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WASHINGTON (AP) — The Washington, D.C. street leading to the White House now features the phrase Black Lives Matter in enormous yellow letters visible from high in the sky. D.C. Mayor Muriel Bowser tweeted aerial video of the mural shortly after it was completed Friday, saying “Breonna Taylor, on your birthday, let us stand with determination. Determination to make America the land it ought to be.”Bowser also said on Instagram that the section of 16th Street in front of the White House in now officially “Black Lives Matter Plaza.” The announcement was accompanied by a video of a worker hanging a sign on a street post. 638

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

WASHINGTON, D.C. — Treasury Secretary Steven Mnuchin punted again Wednesday when pressed about an Obama-era plan to put Harriet Tubman on the bill.Rep. Ayanna Pressley, a Massachusetts Democrat, questioned Mnuchin during a House Financial Services Committee hearing, asking about 296

Whenever New York Gov. Andrew Cuomo hears of an aircraft hitting a building, the September 11 terror attacks immediately come to mind.Monday was no different, when a helicopter crash-landed on the roof of 787 Seventh Ave. in midtown Manhattan."If you're a New Yorker, you have a level of PTSD from 9/11. And I remember that morning all too well," he said."So as soon as you hear an aircraft hit a building, my mind goes where every New Yorker's mind goes."New York Mayor Bill de Blasio said nothing suggests the crash was a terror attack, although the cause is still under investigation. One person believed to be the pilot is dead.But the initial minutes of confusion evoked the terror of the September 11 attacks for those inside the building.Nathan Hutton, who works on the 29th floor of 787 Seventh Ave., said many people felt the building shake.Initially, no one though much of the shaking, he said, "until security said, 'get out of the building,' then you got a little nervous.""Do I want to be coming down a staircase if there is something bad that's happening?" Hutton said."We had no choice, we all got out. Everybody was somewhat calm, but they were nervous because that thought is in the back of your mind." 1231

White supremacist mass murderer Dylann Roof staged a hunger strike this month while on federal death row, alleging in letters to The Associated Press that he’s been verbally harassed and abused without cause” and “treated disproportionately harsh." The 25-year-old Roof killed nine black church members in Charleston, South Carolina, in 2015. He told the AP that staff at a federal prison in Indiana feel justified in their conduct “since I am hated by the general public.” A person familiar with the matter would say only that Roof had been on a hunger strike but is no longer on one. 598

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