The predicted risks didn’t align well with actual events, raising questions about how well the tool will fare if rolled out.
Cardiovascular risk prediction using the new PREVENT calculator developed by the American Heart Association appears to have variable calibration depending on the patients, their underlying comorbidities, and the healthcare system in which it’s used, according to a new study.
Across four different healthcare systems in the United States, PREVENT underestimated the risk of atherosclerotic cardiovascular disease (ASCVD) events in three of them, with the predictive performance of the calculator also varying by race and ethnicity.
The findings, researchers say, suggest there may be a need to calibrate the PREVENT risk calculator by region and for physicians to individualize the results in order to accurately gauge a patient’s 10-year risk of ASCVD.
“I was surprised by its performance,” senior investigator Pradeep Natarajan, MD (Massachusetts General Hospital, Boston, MA), told TCTMD. That PREVENT underestimated patient risk is not totally new, he added, noting that prior studies have suggested the predicted risks tended to be lower than with the pooled cohort equations (PCE). However, “because of the extensive, more contemporary training data, there is an assumption that the calibration would be better. I was very surprised that the calibration actually was worse with PREVENT, even relative to the pooled cohort equations.”
How well PREVENT is calibrated—the agreement between predicted risks and observed event rates—is important because treatment recommendations, such as the need for additional testing or starting lipid-lowering therapy, are based on 10-year risk estimates. While no clinical guidelines have yet adopted the calculator as a risk-prediction tool, it’s largely expected to be part of future recommendations.
“I think we need clinicians and patients to know what they probably already know: there is some imprecision around the estimates of risk calculators,” said Natarajan. “They need to use the calculator plus their overall clinical impression and various different considerations related to the patient to figure out what to do for the next step. The risk calculators are still a helpful initial starting point.”
Limitations of PREVENT
The PREVENT equations, which can be used in patients as young as 30, update the PCE for ASCVD that are currently recommended by clinical guidelines to aid decision-making in primary prevention. PREVENT encompasses the full spectrum of cardiovascular, kidney, and metabolic risk factors and is intended to estimate both the 10- and 30-year risks of MI, stroke, and heart failure for a broad spectrum of patients.
PCE have been criticized in the past for overestimating patient risk and being less accurate in certain groups, including Asian and Hispanic adults. The PREVENT calculator was developed from a larger, more diverse population and no longer includes race/ethnicity as a variable.
Studies have shown that PREVENT works well in older adults and patients with high lipoprotein(a) levels. It also accurately predicted the risk of cardiovascular mortality in an external validation cohort.
Other studies, however, have suggested that PREVENT gave substantially lower 10-year ASCVD risks. Additionally, research has shown that adopting PREVENT over the PCE would lead to fewer patients treated with medications, particularly statin therapy. In one analysis, for example, it was estimated that more than 14 million US adults would no longer be eligible for statin therapy with the PREVENT risk-assessment tool and 2.6 million adults would not be eligible for antihypertensive medications.
We need clinicians and patients to know what they probably already know: there is some imprecision around the estimates of risk calculators. Pradeep Natarajan
The new study, which was published this week in JACC, evaluated the performance of PREVENT in four integrated healthcare systems: Mass General Brigham Healthcare (MGB) in New England; Mount Sinai Health System in New York, Westchester County, and Long Island, NY; Penn Medicine in Pennsylvania and parts of New Jersey and Delaware; and Vanderbilt University Medical Center (VUMC) in Nashville, TN. In total, 270,320 patients were included in the analysis.
The mean predicted 10-year risk of ASCVD was 4.9% at MGB, 6.0% at Mount Sinai, 6.0% at Penn Medicine, and 4.8% at VUMC. The PREVENT calculator underestimated risk at all but Penn Medicine. At MGB and VUMC, for example, the observed 10-year event rates were 15.7% and 16.1%, respectively. In contrast, the predicted and observed ASCVD event rates were more closely aligned in the Penn Medicine healthcare system. There was moderate ASCVD event discrimination in all four healthcare systems, with C-indexes of 0.70 for MGB, 0.74 for Mount Sinai, 0.69 for Penn Medicine, and 0.73 for VUMC.
Additionally, the ability of PREVENT to predict ASCVD events varied by sex, race, ethnicity, and underlying conditions. The discordance was lower in women who were part of the MGB and VUMC healthcare systems, but lower among men in the Mount Sinai system. PREVENT underestimated the risk of ASCVD across all racial and ethnic categories at MGB, Mount Sinai, and VUMC.
The PCE, on the other hand, resulted in higher predicted 10-year risks in the MGB, Mount Sinai, and Penn Medicine healthcare systems, but to a lesser extent in VUMC. With PREVENT, anywhere from 35% to 73% of patients eligible for statins using the PCE were reclassified to a lower-risk category.
As a practicing preventive cardiologist, “the way I can do my job well is if there is accurate risk prediction,” said Natarajan. “In the end, we and our patients are not so interested in continually refining our ‘crystal ball,’ but using it to make accurate recommendations or at least make recommendations for preventive therapies and measures that identify patients who are going to benefit the most.”
Risk Factors Not Captured by PREVENT
There are limitations to their data, including that the findings depend on the accuracy of billing/procedure codes. Additionally, there is a risk of bias resulting from differences in healthcare utilization in and out of each network. That, however, would likely lead to underreporting of ASCVD events, which would only widen the gap between predicted and observed events, said Natarajan.
In an editorial accompanying the study, Yuan Lu, ScD (Yale School of Medicine, New Haven, CT), and Khurram Nasir, MD (Houston Methodist, TX), write that for PREVENT to be successful as a clinical tool, it needs to perform robustly across different healthcare environments and be accurate in diverse patient groups.
While PREVENT improves upon the PCE, “the inconsistent calibration demonstrated in this study and other analyses in younger cohorts reinforces longstanding challenges in achieving accurate risk prediction across heterogeneous populations,” they say. “Clinically, these findings support a cautious approach to using PREVENT in its current form. Awareness of misclassification—particularly risk underestimation in historically underserved populations—is essential to avoid inappropriate treatment decisions.”
At the local healthcare level, recalibrating PREVENT before using it could also be considered, say Lu and Nasir. However, as Natarajan noted, the calculator can’t be changed as the PREVENT calculator is currently licensed for use. “There’ll need to be some thought around that,” he said. “This has been demonstrated with the pooled cohort equations, for example. Recalibration has been shown to improve the accuracy when applied to different scenarios.”
Like on Android, the Phone by Google app is getting a M3 Expressive redesign on Wear OS.
People are seeing an update to the in-call screen. The end call button hugs the bottom edge of the display. It’s larger than the existing circle for a bigger touch target that’s helpful on this small screen.
Similarly, the mute and three-dot overflow buttons are further up the screen, with the call duration placed in the middle on the same line.
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There are similar updates when you’re dialing a number. The Google Phone Wear OS homescreen is presumably also getting M3 Expressive. This is not yet widely rolled out on watches we checked today.
New
These are modest modernizations that are inline with the in-call screen redesign on phones. The “More” menu still exists, but it’s now a list like Call Assist instead of a grid. The bigger update is the incoming call screen that lets you pick between a left/right slide or buttons to answer calls.
Some users on the beta have the Home, Keypad, and Voicemail bottom bar already, while others have the full revamp with Material 3 Expressive.
More M3 Expressive:
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The newest craze for families with children under age 15 is something called Labubu dolls, which is the subject of many unboxings on Tik Tok. The newest dolls were even featured on NPR’s program, “Wait, Wait, Don’t Tell Me.”
To find out what a Labubu is, GBH’s Henry Santoro invited Alexander DePaoli, an Associate Professor of Marketing at Northeastern to join him on GBH’s Henry in the Hub program.
Henry Santoro: As best you can, will you describe a Labubu for those who do not know what it is?
Alexander DePaoli: It is a line of toys and accessories from the Chinese toy company Pop Mart. They are customizable, they are fuzzy, they’re described as monster elves. And they are generally characterized by being cute, but not too cute, just a little off. And that’s part of their appeal.
Santoro: And they are taking the world by storm right now?
DePaoli: Yes, yes, they are.
Santoro: For some reason, people love to hang these things off their backpacks or their purses or pocketbooks.
DePaoli: Whatever… keychains, purse charms, bag charms… That’s kind of the big appeal right now for them. They do also have figurines and plushies. And there was a life-size one that recently made headlines for selling for some absurd amount of money.
Santoro: And I’m sure there’s going to be a Labubu Halloween costume?
DePaoli: I have no doubt.
Santoro: When did this begin? When did the whole craze begin for Labubu?
DePaoli: Labubu itself is almost 10 years old at this point, shockingly. But the craze started last year — I believe around April — when they were first spotted being worn by a member of Blackpink, the K-pop group and its member named Lisa. I think that that was sort of a big kickoff.
And then you saw other celebrities like Dua Lipa and Rihanna also sporting these accessories that helped to spread the appeal across the West. And that sort of kicked off the fad for it outside of China —potentially only growing because supposedly only 40% of their sales this past year were outside of China and it was already a 1.8-billion-dollar brand.
Santoro: And I’m sure that this company in China can thank TikTok for a lot of their business.
DePaoli: I think absolutely, yes. TikTok has been very helpful for sort of spreading both the toy itself and the kind of culture that thrives on that sort of off appeal of the toy.
Santoro: How long do these crazes last? Do we know?
DePaoli: It’s always hard to say.
Santoro: But, you can go back years and see how crazes like this happen, like Beanie Babies, Cabbage Patch Kids…
DePaoli: I think an important distinction, and this is true for Jelly Cat, and I think it’s especially true for Labubu, is that they’re not just toys, right? Cabbage Patch Kids is a toy, versus Labubu is an accessory as well. So, you sort of have these multiple pathways to desire, multiple pathways of use, if you will. They feel more functional to the buyer, and because of that, they have more staying power. They’re kind of easier to justify buying and holding onto, but I think that you will not see it disappear as thoroughly as a straight toy.
Santoro: And we probably won’t see it show up in a Happy Meal.
The Guide is 200 issues old today – maybe not the biggest milestone, but one worth marking. So this week we’re doing just that, ending our recent miniseries on the culture of the past 25 years with a listicle spectacular.
We’ve picked a piece of popular culture for each year of the 21st century so far. Which isn’t to say a definitive list of the best culture of the 21st century – the Guardian’s arts desk already did that far more conclusively than we ever could. Instead, we’ve selected 21st-century TV shows, films, plays, podcasts, artworks, albums and games that together hopefully help explain how culture has evolved in that time.
It’s a hefty list, so there’s no room for our regulars this week, but at least a few of these will serve as recommendations. Normal service will return next week. Anyway, on with the list!
Craig Phillips outside the Big Brother house after winning the first series. Photograph: Ferran Paredes/Reuters
2000 | Big Brother
Channel 4, what hast thou wrought! Reality TV has loomed over pop culture for the past 25 years, and Big Brother’s DNA can be found in every last Real Housewife or Love Islander. But, as bad as some of the TV that followed in its wake was, BB was – in its first outing at least – a genuinely radical social experiment. And great drama too, not least when Nasty Nick broke bad midway through the series.
Also this year: Radiohead’s Kid Abanishes guitars – and revitalises rock music; The Sims allows gamers to play God in both mundane and thrilling ways.
2001 | A Stroke of Genius
The Guardian declared this mashup of Hard to Explain and Christina Aguilera’s Genie in a Bottle the song that defined the 2000s, and 15 years later, it still feels predictive. Witness the way that someone like PinkPantheress inserts whole choruses from other songs into her thoroughly modern dance-pop – or head to YouTube, where you can find thousands of similarly inventive cut-and-shunts.
Also this year: the gorgeous Spirited Away kicks off Ghibli-mania in the west; Jeremy Deller re-enacts The Battle of Orgreave in a giant piece of participatory art.
2002 | Russian Ark
Niche it may be, but Aleksandr Sokurov’s film – which traces the modern history of Russia through the halls of St Petersburg’s Hermitage Museum – was also the first pebble that started an avalanche. Its single-take conceit, fresh in 2002, has since become the go-to cinematic trick shot for show-off directors, seen everywhere from bloody war sagas to Oscar-winning navel-gazes. But unlike many of those films, Russian Ark was authentically, mind-blowingly shot in one uninterrupted take.
Also this year:Martin McDonagh’sThe Lieutenant of Inishmorebrings Tarantino-level violence to the West End; The Wiredebuts and makes the TV show novelistic.
2003 | The Weather Project
Since it opened in 2000, Tate Modern has upended the British public’s once wary relationship with contemporary art. None of its installations better demonstrates that than the giant, beaming “sun” installed by Olafur Eliasson in the Turbine Hall, which visitors thronged to gawp at en masse. An “almost psychotropic transformation of human social behaviour” was how Jonathan Jones described the public’s gaga response at the time.
Also this year:graphic novelPersepolisis the first of many great artworks about Iran this century; the White Stripes release Seven Nation Army, a track that first takes over indie dancefloors – and then moves on to the football terraces.
2004 | World of Warcraft
The massively multiplayer online role-playing game had been around for years before Blizzard Entertainment entered the fray, but this fantasy steampunk adventure soon dominated the scene. Effectively an online version of Dungeons and Dragons, it allowed players to create warriors, join clans and fight monsters as a team – and that’s pretty much what they’re still doing 20 years later. With an estimated 7.5 million players, the virtual world of Azeroth has a larger population than Denmark. Picked by Keith Stuart, Guardian games correspondent
Also this year: Matt Stone and Trey Parker puncture liberal pieties with puppets in Team America; Strictly Come Dancing and The X Factor reinvent shiny-floored Saturday evening TV.
2005 | Never Let Me Go
Kazuo Ishiguro’s poignant, sci-fi-tinged novel is emblematic of the collision of pop fiction and literary fiction that seemed to accelerate in the 21st century, as serious authors like Colson Whitehead or Emily St John Mandel dabbled effortlessly in genre. But more than that, Never Let Me Go is a novel that has been held close by a generation of readers enchanted – and devastated – by its raw coming-of-age tale.
Also this year:Stewart Lee ushers in the age of deconstructed standup with 90s Comedian;Gay cowboy romance Brokeback Mountain has audiences weeping in the cinema aisles – and again a year later, when it loses out on the best picture Oscar to the abysmal Crash.
2006 | Back to Black
A mark of how good Amy Winehouse’s second album was – and still is – is that it remains enlivening to listen to even while its lyrics attest to – and predict –perhaps the bleakest celebrity rise and fall story of the past 25 years. Back to Black’s merging together of classic Motown soul and contemporary, deeply personal lyrics has influenced a generation of songwriters, and set Mark Ronson on the path to being the key producer of the 21st century – but the absence of the superstar at its centre is still painfully felt.
Also this year:Planet Earth changes the game for nature documentaries; the Nintendo Wii brings a new dimension to gaming with its motion controller – leading to plenty of smashed tellies.
2007 | Punchdrunk: The Masque of the Red Death
Punchdrunk’s pawprints are all over theatre this century: immersive experiences litter the West End, and audiences have grown used to finding themselves, sometimes unwillingly, part of the play. Any number of Punchdrunk productions could slot neatly into this list, but this one, a bacchanalian adaptation of Poe’s short stories made in collaboration with the Battersea Arts Centre gets the nod as the Guardian critics’ favourite Punchdrunk production of the 21st century.
Also this year:The Sopranos finale cuts to black, raising the bar for TV endings; the haunted dubstep of Burial’s Untrue inspires endless downbeat dance imitators.
2008 | The Dark Knight
This was the year the soon-to-be-dominant superhero movie genre split off in two distinct directions: on one path, there was the shiny, quippy planet-smashing of Marvel’s Iron Man; the other, the darkness – in both look and outlook – of Christopher Nolan’s landmark second Batman film. That Dark Knight would inspire numerous less talented film-makers to make a succession of gloomy, self-serious superhero movies shouldn’t count against what is still arguably the best superhero movie of this era. Nolan, of course, would go on to parlay its success into a series of mad, ambitious original blockbusters.
Also this year: groundbreaking doc 102 Minutes That Changed Americatells the story of 9/11 through a collage of amateur footage, anticipating the YouTube age; The Girl With the Dragon Tattoo is translated, bringing Scandi-noir to our shores.
2009 | Parks and Recreation
The mockumentary has become comedy’s default mode in the 21st century: if you want to make a workplace sitcom (in a school or a hospital, say), you had to pretend it’s a documentary, for some strange reason. 2009 was when this informal rule was established: this year The Office US enjoyed its highest ratings, and Modern Family debuted to enormous viewing figures. Better than both though – if not as popular – was Michael Schur’s lovely local government mockumentary, which would shake off the cynicism of 00s comedy to become the first in a wave of “nice” 2010s sitcoms (The Good Place, Brooklyn Nine-Nine).
Also this year: Sandbox game Minecraft inspires a generation of “chicken jockey”-screeching coders; Jez Butterworth’s “play of the century” Jerusalem diagnoses Broken Britain.
Robyn at The Warfield in 2010, San Francisco, California. Photograph: Tim Mosenfelder/Getty
2010 | Robyn: Body Talk
Giving the world Dancing on My Own and Call Your Girlfriend – the “crying-while-dancing” ur-texts – would alone be enough to secure a place on this list. But the institutional ripple effects of Body Talk are still being felt, too. It set the template for the heights an emancipated pop star could reach. Independence from a major label allowed the Swede to pursue an auteurist strain of pop that has since become the norm – think Charli xcx et al – and Body Talk’s unerring quality brought a generation of indie snobs in from the cold, becoming a poptimist set text. Picked by Laura Snapes, Guardian deputy music editor
Also this year: Christian Marclay’s video artwork The Clockcreates a 24-hour timepiece out of film footage; The Great British Bake Off cooks up a cosier, kinder form of reality TV.
2011 | White House correspondents’ dinner
Were these the most consequential gags of the 21st century? Many have pinpointed the flurry of digs aimed – first by Barack Obama, then comedian Seth Meyers – at a glowering Donald Trump, at this event as the inciting incident in persuading Trump to run for president and stick it to the elites that had laughed at him. Perhaps we shouldn’t look back on it too fondly then – though the gags still hold up: “Donald Trump often appears on Fox, which is ironic because a fox often appears on Donald Trump’s head,” deadpanned Meyers as Trump’s vulpine ‘do quivered angrily in the audience.
Also this year:Game of Thrones lops off its hero’s head, changing genre TV for ever; One Man, Two Guvnors ushers in the age of James Corden.
2012 | The Visitors
In a grand, dilapidated mansion in upstate New York, nine Icelandic musicians (including the artist, playing the guitar in the bath) extemporise a gently melancholic song for more than an hour. So why is this nine-screen film installation so compelling? Named after Abba’s then-final LP, The Visitors captures the wistful end of youth, the sadness at the conclusion of a marriage, and the fragile optimism of liberal America (Obama had just been re-elected). It’s as gorgeous as the last golden hour of summer. Picked byAlex Needham, Guardian arts editor
Also this year: Psy’s Gangnam Style complete with preposterous horsey dance becomes the biggest viral hit of the decade; Danny Boyle wows the world with the London 2012 opening ceremony. (Props for smuggling Fuck Buttons in there, Danny.)
2013 | Breaking Bad: Ozymandias
The breathless Ozymandias has a decent claim to be the best episode of TV’s golden age, but its significance is even bigger than that: it helped set Netflix on the path to replacing TV. This was the year that the streaming service first became indispensable – thanks in part to a series of buzzy originals (House of Cards, Orange is the New Black, the Arrested Development reboot), sure. But many of us signed up that year purely to watch every horribly tense moment of Breaking Bad’s final season.
Also this year:Beyoncé’sself-titled fifth LP popularises two 21st-century trends – the visual album and the surprise release;Grand Theft Auto V pushes gaming to new heights (hurry up with the sequel, Rockstar!).
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Sarah Koenig with her microphone at the court in Baltimore as the judge overturns Adnan Syed’s conviction on 19 September 2022. Photograph: Jonathan Ernst/Reuters
2014 | Serial
Podcasts had existed for a decade before Sarah Koenig called Adnan Syed on his prison payphone and pressed record, but Serial was the breakout moment for the medium, not to mention that of true crime: a year later Making a Murderer and The Jinx would premiere, and today every streaming service or podcast platform hoping to turn a profit has to have at least one salacious crime doc on its books. Vanishingly few, though, are as compassionate, thoughtful or just plain good as Koenig’s.
Also this year: Richard Linklater’s mesmerising Boyhood is like a coming-of-age drama meets nature-doc time-lapse footage; Happy Valley brings noir drama to Hebden Bridge – complete with shockingly un-BBC levels of violence.
2015 | Hamilton
The words “rap battle musical about America’s founding fathers” should by rights send a shiver down the spine of any right-thinking person … which makes Hamilton’s success all the more remarkable. A key moment in the re-emergence of the Broadway musical, Lin-Manuel Miranda’s hymn to disagreeing agreeably also felt perfectly timed for Trump’s first reign. A decade and endless stagings around the world later, few recent productions can be considered as influential.
Also this year: Ta-Nehisi Coates’s Between the World and Me is an electrifying memoir for the BLM era; Kendrick Lamar’s dizzying, righteous To Pimp a Butterfly plays a similar role for the album.
2016 | Pokémon Go
Created by innovative American studio Niantic, a specialist in augmented reality mobile phone games, Pokémon Go set Nintendo’s legendary monster collecting adventure free from consoles and thrust it into the real world. Suddenly, the likes of Pikachu and Jigglypuff could be located in your garden, local town centre or on holiday, and you could team up with pals and strangers to find them. An incredible experiment in location-based entertainment, sending millions of fans out into the sunshine. Keith Stuart
Also this year: Barry Jenkins’ beautiful Oscar winner Moonlight announces the arrival of hipster studio A24; The Crown turns the lives of the Windsors into luscious, gourmet TV.
2017 | Get Out
Nearly a decade on, the decision not to give Jordan Peele’s timely race relations horror satire the best picture Oscar seems even more glaring than it did at the time. But no matter: its influence has been felt elsewhere, with it teaching a generation of directors (Ari Aster, Robert Eggers et al) that horror – far from a constrictive and formulaic genre – could be a blank canvas on which to splatter their wildest, goriest ideas.
Also this year: David Lynch breaks the rules of TV – again! – with Twin Peaks revival The Return; Stormzy takes grime to No 1 with debut album Gangs Signs & Prayer.
2018 | Normal People
Marianne and Connell’s will-they-won’t-they romance took a generation by storm, earning Sally Rooney the title of “the first great millennial author”. Set in mid-2010s Ireland, Normal People captured the post-2008 crash anxieties of the era, looking at the possibilities of love under contemporary capitalism. It also put the Sad Girl Novel on the map, with books like Ottessa Moshfegh’s My Year of Rest and Relaxation, Naoise Dolan’s Exciting Times and Megan Nolan’s Acts of Desperation riding the wave. Picked byElla Creamer, who writes the Guardian’s Bookmarks newsletter
Also this year:Red Dead Redemption 2 takes the open-world sandbox game to eye-popping new heights; Succession debuts and everyone says they can’t stomach watching such horrible people … then do exactly that for four seasons.
2019 | Blinding Lights
One of the many ways Spotify has changed music is in how we quantify a hit: where once we counted in millions, we now consider billions the benchmark. Blinding Lights, The Weeknd’s synth-pop tingler, is the most listened-to song on Spotify with 3.9bn streams. A scarcely fathomable number – it would take more than 27,000 years to listen to those streams one-by-one – but also sort of small: Spotify’s only less than two decades old, after all. What sort of streaming numbers will be the benchmark when we’re halfway through this century: hundreds of billions? Trillions?
Also this year: Bong Joon-ho’s brilliant Parasite breaks down the one-inch barrier of subtitles; a brilliant Nan Goldin retrospective hits London – right as Goldin is tearing up the art world with her protests against opioid scions (and major art benefactors), the Sackler family.
Michaela Coel in I May Destroy You. Photograph: Landmark Media/Alamy
2020 | I May Destroy You
It feels like Michaela Coel’s one-series wonder has been memory-holed in recent years, the result perhaps of landing smack bang in the middle of that fuzzy, time-bending Covid era. Harsh, as IMDY was and remains a major piece of work. The culmination of a decade’s-worth of auteurist comedy-dramas often mislabelled as sadcoms (Girls, Master of None, Fleabag), it stretched that mini-genre into unpredictable new shapes, reckoning with sexual assault, racism, representation, financial precarity and everything else under the sun in its restless, experimental 12 episodes.
Also this year: Fiona Apple’s singular Fetch the Bolt Cutters manages a perfect 10 on Pitchfork; Hilary Mantel completes her Thomas Cromwell trilogy – and the final book of her lifetime – with The Mirror and the Light.
2021 | Bo Burnham: Inside
This was released at the peak of the “lockdown art” era, where creative types with nowhere to go made ambitious work in their own front rooms. No one pushed that idea further than Burnham, who holed himself up in his LA guest room for a year devising a musical comedy spectacular that doubled up as a meditation on lockdown loneliness. Was it even standup comedy? No one was sure, but its invention sure put the frighteners up other comics: James Acaster said it made him want to quit comedy.
Also this year: gruesome TV megasmash Squid Game caps a period of Korean cultural dominance; Rebecca Frecknall’s Cabaret at the Kit Kat Club marked the return of theatre post-Covid, with celebrity (Jessie Buckley, Eddie Redmayne) and cocktails.
2022 | Top Gun: Maverick
Barbenheimer might get most of the plaudits for coaxing audiences back after Covid, but it was Tom Cruise and his F-14 that really bailed cinema out at its lowest point, with a blockbuster that demanded to be seen on the big screen, then sent audiences out of multiplexes high on the heady fumes of nostalgia. Released just weeks shy of Cruise’s 60th birthday, Maverick also underscored that action cinema had become a country for old-ish men: see also Brad Pitt in this year’s F1.
Also this year:Severance, a puzzle-box mystery tailor-made for the Reddit age, debuts on Apple TV+; the gaming world is bowled over by Elden Ring, a jaw-droppingly vivid fantasy adventure.
A Swiftie takes a photograph at the Swiftie Steps and murals at Wembley Park, north west London. Photograph: Yui Mok/PA
2023 | The Eras tour
More than 10 million attended across 149 dates, with $2bn raised in ticket sales – plus who knows how much more from a coordinated merch onslaught … This was the tour that obliterated all tours, confirming Taylor Swift’s place as the biggest artist of her age, and maybe any age. But it was also the crowning moment of a post-pandemic communion, as people all across the world returned giddily to gigging.
Also this year: The Legend of Zelda: Tears of the Kingdom became a true crossover event, with even casual gamers entranced by its imagination and humour; Steve McQueen’s haunting video art piece Grenfelluses drones to silently bear witness to a British scandal.
2024 | All Fours
If autofiction was one of the big literary trends of this century – with novelists suddenly choosing to use their own life stories rather than making things up – Miranda July was the movement’s megastar. All Fours, her account of a perimenopausal woman’s sexual awakening, inspired as Zoe Williams put it in her interview with July, “the sort of mania last experienced when the final Twilight book dropped, except this time for women in midlife rather than teenage girls”. A true cultural phenomenon.
Also this year: Richard Gadd turns his Baby Reindeer fringe show into a remarkably revealing – if ethically murky – Netflix hit; Cindy Lee’s haunted alt-pop album Diamond Jubilee is an old school word-of-mouth hit … that you can’t find on Spotify.
2025 | ?????
With half a year still to go, it would be a bit premature to pencil in a name here, but we’re certainly not short of contenders, from Adolescence to Sinners or the Oasis reunion tour. Let’s check back at the end of the year, shall we?
Erik ten Hag endured a nightmare start to life as Bayer Leverkusen manager as his side lost 5-1 to Flamengo U20s.
Leverkusen became the first Bundesliga club to stage a pre-season tour in South America this summer and the former Man Utd boss named a strong starting lineup in his first game since replacing Xabi Alonso.
Nigerian international Victor Boniface led the line, while Mark Flekken – a summer signing from Brentford – and 17-year-old Axel Tape – who arrived on a free from Paris Saint-Germain – all started in Rio de Janeiro.
Image: It was 4-0 at the break in Rio de Janeiro
Lorran put Flamengo in front after a rapid counter-attack inside two minutes, and it was 2-0 inside 10 when Arthur miscued a clearance, with the ball trickling into the back of his own net.
Flekken and Boniface were substituted off with just 36 minutes on the clock, with Niklas Lomb and Alejo Sarco their replacements.
It got worse before the break, as Matheus Goncalves headed in a cross from the left, before Pedro Leao struck after shot from distance had ricocheted back off the left-hand post.
Ten Hag made 10 changes shortly after Gusttavo made it 5-0 following a menacing run in from the flank.
Granit Xhaka – the subject of an ambitious move from Sunderland – Edmund Tapsoba, Alex Grimaldo, Patrick Schick, and former Southampton and Burnley forward Nathan Tella were among those to join the action.
But a tap-in from Germany U18 international Montrell Culbreath was all they could muster in what remained.
US rejects WHO pandemic changes to global health rules Reuters
US rejects WHO global pandemic response accord Dawn
Joint Statement by Secretary of Health and Human Services Robert F. Kennedy, Jr. and Secretary of State Marco Rubio on International Health Regulations Amendments HHS.gov
Trump Rejects Global Pandemic Plan’s ‘Solidarity’ Reforms The Daily Beast
US rejects amendments to WHO international health regulations The Hill
Clippers rookie Yanic Konan Niederhäuser has been showing off his 7-foot-3 wingspan in NBA 2K26 Summer League.
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LAS VEGAS — Yanic Konan Niederhäuser was in the dunker spot Monday at the Thomas & Mack Center when LA Clippers teammate Zavier Simpson drove hard down the middle of the paint. Simpson hit the rookie center with a good bounce pass and watched him go up against Los Angeles Lakers center Christian Koloko — and miss everything.
At that point, Konan Niederhäuser had made only two shots in nine quarters of summer-league action. None of those makes came in his first seven quarters. He only attempted one shot in his second summer-league game the night before.
In the second quarter, though, Konan Niederhäuser got a couple of dunks, including one in Koloko’s grill. He cut off another Simpson drive in the third quarter, finishing another dunk. And to cap the show, Konan Niederhäuser took two dribbles on a fast break following a Lakers turnover and launched himself toward the basket just inside of the free-throw circle, with total disregard for backpedaling power forward Cole Swider. It was the kind of dunk that showcased the 7-foot-3 wingspan and 37-inch maximum vertical leap from a man who checks in at 6-feet-11 and 243 pounds.
“I was just way more aggressive today,” the 22-year-old said after scoring 10 points on 5 of 9 field goals against the Lakers as part of a 67-58 win. “I rolled harder to the rim. Also, when I left the hotel, I said, ‘Today, Konan gotta be here. Not Yanic. Konan the Barbarian.”
Monday night was a breakthrough for Konan Niederhäuser, but it still highlighted areas where he has room for improvement. In a game the Clippers won by nine points, the Lakers outscored them by nine in Konan Niederhäuser’s 22:54. While the Clippers were at their best with burgeoning young defender Trentyn Flowers on the floor, it has been a struggle for them to keep Konan Niederhäuser included offensively through three games. His only two free-throw attempts came in his first game Friday against the Houston Rockets, he hasn’t made any shots outside of the paint despite attempting two 3-pointers, and his next assist will be his first in summer league.
“He’s got to run the floor all day,” Clippers summer-league head coach Jeremy Castleberry said when asked about what Konan Niederhäuser needs to do to get more opportunities to score. “If he runs the floor all game, rim protects and continues to get behind the defense, he’ll be OK. He’s got to get his conditioning in shape. He’s working on it. Like I said, every game, he’s getting better. I like everything he’s doing. I have no issues with him, as long as he comes in and works harder than he did the last day.”
The Clippers drafted the Switzerland-born Konan Niederhäuser with the 30th pick in June, making him the first Penn State player selected in the first round of the NBA Draft. Even with that pedigree, he is set to be a multi-year project.
General manager Trent Redden said that Konan Niederhäuser went from 6-1 as a 15-year-old to 6-9 by the time he was 18. Before he landed at Penn State, he played at Northern Illinois for two years. Now, as the third-string center behind two starting-caliber veterans who both took the long road toward improving their games, he has a long way to go and a relatively short time to get there.
When Ivica Zubac was traded to the Clippers in 2019 from the Lakers, he was a month away from his 22nd birthday on March 18. Niederhäuser turned 22 on March 14. Zubac was given a starting job right away with the Clippers and didn’t permanently earn that spot until 2021. This past season, he blossomed into a 30-minute player for the first time, earning his first career All-Defense selection while averaging career bests in points (16.8), rebounds (12.6) and assists (2.7).
“I was excited, happy. I felt I was in a great spot, especially with all these veterans who I can learn from,” Konan Niederhäuser said. “A great spot to just develop and get better. It’s my main goal to improve every year and just get better.”
Konan Niederhäuser knew Zubac would be his teammate when he was drafted. Once free agency began, the Clippers added 2021 NBA champion Brook Lopez on a two-year deal. Lopez, like Zubac, knows a thing or two about development. Lopez didn’t make more than two 3-pointers in a season until his ninth year. Now, he’s known as one of the league’s elite 3-point shooting, rim-protecting centers who can still score inside at a high level.
Lopez said he is willing to be a mentor to Konan Niederhäuser while also pushing the young center to get the most out of his ability.
“I was fortunate to play with a lot of great players throughout my career,” said Lopez, who turned 37 in April. “Kevin Garnett, Paul Pierce, Giannis (Antetokounmpo), Vince Carter. I can go down the line. But particularly, KG was someone I was fortunate to have played with when I was a younger player in this league.
“He helped mold me into the player I am today. And so, I think it’s only right to pass on the things he taught me, help the younger guys the same way he helped me. I wouldn’t be here if it weren’t for him. So I’m absolutely ready to get on the court, help him out and then help him adjust and become a great player in this league.”
Konan Niederhäuser was the fifth center selected in June. The only true center who went in the lottery was Khaman Maluach out of Duke, who went No. 10 to the Phoenix Suns. The other three first-round centers were Thomas Sorber out of Georgetown (15th to Oklahoma City), Yang Hansen out of China (16th to Portland) and Joan Beringer out of France (17th to Minnesota). All of those centers are younger than Konan Niederhäuser.
The Clippers worked out Creighton center Ryan Kalkbrenner, who became the sixth center drafted, going 34th to the Charlotte Hornets. Kalkbrenner is more experienced and pro-ready than Konan Niederhäuser, but Kalkbrenner is more than a year older after spending five years in college. Konan Niederhäuser’s athletic tools — he had the second-best standing vertical leap of any player at the combine at 33 1/2 inches — likely give him the higher ceiling. Still, Kalkbrenner will likely be watched by Clippers fans as a counterpart to Konan Niederhäuser.
“I feel like I’m in a great spot,” Kalkbrenner told The Athletic. “Part of making it in the league is being in the right place at the right time, and I feel I am. I feel there’s an opportunity to play. I feel management and coaches all have a plan for me, want me to be a part of the long-term plan.So I just got to come in and do what they ask … but obviously being a fifth-year player, I have the expectation of myself, and they have the expectations of me to come in and to do some things right away. Obviously I don’t think that’s going to happen. You don’t expect most rookies to come in and be an All-Star right away or be a star player right away, but I think I can definitely come in and impact the game right away.”
Even with the high expectations a player like Kalkbrenner has, he can relate to Konan Niederhäuser’s assimilation to being a center in summer league. In three games, Kalkbrenner has 26 points on 10-of-21 shooting from the field, with a high of 10 points (the same single-game scoring high as Konan Niederhäuser).
As the Clippers progress through summer league, Konan Niederhäuser will progress through his development. Over time, the Clippers hope he learns how to use his body to effectively put himself in a position to make an impact on both ends of the floor. Because Konan Niederhäuser is 22 and not 19, it is even more critical to show he can make it with the Clippers; it’s harder to sell the other 29 teams on a second-chance 25-year-old than it is for a second-chance 22-year-old.
Konan Niederhäuser is getting a taste of what it’s like to get better in a short amount of time. And he knows that he needs to channel that “barbarian” to be the best version of himself.
“He’s ruthless — I watched his movie,” Konan Niederhäuser told The Athletic when asked about “Conan the Barbarian.” “I know he’s got his goal in mind, and if he wants to get something, he’s going to get it. And he’s going to do whatever he’s got to do to get it.”
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Law Murray is a staff writer for The Athletic covering the LA Clippers. Prior to joining The Athletic, he was an NBA editor at ESPN, a researcher at NFL Media and a contributor to DrewLeague.com and ClipperBlog. Law is from Philadelphia, Pa., and is a graduate of California University of Pennsylvania and the University of Southern California. Follow Law on Twitter @LawMurrayTheNU
Keeping multiple devices charged while traveling usually means packing several wall warts and cables. Thanks to the clever design of the Twelve South Butterfly SE 2-in-1 Qi2 Charger, however, you can power two Qi2-compatible devices with a single, compact accessory. Best of all, the foldable charger is now on sale at Amazon and Best Buy starting at $40.99 ($59 off), which is the lowest price we’ve seen.
The Butterfly SE features two soft-touch charging discs, one that delivers up to 15W for your phone and another that provides up to 5W for your smartwatch. The two discs are connected by a flexible strap, and they snap together magnetically for travel, folding down to roughly the size of an AirPods Pro case. The versatile charger can also fold into a stand, allowing you to display the iPhone in StandBy mode, which transforms the device into a bedside clock or photo frame.
Each purchase comes with a color-coordinated woven USB-C cable, though it doesn’t include a wall adapter. For this kit to work, you’ll need a 30W charger (this one from Anker is currently down to $12.29 at Amazon). Twelve South also offers an aluminum version of the Butterfly, which is also on sale for $79.99 ($50 off) at Amazon. Build quality aside, the so-called Butterfly 2-in-1 MagSafe Charger is essentially the same thing, but it includes the necessary 30W power adapter and four international adapters.
If you’ve ever tried to get in-app support on WhatsApp, you know the process used to start with filling out a form, possibly attaching a few files, and waiting for a support rep to eventually get in touch.
Now, that form is on its way out, and the screening process is, you guessed it, becoming AI-based. But that’s not necessarily a bad thing.
Out with the form, in with AI
Unless you’re Stephen Hackett, support knowledge bases are never fun to navigate, especially if you are in a hurry and already feeling aggravated as you try to sort through large quantities of help options that rarely fit your specific problem.
On WhatsApp, the old process could be especially anxiety-inducing. Filling out a contact form and sending it into the void, not knowing exactly when you should expect a response, wasn’t the most reassuring experience in an emergency situation.
Now, as reported by WABetaInfo (via Tecnoblog), going to Settings > Help > Help Center > Contact Us takes you straight to a new chat window, where a support bot tries to understand the issue, search WhatsApp’s help docs, and walk you through a solution in natural language.
If necessary, it can ask for more information before escalating the conversation to a human.
Interestingly, WABetaInfo notes that the feature was recently added to the TestFlight beta of WhatsApp, but it already appears to be live for some users. I was able to access the new form-free support chat in the regular app, so the rollout may be imminent, or possibly happening gradually by region.
AI-based support is inevitably becoming the rule
It is worth noting that WhatsApp is not the only company heading down this path. As recently reported, on bringing a generative AI assistant to its Support app, likely to help handle common issues automatically and escalate only the trickier ones to a human.
If implemented correctly, AI-based chatbots can handle the more common issues, allowing for human agents to focus on more tricky cases. And with fewer of those piling up, users might get to them faster, too.
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