top receivers.
How lip-syncing to AI let Forced Entertainment ‘play the game of theatre’
Today we have a fascinating piece by long-time Forced Entertainment fan Ben Kulvichit, speaking to Tim Etchells about their latest show Cold Sweat, how they are integrating lip-sync and AI voices into their work, the question of ‘authenticity’ on stage, and how lip-sync has even opened the door for them to make “something a little bit like drama”. This piece is a paid partnership with the Southbank Centre, where you can see Cold Sweat next month – we’re very grateful to the Southbank Centre for their ongoing support for Exeunt. Holly Williams ‘It was immediately interesting and uncanny’ **By Ben Kulvichit** “Is the microphone on?” So goes one of the opening lines of Signal to Noise, delivered by a human performer lip-syncing to an AI-generated voice. The voice is American, cheery but sluggish, slowed down into a gelatinous drawl. It repeats ad infinitum in a farce of stuckness; an answer never materialises. I find myself asking the same question as I hop on a Google Meet call with Tim Etchells, the artistic director of Forced Entertainment. We spend five or ten minutes frowning at each other, muting and unmuting, me gesticulating in semaphore into my webcam, checking if I am coming through now, restarting the laptop. To Etchells, I appear exaggeratedly mouthing words, my voice missing. In this gloopy purgatory of broken communication, life imitates art imitates life imitates art. We try a Zoom instead. Forced Entertainment, the pioneering British theatre company who have been at the avant-garde of performance since the 1980s, turned an interesting artistic corner with Signal to Noise, created on the occasion of their 40th anniversary. The whole performance employed this lip-sync technique to AI voices; on the face of it a left-field move from a company whose identity has long been grounded in the earthy, immediate presences of its performers and its unassuming, low-tech approach to theatricality. The technique, however, turned out to provide the company with a “rich new seam” of artistic enquiry, and has now spawned a trilogy of works. The second instalment, Cold Sweat, plays at Sheffield Theatres, Southbank Centre, and Lancaster Arts in October, while the third part, Everything Must Go, has been touring in Europe and is slated to come to the UK in 2027. As is often the case with Forced Entertainment shows, the main conceit for this work didn’t arrive until quite late. They were “four or five weeks into rehearsals for Signal to Noise,” Etchells recalls, and getting nowhere. Away from rehearsals, he had been playing around with feeding “weird texts” to AI voices to see how they would cope with them – “basically for my own amusement” – and was compelled by the uniformly “serviceable, benign, good-natured” tone they would read in, no matter how poetic, fractured or experimental the writing. On a hunch, he brought some examples into rehearsals and the performers gave lip-syncing a go. “It was immediately interesting and uncanny,” he recalls, with the performers having to deal in the moment with the problem of mapping themselves onto another artificial ‘performer,’ which itself was dealing with the problem of a very human text. “Almost all the writing for these projects would be useless to us unless it was done in this way,” says Etchells. “We wouldn’t know what to do with it. It’s too poetic. It’s too fictional. It’s too tangled.” But exploring lip-syncing along to the text has opened “an enormous reservoir of ways of thinking about writing and performing.” Subscribe to Exeunt, and get two in-depth pieces on theatre a week, direct to your inbox Subscribe Forced Entertainment have long been sifting through the detritus of popular culture, from daytime TV to end-of-the-pier vaudeville, magic acts and clown shows, to find frameworks for their own unusual entertainments. Lip-syncing, then, makes sense for them to experiment with. As a mode of performance, it’s wired into popular consciousness through pop stars trying to convince stadium audiences of their liveness, or those same voices as channeled through the made-up lips of contestants on RuPaul’s Drag Race, or movie dialogue spreading virally through the host bodies of TikTok users. For Etchells, lip-syncing is often about “approaching real voices and trying to take on their aura,” subsuming that original human presence into yours. “There’s a very basic, elemental sort of theatre magic to it, produced in this very easy way.” This broad approach resonates with instances of lip-syncing within contemporary performance, too. In works like Re-Member Me and Showmanism, performance artist Dickie Beau acts as a kind of spirit medium for archival recordings (this process of re-membering – as in, giving corporeal form to voices – relies on his masterfully precise actor’s technique), while Frankie Thompson is similarly possessed by a host of characters ranging from a nine-year-old Jacob Rees-Mogg to Cliff Richards, all of whom she finds compellingly nauseating, in the exorcism ritual that is her latest show, Horrible Things. What’s different about Forced Entertainment’s use of lip-syncing is that here, there is no original presence to be channeled. The performers are instead taking on what Etchells describes as “the voices of nobody,” or rather the “phantasmic, aggregated echoes” of the many many voices on whose data the AI has been trained, and which are now conjuring into existence words they never actually said. There is a sort of mournful, empty quality to these voices, having “washed up” far away from the people they originally belonged to, to find themselves in stranger’s mouths listing objects, wondering if anyone can hear them and glitching in interminable loops. There is a cold, sad anonymity to it all. Etchells remarks that occasionally the software company he used has notified him that particular people are withdrawing their voices from the platform, instructing him to cease use of those voices. Using these technologies in performance certainly brings up ethical questions around digital rights, consent, identity and ownership, although in the grand scheme of things, Etchells is fairly blasé about it: of all the purposes someone’s voice might be put to without their knowledge, “an avant-garde performance is probably the least of their worries.” [ ](https://exeuntmagazine.substack.com/p/frankie-thompson-horrible-things-essay-mental-health-compulsive-behaviours-pleasance-courtyard-soho-theatre) [ Frankie Thompson: How I manage my own ‘horrible things’ at the Edinburgh Fringe ](https://exeuntmagazine.substack.com/p/frankie-thompson-horrible-things-essay-mental-health-compulsive-behaviours-pleasance-courtyard-soho-theatre) Exeunt · Aug 25 [ Read full story ](https://exeuntmagazine.substack.com/p/frankie-thompson-horrible-things-essay-mental-health-compulsive-behaviours-pleasance-courtyard-soho-theatre) For the performers, though, lip-syncing to these strange, artificial voices is an odd task, requiring them to bend their live, human presence into the shapes produced by machines. Politically, it mirrors processes that are already at play in the continued computational automation of human life. Etchells brings up James Bridle’s writings on new technologies as a reference point: one example Bridle gives is of “chaotic storage”, a logistics technique employed by Amazon fulfilment centres whereby items are stored not according to traditional methods of categorisation or alphabetisation, but in a way that an algorithm determines to produce the most efficient routes for ‘picking’ based on customer purchase patterns. This appears completely random and incomprehensible to humans, with paddling pools sitting next to USB sticks sitting next to blowtorches, and so for the warehouse workers, the process of picking items becomes completely reliant on technology which tells them where to go. Our world is increasingly being designed not with humans in mind, but rather machines. As Etchells puts it, “technology malforms the space, and then you end up having to live in it.” Initially, Forced Entertainment tried their best to live in the world of machines: “I was in the it’s-got-to-be-perfect school of lip-sync,” says Etchells. But with their aesthetic being so tied to the failing act, the slipping mask, the shoddy costume, “it’s no surprise really that that didn’t last.” Instead, the performers got to enjoy being late for a line, or playing games with each other, “stealing” each other’s voices. Etchells compares it to the principles of ventriloquism, in which a free-floating voice unattached to a body is fundamentally discomforting and “sort of traumatic”. That discomfort is equally as alluring to Forced Entertainment as the satisfaction of precision, the pretence of authenticity only interesting if shown to be a pretence. Lip-sync has also opened up new avenues for the company. Having been allergic all their lives to Plays-with-a-capital-P, with Cold Sweat Forced Entertainment find themselves approaching something a little bit like drama. Rather than the presentational arena of Signal to Noise’s open white stage, Cold Sweat places us more decisively in a “fictional locale”: what appears to be “the aftermath of some disastrous party or backyard drinking binge” where three figures – family members, or neighbours, perhaps – are the last ones standing. “It’s all quite acrimonious and accusatory, everyone’s talking over each other.” For Etchells, this more fictional mode is “a door that we’ve never been able to open. We’ve just never really gone there.” Perhaps it is the technique of lip-syncing, an extra buffer of mediation, that allows them to venture away from the here-and-now without feeling that they have to commit to the “psychological claptrap” that comes along with acting; to be able to “play the game of theatre, without getting one’s hands too dirty.” As I wonder how else the impulses behind Forced Entertainment’s work have changed over time, it occurs to me that over the last ten years of new creations, with the exception of If All Else Fails, the company’s performers haven’t ever spoken on stage: there were two shows without any language at all, Out of Order and Under Bright Light, and then this trilogy of lip-sync works. Etchells agrees it’s a shift away from earlier productions, that were so often about “the actual voices of the performers and their actual presences. We had a lot of money, in some ways, on an authentic approach to what it might mean to speak on the stage.” But this sense of authentic presence itself had a fakeness to it; these days, Etchells can’t stand that mode of being onstage where performers “are here to be cheeky and witty versions of themselves. I don’t want to be charmed.” Pulling back into a more anonymous space has resulted in works that feel slightly sharper-edged, more brutal in a way. “All of these shows are post-Brexit, post-Trump, post-truth, post-everything,” Etchells notes. Speech, charisma, authenticity – these things feel politically loaded, and perhaps warmth and openness just don’t feel like the right tools to reflect the world we’re living in. “It feels like the space is closing down, and we’re trying to deal with the fact that the system, the structure that you’re in, is more oppressive and more powerful. It probably always was, but I think we’re just more tuned to it now.” Yet even without their voices, the performers’ distinctive presences – ones that many audiences have followed around for years, if not decades – still, inevitably, shine through as they physically navigate whatever unending task the system of the piece has set for them. They’re still trying to keep up with the onslaught of text, still running about, changing costumes, moving stuff around. The human is always stuck in the teeth of the machine, jamming the smooth, frictionless cheeriness of the not-real, gesticulating silently, trying desperately to communicate. Cold Sweat is at Sheffield Theatres, 2 to 3 October; Southbank Centre, London, 9 to 10 October; Lancaster Arts, 14 October [ ](https://exeuntmagazine.substack.com/p/exeunt-recommends-the-best-autumn-theatre-2026-lives-of-others-standard-of-living-our-friends-in-the-north-lanny-) [ Exeunt recommends... the best autumn theatre ](https://exeuntmagazine.substack.com/p/exeunt-recommends-the-best-autumn-theatre-2026-lives-of-others-standard-of-living-our-friends-in-the-north-lanny-) Exeunt · Sep 16 [ Read full story ](https://exeuntmagazine.substack.com/p/exeunt-recommends-the-best-autumn-theatre-2026-lives-of-others-standard-of-living-our-friends-in-the-north-lanny-) This piece was paid for by the Southbank Centre. Such support helps Exeunt to keep publishing the most interesting writing, about the most exciting theatre. Interested in partnering with Exeunt? Visit our Advertise with Exeunt page, where you can get more information, download an advertising pack, and find our contact details.
Juventus plans to sign €50m goalkeeper in the summer
Marco Carnesecchi has been on Juventus’ radar since he was on loan at Cremonese some years ago, and they are ready to make a significant investment to sign him at the end of this season.Luciano Spal...
Bromance Breakup? ‘Definitely Cut Jon Jones’
That wasn’t supposed to happen. UFC 331 featured one of the biggest upsets of all time, as Sean Sharaf scored the first win of his UFC career by starching Olympic gold medalist and Jon Jones’ protege Gable Steveson (watch here). In the literal first exchange of the fight, Sharaf caught Steveson pulling backwards with a […]
'Alarming' - does WSL have a homegrown problem?
The London City Lionesses raised eyebrows with no English players in their starting line up against Manchester United, but is there a wider trend?
Darius Slayton signs with the Indianapolis Colts
Former NY Giants WR Darius Slayton reunites with Daniel Jones.
Staff Takeaways: Fulham 1-1 Manchester United
Staff takeaways from Manchester United’s weekend draw with Fulham. Vince: United Are Lifeless Manchester United are playing with the energy level of a retirement home right now. There’s no spark, no pace, no urgency — honestly, there’s very little that resembles a team that actually wants to be out there. Everything feels slow and predictable, […]
Jon Jones Reveals Decision to Take Gable Steveson Backstage
UFC legend Jon Jones revealed it was his decision to take Gable Steveson backstage instead of waiting for Sean Sharaf’s hand to be raised. In the biggest upset in UFC history, according to the betting odds, Steveson was brutally knocked out as a -2500 betting favorite in just 12 seconds by Sharaf on the UFC […] The post Jon Jones Reveals Decision to Take Gable Steveson Backstage appeared first on HEAVY.
Trump claims his proposed triumphal arch will now double as a military complex with snipers and drones
Miami Dolphins sign defender from Buffalo Bills practice squad
Miami signs Andre Jones Jr. following defeat at San Francisco.
Original ‘Lioness’ star opens up about her shocking return in the season 3 finale: ‘I screamed’
The ‘Lioness’ actor behind the surprise cameo at the end of the season 3 finale is sharing the details of her shocking return.
Buffalo Bills Lose Linebacker To AFC East Rival
Miami poaches linebacker Andre Jones Jr. from Buffalo’s practice squad, securing a versatile special teams asset while leaving the Bills with a fresh vacancy to fill immediately.
Nicole Kidman urges fans to ‘demand’ a season 4 for ‘Lioness’: ‘We need loud voices’
Nicole Kidman weighs in on the shocking ‘Lioness’ season 3 finale and what might come next for the Paramount+ series.
Pirates' Paul Skenes Gets Honest About Big Mistake He Made
Pittsburgh Pirates star pitcher Paul Skenes spoke out honestly about a big mistake he made before this season.
Dodgers' Josue De Paula Gets Honest About Defense
The Los Angeles Dodgers called up Josue De Paula directly from Double-A earlier this year
New entertainment zones expand locations for to-go alcohol e...
Sacramento has expanded its entertainment-zone program to 11 areas, allowing participating businesses to sell to-go alcohol during approved special events in do...
Chris Jones has ‘two middle fingers’ for Harrison Butker doubters
Chris Jones calls out the haters after Harrison Butker makes the game winning FG in OT.
Small Business, Big Lessons® — That Old Time Rock & Roll or Blue Dot Fever?
This post builds on my Water Balloon Economics idea and adds a twist: knowing when it’s time to wrap up a “wonderful” career or business, recognizing your own limitations, and being honest about the experience you’re delivering.
Spencer Jones just made the Yankees’ October call harder
Spencer Jones went 1-for-4 with a homer in Saturday’s loss to Arizona, and the hit was not some isolated late-September […]
Got an Android Phone? Google Thinks You’ll Probably Want a Googlebook Laptop
Apple lovers have long enjoyed seamless connectivity between their iPhones and Macs. Now, Google’s bringing that experience to Android.
Ruben Amorim makes stark admission about his Manchester United stint
1 AC Milan boss Ruben Amorim has made an honest admission about his time in charge of Manchester United.Doomed stintIn January, United confirmed the sacking of Amorim after 14 months in charge.His fir...
Apple Siri settlement claims window now open. How to file for money
Some iPhone users may be eligible to claim money from a $250 million Apple settlement. Here's who's eligible and how to file.
Glacial risk zones identified in Nepal after flood
A flood on the Nepal-Tibet border highlighted glacial disaster risks in the Himalayas, High Mountain Asia and Peru, where expanding glacial lakes threaten nearby communities.
Trump says his planned arch would become a 'military complex'
It would be able to host drones and snipers while storing ammunition, the president said
Business Notes: Airports awarded millions in grants; renovated library reopens
View which organizations are landing grants and which businesses are celebrating milestones.
Northern Light Health Walk for Hope honors loved ones impacted by cancer
Participants of the fundraiser paid tribute to their loved ones through holding signs and sharing stories.
Is everyone Bricking their phones without you? The anti-FOMO (and anti-doomscroll) wellness craze
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
Some of China’s 11,000 mega bridges could be at risk from small drones: study
Chinese researchers simulated attacks on a typical suspension bridge and found a precisely targeted small strike could trigger collapse.
He's the one, Jurgen Klopp favourite will solve Liverpool's midfield
A Jurgen Klopp favourite is the man to solve Liverpool's midfield. Let's be honest, if you asked a Reds fan right now about where they would like further reinforcements in the current squad, they woul...
Med Center Health 10K runners pounded the pavement Saturday
The Med Center Health 10K Classic, in its 47th year, was run Saturday , Sept. 19, 2026, at the Bowling Green Ballpark. The event featured a 10K wheelchair race, 10K race, 5K race and the Children’s Classic Run. Titus Winders won the men’s overall title with Corbin Harris coming in second and Wayne Blas third. Purity Sanga won the women’s overall title with Daisy Jepkosgei second and Rachel Tinius third. Matthew Porterfield won the wheelchair race with Matt Davis coming in second. Aerelle Jones won with 10K female wheelchair race. The top three male 5K winners were, in order, Lucas Page, Jay Beckner and Logan Rose. The top three female 5K winners were, in order, Sarah-Emily Woodward, Anna Cline and Autumn Tandy. (Joe Imel/Daily News)
Culturally Relevant Cardiovascular Disease Prevention and Care Strategies
(Feature Impact) Driven by rising rates of obesity, diabetes, high blood pressure and other risk factors, cardiovascular disease has surpassed cancer as the leading cause of death among Hispanic adults in the United States. googletag.cmd.push(function() { googletag.display('fixed-big-ad-top-asset'); }); Hispanic people represent nearly 1 in 5 of the U.S. population and are the nation’s largest ethnic minority group, yet many continue to face barriers to achieving heart health and accessing high-quality healthcare. A new scientific statement published in the American Heart Association’s flagship journal, “Circulation,” revealed how social, economic, cultural and environmental factors contribute to persistent disparities in cardiovascular health, calling for culturally tailored prevention strategies, equitable access to care and greater representation of Hispanic populations in cardiovascular research.“Hispanic populations in the U.S. are incredibly diverse even within their own communities with differences in genetic ancestry, language, cultural traditions and social experiences that can significantly influence cardiovascular health,” said Johanna Contreras, M.D., M.Sc., FAHA, director of the Division of Heart Failure and medical director of the Hispanic Heart Center within the Mount Sinai Health System. “Yet Hispanic people remain underrepresented overall in the research that guides prevention and treatment strategies… Without better representation and more detailed data, we risk overlooking important differences that can help us improve care and save lives.”Hispanic Cardiovascular Health by the NumbersCardiovascular risk factors – obesity (nearly 46%), type 2 diabetes (15.5%) and high blood pressure (approximately 44%) – are prevalent among Hispanic adults and often emerge at younger ages and occur more frequently among Hispanic adults compared with white adults.According to the report, only about 1 in 5 Hispanic adults achieves ideal cardiovascular health as defined by the American Heart Association’s original Life’s Simple 7 metrics. Updated analyses using the Life’s Essential 8 framework demonstrated persistent disparities for heart and brain health, as well as suboptimal dietary quality, sleep patterns and levels of physical activity.Social and Economic Barriers MatterBiology alone does not explain cardiovascular health disparities. The environments where people live, work and age, along with social and economic challenges, impact heart health. In fact, approximately 17% of Hispanics live below the federal poverty threshold, compared with 8.2% of white adults. googletag.cmd.push(function() { googletag.display('fixed-big-ad-middle-asset'); }); “Many Hispanic adults face obstacles that extend far beyond the doctor’s office,” Contreras said. “Limited health insurance coverage, language differences, food insecurity, environmental exposures and concerns related to immigration status can make it more difficult to prevent disease, manage chronic conditions and receive timely treatment.”Contreras emphasized the cultural values and practices of Hispanic people also influence how they perceive their health and healthcare options.“Family plays a central role in many Hispanic communities and can be an extraordinary source of strength, support and resilience,” Contreras said. “At the same time, family members are often called upon to translate medical information, navigate health systems and help make healthcare decisions for loved ones. Those responsibilities can shape how health information is understood and acted upon.”An Action Plan for Improving Hispanic HealthThere are practical opportunities to achieve equitable cardiovascular health and reduce disparities through community engagement, culturally responsive care, inclusive research and policies that address the underlying drivers of health.“Reducing cardiovascular disease among Hispanic populations demands action at every level,” Contreras said, “from improving access to culturally responsive care and expanding research participation to addressing the social and environmental conditions that shape health.”By addressing both medical risk factors and the social conditions that shape health, experts believe there is an important opportunity to reduce disparities and help more people live longer, healthier lives. Learn more at Heart.org.Photo courtesy of Shutterstock googletag.cmd.push(function() { googletag.display('fixed-big-ad-bottom-asset'); });
Culturally Relevant Cardiovascular Disease Prevention and Care Strategies
(Feature Impact) Driven by rising rates of obesity, diabetes, high blood pressure and other risk factors, cardiovascular disease has surpassed cancer as the leading cause of death among Hispanic adults in the United States.Hispanic people represent nearly 1 in 5 of the U.S. population and are the nation’s largest ethnic minority group, yet many continue to face barriers to achieving heart health and accessing high-quality healthcare. A new scientific statement published in the American Heart Association’s flagship journal, “Circulation,” revealed how social, economic, cultural and environmental factors contribute to persistent disparities in cardiovascular health, calling for culturally tailored prevention strategies, equitable access to care and greater representation of Hispanic populations in cardiovascular research.“Hispanic populations in the U.S. are incredibly diverse even within their own communities with differences in genetic ancestry, language, cultural traditions and social experiences that can significantly influence cardiovascular health,” said Johanna Contreras, M.D., M.Sc., FAHA, director of the Division of Heart Failure and medical director of the Hispanic Heart Center within the Mount Sinai Health System. “Yet Hispanic people remain underrepresented overall in the research that guides prevention and treatment strategies… Without better representation and more detailed data, we risk overlooking important differences that can help us improve care and save lives.”Hispanic Cardiovascular Health by the NumbersCardiovascular risk factors – obesity (nearly 46%), type 2 diabetes (15.5%) and high blood pressure (approximately 44%) – are prevalent among Hispanic adults and often emerge at younger ages and occur more frequently among Hispanic adults compared with white adults.According to the report, only about 1 in 5 Hispanic adults achieves ideal cardiovascular health as defined by the American Heart Association’s original Life’s Simple 7 metrics. Updated analyses using the Life’s Essential 8 framework demonstrated persistent disparities for heart and brain health, as well as suboptimal dietary quality, sleep patterns and levels of physical activity.Social and Economic Barriers MatterBiology alone does not explain cardiovascular health disparities. The environments where people live, work and age, along with social and economic challenges, impact heart health. In fact, approximately 17% of Hispanics live below the federal poverty threshold, compared with 8.2% of white adults.#placement_976606_0_i{width:100%;max-width:550px;margin:0 auto;}var rnd = window.rnd || Math.floor(Math.random()*10e6);var pid976606 = window.pid976606 || rnd;var plc976606 = window.plc976606 || 0;var abkw = window.abkw || '';var absrc = 'https://ads.empowerlocal.co/adserve/;ID=181918;size=0x0;setID=976606;type=js;sw='+screen.width+';sh='+screen.height+';spr='+window.devicePixelRatio+';kw='+abkw+';pid='+pid976606+';place='+(plc976606++)+';rnd='+rnd+';click=CLICK_MACRO_PLACEHOLDER';var _absrc = absrc.split("type=js"); absrc = _absrc[0] + 'type=js;referrer=' + encodeURIComponent(document.location.href) + _absrc[1];document.write('');“Many Hispanic adults face obstacles that extend far beyond the doctor’s office,” Contreras said. “Limited health insurance coverage, language differences, food insecurity, environmental exposures and concerns related to immigration status can make it more difficult to prevent disease, manage chronic conditions and receive timely treatment.”Contreras emphasized the cultural values and practices of Hispanic people also influence how they perceive their health and healthcare options.“Family plays a central role in many Hispanic communities and can be an extraordinary source of strength, support and resilience,” Contreras said. “At the same time, family members are often called upon to translate medical information, navigate health systems and help make healthcare decisions for loved ones. Those responsibilities can shape how health information is understood and acted upon.”An Action Plan for Improving Hispanic HealthThere are practical opportunities to achieve equitable cardiovascular health and reduce disparities through community engagement, culturally responsive care, inclusive research and policies that address the underlying drivers of health.“Reducing cardiovascular disease among Hispanic populations demands action at every level,” Contreras said, “from improving access to culturally responsive care and expanding research participation to addressing the social and environmental conditions that shape health.”By addressing both medical risk factors and the social conditions that shape health, experts believe there is an important opportunity to reduce disparities and help more people live longer, healthier lives. Learn more at Heart.org.Photo courtesy of Shutterstock
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She's still a blonde beauty!
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She's still a blonde beauty!
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A total of 73 new confirmed cases of Ebola Virus Disease (EVD) were reported on September 18, 2026, including 25 community deaths. Of these confirmed cases, 46 were from Ituri province, 18 from North Kivu, 6 from Haut-Uélé, and 3 from Tshopo. A new health zone, Dungu, in Haut-Uélé province, was affected during the day. As this zone borders South Sudan, strengthening cross-border surveillance is necessary. During the day on September 18, 2026, 12 deaths within Ebola Treatment Centers (ETCs)—10 in Ituri and 2 in North Kivu—were unfortunately recorded, bringing the total number of deaths for the day to 37. However, 41 patients were declared recovered (30 in Ituri, 6 in Haut-Uélé, 3 in North Kivu, and 2 in Tshopo) after testing negative for EVD twice. Since the start of the epidemic in the Democratic Republic of the Congo (DRC), a cumulative total of 7,614 confirmed cases, including 3,676 deaths, has been recorded, representing a case fatality rate of 48.3%. The epicenter remains Ituri province, which accounts for 77.2% of the confirmed cases reported across the seven affected provinces and also accounts for 63.0% of the new confirmed cases. A new health zone was affected on September 18, 2026. Consequently, 63 out of 167 health zones (37.7%) across 7 provinces are affected. Subscribe to Outbreak News TV on YouTube Response measures feature 97% traveler screening at entry points, surveillance expansion to new area Dungu, and community outreach sensitizing over 110,000 people in one day. The Democratic Republic of the Congo’s health system faces deep, structural constraints that predate the current Ebola outbreak and make epidemic response far harder. These problems are most acute in rural areas and the conflict-affected east. Outbreak News Today is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe Eastern provinces have seen health facilities damaged, looted, or abandoned. Insecurity delays patients, blocks supply deliveries, and exposes staff to attacks. Millions of displaced people live in camps with poor water, sanitation, and health services, increasing outbreak risk. Vast distances and poor roads mean many people walk hours or days to reach care. These same weaknesses explain why Ebola has continued to spread into new, under-prepared health zones even as some original hotspots show improvement: surveillance, laboratory turnaround, contact tracing, and infection control remain thin outside the best-supported sites. The Ministry of Health and partners have scaled up treatment centres, laboratories, and vaccination in the current outbreak, and some digital surveillance systems (DHIS2) provide a useful backbone. However, the underlying gaps in staffing, basic infrastructure, reliable funding, and logistics have not been closed. Without sustained investment in those foundations, the system will remain vulnerable to both routine disease burden and the next large outbreak. If you like the reporting on Outbreak News Today, please consider a paid subscription for $5/month or $30 a year. Help support the cause of this niche journalism. It is appreciated.
Dre’Mont Jones exits Patriots vs. Steelers with shoulder injury
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First pediatric medical-behavioral Health Unit opens, Deaconess partners with Evansville Fire Dept
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President Donald Trump says the massive arch he wants to build between the Lincoln Memorial and Arlington National Cemetery would become a “top grade military complex” able to host drones and snipers while storing ammunition | Newsradio 1140 WRVA
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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
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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. 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