Apple has secured a top-five spot in the most-watched streaming series with its original programming for the first time, Bloomberg reports.
According data from Nielsen, Apple TV+ claimed one of the five most-viewed original streaming titles in the United States during the first half of 2025. While Netflix maintained three of the top four positions and Amazon’s Reacher performed strongly in second place, Apple emerged alongside those longstanding competitors for the first time with the second season of Severance.
Nielsen’s rankings are based on total minutes viewed and represent U.S. audiences only, combining viewership across connected TVs and select devices. The most-watched shows in the United States in the first half of 2025 are as follows:
Apple’s rise in the rankings coincides with a broader trend; Netflix’s share of the most-watched streaming titles declined from more than 80% in 2021 to just under 50% in the first half of 2025. The figures reflect increasing competition from rivals such as Amazon, HBO, Hulu, Paramount+, and Apple TV+, all of which have placed shows in the top 10 so far this year. Disney+, by contrast, has not had a single original series appear in Nielsen’s top 10 to date.
While Netflix remains the most consistent producer of hits overall, with a larger number of top-performing series than any other service, its share of total streaming viewership has plateaued. Nielsen reported that total streaming consumption in the U.S. grew by 6% year-over-year in the first half of 2025, but Netflix’s share of that growth remained flat. Free ad-supported platforms, such as YouTube, Tubi, and the Roku Channel, are increasingly capturing viewers from traditional TV and paid subscription services alike.
Apple does not disclose subscriber figures for Apple TV+, but Ampere Analysis estimated in May that the service has surpassed 60 million paying users globally, with the strongest growth occurring in North America and Western Europe over the past 12 months. Apple has renewed Severance for a third season.
In our study, measles seroprevalence was 46.1%, and the seroprevalence was higher in the group born between 1986 and 1997 than in the group born between 1998 and 2004. It was also determined that the seropositivity rate exceeded 50% in those born before 1997.
There are different data in the literature regarding measles seroprevalence in Turkey. In a study examining measles serology in students residing in our university dormitory, measles seropositivity was found to be 100% in the population born before 1986 [15]. In the study conducted by Açıkgöz et al., it was found that measles seropositivity was higher among students aged 21 and older and those with lower income levels in Turkey [16]. In a study conducted by Köse et al., the seropositivity rate was found to be 72% in the group aged 18–25, 88.8% in the group aged 26–35, and 95.2% in the group aged 36–45 [17]. These findings are similar to the finding of lower seropositivity rate in the younger group in our study. In a study that included employees of a university hospital and medical students, measles seroprevalence was found to be 57% [18]. In the same study, susceptibility rate was 46% in the group aged 18–25, while it was determined that the entire group over the age of 38 was immune [18]. Consistent with previous studies, our findings indicate that younger individuals demonstrate increased susceptibility to measles.
Medical students, as early-career healthcare workers, are at particularly high risk of exposure to measles due to their frequent patient contact in clinical settings. The lower seroprevalence observed in younger individuals, particularly those born between 1998 and 2004, suggests that a significant proportion of medical trainees may be susceptible to measles infection. Given that medical students will transition into clinical settings, ensuring their immunity is important for both personal safety and infection control in healthcare settings.
In different studies reported from Europe, it has been observed that the seropositivity rate is lower among younger healthcare workers, similar to the results in our country [19, 20]. In a study reported from Latvia in 2022, a seroprevalence of 77.3% was found in healthcare workers, while the lowest seroprevalence was in the 26–35 age group at 53% [21]. The same study revealed that seronegativity for measles was higher compared to diphtheria among healthcare workers [21]. In a study reported from Korea, it was shown that while the general measles seropositivity in healthcare workers was 73%, immunity decreased to 42% in the group born after 1995 [22].
In our study, a strong negative correlation (r = -0.964) was found between year of birth and measles seroprevalence, indicating that younger individuals have lower immunity to measles compared to older groups. This finding is particularly important when considering the seroprevalence patterns across age groups. Individuals born between 1998 and 2004 exhibited lower measles seroprevalence, suggesting higher susceptibility in this group. Several factors may contribute to this observed decline in immunity. First, waning vaccine-induced immunity over time may be a possible explanation. Unlike natural infection, which usually provides lifelong immunity, vaccine-induced immunity is known to wane over time, particularly in the absence of booster doses or exposure to circulating wild-type virus. In addition, gaps in vaccination coverage or primary vaccine failure in this group may have led to a lower seroprevalence rate. In contrast, higher measles seropositivity was found in older individuals born between 1986 and 1997. This group may have been more frequently exposed to wild-type measles virus, which confers immunity from natural infection, which is known to be more stable and durable than vaccine-induced immunity. Before widespread implementation of measles elimination programs, periodic outbreaks may have contributed to the strengthening of herd immunity, allowing individuals to acquire strong and durable immune responses.
It is thought that the low measles seroprevalence in the group born between 1998 and 2004 may be related to the vaccination policies in our country. An examination of the historical vaccination policies in our country reveals that 1998 marked the year when second dose of the monovalent measles vaccine was first administered to school-age children, and the monovalent measles vaccine continued to be used until 2006. It is expected that 93–95% protection will be achieved after a single dose of monovalent measles vaccine, and 97–99% after a second dose. This suggests that the low seroprevalence rate found in our study may be due to disruptions in the implementation of new vaccination practices. Since the vaccination histories of the participants could not be obtained, no definitive comment could be made on this matter. Secondary vaccine failure and waning measles immunity are also known to play a role in low seroprevalence [23]. Adolescents and young adults, whose immune systems may weaken over time, are particularly affected by these factors. These groups may be more vulnerable to disease in later years, as immunity levels may decline after vaccination. Additionally, individuals with diseases or medical conditions that suppress the immune system may have waning immunity over time, which may increase susceptibility to measles infection.
In our study, no relationship was found between measles seropositivity and gender. In another study conducted in 2012 on healthcare workers, it was shown that the immune response did not change significantly by gender, while a study conducted in 2015 found that seronegativity was higher in females [24, 25]. More recent studies including the young adult group showed no difference between genders, similar to our study [17, 26].
Looking at the studies reporting measles seroprevalence from Turkey, regional differences can be seen. In Şanlıurfa, it was reported that measles seroprevalence was 52.6% in the 18–21 age range and 77.7% in the 22–25 age range in 2023. In a study conducted in Manisa in 2017, seroprevalence was found to be 74.1% in the 18–29 age group [27]. There is no comprehensive study in the literature that provides seroprevalence according to regions. In our study, measles seroprevalence was found to be the lowest in the Eastern Marmara Region (34.5%) and the highest in the Western Black Sea Region (59.5%). The Eastern Marmara statistical region includes Kocaeli, Sakarya, Düzce, Bolu, and Yalova. Although measles seroprevalence was expected to be relatively high in the Eastern Marmara Region due to its socioeconomic status, the lowest seroprevalence was observed in this region in our study. After the 17 August 1999 Gölcük Kocaeli and 12 November 1999 Düzce Earthquakes, there were significant disruptions in the supply of vaccines and the implementation of healthcare services in the region. It is thought that these painful historical events may be a reason for the current low seroprevalence in the young adult population born and raised in the region.
Our study has several limitations. It was conducted at a single center, and therefore it is not possible to make a definitive conclusions about measles seroprevalence in healthcare workers and the general population on a national or international level. Vaccination records of all participants could not be obtained, and since some of the participants who were asked about their vaccination history were unable to recall their vaccination status, preventing a thorough assessment. Additionally, since the participants who applied to our polyclinic voluntarily were included in the study, differences were observed in the number of applications over the years.
Our study covers a 14-year period and evaluates a single group within healthcare workers. To the best of our knowledge, this is the first study in our country to compare measles seroprevalence with birth year and place of birth among healthcare workers.
Universal’s “Jurassic World Rebirth” retained its lead at the China box office for a second weekend, earning RMB80.2 million ($11.1 million) from July 11–13, according to data from Artisan Gateway.
The dinosaur tentpole has now amassed $62.8 million after 12 days on release.
In a rare tie, local thriller “Malice” and racing drama “F1: The Movie” shared second place with $8.2 million each. “Malice,” produced by As One Production, has reached a cumulative total of $25.6 million. Directed by Lai Mukuan and Yao Wenyi, the film follows journalist Ye Pan (Zhang Xiaofei), who becomes the centre of controversy when she accuses nurse Li Yue and mother You Qian of involvement in a mysterious double fall. Her reporting ignites a public uproar as layers of truth and public opinion collide.
“F1,” from Apple Original and Warner Bros., stands at $35.6 million after three weekends in the Middle Kingdom.
Warner’s DC Studios launched “Superman” in fourth place with $6.2 million, marking a soft debut for the superhero reboot.
Rounding out the top five was Chinese animated fantasy “Curious Tales of a Temple,” which opened with $5.7 million. Produced by Light Chaser Animation, the anthology is based on Pu Songling’s classic “Strange Tales from a Chinese Studio.” The film features six interlinked ghost stories all tied to the mysterious Lanruo Temple, and is co-directed by Cui Yuemei, Liu Yuan, Xie Junwei, Zou Jing, Huang Heyu, and Liu Yilin. The voice cast includes Lu Lifeng, Lin Qiang, Zhang He, and Chen Ziping.
The weekend’s overall box office reached $51.3 million, bringing China’s 2025 year-to-date gross to $4.24 billion, a 20.2% increase over the same period last year.
Chronic obstructive pulmonary disease (COPD) is a prevalent and debilitating respiratory condition characterized by irreversible airflow limitation, primarily resulting from chronic bronchitis and emphysema. It significantly impairs patients’ quality of life and is a leading cause of morbidity and mortality worldwide, contributing to a substantial burden on healthcare systems. Despite advancements in pharmacological management and rehabilitation approaches, there remains a critical need for comprehensive strategies that address the multifaceted nature of COPD, including its exercise-induced symptoms and associated comorbidities.1,2
In particular, exercise-induced desaturation (EID) during physical activity is a common phenomenon among COPD patients, with studies indicating that approximately 20% or more of this patient population experiences significant oxygen desaturation during exertion.3–5 Current literature highlights the importance of assessing EID as an indicator of disease severity and a predictor of adverse outcomes, such as increased hospitalization and mortality rates.6 Nonetheless, the criteria for diagnosing EID are inconsistent across studies,7 often relying on single assessments of resting SpO2 or subjective evaluations of exercise tolerance. This inconsistency underlines a significant gap in our understanding of how EID manifests in different COPD phenotypes and its implications for patient management.8 Furthermore, dynamic monitoring of SpO2 during standardized exercise tests, particularly the six-minute walk test (6MWT), is essential for accurately capturing EID and its physiological correlates.9 The 6MWT has emerged as a widely accepted tool for evaluating exercise capacity in COPD patients, providing valuable insights into their functional status and prognosis.10 It is not only straightforward to administer but also sensitive to changes in patient condition, making it a pivotal component of routine clinical assessments. Previous studies have demonstrated that a decline in SpO2 during the 6MWT is associated with a higher risk of COPD exacerbations and mortality, reinforcing the need for continuous monitoring of oxygen levels during exertion.9,11–13 However, the relationship between EID severity and health-related quality of life remains underexplored, with limited research investigating how varying degrees of desaturation impact patients’ daily functioning and overall well-being. In summary, while the multifactorial nature of COPD necessitates a nuanced understanding of its clinical manifestations, existing literature provides a foundation for investigating the prevalence and implications of exercise-induced desaturation. This study endeavors to fill the current research void regarding EID characteristics and health-related quality of life among COPD patients, thereby advancing the knowledge base in this critical area of respiratory medicine. The present study adopts a retrospective design to address these gaps by analyzing data from 116 COPD patients who underwent the 6MWT. It aims to classify the severity of EID and evaluate its association with various physiological parameters, including forced expiratory volume (FEV1) and the distance walked during the test. Additionally, the research will assess the impact of EID on health-related quality of life, utilizing standardized measures such as the EQ-5D, to identify potential predictors of EID severity and their clinical implications. By elucidating these relationships, this study seeks to contribute to the development of targeted interventions for COPD patients, ultimately enhancing their management and quality of life.14–17
The study ethical approval was obtained from the China–Japan Friendship Hospital (2022-KY-141; clinical trial registration number: NCT04318912). Informed consent was obtained from all participants prior to their inclusion in the study. Patient data confidentiality was strictly maintained, and all procedures were in compliance with the Declaration of Helsinki. This study included 116 COPD patients diagnosed between May 1, 2023, and June 30, 2024, at the China–Japan Friendship Hospital. The cohort consisted of 97 males and 20 females. Inclusion criteria were based on the 2020 GOLD guidelines for stable COPD. Exclusion criteria included:
1. Resting SpO2 ≤ 92%, HR > 120 bpm.
2. Systolic BP > 180 mmHg or diastolic BP > 100 mmHg.
3. Malignant arrhythmias.
4. Severe valvular disease.
5. Walking limitations due to neurological or musculoskeletal disorders.
6. Concurrent malignancy. Demographic data such as gender, age, baseline heart rate, and SpO2 were extracted from electronic medical records.
Pulmonary function tests were performed using the MasterScreen™ PFT system (CareFusion Germany GmbH, Höchberg, Germany) following ATS/ERS guidelines. Parameters measured included forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, peak expiratory flow (PEF), and their respective predicted values.
The 6MWT was performed in a 30-meter indoor hallway following ATS guidelines as described previously,18,19 supervised by two trained assessors. Continuous SpO2 was monitored using a Multidimensional assessment system for 6-minute walk test with integrated wearable cardiopulmonary exercise test (Yiliankang Medical Technology Co., Zhejiang, China), with Bluetooth-enabled data acquisition at 3-second intervals from 1 minute pre-test to 4 minutes post-test. Subjective dyspnea and fatigue were assessed using the Borg scale post-test. EID was classified as follows: Mild EID: SpO2 decrease ≥4% with nadir SpO2 ≥90%. Severe EID: SpO2 decrease ≥4% with nadir SpO2 ≤90%. Non EID: SpO2 decrease <4% with nadir SpO2 ≥90%.16
The validated questionnaire was administered to evaluate symptom burden.20 The CAT consists of 8 items (cough, cough sputum, chest tightness, shortness of breath climbing/walking up stairs, limitation of daily activities, confidence to go out, sleep quality, energy level), each using a 0–5 point Likert scale (0 = no effect, 5 = extremely severe).
Measured using a Jamar Hydraulic Hand Dynamometer (KDG Grip Strength Tester, Bolingbrook, USA), with participants seated and elbow flexed at 90°.
Assessed with an isokinetic dynamometer (MicroFET 2; Hoggan, West Jordan, UT), with participants positioned in 90° hip flexion and 60° knee flexion.
Patients were followed up six months post-clinic visit via telephone to record survival status, adverse events (acute exacerbations, complications, rehospitalizations), and quality of life using the Chinese EQ-5D-5L questionnaire.
EQ-5D-5L questionnaire includes five dimensions graded into five levels and a visual analog scale (EQ-VAS) for overall health evaluation.21 Five dimensions of health included mobility, self-care, activities of daily living, pain/discomfort, anxiety/depression with 5 severity levels for each dimension. Health Status Codes: 5-digit codes (eg, “12345” for no difficulty with mobility, minor difficulty with self-care, etc), detailed information regarding the scoring system of the EQ-5D-5L questionnaire has been added to the Table S1. Indicator conversion was based on country/region-specific utility weights (eg, China). Conversion of 5-digit code to a single health utility index based on country/region-specific utility weights.
Statistical analysis was performed using IBM SPSS Statistics (version 26.0; IBM Corporation, Armonk, New York, USA). Measurement data following a normal distribution were expressed as mean ± standard deviation (xˉ±s). ANOVA was used to compare means across ≥3 groups, justified by confirmed normality (Shapiro–Wilk test) and equal variance (Levene’s test). Post hoc Bonferroni tests identified specific group differences if ANOVA was significant (*p < 0.05*). Count data were expressed as numbers or percentages and analyzed using the chi-square test. Significance testing of regression coefficients was performed at a significance level of 0.05. Multivariate logistic regression was used to analyze factors influencing severe EID in COPD patients. ROC curves were plotted to evaluate the predictive ability of influencing factors for the severity of EID.
A total of 116 COPD patients were included in the study, with an average age of 63.32 ± 7.99 years. Among them, 44.8% patients had no EID, 36.2% had mild EID, and 19.0% had severe EID. There were no statistically significant differences in gender, age, BMI, grip strength, knee extension strength, or rest heart rate among the three groups (p > 0.05). Compared to patients with no or mild EID, those with severe EID had significantly lower levels of rest SPO2 (%), PEF (L/s), PEF (%), FEV1 (L), and FEV1 (%) (SPO2: p = 0.002; PEF: p < 0.001; PEF (%): p < 0.001; FEV1: p = 0.026; FEV1 (%): p = 0.001). Severe EID patients also had shorter 6MWD (P < 0.001) and experienced more severe dyspnea and fatigue (Borg dyspnea: p = 0.040; Borg fatigue: p = 0.015). (See Table 1).
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Table 1 Basic Characteristic Information of Patients with Different Degrees of EID in Chronic Obstructive Pulmonary Disease
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Taking the severity of EID in COPD patients as the dependent variable (1 = severe EID, 0 = non-severe EID), variables with p <0.05 from Table 1 were included as independent variables in the logistic regression analysis. Results showed that low FEV1(%), low 6MWD, and low blood SpO2 were risk factors for severe EID in COPD patients (FEV1(%): p = 0.002; 6MWD: p = 0.008; blood oxygen: p = 0.018). (See Table 2).
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Table 2 Identifies the Factors Influencing Severe EID Through Logistic Regression and Establishes a Regression Model
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The optimal cut-off values for predicting EID severity were as follows: FEV1(%): 54.45, with an AUC of 0.716. 6MWD (m): 450.5 m, with an AUC of 0.761. SpO2 (%) at rest: 94.5%, with an AUC of 0.737. FEV1(%), 6MWD, and resting SpO2 effectively distinguished patients with severe EID from those with non-severe EID. (See Figure 1 and Table 3).
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Table 3 Comparison of FEV1(%), 6MWD, and Resting SpO2 Between Severe and Non-Severe EID Patients
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Figure 1 ROC curve with FEV1, 6MWD, and resting blood oxygen can distinguish between severe EID patients and non-severe EID patients.
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No deaths were reported during the follow-up period. Severe EID patients had significantly lower EQ-5D index and EQ VAS scores (EQ-5D index: p = 0.002; EQ VAS: p = 0.005). Among the five dimensions of the EQ-5D-5L scale, there were no significant differences in self-care, pain/discomfort, or anxiety/depression scores among groups (p > 0.05). However, patients with severe EID had significantly lower scores in mobility and usual activities compared to those with no or mild EID (mobility: p = 0.001; usual activities: p = 0.038). (Figure 2 and Table 4). Besides, there is no statistically significant difference in the frequency of acute exacerbations, emergency department visit or hospitalization rates, and Respiratory tract infection incidence rates among the different EID groups (p > 0.05) (Table 5).
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Table 4 Follow-Up EQ-5D Data of COPD Patients with Different Degrees of EID at 6 Months
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Table 5 Follow-Up Data of COPD Patients with Different Degrees of EID During 6 Months
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Figure 2 The violin plot used to display the distribution of EQ-5D index across three groups, including statistical information such as density distribution, median, and quartiles. P-value * < 0.05, ***< 0.001, ns >0.05.
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The study highlights actionable thresholds (FEV1%, 6MWD, SpO2) and symptom metrics (Borg scores) that are clinically practical for EID management. By translating these findings into care pathways, clinicians can improve early diagnosis, tailor interventions, and optimize patient-centered outcomes.
Effective management strategies are critical, yet they often fall short of comprehensively addressing the multifaceted nature of the disease, particularly as COPD progresses and leads to exacerbations and comorbidities that further complicate patient care.4 This study aims to investigate the characteristics of EID in COPD patients, identify predictive factors for varying degrees of EID, and evaluate the impact of EID on health-related quality of life (HRQoL). By analysis of clinical data from 116 COPD patients undergoing the six-minute walk test (6MWT), we aim to elucidate the relationship between physiological parameters and EID severity. In this study, approximately 55% of COPD patients exhibited EID. Research has shown that the severity of airflow limitation is associated with EID, with patients experiencing reduced FEV1 having a higher risk of EID.3 Another study indicated that the decline in SpO2 was significantly associated with reduced FEV.19 This study demonstrated that pulmonary function parameters such as FEV1, and FEV1%value were associated with EID, suggesting that worsening EID is related to deteriorating pulmonary function, consistent with previous studies. However, some studies have indicated that pulmonary function alone may not sufficiently predict a reduction in 6MWD. The relationship between obesity and EID remains unclear. Some studies have identified obesity as a positive predictor of EID, possibly because obese patients are more prone to dyspnea.3,12 Waatevik et al13 found a significant association between obesity and EID before incorporating the modified Medical Research Council dyspnea score into their model. However, other studies reported a negative correlation, with moderate obesity potentially mitigating hyperinflation and improving dyspnea in COPD patients.4 Kim et al6 found that patients with EID had lower average BMI, with BMI reduction linked to increased mortality risk. In this study, obesity was not associated with EID, possibly due to the small sample size. The relationship and underlying mechanisms between obesity and EID require further exploration. Furthermore, some studies have indicated that advanced age and female sex are associated with an increased risk of EID.5 However, in this study, neither age nor sex was related to EID, which may be attributed to selection bias in the sample.
The prediction of EID can provide valuable guidance for clinical practice and prognostic management. Perez et al4 reported that an abnormal reduction in resting SpO2 could serve as a predictor of EID. Andrianopoulos et al7 identified the 6MWT as the preferred exercise test due to its simplicity and sensitivity to arterial oxygen desaturation. This study showed that FEV1%, 6MWD, and resting SpO2 could effectively predict the degree of EID, consistent with previous research. Additionally, some studies have suggested that diffusion capacity of the lung for carbon monoxide (DLCO) could predict the extent of oxygen desaturation. CT-defined emphysema has been found to outperform19 and resting SpO2 in specific predictive contexts.13 The current limitations of single-factor EID prediction emphasize the need for further research into multifactorial predictive models to more accurately predict EID and guide clinical and prognostic interventions.
Furthermore, this study found that severe EID reduces HRQoL, primarily by impairing mobility and causing inconvenience in daily life. Patients with EID face a higher risk of dyspnea or fatigue during routine activities. Salant et al14 reported that the mean utility value for assessing COPD patients using EQ-5D-5L in a meta-analysis was 0.676, compared to 0.780 for EQ-5D-3L. Moreover, longer timeframes in the EQ-5D scale can reduce ceiling effects and enhance reliability.17 In this study, the timeframe for the EQ-5D scale was set as “today”. Using a longer timeframe, such as “1 week” or “4 weeks”, might better reflect the overall HRQoL of patients.
The findings will enhance our understanding of the predictors of EID and provide insights into how EID correlates with patients’ functional status and overall quality of life, thereby guiding clinical management approaches tailored to individual patient needs. The innovation of this study lies in its comprehensive evaluation of EID in COPD patients through the lens of the 6MWT. Unlike previous research which primarily focused on static measurements of lung function,4,9,10,22 our study highlights the dynamic nature of SpO2 during exertion, filling a significant gap in the literature. While earlier studies, such as those by Chang et al,5 indicated correlations between static pulmonary function metrics and EID, our findings suggest that factors such as the 6MWD and resting SpO2 levels serve as critical predictive markers for EID severity. This research not only corroborates existing knowledge but also provides novel insights into the prognostic implications of EID for COPD patients, particularly in predicting long-term outcomes and guiding therapeutic interventions. The implications of our findings extend to clinical practice and policy-making. By identifying specific risk factors associated with EID, such as low FEV1% and diminished 6MWD, clinicians can implement targeted interventions for high-risk patients. This could include more personalized rehabilitation programs and the potential use of supplemental oxygen during physical activity to enhance exercise tolerance. Moreover, the identification of EID as a significant predictor of adverse outcomes highlights the necessity for routine monitoring of SpO2 during physical exertion in COPD management protocols. These insights could influence health policy by advocating for integrated care approaches that prioritize exercise assessments alongside traditional pulmonary function tests, ultimately aiming to improve patient quality of life and reduce healthcare costs associated with COPD exacerbations.
Importantly, our previous study did examine the relationship between cardiovascular function and EID, despite evidence suggesting that conditions such as atrial fibrillation may increase the risk of EID during six-minute walk tests.16 Chang et al5 had found that atrial fibrillation was associated with EID, with COPD patients exhibiting higher risks of oxygen desaturation during the 6MWT. Mesquita et al23 had reported that COPD patients with impaired left ventricular ejection fraction had significantly reduced 6MWD. But, the impact of left ventricular ejection fraction on six-minute walk distance was not investigated, despite existing literature indicating that compromised cardiac function could affect exercise capacity in COPD patients. In the future, the relationship between cardiovascular function and EID should be analyzed.
However, this study is not without limitations. The relatively small sample size may hinder the generalizability of the findings. Future research should aim to include larger, multicentric cohorts to validate our results further. Additionally, the proportion of patients who experienced exacerbations during the 6-month follow-up was relatively low, which may have reduced the statistical power to detect the association between EID and the risk of exacerbations. This limitation is partly due to the characteristics of the study cohort, which included stable COPD patients with good adherence to treatment and regular health management. Therefore, caution is needed when interpreting the relationship between EID and exacerbation risk based on our findings, and future studies involving cohorts with higher exacerbation rates are warranted to validate these results.
In summary, this study elucidates the clinical characteristics and predictive factors associated with EID in COPD patients, revealing a significant impact on their quality of life. The findings underscore the importance of early identification and management of EID to improve patient outcomes. By establishing the relationship between various physiological parameters and EID severity, this research provides a foundation for developing targeted interventions aimed at enhancing the quality of life for individuals with COPD. Future studies should focus on validating these predictive factors in larger, diverse populations and exploring the interplay between cardiovascular and pulmonary functions to further refine management strategies.
This study highlights the necessity of a multifactorial approach to EID management, considering pulmonary function parameters, mobility, baseline oxygen saturation, and subjective patient experiences. These factors not only aid in identifying high-risk patients but also provide a basis for personalized treatment. Moreover, the relationship between EID and HRQoL underscores the importance of considering patient quality of life in COPD management. Monitoring parameters such as FEV1%, 6MWD, and resting SpO2 can facilitate the effective assessment of EID in COPD patients, enabling earlier interventions to enhance patient outcomes and quality of life.
The data that support the findings of this study are available from the corresponding author upon reasonable request.
We thank the staff of the Department of Rehabilitation Medicine and Department of Clinical Research and Data Management for participating in this research.
All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.
This work was supported by 1.National High Level Hospital Clinical Research Funding, 2.Elite Medical Professionals Initiative of China-Japan Friendship Hospital (NO.ZRJY2025-GG04), 3.the National Natural Science Foundation of China (82102654), 4.the Beijing Natural Science Foundation (2024BZR-7242126), 5.Medical and health technology innovation project of Chinese Academy of Medical Sciences (2021-12M-1-049), 6. the Capital’s Funds for Health Improvement and Research (2024-2-4069). The funding body had no role in the design of the study or collection, analysis, or interpretation of data, nor in writing the manuscript.
The authors report no conflicts of interest in this work.
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Perplexity AI’s founder said he has seen a dramatic difference in engineering productivity with AI coding tools.
Aravind Srinivas, who is also the search engine’s CEO, said at a Y Combinator event in June that the company has “made it mandatory” for employees to use at least one AI coding tool. That usually means using Cursor or GitHub Copilot, or a mix of both.
For engineers, using these tools to prototype has reduced “the experimentation time from three, four days to literally one hour,” said Srinivas in a conversation that was uploaded to YC’s YouTube channel on Friday.
That speed isn’t limited to hardcore algorithm work. Srinivas said non-technical colleagues are changing interfaces quickly with these tools.
“I just give them feedback where I take a screenshot of my iOS app, and I say, ‘This button needs to move here with an arrow,’” he said. “They upload my screenshot to Cursor and then ask it to write a change to the Swift UI file,” he added.
“That level of change is incredible,” he said. “The speed at which you can fix bugs and ship to production is crazy.”
But Srinivas also said that these tools are not perfect — they can introduce new bugs that people don’t know how to fix.
Srinivas and Perplexity did not respond to a request for comment from Business Insider.
AI coding tools are gaining traction across the tech industry.
Last month, Business Insider reported that job listings from Visa, Reddit, DoorDash, and a slew of startups showed that the companies explicitly required experience or familiarity with tools like Cursor and Bolt.
A recent survey also shed light on the explosive growth and impact of these tools in software development, Business Insider’s Alistair Barr exclusively reported earlier this month.
Jellyfish, which helps companies manage developer teams, found that 90% of engineering teams are now using AI in their workflows, up from 61% just one year ago. About 48% of respondents reported using two or more AI coding tools, suggesting teams are taking a diversified, exploratory approach.
The survey in May polled 645 full-time professionals in engineering roles, from individual contributors to managers and executives. Respondents came from companies ranging from small teams with fewer than 10 people to large enterprises with over 500 engineers.
A few industry leaders also said the AI coding hype comes with trade-offs.
GitHub’s CEO, Thomas Dohmke, said using AI coding tools might slow down experienced engineers. On a podcast episode released in June, he said a worst-case scenario is when a developer is forced to provide feedback in natural language when they already know how to do it in a programming language.
That would be “basically replacing something that I can do in three seconds with something that might potentially take three minutes or even longer,” Dohmke said.
OpenAI’s cofounder Greg Brockman also said using these tools has left humans with the less enjoyable parts of coding.
He said the state of AI coding had left humans to review and deploy code, which is “not fun at all.”
BBC News, Guernsey
BBCAn islander who suddenly became homeless and found herself living in a garden shed has described the desperation of trying to find somewhere to stay.
Sheyanne Mahy, 26, said she and her husband became homeless in March and had asked the States for help but faced a long waiting list for public housing.
She said she was told there was a one-year wait for housing and they were better off looking in the private market but prices were “way beyond her reach”.
Ed Ashton, director of operations for Social Security, States Housing & Inclusion, said: “We want to house people as soon as possible, however, being able to provide accommodation relies on a property becoming available for them.”
Mrs Mahy said: “I got extremely lucky and was able to stay in a garden shed with my dog with my gran and was there for the duration.
“My husband was able to bounce around different places on the sofa, mostly staying between three or four different people.
“When things got tough we phoned up and questioned again with the States [and said] you know, its starting to get difficult, where are we looking?
“Each time we asked it was back and forth.”
Mrs Mahy said she was told there were lots of people in a similar situation to them and they were better off looking privately, but prices were mostly out of reach for her.
After posting on social media sites looking for accommodation, they were able to secure a winter let owned by Lorraine Lane for about 10 weeks.
During a two-week break from the winter let due to a pre-booked guest, the couple said they were able to secure full-time rented accommodation which is where they still live.
Mrs Lane, 68, said she had encountered many islanders who were experiencing housing issues and she never usually used to rent out her property during the off-season.
“Before Covid I didn’t do it but now with the crisis I seem to have plenty of interest even for such short slots,” he said.
States figures showed there were 66 people on the Band 1 housing list, which are those most in need, but it still takes about a year to secure accommodation.
Jane St Pier, chairwoman of At Home in Guernsey, a charity supporting people experiencing homeless, said: “Everyone is being forced into a very tight funnel.
“The reality is we have lots of pathways into the risk of homelessness right now and we have very few pathways out.”
The figures showed there were 40 people waiting for a one-bed properties and they estimated the wait would be nearly two years.
For a two-bed property, it is a 15-month wait and there were 17 people on that list.
For three-bed properties, there are nine people on the list and the wait time was estimated to be about a year, it said.
Mr Ashton, from the States, said: “We want to house people as soon as possible, however, being able to provide accommodation relies on a property becoming available for them.
“Waiting times are also dependent on the type and size of the property required.
“We remain committed to supporting those who are struggling to find suitable housing, and would urge anyone facing such hardship to contact Income Support.”
STOCKHOLM (Reuters) -Swedish headline consumer prices rose 0.5% in June from the previous month and were up 2.8% from the same month a year earlier, final figures from the statistics office (SCB) showed on Monday.
Stripping out volatile energy prices, a measure the Riksbank is looking at closely, inflation was 3.3% compared to June 2024.
The central bank targets 2 percent CPIF inflation.
Analysts had forecast headline inflation of 2.9% year-year-on-year and 3.3% stripping out energy prices, in line with flash figures released last week.
Flash inflation had come in well above forecasts by both the Riksbank and analysts, casting doubt on whether the central bank will cut rates again this year.
Cutting to 2.00% in June, the Riksbank said the outlook for inflation meant it might be possible to ease policy again before the end of the year to boost stalled growth.
(Reporting by Simon Johnson, editing by Louise Rasmussen)
LOS ANGELES (AP) — “Love Island USA” culminated a tumultuous summer full of explosive breakups and shock exits in its season finale Sunday.
LOS ANGELES (AP) — “Love Island USA” culminated a tumultuous summer full of explosive breakups and shock exits in its season finale Sunday.
A public vote (spoilers ahead) crowned Amaya Espinal, 25, and Bryan Arenales, 28, as the winning couple of its seventh season.
The Peacock reality series has had a chart-topping run since the season premiered on June 3. “Love Island” brings young singles together in a remote villa in Fiji to explore connections with the ultimate goal of finding love.
Espinal and Arenales formed a connection late in the season, bonding over their shared Latino culture. Espinal, a New York City native, is Dominican, and Arenales is of Puerto Rican and Guatemalan descent, according to his Instagram page.
“I often said how much I wanted to provide that safe place here for you, but little did I know that you would do that for me, too,” Arenales said during his final speech before the winners were announced. “You said I was the water to your fire, but you are my peace to this madness.”
Each contestant in the winning couple randomly picked from two envelopes, one which contained the $100,000 prize and the other nothing. Arenales got the full prize, and chose to split it evenly with Espinal.
Olandria Carthen and Nicolas Vansteenberghe were the runners-up, and Huda Mustafa and Chris Seeley — who went through an awkward and emotional breakup during the finale — came in third place. Iris Kendall and Jose “Pepe” Garcia-Gonzalez placed fourth.
The show’s host, Ariana Madix, also announced that the entire cast of Season 7 will come together again for a New York reunion, which will be released on Peacock on Aug. 25, she said.
A season of shake-ups and scandal
The show, an American spinoff to the UK series, has shaken up reality TV, becoming Peacock’s most watched entertainment series on mobile devices, according to NBC Universal.
It became a breakout success and captured mainstream attention last summer, and this season grew into a true cultural phenomenon.
“Love Island: Beyond the Villa,” a new series spinoff, premiered Sunday and follows Season 6’s main cast as they navigate relationships, life and newfound social media fame in Los Angeles.
This season also came under fire as two contestants — Cierra Ortega and Yulissa Escobar — left the villa following resurfaced posts in which they used racial slurs.
Ortega, who was half of one of the season’s strongest couples with Vansteenberghe, left the villa just a week before the popular reality show’s finale after old posts resurfaced that contained a slur against Asian people. She apologized for the resurfaced posts in a nearly five minute TikTok video Wednesday.
Friday’s episode saw the elimination of Ace Greene and Chelley Bissainthe, setting the stage for the finale. Green and Bissainthe were the only couple to maintain a relationship throughout most of the show.
A ‘Dominican Cinderella’ story
The final four couples each went on dates during the last episode before the winners were crowned.
Espinal and Arenales were given a photo book with pictures of each other throughout their lives, culminating with photos from their relationship during the show. The two bonded over family traditions.
“With you, I don’t ever cry out of sadness. Every time I feel like a heightened emotion with you, it’s always just like happy tears,” Espinal said.
The date ended with Espinal and Arenales taking a picture, a final memory from their time on “Love Island USA.” The couple then made their relationship exclusive, noting they will only focus on each other when they leave the island.
“I feel like I’m a Dominican Cinderella when I’m with you, and I finally found my perfect glass slipper,” Espinal said during their date.
How ‘Love Island USA’ works
Stripped of their phones and connection with the outside world, five men and five women arrive in the villa and coupled up based on initial romantic interest. Throughout the season, the show introduces a steady stream of bombshells, new contestants who are brought in to disrupt existing relationships and build new storylines.
Contestants are routinely dumped from the villa, removed either by a public vote or by the islanders themselves.
Under constant surveillance, contestants partook in kissing competitions, heart rate challenges and drama-inducing games ripe for viral moments. Halfway through the season, established couples were temporarily separated for Casa Amor, the show’s ultimate test, and encouraged to explore new relationships with a fresh group of single contestants.
Amaya and Bryan, from late arrivals to America’s sweethearts
Espinal made waves when she walked in as a bombshell early in the season and has been credited for some of the season’s most viral moments.
“I never said I was perfect. I never said I didn’t have any flaws. But at least I’m pretty, and at least I’m a little funny, and at least I’m my own best friend,” Espinal sang to herself in the makeup room, which prompted various covers online and inspired a Google pop-up message when you search up her nickname, Amaya Papaya.
The New York City native, who labeled herself a “sensitive gangster,” tested various connections, including Greene, Austin Shepard and Zak Srakaew, that all fizzled out. Her previous partners on the show said Espinal, who is Dominican, expressed affection too quickly.
A connection sparked between Espinal and Casa Amor contestant Arenales late in the season after he defended her, saying that “coming from a Hispanic household, calling someone babe, mi amor, mi vida, that’s just how we talk.”
“Every time I talk to you, like, my energy is up. I’m walking out smiling. That’s what I want in my life,” Arenales told Espinal during their final date.
Espinal said Arenales lets her express her emotions freely, a difference from her previous connections, which she said “made me feel misunderstood and as if the love I had to give to the world needed to be watered down, but every decision led me to find my personal prince charming.”
Arenales ended his speech by calling Espinal, “mi diabla, mi alma, y mi loquita,” which translates to “my devil, my soul, and my madness.”
Itzel Luna, The Associated Press
An association of Indian pilots has defended the crew of the Air India Flight 171 which crashed in June, killing 260 people.
The Indian Commercial Pilots’ Association (ICPA) said the crew “acted in line with their training and responsibilities under challenging conditions and the pilots shouldn’t be vilified based on conjecture”.
“To casually suggest pilot suicide without verified evidence is a gross violation of ethical reporting and a disservice to the dignity of the profession,” it added.
A preliminary report did not blame the pilots. It said seconds after take-off, both of the Boeing 787 Dreamliner’s fuel-control switches moved to the “cut-off” position, starving the engines of fuel.
The report released on Saturday gave details of the cockpit voice recording with one pilot asking the other why he “did the cut-off”, to which the other replies that he didn’t. The recording doesn’t clarify who said what. Data shows the switches were then moved to “run” position, but the plane crashed within seconds.
Aviation experts and pilots say the fuel switches are designed to prevent accidental activation and they must be pulled up to unlock before flipping. Protective guard brackets further shield them from accidental bumps.
The preliminary report does not throw any light on how the switches were moved to cut-off, but since its release, sections of media and social media has been awash with unsavoury speculation about the role of pilots.
“We are deeply disturbed by speculative narratives emerging in sections of the media and public discourse – particularly the reckless and unfounded insinuation of pilot suicide,” the Indian Commercial Pilots’ Association (ICPA) said in a statement released late on Saturday night.
“Let us be unequivocally clear: there is absolutely no basis for such a claim at this stage, and invoking such a serious allegation based on incomplete or preliminary information is not only irresponsible – it is deeply insensitive to the individuals and families involved.”
The statement added that until the official investigation was concluded and the final report was published, “any speculation – especially of such a grave nature – is unacceptable and must be condemned”.
The preliminary investigation was led by Indian government with experts from Boeing, General Electric, Air India, Indian regulators and participants from the US and UK. A final report is due to come out in a year.
On Saturday, another pilots’ grouping – the Airline Pilots’ Association of India (ALPA India) – had raised concerns over the way the investigation was being handled.
It highlighted that the report also mentions that in December 2018, the US Federal Aviation Administration issued a Special Airworthiness Information Bulletin (SAIB) highlighting that some Boeing 737 fuel control switches were installed with the locking feature disengaged.
While the issue was noted, it wasn’t deemed an unsafe condition requiring an Airworthiness Directive (AD) – a legally enforceable regulation to correct unsafe conditions in a product.
The same switch design is used in Boeing 787-8 aircraft, including Air India’s VT-ANB which crashed. As the SAIB was advisory, Air India did not perform the recommended inspections.
Taking note of the bulletin, ALPA India said “it demands clarity on whether the recommendations outlined in the bulletin were implemented before the flight”. (Air India hasn’t commented on the specific issue.)
The pilots’ union said it was “surprised at the secrecy surrounding these investigations” and alleged that “suitably qualified personnel were not taken on board for the probe”.
“We feel that the investigation is being driven in a direction presuming the guilt of pilots and we strongly object to this line of thought,” ALPA India’s president Captain Sam Thomas said in the statement.
The union also urged the authorities to allow it to join the process “even in the capacity of observers so as to provide the requisite transparency in the investigations”.
Following the report’s release on Saturday, Indian Civil Aviation Minister Ram Mohan Naidu told reporters to not “jump to any conclusions at this stage. Let us wait for the final report”.
Describing the pilots and crew in India as the “backbone of this civil aviation”, he said India had “the most wonderful workforce in terms of pilots and the crew in the whole world”.
Flight 171 had taken off from the western Indian city of Ahmedabad for Gatwick in London on 12 June with 242 people on board. The crash killed 241 onboard – one passenger miraculously survived – and 19 people on the ground.
The report says the pilots, based in Mumbai, had arrived in Ahmedabad the previous day and were adequately-rested. They had passed breathalyser tests and were cleared to fly, it adds.
