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Two centuries after its invention, the stethoscope — the very symbol of the medical profession — is facing an uncertain prognosis.It is threatened by hand-held devices that are also pressed against the chest but rely on ultrasound technology, artificial intelligence and smartphone apps instead of doctors’ ears to help detect leaks, murmurs, abnormal rhythms and other problems in the heart, lungs and elsewhere. Some of these instruments can yield images of the beating heart or create electrocardiogram graphs.Dr. Eric Topol, a world-renowned cardiologist, considers the stethoscope obsolete, nothing more than a pair of “rubber tubes.”It “was OK for 200 years,” Topol said. But “we need to go beyond that. We can do better.”In a longstanding tradition, nearly every U.S. medical school presents incoming students with a white coat and stethoscope to launch their careers. It’s more than symbolic — stethoscope skills are still taught, and proficiency is required for doctors to get their licenses.Over the last decade, though, the tech industry has downsized ultrasound scanners into devices resembling TV remotes. It has also created digital stethoscopes that can be paired with smartphones to create moving pictures and readouts.Proponents say these devices are nearly as easy to use as stethoscopes and allow doctors to watch the body in motion and actually see things such as leaky valves. “There’s no reason you would listen to sounds when you can see everything,” Topol said.At many medical schools, it’s the newer devices that really get students’ hearts pumping.“Wow!” ″Whoa!” ″This is awesome,” Indiana University medical students exclaimed in a recent class as they learned how to use a hand-held ultrasound device on a classmate, watching images of his lub-dubbing heart on a tablet screen.The Butterfly iQ device, made by based by Guilford, Connecticut-based Butterfly Network Inc., went on the market last year. An update will include artificial intelligence to help users position the probe and interpret the images.Students at the Indianapolis-based medical school, one of the nation’s largest, learn stethoscope skills but also get training in hand-held ultrasound in a program launched there last year by Dr. Paul Wallach, an executive associate dean. He created a similar program five years ago at the Medical College of Georgia and predicts that within the next decade, hand-held ultrasound devices will become part of the routine physical exam, just like the reflex hammer.The devices advance “our ability to take peek under the skin into the body,” he said. But Wallach added that, unlike some of his colleagues, he isn’t ready to declare the stethoscope dead. He envisions the next generation of physicians wearing “a stethoscope around the neck and an ultrasound in the pocket.”Modern-day stethoscopes bear little resemblance to the first stethoscope, invented in the early 1800s by Frenchman Rene Laennec, but they work essentially the same way.Laennec’s creation was a hollow tube of wood, almost a foot long, that made it easier to hear heart and lung sounds than pressing an ear against the chest. Rubber tubes, earpieces and the often cold metal attachment that is placed against the chest came later, helping to amplify the sounds.When the stethoscope is pressed against the body, sound waves make the diaphragm — the flat metal disc part of the device — and the bell-shaped underside vibrate. That channels the sound waves up through the tubes to the ears. Conventional stethoscopes typically cost under 0, compared with at least a few thousand dollars for some of the high-tech devices.But picking up and interpreting body sounds is subjective and requires a sensitive ear — and a trained one.With medical advances and competing devices over the past few decades, “the old stethoscope is kind of falling on hard times in terms of rigorous training,” said Dr. James Thomas, a cardiologist at Northwestern Medicine in Chicago. “Some recent studies have shown that graduates in internal medicine and emergency medicine may miss as many of half of murmurs using a stethoscope.”Northwestern is involved in testing new technology created by Eko, a Berkeley, California-based maker of smart stethoscopes. To improve detection of heart murmurs, Eko is developing artificial intelligence algorithms for its devices, using recordings of thousands of heartbeats. The devices produce a screen message telling the doctor whether the heart sounds are normal or if murmurs are present.Dennis Callinan, a retired Chicago city employee with heart disease, is among the study participants. At age 70, he has had plenty of stethoscope exams but said he feels no nostalgia for the devices.“If they can get a better reading using the new technology, great,” Callinan said.Chicago pediatrician Dr. Dave Drelicharz has been in practice for just over a decade and knows the allure of newer devices. But until the price comes down, the old stalwart “is still your best tool,” Drelicharz said. Once you learn to use the stethoscope, he said, it “becomes second nature.”“During my work hours in my office, if I don’t have it around my shoulders,” he said, “it’s as though I was feeling almost naked.” 5223

U.S. Navy officials say nearly 3,000 sailors aboard a U.S. aircraft carrier where the coronavirus has spread will be taken off the ship by Friday as military leaders struggle to quarantine crew members in the face of an outbreak. The USS Theodore Roosevelt is now docked in Guam. Navy leaders say nearly 100 of the 5,000 sailors assigned to the Roosevelt have tested positive for the virus. But the Navy is moving sailors into various facilities and probably will begin using hotel rooms in the coming days. Navy leaders are talking with government officials to identify rooms for the crew members. 610

White House senior adviser Stephen Miller indicated on Monday that President Donald Trump has not quite made the decision to shut down the border, saying it depends on how the week goes, according to notes from a conference call taken by a listener and obtained by CNN."We will see how much progress we are able to make in the ensuing days, in terms of getting more enforcement with Central and South America, so that we are not getting swamped by meritless asylum claims predominantly from Central America," Miller told top administration immigration surrogates on a conference call, according to the notes.Trump 626

When you think of amusement parks, roller coasters, funnel cakes and games come to mind. But do you think of art? There is one amusement park that's changing the way visitors experience a ride.Elitch Gardens amusement park in Colorado just opened their new ride called Kaleidescape, an art-focused ride. The park partnered with Santa Fe, New Mexico’s famous art installation Meow Wolf, which is known for an immersive, interactive experience. They wanted to bring that same focus to the ride.“It is very visually dense," describes artist Frankie Toan, who helped create the ride. "There’s lot of color, shapes, and lights, and all kinds of things going on.”Meow Wolf’s co-founder Matt King says audiences are given a chance to immerse themselves into fantastic realms of story and exploration."We create things that are very different than what Disney does, what Universal does," King says.The artists behind the ride enjoy that Elitch Gardens is a non-traditional art space.“It’s just such a fun place to work, because the rules of a gallery or museum don’t necessarily apply here," Toan says.Meow Wolf’s ride is changing the way people look and understand art.“Meow Wolf's great strengths is that they get people who maybe don’t normally go to see art, especially in a gallery or museum setting," Toan says. "They get to experience really contemporary, lively art in a non-traditional space.”Elitch Gardens hopes to make Kaleidescape a permanent ride. 1465

Warmer weather means tick season across the U.S., and a number of tick-borne disease cases has increased over the past few years.“Lyme disease is gonna be the most common disease we see,” said Nicole Chinnici, laboratory director of the Dr. Jane Huffman Wildlife Genetics Institute. Chinnici is part of the Pennsylvania Tick Research Lab.“Tick season generally starts in the spring. It’s as we're coming out of winter and getting into the warmer months,” explained Dr. Mark Montano, the medical director of CareNow Urgent Cares in Colorado.The CDC said disease cases from mosquito, tick, and flea bites more than tripled from 2004 to 2016 in the U.S.. They predict the number of infections in any given season is complicated, but to put it in perspective, the number of tick-borne disease cases increased from 48,610 reported cases in 2016 to 59,349 reported cases in 2017. “There’s a lot of factors in it,” Chinnici said. She said reasons could include how mild the winter was, how long the warmer months are, and even animal hunting and population control. Another factor is how much time people spend outside.“People are free right now. They're working from home, so they are spending more time outdoors, so that's putting them at a greater risk just because of everything else going on with COVID-19,” Chinnici said.The tick research lab is one of only a few in the U.S. “We receive ticks from people, physicians, and then we test them in the lab using molecular techniques, and then we report the results back to the customer within 72 hours,” she explained.All you have to do is send it in. For Pennsylvania residents, it’s free. For cases in other parts of the U.S., there is a fee that comes with the lab test.“We’re providing the individual that was exposed to the tick bite with early detection of whether or not they've been exposed to a tick-borne disease,” Chinnici said.A quick look at their 1918

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