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Tigers Led MLB in Extreme Scoring Games
Detroit’s feast-or-famine offense defined a frustrating season, oscillating between shut-down scoring droughts and explosive outbursts that left no middle ground for a team desperate for consistency.
Amazon Just Restocked the Rare Pokémon TCG Destined Rivals Elite Trainer Box for Under Market Price in the Prime Day Sale — Here Is Why Collectors Are Grabbing It Fast
Amazon has restocked the rare Pokémon TCG Destined Rivals Elite Trainer Box for under market price in the Prime Day sales. But, stock is extremely limited.
Argonne Uses AI Agents to Get Closer to Self-Driving Microscopes
Scientists often wait months to get their hands on some of the world’s most powerful research instruments, such as state-of-the-art microscopes. At facilities like Argonne National Laboratory’s Advanced Photon Source, these machines allow researchers to use extremely bright X-rays to study materials at microscopic scales. Once they get access to such instruments, every hour counts. […]
Webb finds a surprising atmosphere on a scorching lava world
The James Webb Space Telescope has found strong evidence that the rocky lava world HD 3167 b has an atmosphere, despite circling its star every 24 hours under extreme heat. The surprising discovery could help scientists understand how rocky planets retain atmospheres and what the young, molten Earth may once have looked like.
Scientists Create Hexagonal Packed Ice At Extreme Pressures
One of the problems with planetary science is that you generally cannot easily investigate the exact conditions in their interior, so you’re left to extrapolate what is happening inside them …
Extreme Heat Is Making Pregnancy More Dangerous For Mothers And Newborns
Nearly three in four maternal healthcare workers say extreme heat-related complications among pregnant women have increased over the past five years,
Opinion: El Paso women cannot underestimate the danger in Texas’ extreme reproductive policies
After experiencing miscarriages in El Paso and Ciudad Juárez, Rebecca Guerrero reflects on why she felt better supported across the border and urges Texans to vote for reproductive health protections.
URI astrophysics student earns coveted Association for Computing Machinery’s SIGHPC fellowship
KINGSTON, R.I. – Oct. 6, 2026 – Ever since she was young, Genevieve Payne has always had a deep interest in nature and understanding hidden systems and patterns within it, hoping to one day study some of the universe’s most extreme and least-understood phenomena. This interest developed into a focus on gravitational wave and high-energy […]
Global Heat Forum seeks to galvanize action and investment
BANGKOK – The first Global Heat Forum opened today to unlock finance and supercharge solutions on extreme heat, amid record-breaking temperatures and an intensifying El Niño. The four-day event in Bangkok takes place as the Thai capital recovers from devastating rainfall and deadly floods.
New Editorial Calls for Investing in Hospital Nursing Workforce to Address Health Impacts of Extreme Heat
Hospitals should make nurse staffing and supportive nurse work environments a core part of extreme heat emergency preparedness, according to a new editorial from Penn Nursing’s Center for Health Outcomes and Policy Research (CHOPR), as record-breaking temperatures and heat-related emergency department visits continue to rise across the United States. The editorial appears in Public Health Nursing.
Tributes to Justice Melissa Hart
It was an extremely busy few weeks in court-related news, but the biggest and most unexpected development was the death of former state Supreme Court Justice Melissa Hart.
Kings HC Christie 'Really Enjoying' FA Signing Simmons
The Sacramento Kings are hoping free agent pickup Ben Simmons can get back to a semblance of his old self, while giving the team a much-needed boost on the defensive end. Head coach Doug Christie has been extremely positive regarding Simmons, calling him a "special" player.
You should care about politics
Ever since America’s founding, the United States has been extremely politically charged. From the civil war in the 1860s, to the civil rights movements of the 1950s, America has always had politics at the root of economic, social and institutional change. So then why do Americans care so little about it? In 2024, about 63.9...
HEALTH AND FITNESS: Celebrate Walktober by going for a walk
Now that the extreme heat of our seemingly endless summer weather is behind us, being active outdoors is more enjoyable. October is a great time to get outdoors and go for a walk! That is the spirit of Walktober, an initiative adopted by health organizations, companies and communities around the globe.
WHO joins Pre-COP31 to advance climate action that delivers for people’s health
The World Health Organization (WHO) is joining Pacific leaders, governments and partners at Pre-COP31 in Fiji from 5 to 8 October to advance health priorities in climate action and strengthen the Pacific voice ahead of the 31st Conference of the Parties (COP31) to the United Nations Framework Convention on Climate Change (UNFCCC).COP31, to be held next month in Antalya, Türkiye, marks an important step for global climate and health action. Health is one of the 10 priority themes of the COP31 Action Agenda, “Dynamic and Resilient Health Systems”, and a dedicated Health Day will take place on 9 November, the first day of COP31. The inclusion of health reflects growing global recognition that climate action and health are closely connected. The climate crisis is affecting population health globally. Across the WHO Western Pacific Region, which includes Pacific island countries and areas, the consequences of climate change include extreme heat, cyclones, floods, rising sea levels, food and water insecurity, infectious diseases and disruptions to essential health services. The Pacific in particular faces additional challenges. A recent review of 76 hospitals in 14 Pacific island countries found that 62% of health facilities are located within 500 metres of the sea or a river, leaving them particularly exposed to flooding, storm surges and sea-level rise.Bringing Pacific priorities to the global climate agendaThe Pacific Pre-COP31 provides an important opportunity for Pacific countries and partners to consolidate regional priorities and bring the experiences and leadership of Pacific communities into global climate discussions.Pacific countries have been advancing practical approaches to protect health in a changing climate, including strengthening climate-resilient health systems, improving preparedness for extreme weather events, building resilient health infrastructure and mobilizing climate finance for health. “This Pre-COP is an important moment for the Pacific, bringing global climate discussions to a region that has long been at the forefront of the climate crisis. It provides an opportunity for Pacific countries and areas to set their priorities, experiences and leadership on the global stage, and to ensure that the realities of Pacific communities are genuinely reflected in the decisions made on climate action,” said Dr Saia Ma’u Piukala, WHO Regional Director for the Western Pacific.Throughout this week, WHO will co-convene and participate in high-level discussions and events focused on climate and health, climate resilience, adaptation, financing and implementation. “Climate finance is essential for resilient and healthy Pacific communities,” emphasized Dr Mark Jacobs, WHO Representative to the South Pacific and Director of Pacific Technical Support. “We must ensure that financing reaches the people, communities and essential services most exposed to climate risks, supporting locally defined priorities and investments.”WHO will work with partners to strengthen the integration of health considerations across climate policies and investments, including national climate plans and resilience initiatives.Health as a driver of climate actionAmid the risks to health and pressures on health systems, well-strategized and implemented climate action can deliver significant health benefits. Investments in clean energy, sustainable transport, resilient infrastructure, food systems and nature-based solutions have proven to reduce health risks while contributing to climate mitigation and adaptation.“Climate action is truly an investment in health. Cleaner energy, healthier food systems and climate-resilient health services can protect lives while building stronger communities. We now need to turn these opportunities into action and make health a core part of climate investments,” said Dr Sandro Demaio, Director and Head of Office, WHO Asia-Pacific Centre for Environment and Health in the Western Pacific Region. “These benefits demonstrate that climate action is not only about reducing future risks. It is also an opportunity to improve lives today while building healthier, safer and more resilient societies.”At COP31 next month, WHO will also support the Health Pavilion, which will bring together the global health community and partners to advance health and equity within climate negotiations. With COP31 poised to move health higher on the global climate agenda, WHO will continue working with countries and partners across the Western Pacific Region and globally to strengthen climate-resilient and low-carbon health systems, and ensure that climate action protects and improves people’s health.____________________Media contactsElizabeth Bennett, WHO Asia-Pacific Centre for Environment and Health in the Western Pacific Region, elizabeth.bennett@who.intJulia Dongwhan Shin, WHO Asia-Pacific Centre for Environment and Health in the Western Pacific Region, dong.shin@who.intWHO Western Pacific Communications, wprocom@who.int
Some Democrats, Scarred by 2024, Take a Harder Line on Trans Athletes
Democrats competing in historically conservative territory in the midterms are more aggressively responding to Republican attacks casting them as extreme.
New Research Strengthens the Link Between Warming and Extreme Weather
A growing body of attribution research shows that human-caused warming is increasing the likelihood or severity of many extreme weather events.
Weather extremes could raise costs and reshape decisions for Indiana businesses
By Sam Stall | Indianapolis Business Journal
Scientists recreate Enceladus’s ocean and watch Earth microbes thrive
Water-rock chemistry helped methane-producing microbes survive extreme alkaline conditions modeled on Enceladus’s hidden ocean.
Democratic mayors in red states launch new group to counter MAGA and far-left extremes
Cleveland Mayor Bibb will lead Blue Cities/Red States, launching next week.
Exynos 2700 Enters Mass Production, Claims Tipster, 10% Higher Volume Than Exynos 2600 & 10% Higher Multi-Core Performance Than Snapdragon 8 Elite Extreme Gen 6
Exynos 2700 is reportedly in mass production, a tipster claims, with 10% higher volume than Exynos 2600 and 10% faster multi-core speeds than Snapdragon
Extreme Heat Warning Health Alert Issued for Santa Barbara County
A long-duration heat wave is forecast to bring dangerously hot weather this Friday through next Thursday.
Santa Barbara County Health Department Issues Health Alert Due to Extreme Heat Warning
High temperatures anticipated for parts of Santa Barbara County.
Composition of Extreme Debris Disks Across Time
By investigating the compositions of extreme debris disks, scientists inferred that silica-rich disks are produced by high-energy impacts of Mars-sized objects, while silica-poor disks are created by less energetic events from Moon-sized bodies.
90 Ideas in 90 Minutes: Eileen Wixted
High performing team: You belong In work and in life, you will likely find yourself on a committee or team. And there has been significant study and research on why some teams fail and others perform extremely well. According to Harvard business professor and researcher Amy Edmondson, the answer is psychological safety. Team members who…
September Monthly Review: Health MCP Guy?
For all the time I spend talking about APIs and data exchange, this newsletter has had embarrassingly little interoperability of its own. It’s old-school SaaS, baby - UI or bust. Not all of that is my fault! Substack, for all its popularity, is (as mentioned before) really frustrating as my system of record. The primary user it optimizes towards is the reader, whose attention feeds the app, the Notes feed, and the recommendation network that Substack is actually selling. Health API Guy is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe They’re falling into the same trap that Medium once sprinted into, albeit at a much more glacial speed. Younger generations may not remember (or never knew) it, but Medium once lured publications like The Ringer and Signal v. Noise onto its platform, only to lose them as it rebuilt itself around a paywall and an algorithmic feed. Substack’s original pitch circa 2020 was the antidote (you own your list), but every new feed feature chips away at it. I get it: writers are generic supply in the eyes of the Substack product team. Generic supply follows demand, so the consistent pressure on the PMs is to generate demand, which leads to every product cycle going toward discovery (Notes, recommendations, the app, live video). The end result lackluster author tools (laggy and broken analytics are truly crippling) all despite the premium price point. The archive is where it crosses from authorial gripes to actual reader impact, though. Across Substack and LinkedIn, I’ve published 1,218 posts and nearly 900,000 words since 2018. Substack’s native search can see only the 464 posts that live on Substack, and even there it’s woefully inadequate at surfacing relevant content (even for the guy who wrote it)! Readers have the same problem, writ large. Ask the Archive Fixing search (for both my readers and my own use) turned out to be extremely non-trivial, unfortunately: There’s no public API for readers to access content RSS exists for new content notification, but it only carries the 20 most recent posts and cuts paid ones off at the preview The only Substack MCP is an admin tool for analytics The export exists for authors, but it’s painfully awkward and slow. So I built something to work around that: the Health API Guy MCP. It’s a private MCP server holding the full text of everything I’ve written across Substack and LinkedIn. Add it to Claude or ChatGPT as a connector and you can ask things like: It pairs keyword search (for acronyms and case names, of which we have many) with semantic search. Every post is also labeled by topic, form, and court case, so you can pull a lawsuit’s (or multiple cases’) entire docket across Substack and LinkedIn in one query: Hail, Healthapiguyhydra This is also a bit of me eating my own cooking. I’ve spent the year arguing that headless healthcare is arriving and that developers want primitives over abstractions. Last week in Hail, Benihydra, I watched Salesforce plug its platform into Claude and bet that the records underneath outlive whatever interface sits on top: Salesforce must believe that the Hydra’s immortal head is the records, permissions, and business logic (in that they will survive whatever happens to the interface). It felt a bit hypocritical to keep my own archive behind a Substack search bar. The archive is the body. Substack is one head, and now whatever tool you might use is another. Will the EHRs follow my lead? Probably not imminently, but one can hope! Why Founding Members Only The MCP is available to Founding Member subscribers. A few reasons: It costs money and time to run. Hosting, the database, Clerk usage and AI compute for search and labeling are significant operational costs (that increase with usage). Substack gives me no way to automate access. There’s no API to check whether someone is a paid subscriber, so every user is manual operations for now. It’s a beta. We’ll need to improve things and parts will break. I’d rather they break for a small group of dedicated readers who will tell me about it. The Founding tier deserved a real benefit. Until now it was mostly a generous tip. Now it comes with something. If you’re already a Founding Member, reply to this email with the address you’d like provisioned. If you’re not and want in, upgrade here. Larger teams (such as companies) can get access too: group subscriptions at the Founding tier come with the group discount. The admin for the subscription can reply with the list of addresses to provision. Get 20% off a group subscription Pricing Founding membership is now a flat $200 a year, replacing the old suggested $150 that readers could adjust. Existing Founding Members will have access grandfathered in at their previous rate. Month in Review Articles Published Make Networks Dumb Again (Sep 11): AI is making old analog networks cheaper to use and flooding them with machine traffic in the process. A plea for agent-native rails with the intelligence at the endpoints, and for Washington to drag them to ubiquity. Interoperability, Unbuttoned (Sep 29): Interoperability is a series of workflows in a trenchcoat, and this post finally takes the trenchcoat off. A color-coded map shows which provider workflows went digital, which are fragmented, and which still run on fax. Video Content Antitrust’s System of Record Problem (Sep 3): The FTC’s investigation into Epic prompted a ninety-minute webinar, now posted with chapters and a smoothed transcript. We get into why market definition, missing B2B share data, and the SSNIP test leave antitrust poorly suited to systems of record, plus why information blocking may be doing more than any pending lawsuit. The Information Exchange: Cerner Milking Edition (Sep 18): This was so fucking fun. Ryan Tucker, Ryan Brickner, Brad Thorson, and I try an Around the Horn format, complete with points, penalties, and a mute button. We debate whether Oracle Health is dead, who would actually buy Cerner (IBM enters the chat), p(Doom), and why the front desk still hands you a clipboard. Regulatory Ask Not What Your Network Can Do (Sep 23): CDC’s RFI on public health data intermediaries lists use cases already served, unevenly, by eCR, lab reporting, IZ Gateway, and syndromic surveillance. The real opportunity sits in one question about AI: a network that can handle the next emergency without another interface project. Court cases Particle v. Epic: The Naughty Schoolteacher (Sep 4): After a summer-long vigil, the answer on Epic’s early summary judgment bid is two paragraphs and a remedial assignment. Particle advances to the next grade, and market definition gets another year of discovery. The Epic Discovery Files (Sep 8): Texas’s motions to compel arrive with a 251-page appendix of requests, objections, and meet-and-confer letters with Cravath. Inside: Epic using generative AI for document review, denied interoperability requests in scope, and Noerr-Pennington raised against lobbying discovery. Epic v. Health Gorilla: “Working as Designed” (Sep 9): Epic wants nothing to do with the data breach MDL, and explaining why puts fresh discovery on the public docket. The spiciest allegation: Health Gorilla told GuardDog to scrub its law firm business from its website instead of cutting off access. Veeva v. Epic: Legal Bypass Surgery (Sep 15): Veeva asks the Wisconsin Supreme Court to skip the Court of Appeals, while law professors and three policy groups line up as amici. Meanwhile, Epic’s lawyers apologize for another round of citation errors, including a quote that never existed. Texas v. Epic: Behind the Black Bars (Sep 17): The court portal served up Epic’s unredacted filings, revealing a $5 million document review budget and the AI workflow behind it. Also inside: the 200-plus company names Texas wants searched, and one very expensive Zoom invitation. OpenEvidence v. Doximity: Consequences Will Follow (Sep 25): OpenEvidence tells the court it will not comply with a discovery order, and its own lawyers at Quinn Emanuel say they won’t defend the choice. Add years of Slack reported unrecoverable, and Rule 37 sanctions come into view. Health Tech Keeps Choosing Violence (Sep 28): Doximity moves to end OpenEvidence’s case, Epic asks Texas to show its work, and a sleepy Audacious Inquiry patent fight sprouts antitrust and information blocking counterclaims. The main event is a long-sealed Cognizant v. Infosys ruling that hints where system of record antitrust claims can survive. EHRs One Verb for Oracle Health (Sep 14): Oracle’s earnings call quantifies every data center to the decimal point, while Oracle Health gets a single verb: “accelerate.” Panning the few healthcare mentions turns up an agentic care management system, a research-to-care ledger play, and the question of whether healthcare gets Larry’s patience. Epic’s Forretress Under Siege (Sep 30): Judy Faulkner tells a panel Epic paused hundreds of projects to harden its software and calls it a “shame,” while a spokesperson insists the roadmap hasn’t changed. Project Glasswing, a Pokémon-branded QAN sprint, and a trove of Jodel grievances reconcile the two Epics and preview the Jevons paradox coming for all software. Industry Analysis Scanning for a Network (Sep 1): Scan.com raises $220M to build the imaging network labs never got, speedrunning Zocdoc’s consumer-to-B2B pivot. Its wedge to network density may be the most American one available: personal injury litigation. The Front Desk Wants the Damn Whole Building (Sep 16): Hello Patient buys Converse Health, pushing its AI front desk into referrals, chart work, and prior auth. The copilot categories keep blurring, and your distribution partner is still your final boss. Cross-industry Comparisons A Different Patchwork Quilt (Sep 10): Healthcare loves to envy open banking, but the US version has no mandate, a toll booth at Chase, and data quality problems of its own. The grass isn’t greener; it’s another American patchwork quilt, and perhaps a worse one. Hail, Benihydra (Sep 21): Salesforce brings its platform into Claude, Slack, and its own agent, inviting the interfaces that might replace it. Cut off one head and more grow back, so long as the records underneath stay put. Living on A Trade Secret Prayer (Sep 22): Six credit unions are suing Fiserv, the Epic of core banking, by claiming their own member records as trade secrets. Banking has no Cures Act, so its lawyers reach for legal alchemy that healthcare has already tried. Other News None this month External Media Nabla Accelerate NYC: I kicked off fall conference season at Nabla’s Accelerate event in New York, where Delphine Groll opened by asking the room to picture the company it wants to become and the one it doesn’t. I liked her framework of bureaucracy, fear, and ego as the blockers. I also love vendor conferences/events in general - different vibe than industry biggies. Healthcare 101 with Nikhil Krishnan: I briefly guest lectured Out-Of-Pocket’s Healthcare 101 class. Appreciated Nikhil’s takeaways cover whether AI doctors can query HIEs, why healthcare’s data-liberation rules beat most industries’, and the hi-res graphic is in the comments. HCN: Epic Probed by the FTC: I joined the HCN guys to talk through the FTC’s investigation into Epic. Cedric’s new hairdo was an unexpected plot twist. The episode also covers MFN drug pricing, healthcare M&A and Eli Lilly’s acquisition streak. Fall Conferences: At eHealth Exchange’s Annual Meeting in Austin on Oct 27, I’ll moderate a panel on the tensions between AI, HIEs, and timely patient access with Jean Ross (Primary Record), Therasa Bell (Kno2), Byron Crowe (Doctronic), and Michael Marchant (Freenome). Here’s the rest of my schedule if you want to meet up: CommonWell (Redwood Shores, CA): Oct 13-14 Will be participating in a fun Jeopardy event Open@Epic (Madison, WI): Oct 20-23 Will be enjoying Verona, Willy Street, and other local adventures eHealth Exchange and Sequoia Project (Austin, TX): Oct 27-29 Yeehaw HLTH (Vegas): Nov 15-18 Groundhog Day, Venetian Edition RSNA (Chicago): Nov 30-Dec 2 See me at “Governing AI in Breast Imaging: What Health Systems Are Actually Doing” Digital Health Counsel 2026 AI Summit (Seattle): December 2-3 Will likely be speaking to a bunch of lawyers about information blocking Posts I Liked ChatGPT’s Epic integration: game changer or nothing burger?: Joshua Liu, MD offers five thoughts on OpenAI’s Epic launch, starting from the point that it rides the same open APIs available to anyone. He argues read-only access leaves ordering to Art and the ambient startups, and asks why HCA is piloting it alongside Commure. He’s sorta a must-follow at this point - consistently excellent, thought-provoking takes. Epic, Lilly, and the Discovery pass: Seth Chaney reads Epic’s first major Discovery deal (with Eli Lilly), as well as its revised developer terms on commercial displays, as the pipe finally opening between EHRs and pharma. Life sciences and health continue to collide. Scott Rossignol on EHR payer platforms and ePA fees: Scott argues the top ambulatory EHR vendors are turning the prior auth mandate into a per-member-per-year toll on payers, for an API whose operating cost has nothing to do with covered lives. His fix is two lines of regulatory text: put the CRD/DTR/PAS certification criteria in the Base EHR definition, and bring payer-facing ePA connectivity under § 170.404’s cost-based fee rules. It’s a good solution. Health API Guy is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe
Trump cuts to climate science leave us all vulnerable
The Island always feels vulnerable when extreme weather conditions like last weekend’s early-season nor’easter start heading our way. This time was no different, especially as forecasts became more and more dramatic and television meteorologists breathlessly updated viewers from windblown shorelines, reciting scripts filled with dire warnings about heavy rain, high winds, and coastal flooding. The […]
Chargers Named Potential Destination for Former All-Pro WR
The Los Angeles Chargers could use some help offensively.The unit has been extremely disappointing throughout the first three games of the 2026 season, averaging the fourth-lowest points per game in the NFL at 14.7. Adding a proven playmaker could go a long way in bolstering the Chargers’ offense.Los Angeles Chargers Named Potential Destination for Free […] The post Chargers Named Potential Destination for Former All-Pro WR appeared first on HEAVY.
Air Conditioning is Health Infrastructure
In 2023 alone, more than 2,300 people died in the United States directly from extreme heat. Expanding access to residential air conditioning could reduce heat-attributable deaths and adult emergency department.
A record-breaking X-ray flash may reveal the birth of a magnetar
Astronomers have found strong evidence that some mysterious, minutes-long X-ray flashes are produced when two neutron stars collide and create a magnetar. One record-setting event glowed in X-rays for nearly 10 minutes, potentially opening a new way to find these extreme cosmic mergers.
'Damning' and 'extreme' - Football Daily on Man City charges
"I think we have all started to understand the severity of this now," said former Premier League goalkeeper Paul Robinson on the latest episode of BBC Radio 5 Live's Football Daily. In the wake of the Premier League publishing their verdict on Manchester City's charges, Kelly Somers is joined by Robinson, BBC Sport's football issues correspondent Dale Johnson, football finance expert Kieran Maguire and BBC Radio 5 Live's senior football correspondent John Murray on Football Daily, as they break down the "damning statement".
Zygi Kamasa’s U.K. Film Distributor True Brit Entertainment Files for Administration Due to ‘Extremely Challenging Market Conditions’
True Brit Entertainment, the U.K. theatrical distributor that launched less than three years ago, has filed for administration, a British legal process similar to Chapter 11 bankruptcy. The company, w...
Asia’s boardrooms risk missing the biggest cost of climate change: human health
Extreme heat is already draining worker productivity across Asia.
WHO releases new guidance to prevent heat-related illness at mass gatherings
To help host countries and event organizers better anticipate and manage heat-related health risks, WHO is releasing a new set of resources under the title Prevention and management of heat-related illness at mass gatherings, building on evidence synthesized through systematic reviews and lessons learned from mass gathering events worldwide.
Newly discovered iron minerals might hold primordial water from when Earth formed
Researchers may have found a missing link in how Earth's mantle gets wet: newly discovered iron minerals that can store water at the extremely high temperatures and pressures present near our planet's core.
Extreme sports exhibit at the Orlando Science Center
A new exhibit at the Orlando Science Center explores the psychology and science behind extreme sports. At Extreme Sports: Beyond Human Limits visitors can test their mental and physical skills through different activities. FOX 35's David Martin has all the details.
Ending extreme poverty may cost less than you think
Targeted cash transfers totaling just 0.3% of global GDP could reduce global extreme poverty to about 1%, according to new research.
‘Powerful and beautiful’: Here’s why we all need body fat
From releasing hormones to regulating our temperature, fat has myriad roles in the body. Here’s how much you need and why chasing extreme fat-loss goals is unhealthy.
‘Powerful and beautiful’: Here’s why we all need body fat
From releasing hormones to regulating our temperature, fat has myriad roles in the body. Here’s how much you need and why chasing extreme fat-loss goals is unhealthy.
Health board declares critical incident over 'extreme' A&E pressure
NHS Grampian say A&E and care services in Aberdeen and Elgin are under significant strain ahead of a local holiday.
Health board declares critical incident over 'extreme' A&E pressure
NHS Grampian say A&E and care services in Aberdeen and Elgin are under significant strain ahead of a local holiday.
Orlando Science Center opens Extreme Sports: Beyond Human Limits exhibit
Orlando Science Center opens its Extreme Sports: Beyond Human Limits exhibit today, featuring interactive activities.
Beyond the Damage: The Trauma that Lingers after the Storm
Mental health concerns can arise during extreme events and even years later.
Beyond the Damage: The Trauma that Lingers after the Storm
Mental health concerns can arise during extreme events and even years later.
Xiaomi 18 Pro vs. Xiaomi 18 Pro Max: Video shows big difference between the two Leica main cameras
There are obvious and less obvious differences between the two new Leica camera flagships based on the 2 nm Snapdragon 8 Elite Gen 6 and Snapdragon 8 Elite Extreme Gen 6 chipsets. The difference between their main camera sensors is far from transparent, but it makes a major difference in daily life, as a comparison video demonstrates.
Quantum computer simulates matter “popping into existence”
Scientists recreated a particle-forming process linked to the extreme physics of the early universe using a 13-ion quantum simulator. The breakthrough suggests quantum computers could eventually help researchers investigate how matter formed and evolved after the Big Bang.
3 ways the Snapdragon 8 Elite Gen 6 is actually worse than last year’s chip
The Snapdragon 8 Elite Gen 6 cuts key features found on last year's Gen 5 chip. Is Qualcomm's new flagship processor a hidden downgrade?
‘War’ review: HBO legal drama is a delicious dive into the muck
The eight-episode series, premiering Oct. 1 on HBO Max, focuses on the tense legal battle behind an extremely high-profile and nasty divorce.
(LKL) ROCKET FUEL FOR STORMS: THE SCIENCE BEHIND EL NINO
Hurricane Polo weakened to a strong Category 4 off Mexico’s Pacific coast after undergoing extreme rapid intensification and hitting rare Category 5 status on Tuesday. Its rapid growth was due
(LKL) ROCKET FUEL FOR STORMS: THE SCIENCE BEHIND EL NINO
Hurricane Polo weakened to a strong Category 4 off Mexico’s Pacific coast after undergoing extreme rapid intensification and hitting rare Category 5 status on Tuesday. Its rapid growth was due
ROCKET FUEL FOR STORMS: THE SCIENCE BEHIND EL NINO
Hurricane Polo weakened to a strong Category 4 off Mexico’s Pacific coast after undergoing extreme rapid intensification and hitting rare Category 5 status on Tuesday. Its rapid growth was due
ROCKET FUEL FOR STORMS: THE SCIENCE BEHIND EL NINO
Hurricane Polo weakened to a strong Category 4 off Mexico’s Pacific coast after undergoing extreme rapid intensification and hitting rare Category 5 status on Tuesday. Its rapid growth was due
ROCKET FUEL FOR STORMS: THE SCIENCE BEHIND EL NINO
Hurricane Polo weakened to a strong Category 4 off Mexico’s Pacific coast after undergoing extreme rapid intensification and hitting rare Category 5 status on Tuesday. Its rapid growth was due
Measuring the toll of extreme heat on workers’ health | Harvard T.H. Chan School of Public Health
Researchers are working to quantify the impact of working in extreme heat and humidity in order to help identify interventions that make a difference.
Scientists warn record El Niño will bring deadly extreme heat
They predict that global land temperatures will be 2.1°F above normal in the coming months due to the current "Super El Niño" that began in June. The post Scientists warn record El Niño will bring dea...
From 15,000 to 185 to Zero: Trump’s Claims of Illegal Voting in Nevada Fizzle
It was the Trump administration’s latest stumble in its effort to find proof of widespread noncitizen voting, despite decades of evidence that it is extremely rare.
'Extreme concern': OpenAI agent hacked Australian public health website, prime minister says
An OpenAI agent "infiltrated" an Australian public health website earlier this summer, Prime Minister Anthony Albanese told reporters during a media briefing.
This year's El Niño just broke a record months before it's expected to peak
Daily sea surface temperatures in the region where El Niño develops are more extreme than at any point in recorded history.
Climate change is expanding extreme heat's threat to human health
I was 12 when the worst heat waves hit our home in rural New South Wales, Australia. It was summer vacation, a few weeks after we'd celebrated Christmas. I sat at the kitchen table, next to the sheets ...
Australian health website breach by OpenAI causes concern
Prime Minister Anthony Albanese said he was extremely concerned about OpenAI 's breach of an Australian health department website and that the company took too long to reveal the incident.
OpenAI’s breach of Australian health department website prompts rebuke
Australian Prime Minister Anthony Albanese said he expressed “Australia’s extreme concern about this incident,” in a conversation with OpenAI chief executive Sam Altman.
Congo is running short of health workers as Ebola remains out of control, WHO says
The outbreak is spreading under extremely difficult conditions, fueled by insecurity, displacement, a health workers’ strike and intense population movements.
OpenAI's breach of Australian health department website prompts rebuke
Prime Minister Anthony Albanese said he was extremely concerned about OpenAI 's breach of an Australian health department website that the artificial intelligence company took too long to reveal.
OpenAI's breach of Australian health department website prompts rebuke from Albanese
Australian Prime Minister Anthony Albanese says he is extremely concerned about OpenAI's security breach of a government website, which the artificial intelligence company took too long to reveal....
OpenAI's breach of Australian health department website prompts rebuke from Albanese
Australian Prime Minister Anthony Albanese says he is extremely concerned about OpenAI's security breach of a government website, which the artificial intelligence company took too long to reveal
Australian prime minister says OpenAI agent accessed government health website, raises 'extreme concern'
Australian Prime Minister Anthony Albanese said investigations are ongoing into the June incident involving Australia's Medicare Statistics Reporting Service portal.
Orlando Science Center exhibit will sport extreme action
‘Beyond Human Limits’ spotlights rock climbing, a high line, wingsuits, more
From Boosting Mental Health to Reducing Dementia Risk, Here's Why Reading Is Extremely Good for You, According to Science
Mounting evidence suggests that regularly cozying up with a book can increase brain and mental health, improve literacy and math skills, and even slow cognitive decline. What's more, fiction seems to have the added benefit of introducing readers to others' perspectives
From Boosting Mental Health to Reducing Dementia Risk, Here's Why Reading Is Extremely Good for You, According to Science
Mounting evidence suggests that regularly cozying up with a book can increase brain and mental health, improve literacy and math skills, and even slow cognitive decline. What's more, fiction seems to have the added benefit of introducing readers to others' perspectives
Environmental disasters are becoming a public health focus
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Jiang Feng: The Unravelling of German & European Politics
A state election in eastern Germany has become a revealing test of the changing political landscapes of Germany and Europe, writes Jiang Feng, Professor and Chairman of the Council of the Shanghai Academy of Global Governance and Area Studies (SAGGAS) at Shanghai International Studies University. His analysis follows the decisive victory of the Alternative for Germany (AfD) (which has been classified as right-wing extremist by German authorities)in the state of Saxony-Anhalt on 6 September, in which it finished far ahead of its mainstream rivals. Jiang previously served as Minister-Counsellor at the Chinese Embassy in Berlin. The following article was published on 8 September 2026 on huanqiu.com, the online platform of the Global Times. On 6 September, the results of the state election in Saxony-Anhalt, Germany, were announced. The Alternative for Germany (AfD), classified as far-right by German authorities, made history by becoming the largest party in the state parliament, winning 43.8 per cent of the vote — twice its share in the previous election. The Christian Democratic Union (CDU), which had governed the state continuously for 24 years, won just 17.2 per cent, its worst result ever in Saxony-Anhalt. On the night the results were announced, the atmosphere at the CDU gathering was unusually calm. There was neither shock nor argument, as if the defeat had long been expected. Several veteran party members who had spent years working in the state government said: “Defeat is not a bad thing. It is time to make changes.” This state election has not only upended Saxony-Anhalt’s political landscape, but also laid bare the deep tensions between Germany’s traditional party structure and model of governance, on the one hand, and an increasingly polarised society on the other. Its repercussions are already being felt at the federal level, making Saxony-Anhalt a useful case study of the broader trend towards political polarisation and realignment in Europe. Governing Difficulties after Electoral Victory The most immediate consequence of the election is a historic setback for the mainstream party order that took shape in post-war Germany. In Saxony-Anhalt, the AfD has leapt from a peripheral party to the largest political force in the state. Its electoral base has expanded beyond the traditional category of “marginal protest voters” to take on the characteristics of a cross-class coalition. The party has not only consolidated its support in rural areas, but also attracted many middle-class voters and even members of the social elite with stable jobs, their own homes, and substantial incomes. It has thus evolved from a “protest party” into one with the potential to govern. Despite its commanding lead in the vote, however, the AfD faces an institutional obstacle to governing the state: the mainstream parties’ long-standing “firewall” against it. Neither of the two potential routes to forming a government appears likely to break the current political deadlock. The first would be a coalition of establishment parties, led by the CDU and bringing together the Social Democratic Party (SPD), the Greens, the Left Party (Die Linke) and the Sahra Wagenknecht Alliance (BSW) in a cross-camp government. In terms of parliamentary arithmetic, such a coalition could prevent the AfD from forming a government and preserve the outward stability of the traditional political order. Yet these parties are fundamentally divided over key issues including immigration, the energy transition, economic management, and cultural and education policy. Coalition negotiations would therefore be extremely difficult, and even if a government could be formed, it would most likely prove short-lived. More importantly, an alliance of establishment parties aimed at keeping the largest party out of government would play directly into the AfD’s narrative that “political elites are suppressing public opinion”. It could deepen perceptions of political unfairness, further strengthening the AfD’s political capital, and creating a dynamic in which “the more it is suppressed, the more people vote for it”. Ulrich Siegmund, the AfD’s candidate for state premier, has said that if efforts to form a government fail because other parties refuse to cooperate, the AfD will push for a fresh election, which he believes could deliver the party an absolute majority of seats. This points to more intense political battles ahead. The second option would be a coalition between the AfD and the BSW. Together, the two parties would command a simple majority in parliament, making this, on paper, the quickest route to forming a government. The BSW is the only elected party that has not ruled out cooperation with the AfD, and the two parties share some common ground, including on policy towards Russia. There is therefore a degree of political basis for cooperation. Were such a coalition to materialise, Germany would see its first state government jointly formed by a party defined as far-right and one with a far-left background, creating what might be called a “bipolar anti-establishment alliance”. Such an outcome would fundamentally break with the ideological boundaries of post-war German party politics. It is worth noting that even if the AfD ultimately fails to enter the state government, its roughly 47 per cent share of parliamentary seats would give it a powerful blocking minority. Without its consent, major decisions requiring a two-thirds majority — including constitutional amendments, significant budgetary adjustments, and state-level institutional reforms — would be extremely difficult to pass. Therefore, whoever ultimately forms the government, the AfD will be an unavoidable force in Saxony-Anhalt politics, with a direct influence on the state’s legislative process. Systemic Failures in Germany’s Governance Model The Saxony-Anhalt election result reflects a systemic failure of Germany’s post-war mainstream-party model of governance to adapt to rapidly changing socioeconomic conditions. It stems from multiple, mutually reinforcing structural tensions and highlights the existing political system’s difficulty in adapting to “an increasingly polarised society First, collective anxiety has replaced individual material hardship as a central driver of political mobilisation. The rise of the AfD can no longer be explained simply by poverty or social marginalisation. Its increasingly cross-class electoral base suggests that what is driving voters towards the party is, above all, concern about the broader direction of society. This anxiety about the future of the political community goes beyond individual gains and losses. In political discourse, economic anxiety has become closely intertwined with immigration, while immigration and refugee issues are, in essence, questions of social fairness. This perception turns conflicts over the distribution of social resources into negative assessments of governing parties, providing a broad social basis for far-right political narratives. Second, regional disparities and East German identity have undermined the strategy of addressing eastern Germany’s structural challenges at the regional level. More than three decades after German reunification, eastern states such as Saxony-Anhalt have experienced periods of economic growth, but their underlying economic structures remain weak, and household incomes and wealth remain significantly below those in western Germany. At the same time, they continue to face population outflow, an ageing population, labour shortages, and other structural challenges. At a deeper level, historical experiences — including the collapse of the former East German economic system, mass unemployment during the transition, and the westward shift of decision-making power over major issues — have left some residents with a sense of being “second-class citizens” and of being excluded. For years, the German government treated the “syndrome” of reunification as a regional problem to be gradually addressed at the local level. That approach is becoming increasingly unsustainable, as regional development disparities emerge as a core structural factor shaping national politics. Third, the erosion of institutional trust is perhaps the most decisive factor. AfD supporters tend to distrust establishment institutions, including parliament, government, and the mainstream media. Their concerns about economic security, pensions, and social fairness are significantly greater than the social average. Increasingly, their support for the AfD reflects not an expectation that the existing system can be improved, but a search for an alternative to the current political order. Such a systemic deficit of trust will be extremely difficult for the traditional parties to repair in the short term. Fourth, a generational shift in political mobilisation has amplified political polarisation. Unlike traditional parties, which rely heavily on offline rallies and mainstream media coverage, the AfD has developed a social-media mobilisation strategy built around “raising an issue — identifying who is responsible — offering a simplified solution — building a shared identity”. It turns complex social tensions into concise political narratives, rapidly channelling public sentiment into political support. The contrast on the eve of the election was particularly telling. The establishment parties, together with trade unions and churches, organised an offline march attended by more than 10,000 people, but its reach was largely confined to those present and to traditional media coverage. The AfD held a much smaller indoor event, yet livestreaming on TikTok, YouTube, and other platforms, combined with the involvement of online influencers, gave it a reach and mobilising capacity far beyond that of the march. The contrast illustrates how the traditional parties’ methods of political mobilisation are increasingly struggling to keep pace with a political environment transformed by changes in media technology. A Microcosm of Structural Political Change in Europe The shockwaves from the Saxony-Anhalt election quickly travelled beyond the state to the federal level. Calls for political accountability followed immediately after the results were announced. The governing CDU and SPD are now under enormous pressure, while Chancellor Friedrich Merz and Vice Chancellor Lars Klingbeil face an unprecedented test. Political polarisation in Germany is no longer simply a regional phenomenon. The post-war model of multiparty government by establishment parties is breaking down and being reshaped. Viewed in a broader European context, the Saxony-Anhalt election is part of a continent-wide wave of party polarisation, mainstream-party decline, and rising right-wing forces. Far from an isolated phenomenon, it is a microcosm of the structural political changes unfolding across Europe. Weak economic growth, cultural tensions over immigration, and declining trust in institutions are fuelling the rise of right-wing forces in several countries, challenging the liberal internationalist order established in post-war Europe. As a core member state of the European Union, Germany’s ability to adapt its political system and the direction of its politics will have profound implications for both European integration and the evolution of the international order. Subscribe [ Pekingnology China’s Germany watchers take stock of Berlin’s uneasy turn On 7 December 2025, nearly 50 Chinese scholars and policy researchers gathered in Beijing for the 2025年德国形势年终研讨会 “2025 Year-End Seminar on the Situation in Germany… Read more 9 months ago · 31 likes · 1 comment · YIRUI LI and Yuxuan JIA ](https://www.pekingnology.com/p/chinas-germany-watchers-take-stock?utm_source=substack&utm_campaign=post_embed&utm_medium=web&embedding_publication_id=1151841) [ Jiang Feng on Germany's 2025 and beyond: no easy exit ](https://www.eastisread.com/p/jiang-feng-on-germanys-2025-and-beyond) Yirui LI and Yuxuan JIA · Jan 24 The following is an op-ed by Jiang Feng, published on 29 December 2025 at Shanghai Observer 上观新闻, the digital platform of Jiefang Daily, the official newspaper of the Shanghai Municipal Committee of the Communist Party of China (CPC). [ Read full story ](https://www.eastisread.com/p/jiang-feng-on-germanys-2025-and-beyond)
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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. There are over 300,000 followers of Ground Truths so more than 90,000 folks who can easily convert to be free subscribers. Your subscription to these free essays and podcasts makes my work in putting them together worthwhile. If you’re not a subscriber, please join! If you found this interesting PLEASE share it! Share Ground Truths The proceeds from all voluntary paid subscriptions go to support our summer internship program. It enabled us to accept and support a record number of 62 summer interns that joined us in 2026! These are high school, college and medical students selected from thousands of applicants. We couldn’t do this expanded program without the funds coming in through Ground Truths. Thank you!
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