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Apple Watch ECG app: How it works and what it means for the future of health

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Apple has long been positioning the iPhone and the Apple Watch as wellness devices — hardware that can help you track markers of fitness including exercise, step count, and even sleep and ‘mindfulness minutes’.

ALSO: Apple Watch ECG app launches today with watchOS 5.1.2 update

But now it’s taking that a step further by adding the sort of heart-monitoring technology more usually of interest to doctors — making it available to anyone with a wrist and a few hundred dollars to spare.

While previous versions of the Apple Watch have been able to measure a wearer’s heart rate, the Apple Watch 4 takes a big step up with its electrocardiogram (ECG or EKG depending on where you are) functionality — which is now live.

Thanks to the new functionality, the Apple Watch will be able to keep an eye on your heart in two ways. First, the Watch’s optical heart sensor quietly measures the wearer’s heart rhythm in the background. If it detects an irregular heartbeat, the Watch flashes up a message warning that you might have a condition known as atrial fibrillation, and so might like to consider a trip to the doctor. Secondly, electrodes in the new model’s crown and back sapphire crystal allow the Watch wearer to take an ECG themselves; again, an alert is delivered if there are signs of atrial fibrillation.


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So what’s the big deal with atrial fibrillation?

Atrial fibrillation, also known as AF or AFib, is a condition where the electrical signals that control the heart go awry. In a normal heart, the signal that tells the heart to beat comes from an area known as the sinoatrial node, and spreads out around the heart from there. The signal should be steady and regular, but in atrial fibrillation the signal to beat is generated outside of the sinoatrial node, and at random, giving someone with the condition an irregular pulse.

While that might not sound worrying, the irregular heart rhythm means the atrium doesn’t pump out blood as it should. The blood hangs around in the upper part of the heart for too long, and clots may form — clots that may ultimately end up in the brain, causing a stroke.

Apart from the irregular heartbeat, someone with atrial fibrillation may have no other symptoms — they may only become aware they have the condition after ending up in hospital. A study published last year found that a stroke was the first symptom of atrial fibrillation in one in five people with the condition, and that around one third of people who were at higher risk of AF had the condition, but hadn’t been diagnosed.

According to the Heart Study (Apple-sponsored research by Stanford University) the Watch was able to identify people with atrial fibrillation 98 percent of the time, and those with normal heart rhythm 99 percent.

SEE OUR SPECIAL FEATURE: Can technology save the NHS?

Atrial fibrillation is a condition that mainly affects the over-65s — although it can affect younger people too, they’re far less likely to experience the condition. One side effect of Apple’s new ECG feature may be that — as Apple Watch users are typically younger – it could lead to a wave of younger people visiting their doctor after a bout of atrial fibrillation. As atrial fibrillation largely hasn’t largely been picked up in a younger population before, because they’re not screened for it in the same way as over 65s, there’s been very little research done on how best to treat them.

“Atrial fibrillation is an important health issue that affects a lot of people, so there’s a lot of sense in trying to recognise people with atrial fibrillation. But what I think is the challenge is that we don’t know enough about the early stage of the disease to really guide people on what treatment to have,” says cardiologist and researcher Rohin Francis.

“The majority of all our information on atrial fibrillation has been in people who have been diagnosed opportunistically or who have had a stroke or mini-stroke, and often it’s something that we’ll find after they’ve had another problem, so we don’t have any real evidence on well patients — particularly younger patients — who might have a bit of atrial fibrillation from time to time.

“If we detect a short run of atrial fibrillation in someone that is otherwise fit and well and doesn’t have major risk factors for stroke otherwise, we don’t know whether they would benefit from the same treatment as someone who’s, say, elderly and has other risk factors, or who has already had a stroke,” Francis says.

Nonetheless, by bringing this sub-population of patients to medical attention, Apple is likely to inspire significant research into how to treat early stage atrial fibrillation in younger patients, particularly as the sheer number of Apple Watch users and the data they bring is likely to be many times what a conventional medical trial could generate.

There are other potential benefits from the Apple’s ECG feature too. As well as finding previously-undiagnosed people with atrial fibrillation, it could help track those already on treatment for the condition. By checking in with the ECG feature, patients with AF could keep their doctors up to date on whether starting a new treatment or swapping to a different medication has decreased the frequency of their atrial fibrillation.


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There are already some caveats to the Watch’s ECG feature, however: it is not to be used by people under 22, for example. The FDA also stipulates that the ECG Watch shouldn’t be used as a replacement for normal medical workup. “The ECG data displayed by the ECG app is intended for informational use only. The user is not intended to interpret or take clinical action based on the device output without consultation of a qualified healthcare professional.. [it] not intended to replace traditional methods of diagnosis or treatment,” it said.

Also, in around 10 percent of cases, the Stanford research found the Watch was unable to read people’s rhythm at all — meaning some Watch wearers who have atrial fibrillation may still go undiagnosed.

What’s next for the Watch’s ECG?

Apple’s Watch is a one-lead ECG, making it a very blunt instrument — it’s only set up to measure the heart’s activity at one point. It can detect atrial fibrillation, but detecting atrial fibrillation isn’t actually that hard: any doctor (and even most medical students) will be able to detect it just by taking a patient’s pulse.

With just one lead, the Watch’s ECG means it won’t become a substitute for a full 12-lead workup that doctors use to diagnose cardiac problems. However, there are other conditions that it could potentially be used to diagnose in future, such as other types of supraventricular tachycardia. Thanks to Apple’s ECG functionality, we could be witnessing the beginning of an era of home diagnostics: a time when a diagnosis is handed down by a device on the wrist, not a doctor in a clinic.

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TikTok is confronting Holocaust misinformation, but antisemitism persists – TechCrunch

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In honor of International Holocaust Remembrance Day, TikTok launched a portal on its Discover page this morning, intended to educate users about the historic catastrophe, as well as the ongoing threat of antisemitism. The platform also hosted a similar portal last year.

When users navigate to the Discover page on the TikTok mobile app, they will see a clickable banner acknowledging International Holocaust Remembrance Day. This directs them to a page with three educational TikToks from Jewish creators, including a 98-year-old Holocaust survivor who makes TikToks with the help of her great-grandson. Plus, from now on, when users search terms like “Holocaust” or “Holocaust survivor” on TikTok, they will see a banner prompting them to “consult trusted sources to prevent the spread of hate and misinformation,” directing them to visit a multilingual website about the Holocaust. In the coming months, TikTok will add a similar notice as a permanent banner on videos about the Holocaust. TikTok made these changes in collaboration with UNESCO and the World Jewish Congress, an organization that has been working with the platform since 2020.

This initiative directly addresses Holocaust denial, a false conspiracy theory that the Holocaust didn’t happen. But some Jewish TikTokers think that antisemitism on the platform is a larger, more complex issue that can’t be solved through a few pop-ups on Holocaust content.

A stylist with 74,000 followers, Liv Schreiber partnered with Jewish dating app The Lox Club on an advertisement in November. A week later, she posted a video showing a cascade of antisemitic comments she received each day since posting the video.

“I don’t understand why antisemitism is tolerated,” Schreiber said in her video. “I don’t understand why it doesn’t get taken down. This is non-negotiable, TikTok.” 

Conversations about antisemitism on TikTok swelled last April when one trend went viral, in which users would sing “If I Were a Rich Man” from the Jewish musical “Fiddler on the Roof” while using a filter that elongated their facial features, like their nose. For Jewish people on TikTok, this trend evoked a historic stereotype, where antisemitic caricatures depicted Jewish people with exaggerated noses, alongside other harmful antisemitic imagery.

As that trend percolated through TikTok, the platform tried to shine a positive light on the app’s Jewish creators through a tag called #MyJewishHeritage, which the app created to celebrate Jewish Heritage Month in May 2021. TikTok highlighted some posts about Judaism on the Discover page, but the creators who had their content promoted got no warning from TikTok. As a result, some Jewish creators were suddenly flooded with a barrage of antisemitic comments.

TikTok said that the creators featured on this year’s International Holocaust Remembrance Day portal were compensated for their work.

“The issue with TikTok antisemitism is you end up being harassed from all sides,” Ezra, a political TikToker with over 37,000 followers, told TechCrunch. “You have far-right accounts, troll accounts, unintentionally antisemitic accounts that don’t know better, and left-wing accounts that can’t differentiate between Jews and Israel. So cracking down on antisemitism is a multi-pronged issue.”

TikTok has publicly condemned antisemitism on its platform, but public gestures of solidarity like the launch of the new portal might ring hollow for users who have experienced harassment on the platform. It’s also unclear how much time TikTok spent on the effort because when TechCrunch first accessed the Holocaust Remembrance Day portal — several hours after its release at 3 AM ET — its link to report an antisemitic incident to the Anti-Defamation League didn’t work. A few hours later, the issue appeared to be fixed. TikTok has not yet responded to inquiries as to why it launched without a functioning link.

Stephanie Gurewitz (@shachar.mg), a grad student who posts about antisemitism on TikTok, was surprised to see that the International Holocaust Remembrance Day portal only addressed the impact of the Holocaust on Jewish people. Yom HaShoah, a separate day of remembrance, specifically observes the death of six million Jewish people in the Holocaust. But the Nazis also persecuted disabled, homosexual and Romani people, among other marginalized populations.

“This is International Holocaust Remembrance Day, rather than the remembrance day that’s specifically for Jewish people,” Gurewitz told TechCrunch. “Today’s about all victims of the Holocaust, and it doesn’t mention anything about Romani people. There are some things missing there, and that’s an issue.”

They mentioned that they’ve received antisemitic comments on their videos today, too.

“People come on TikTok with biases already, and I don’t think banners are enough to stop that,” they said.

Content moderation on a platform with one billion monthly active users is no easy task. But users regularly get around detection mechanisms through means that are obvious to any regular user — even when talking about something like sexuality, users might write “s3xuality” to avoid being wrongfully flagged as violating guidelines (adult content is a violation; talking about homosexuality, for example, is not). These same tactics are regularly applied by malicious users to send antisemitic messages, which TikTok fails to detect.

“I really am all about TikTok and other social media platforms doing what they can to bring attention to important causes […] When I see that [Holocaust Remembrance] portal, I think of all the meetings they had about it internally, and because of that, I’m grateful,” Schreiber told TechCrunch.

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Messenger upgrades its end-to-end encrypted chat experience – TechCrunch

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Although default end-to-end encryption won’t fully arrive on Facebook Messenger until sometime in 2023, the company says today its feature offering end-to-end encrypted group chats and calls in Messenger is now fully rolled out. In addition, Messenger is adding another security feature with the launch of screenshot notifications in end-to-end encrypted chats, similar to rival Snapchat, that will alert you if someone snaps a photo from Messenger’s disappearing messages. Users will also now be able to add GIFs, stickers, and reactions to their encrypted chats, too.

Support for end-to-end encrypted (E2EE) group chats and calls was first announced in August 2021, promising Messenger users a way to keep their personal conversations safe from criminals and nation-state surveillance. Many governments, however, have not necessarily been on board with the idea, saying that Messenger’s plans to expand its encryption efforts would complicate law enforcement’s ability to investigate crimes. But Meta has pushed back, noting that E2EE was already widely used by apps like WhatsApp and was becoming an industry standard.

E2EE for group calls and chats wasn’t fully launched at the time of last year’s announcement, though. Instead, Meta said it would first begin testing the feature for friends and family who already had an existing chat thread and were already connected. It also said it would begin a test for delivery controls that would work with E2EE encrypted chats, allowing users to prevent unwanted interactions so they could decide who went to their chat list, their message requests folder, and who couldn’t message you at all.

Now, months later, the feature is fully rolled out to Messenger users globally, who can choose to turn on E2EE for their private conversations.

Soon, Messenger will also warn users if someone screenshots a disappearing message in E2EE chats. This is the same feature that’s already offered in Messenger’s vanish mode — a feature that functions much like Snapchat, where messages will disappear after they’ve been seen. If someone takes a screenshot of a vanish mode chat — and now a disappearing message in E2EE chats, as well — you’ll receive a notification so you can address this with the other party, or even block or report the conversation if need be. The company says these notifications will roll out “over the next few weeks.”

Image Credits: Meta

Finally, E2EE chats will also gain access to other features that have been available to non-E2EE before, including GIFs, stickers, and reactions, as well as support for replies to a specific thread, typing indications, and forwarding options. Verified badges will also be available to E2EE chats to help you identify authentic accounts, when chatting. And users will be able to save media with a long-press and edit photos and videos before sending. These features are not new, but they’re new to end-to-end encrypted chats.

Image Credits: Meta

Meta says all the features are available on all platforms, including web and mobile, for all users. But the rollout is ongoing, so some people won’t see all of the features immediately.

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U.S. consumers lost $770 million in social media scams in 2021, up 18x from 2017 – TechCrunch

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A growing number of U.S. consumers are getting scammed on social media according to a new report by the Federal Trade Commission (FTC), which revealed that consumers lost $770 million to social media scams in 2021 — a figure that accounted for about one-fourth of all fraud losses for the year. That number has also increased 18 times from the $42 million in social media fraud reported in 2017, the FTC said, as new types of scams involving cryptocurrency and online shopping became more popular. This has also led to many younger consumers getting scammed, as now adults ages 18 to 39 reported fraud losses at a rate that’s 2.4x higher than adults 40 and over.

Scammers have clearly found that social media is one of the most profitable places to commit fraud. More than 95,000 fraud victims said they were first contacted on social media — more than double 2020’s number, and up 19x from 2017.

Image Credits: FTC

More than one in four individuals who reported losing money to fraud to the FTC last year said they first saw a post, message, or ad on social media which had prompted the scam. Excluding reports that didn’t indicate a contact method, social media scams accounted for 26% of the losses attributed to fraud in 2021 ($770 million), followed by websites and apps at 19% ($554 million), then phone calls at 18% ($546 million). The median individual losses, however, were highest with phone fraud at $1,110 compared with $468 for social media fraud.

Facebook and Instagram were where most of these social media scams took place, the data indicated.

In the case of online romance scams, more than a third of users reported the first outreach they had from the scammer was on Facebook or Instagram. Specifically, Facebook accounted for 23% and Instagram 13% of romance scams. These scams would begin with a seemingly innocent friend request, followed by sweet talk, then a request for money, the report explained.

Meanwhile, more than half (54%) of the investment scams in 2021 began with social media platforms, where scammers would promote bogus investment opportunities or connect with people directly to encourage them to invest. Instagram was popular with scammers here, accounting for 36% of investment scams, followed by Facebook at 28%, then messaging apps WhatsApp and Telegram at 9% and 7%, respectively.

A large majority of the investment scams now involve cryptocurrency, the report also found. In 2021, cryptocurrency was the method of payment in 64% of social media investment scams reported to the FTC. Payment apps and services were the payment methods used in 13% of cases, followed by bank transfers or bank payments in 9%.

Image Credits: FTC

Although romance and investment scams continued to account for the largest losses by dollar amounts, even reaching record highs, the scams with the largest number of reports to the FTC involve consumers trying to purchase something they first saw on social media. In most cases, people were trying to make a purchase of something they saw marketed on Facebook or Instagram.

In 2021, 45% of reports sent to the FTC over money lost in social media scams were related to online shopping. Nearly 70% of those involved people who placed an order, typically after seeing an ad on social media, but then never received the merchandise. Some also noted the ads would direct them to “lookalike” websites, designed to fool them into thinking they were purchasing from a real online retailer. Facebook and Instagram served as the platforms of choice for 9 out of 10 of these scams, the report noted.

The increase in online shopping scams isn’t just an issue for the consumers losing money — it’s determinantal to the overall e-commerce ecosystem and social media companies’ businesses. In recent years, Facebook and Instagram have invested heavily in making online shopping a core part of their services, promising to connect advertisers with targeted customers. The Meta-owned apps also now include their own “Shop” sections, where consumers can browse goods and check out directly — without having to exit to an external website. But if consumers become wary of the legitimacy of the online retailers featured on these platforms, they may hesitate to shop from social media in the future.

For Meta, a change in consumer shopping behavior would matter more today than in years past, as the company’s larger ad business has been impacted by Apple’s privacy changes on iOS which let consumers opt out of tracking. Anticipating the market shift that would result from this reduced ability to personalize ads, Meta has been diversifying its revenue by creating in-app shops where it can capture more first-party data based on consumer shopping inside its own platform. It’s also tapping into new revenue streams from the creator economy, like subscriptions and tipping.

The FTC said that investment, romance, and e-commerce scams, combined, accounted for 70% of social media scams in 2021, but there were other types of fraud also associated with social platforms. The report did not break these down by category, however.

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