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Digging Deeper Into Liverpool’s 1-0 Victory Over Bournemouth
The Reds did what they needed for Iraola’s return to his former club to be a happy one.
James Trafford's free-kick flashback and Crystal Palace assessment
James Trafford had a brief flashback to a previous Yéremy Pino free-kick as the Crystal Palace man shaped to shoot in the second half of Sunday's 0-0 draw.Pino found the net against Trafford's former...
Gyokeres Sweden call-up a chance to build some confidence
Photo by Carl Recine/Getty ImagesViktor Gyokeres has been called up by Sweden, with four internationals offering him the chance to get minutes, goals and some confidence after a stop-start beginning t...
Detmers Joins Ohtani, Finley in Angels' 200-Strikeout Club
Reid Detmers became the first Angels pitcher since Shohei Ohtani and the first left-hander since Chuck Finley to reach 200 strikeouts in a season.
Live updates: Manchester United vs Fulham at Craven Cottage
Manchester United need to return to winning ways when they take on Fulham at Craven Cottage on Sunday.Michael Carrick is under pressure and only a win will do before heading into the international bre...
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.
Trump says his proposed arch will include a military complex housing drones and snipers
The announcement marks the second time the president has tied a controversial construction project to national security.
Legendary Rock Band Drops Out of Louder Than Life Music Festival Due to Medical Emergency
The bassist could not perform.
Legendary Rock Band Drops Out of Louder Than Life Music Festival Due to Medical Emergency
The bassist could not perform.
Entertainment Stars Jeon Won-ju, Go Ji-yong, Han So-hee Spark Controversies
Entertainment Stars Jeon Won-ju, Go Ji-yong, Han So-hee Spark Controversies Weekly roundup includes fee disputes, backlash, custody battle, and verbal misstep
East Tennessee has more measles cases. Health officials won’t say where
East Tennessee measles cases tallied six last week, but the state’s health department isn’t disclosing which counties those with the virus live in.
Sports on TV/radio listings: Sept. 20
Where to watch and/or listen to today's sporting events that will be televised or broadcast on the radio.
Townsend run over by pitch roller in Thailand
Former England winger Andros Townsend jokes that playing Stoke away "wasn't so bad after all" following a bizarre incident before a game in Thailand.
Politics: U.S. Senate ag committee advances revised farm bill
A revised farm bill saw action last week after the U.S. Senate Committee on Agriculture passed it by a vote of 12-11, but the amount of true bipartisan support that
Kings fall to Golden Knights in the Empire Classic
Jackson Hallum scores twice in the Empire Classic as the Los Angeles Kings lose 4-2 to the Las Vegas Golden Knights Saturday night in Ontario. Andre Lee and Lane Pederson scored for the Kings, but it wasn’t enough for the Knights’ relentless offense.
Sean Sharaf Pulls Off Biggest Upset in UFC History
Heavyweight Sean Sharaf pulled off the biggest upset in UFC history when he knocked out Gable Steveson in just 12 seconds at UFC 331. Sharaf stormed across the cage and caught Steveson with a massive left hook that immediately knocked him out cold for the biggest win of his MMA career to date and the […] The post Sean Sharaf Pulls Off Biggest Upset in UFC History appeared first on HEAVY.
UFC 331 Post-Fight Press Conference Video
Watch the UFC 331 Post-Fight Press Conference video here.
AI 'warning shots' focus Beijing on national security risks
While AI researchers in the United States fret over out-of-control superintelligence wiping out humanity, Chinese policymakers have until now been more focused on immediate risks, from deepfakes to child safety.
Oregon State football vs. Montana live updates. Score, TV, streaming
Oregon State football hosts Montana at Reser Stadium in Corvallis. Follow along for live updates.
Chile's Bachelet quits race to be next UN chief
Michelle Bachelet, the former president of Chile, withdrew her candidacy for the position of United Nations secretary-general on Saturday, weeks after a straw poll showed her in second to last
Spain star drops out of squad for Nations League fixtures
Luis de la Fuente and the Spanish national team coaching staff have on Saturday been dealt a setback on the personnel front. This comes amid confirmation of Pedro Porro dropping out of La Roja’s lat...
Bucs' Special Teams Hire Already Paying Dividends
Special Teams Coordinator Danny Smith is looking to turn around a Tampa specialist group that has struggled over the past few seasons. In Week 1, it looked like he is on his way to doing so.
Czechs beat USA to qualify for Davis Cup finals
Jiri Lehecka downed Learner Tien in a deciding rubber as the Czech Republic stunned the United States 3-2 in Davis Cup qualifying for a second straight year, while South Korea
Business Tech News: 86% Of Solopreneurs Try AI Before Hiring
SurveyMonkey, Autodesk, Claude, QuickBooks and FreshBooks roll out new AI, security and support tools aimed at helping small businesses work smarter.
Trump says he’s creating an AI force and appointing a czar amid concerns over the rapidly developing technology
The announcement comes as researchers and industry leaders have called for a slowdown in the technology’s development, leading Trump to call the concerns a“hoax.”
Blaze win One-Day Cup in last-ball thriller
Emma Jones seals the Blaze's treble success with a dramatic last-ball boundary to win a thrilling One-Day Cup final and shatter Hampshire's hopes of silverware.
Sevilla vs Barcelona, La Liga: TV & Streaming, Live Thread
Join us for another Barcelona La Liga adventure!
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!
‘Not the most natural place for me’: The little-known Democrat central to Oregon’s political future
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Boston's Contreras has bruised right hand after hit by Jakob Junis pitch
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Bills QB Josh Allen Shares Personal News Before Lions Game
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Expert Explains Why He Got Yankees’ Ben Rice Wrong
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I Built a Company in One Of America’s Most Complex Industries. Here's Why Innovation Alone Won't Make You Successful.
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Joseph Karre pic.jpg
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Colts admit green-dot mistake, shift play-calling duties from FS Camryn Bynum to LB Akeem Gaither-Davis after disastrous season opener
2. Bundesliga Preview: Karlsruher SC vs. 1. FC Nürnberg
Nürnberg will hope to bolster their promotion hopes with three points from Karlsruhe just before the extended international break. The visitors have only dropped points once this season – the 2-2 d...
Alliant expands benefits team with M&A and workforce expertise
Two hires signal what employers now demand from their benefits advisers
Wynne business rebounds three years after tornado
The Cordial Cottage was destroyed in the tornado but now has a new home, along with other businesses on Murray Avenue, about a mile and a half from its original location on Falls Boulevard.
New $50 Polymarket invite code “CUSE” extended for MLB, Bills, and politics odds
The Polymarket promo code CUSE has been extended through this week for all markets—deposit $10, get a $50 bonus, and trade Mariners–Angels tonight.
As shortfall looms, Pillen installs allies on board meant to keep politics out of budget forecast
In an unprecedented move, Gov. Jim Pillen has reshaped the state board that predicts Nebraska’s tax revenues for budget writers, replacing three members with appointees that include two former Republi...
10 Years Later: The Amazing Jenna LaLonde Goes Viral
NEW YORK MILLS, N.Y. -- Ten years ago, the Amazing Jenna LaLonde, of NY Mills, had a wish.
Juwan Johnson sidelined with illness
Saints TE Juwan Johnson unable to practice because of illness
Scientists challenge US NIH grant screening as unconstitutional
A group of scientists filed a class-action lawsuit on Wednesday against the U.S. National Institutes of Health, alleging the agency is unconstitutionally screening research grants to suppress viewpoints the Trump administration disfavors on topics like diversity, gender identity and climate change.
Dartmouth Health CEO says patient care was focus in deciding layoffs
A day after Dartmouth Health and the UVM Health Network announced layoffs affecting hundreds of employees, the CEO of the region’s largest health care provider insists the cuts are unavoidable and will not harm patient care.
Hennepin County ends Operation Metro Surge business relief fund amid fraud concerns
Jeffrey Lunde, a Hennepin County commissioner, explains why the Small Business Recovery Fund was shut down after fraudulent applications.
Constitution Day reminder: Our democracy is not for sale to the highest bidder
The best way to mark Constitution Day, this Thursday, is to fight the influence of money and foreign influence in our politics through active active civic participation, writes Mike Pellittiere, who particularly calls on fellow veterans to step up.
Dodgers on Deck: Thursday, September 17 at Reds
Convenient scheduling brought the Dodgers and Reds together for seven times over 11 days in September, with the last of those contests coming during breakfast time on the west coast on Thursday. The Dodgers will run a bullpen game for the fourth and final game of the series at Great American Ball Park in Cincinnati, […]
Seahawks make final Sam Darnold decision ahead of Cardinals game
The Seattle Seahawks have made their final call about whether Sam Darnold will hit the field for the team in Week 2.
49ers Sign Former Pro Bowl Wide Receiver to Active Roster
With injuries piling up at the wide receiver position, the San Francisco 49ers have decided to sign this former Pro Bowler to their active roster. The post 49ers Sign Former Pro Bowl Wide Receiver to Active Roster appeared first on HEAVY.
No matter how deranged and delusional your podcast is, Liz Truss can go further
In the Trusster’s latest appearance, she says Blair and Brown had a plot to dismantle civilisation and the Tories were part of the woke establishment
Northwest Colorado Health reports $230K loss in financial fraud scheme
Northwest Colorado Health lost approximately $230,000 this summer from fraudulent account transactions, with CEO Steph Einfeld describing the organization as the “victim of a sophisticated crime” involving the impersonation of one of the nonprofit’s financial...