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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

While leading health officials agree that wearing a mask can protect others from being infected by the coronavirus, President Donald Trump and his likely Democratic rival Joe Biden are now actively engaged in a political debate over mask wearing. On Tuesday during a White House briefing, Trump requested a reporter remove their mask when asking a question. When the reporter refused, Trump said the reporter was being “politically correct.”Earlier in the day, Trump retweeted a photo from Fox News personality Brit Hume mocking Biden's appearance for wearing a mask at a Memorial Day commemoration in Delaware. This might help explain why Trump doesn’t like to wear a mask in public. Biden today. 710

Two drivers in Oregon were killed in a crash that was blamed on icy roads early Monday.Oregon State Police said two commercial trailers collided and a fire broke out on the Newberg-Dundee Bypass in the northern part of the state near Portland. A third driver was injured in the crash after she was unable to stop her car and hit the back of one of the trailers. The woman was taken to a hospital after sustaining minor injuries.The Oregon crash comes as cities along the west coast battle dangerous weather conditions. Flooding, mudslides and snow closed several highways in California over the weekend. And widespread rain is expected to continue pouring over the state with new flood threats and heavy mountain snow expected to move in.The California Department of Transportation reopened the Pacific Coast Highway to traffic Monday from south of Encinal Canyon Road in Malibu to Las Posas Road in Ventura County. Mudslides following a Saturday night storm had "wreaked havoc" on the highway, which took officials two days to clear. However, the 1060

When astronaut Scott Kelly was preparing to head to space for a year-long mission on the International Space Station in 2015, he immediately thought about his brother.“This was going to be unique for NASA,” Scott Kelly says in an interview from Space Center Houston. “The first U.S. crew member spending a year in space… maybe there was some value in taking advantage of the fact that…I had an identical twin brother.”His identical twin happens to be former astronaut Mark Kelly, who would be on earth during the same period of time. Scott saw potential to learn something.“I think as an astronaut we have an obligation to promote science, perform the science, to be engaged in science,” he says.The journal publication Science was very interested in the idea. All they needed now was a team of researchers for what would be known as the 850

WASHINGTON — In a surprise move, the Federal Reserve cut its benchmark interest rate by a sizable half-percentage point in an effort to support the economy in the face of the spreading coronavirus, or COVID-19. Chairman Jerome Powell noted that COVID-19 “poses evolving risks to economic activity." According to 324