Category: 3. Business

The behaviour of private water companies is widely recognised as unacceptable: they flout regulations, cause significant environmental harm, neglect their responsibilities, and still pay enormous sums to directors and shareholders. Ofwat’s rulings and fines appear ineffective, often penalising consumers (Letters, 18 August), while renationalisation is dismissed as prohibitively expensive.

We propose an alternative means of controlling private-sector companies – replace Ofwat’s monetary fines with state-owned voting shares of equivalent value. This approach would have several immediate benefits. By exercising shareholder rights, the state – on behalf of the public – could directly influence company policies; the public purse would gain revenue from dividends; and over time, as the state’s shareholding increased, full nationalisation would become financially feasible.
Dr Ruth Sinclair and Dr Jill Vincent
Loughborough, Leicestershire

Your article says that not a single reservoir has been built since water privatisation (How can England possibly be running out of water?, 17 August). But close to 100 were built in the 35 years prior to privatisation. The plundering of our public services and natural resources is a national disgrace. Public ownership is the only way to end this grisly affair.
John Lockwood
Carshalton, London

Microsoft Corp. has curtailed Chinese companies’ access to advance notifications about cybersecurity vulnerabilities in its technology after investigating whether a leak led to a series of hacks exploiting flaws in its SharePoint software.

The change, which occurred last month, will limit access for program participants in “countries where they’re required to report vulnerabilities to their governments,” which would include China, according to David Cuddy, a Microsoft spokesperson. The goal of the Microsoft Active Protections Program, or MAPP, is to provide security software companies around the world with early details about flaws in Microsoft products so they can provide updated protections for their customers faster.

Key Facts

How Have Markets Reacted?

The Nasdaq dropped nearly 290 points (1.3%) by around noon Tuesday, as shares of Nvidia (2%), Intel (7%), Palantir (5%), AMD (2%) and Broadcom led a broader tech selloff. Other firms, including Micron (5%), Tesla (3%), Amazon (2.1%), Apple (1.6%) and Microsoft (0.8%) also declined. In Asia, semiconductor maker TSMC’s shares dropped more than 2%.

Does The U.s. Acquire Stakes In Companies?

The U.S. does not regularly acquire equity in companies, though it previously took equity in some banks and automakers—including General Motors and AIG, among others—during the 2008 financial crisis. Equity has historically been taken by the U.S. in times of financial instability, including Chrysler in the late 1970s and defense-related industries during World War II. Some economists have argued equity held by the U.S. government could expose taxpayers to potential losses, while others believe U.S. investment could boost sectors.

What Has Trump Said About The Chips Act?

President Donald Trump has repeatedly bashed the Biden-era CHIPS Act and has threatened to scrap it. In his address to a joint session of Congress in March, the president said the CHIPS Act was a “horrible, horrible thing,” adding: “We give hundreds of billions of dollars, and it doesn’t mean a thing. They take our money, and they don’t spend it.”

Crucial Quote

Lutnick told CNBC: “The Biden administration literally was giving Intel for free, and giving TSMC money for free, and all these companies just giving them money for free. Donald Trump turns that into saying, ‘Hey, we want equity for the money. If we’re going to give you the money, we want a piece of the action.’”

Tangent

Earlier on Tuesday, Japanese investment giant SoftBank announced it had agreed to a deal to purchase $2 billion worth of Intel stock at $23 per share.

Further Reading

US examines equity stake in chip makers for CHIPS Act cash grants, sources say (Reuters)

Artificial Intelligence (AI)–assisted mammogram readings reduced radiologists’ workload by approximately 40% while maintaining performance accuracy, a new study published in Radiology found.¹

Prior evidence suggests using AI for decision support in breast cancer detection screenings can improve radiologist reading performance. Numerous studies have assessed the proficiency of AI-assisted screenings; however, the new study aimed to assess the reduction in workload AI might provide radiologists by allowing standalone AI interpretation in cases where the model performs as well as or better than the radiologist.

The study introduced an AI model to mammogram screenings that outputs the probability of malignancy (POM) and a measure of its uncertainty. Researchers proposed a hybrid reading approach where recall decisions for additional screenings made by the model were only assessed for a double reading by a radiologist if the predictions were deemed confident by the model itself.

Researchers compiled digital mammographic screening examinations performed between July 2003 and August 2018 at the prevention screening unit in Utrecht, the Netherlands. The AI interpretation model was developed to assess screenings in 3 steps—in contrast to previous models based on a single neural network—which are standard for examination-level predictions. The 3 steps were:

• A sensitivity region detection algorithm that proposes regions of interest
• A region classification network
• The generation of an examination-level conclusion

The certainty of the models’ predictions was based on the region classification stage and its effect on the uncertainty of the entire model. While the region detection network was considered, it was ultimately omitted from certainty projections due to its high-sensitivity operation, which would likely cause false-negative errors at an examination level. The output was measured at the examination level, resulting in an area under the receiver operating characteristic curve (AUC).

AI-Assisted Mammogram Screening Proficiency

The data set, comprised of 41,471 examinations from 15,524 women with a median age of 59 years, included a total of 332 screen-detected cancers and 34 interval cancers. The AUC for the AI mammography interpretation model for detecting malignancies was 0.92 (95% CI, 0.89-0.94), meaning it performed exceedingly well in distinguishing malignant from nonmalignant cases. The single (1 radiologist) and double (2 radiologists) readings by radiologists had sensitivities of 69.2% and 72.3%, respectively, meaning they were able to detect about 69 out of 100 and about 72 out of 100 cancers, respectively. Their specificities of 98.2% (95% CI, 98.0-98.3) and 98.3% (95% CI, 98.2-98.4), respectively, show that radiologists were very accurate in avoiding false positives, although they did miss some cases, resulting in a lower sensitivity. At those specificities, the AI model had a lower sensitivity for both single reading and double reading—62.1% (95% CI, 55.0-68.9; P = .01) and 61.6% (95% CI, 54.3-68.6; P < .001), respectively. These data show that while the AI was able to detect a significant number of cases, when forced to match the high specificity of radiologists, it was much less sensitive.

The uncertainty metric that produced the best results was the entropy of the mean of the POM score of the most specific region. Under this metric, the AI assigns each region of the breast a POM score and then measures the confidence of its interpretation for each score. High entropy means the AI is uncertain, yet using this metric led to a split where the AI was uncertain in 61.9% of cases.

The detection rate and recall rate did not differ drastically, if at all, from that of the standard double readings (recall, 23.7 vs. 23.9 per 1000 examinations), yet 19% of the recalls were triggered by AI alone. The study authors still consider this to be unfavorable, as most women prefer their mammograms to be read by at least 1 radiologist, thus encouraging radiologists to also review recalled examinations by AI despite its confidence in interpretation. ²

Overall, the hybrid reading strategy reduced the radiologist’s workload to 61.9%, with a cancer detection rate of 6.6 per 1000 examinations (95% CI, 5.5-7.7) and a recall rate of 23.6 per 1000 (95% CI, 21.6-25.5). ¹

“Even with this lower performance, leveraging the information gained by estimating the examinations where the model is certain, it is still possible to reduce the workload while maintaining the performance of standard double reading,” the study author explained. “Applying the proposed strategy to a higher-performing model would likely improve the reduction in workload or improve the performance further.”

The limitations of this study address the POM as a fair predictor of certainty because deep neural networks tend to be overconfident in their predictions. Additionally, radiologists’ behavior was not considered despite potential changes due to the prevalence of cancers and subtypes varying within a set, which may have influenced their reading strategy.

“Therefore, further research, ideally a prospective trial, is needed to determine how workload reduction in the number of examinations obtained using this method would translate to a reduction in reading time,” the study authors concluded. “The best uncertainty metric could guide a reading strategy to reduce workload by approximately 40% without decreasing performance even with a model that has lower performance than that of a single radiologist.”

References

1. Verboom SD, Kroes J, Pires S, Broeders MJM, Sechopoulos I. AI should read mammograms only when confident: a hybrid breast cancer screening reading strategy. J Am Coll Radiol. Published online August 19, 2025. doi:10.1148/radiol.242594

2. Ongena YP, Yakar D, Haan M, Kwee TC. Artificial intelligence in screening mammography: a population survey of women’s preferences. J Am Coll Radiol. 2021;18(1 Pt A):79-86. doi:10.1016/j.jacr.2020.09.042

Facundo Arrizabalaga/MyLondon

Facundo Arrizabalaga/MyLondon

‘Dramatically worse’

Health Canada has approved nivolumab (Opdivo) plus ipilimumab (Yervoy) for the first-line treatment of patients with unresectable or metastatic microsatellite instability–high (MSI-H) or mismatch repair–deficient (dMMR) colorectal cancer (CRC) and patients with unresectable or advanced hepatocellular carcinoma (HCC).¹

Data from the phase 3 CheckMate-8HW (NCT04008030) and CheckMate-9DW (NCT04039607) trials supported the approval of nivolumab plus ipilimumab for the respective patient populations. Of note, the CheckMate-8HW study demonstrated progression-free survival (PFS) benefit in patients with MSI-H/dMMR CRC, and the CheckMate-9DW study showed overall survival (OS) improvements in patients with HCC.

“Although we’ve seen progress, MSI-H or dMMR metastatic CRC is clinically complex, particularly in the first-line setting, where there remains an ongoing need for additional treatments,” Sharlene Gill, MD, MPH, MBA, FRCPC, professor in the Department of Medicine in the Division of Medical Oncology at The University of British Columbia in Vancouver, Canada, stated in a news release. “The approval of [nivolumab] plus [ipilimumab], supported by CheckMate-8HW, the largest phase 3 immunotherapy trial to date in this population, offers a well-studied and very clinically meaningful option for patients and clinicians treating this distinct molecular subtype of CRC.”

Efficacy and Safety Data From the CheckMate-8HW Study

In the CheckMate-8HW study, at a data cutoff date of August 28, 2024, the median follow-up was 47.0 months (IQR, 38.4-53.2).² Patients treated with nivolumab plus ipilimumab demonstrated a significant and clinically meaningful improvement in PFS compared with nivolumab alone (HR, 0.62; 95% CI, 0.48-0.81; P = .0003). Notably, the median PFS was not reached (95% CI, 53.8-not estimable [NE]) with the combination compared with 39.3 months (95% CI, 22.1-NE) with nivolumab alone.

Regarding safety, treatment-related adverse effects (TRAEs) of any grade were observed in 81% of patients (n = 285 of 352) treated with nivolumab plus ipilimumab, and 71% (n = 249 of 351) of those treated with nivolumab alone. Additionally, grade 3 or 4 TRAEs occurred in 22% and 14% of patients in the respective arms. Three treatment-related deaths were reported, with one death each caused by myocarditis and pneumonitis in the combination arm, and one death from pneumonitis in the monotherapy arm.

CheckMate-8HW Study Design

The international, open-label, randomized study included patients who are immunotherapy naive with unresectable or metastatic CRC with MSI-H/dMMR status. Patients were randomly assigned 2:2:1 to receive either nivolumab plus ipilimumab, nivolumab alone, or chemotherapy with or without targeted therapies.

The dual independent primary end points are PFS by blinded independent central review (BICR) with nivolumab plus ipilimumab compared with chemotherapy and PFS by BICR with nivolumab plus ipilimumab versus nivolumab.

Efficacy and Safety Data From the CheckMate-9DW Study

Following a median follow-up of 35.2 months (IQR, 31.1-39.9), a significant improvement in OS was observed with nivolumab plus ipilimumab compared with lenvatinib (Lenvima) or sorafenib (Nexavar), with a median OS of 23.7 months (95% CI, 18.8-29.4) vs 20.6 months (95% CI, 17.5-22.5), respectively (HR, 0.79; 95% CI, 0.65-0.96; 2-sided log-rank P = .018).³ The OS rates were 49% (95% CI, 44%-55%) and 39% (95% CI, 34%-45%) at 24 months with nivolumab plus ipilimumab vs lenvatinib or sorafenib; these respective rates were 38% (95% CI, 32%-43%) and 24% (95% CI, 19%-30%) at 36 months.

“For patients with unresectable or advanced HCC, improving outcomes continues to be a critical priority,” Hatim Karachiwala, MD, a medical oncologist at Alberta Health Services in Canada, added in the news release.¹ “Data from CheckMate-9DW provides useful insights into how the [nivolumab] plus [ipilimumab] dual immunotherapy strategy might be considered as part of the initial treatment approach.”

Moreover, grade 3/4 TRAEs were observed in 41% of patients (n = 137 of 332) in the nivolumab plus ipilimumab arm and 42% (n = 138 of 325) of those treated with lenvatinib or sorafenib.³ Twelve deaths were due to treatment with nivolumab plus ipilimumab, and 3 deaths were due to treatment with lenvatinib or sorafenib.

CheckMate-9DW Study Design

The open-label, randomized study included patients who were at least 18 years of age with unresectable HCC who did not previously receive systemic therapy. Patients on the study were required to have at least 1 measurable lesion per RECIST 1.1 criteria, a Child-Pugh score of 5 or 6, and an ECOG performance status of 0 or 1. Patients were randomly assigned 1:1 to receive either nivolumab plus ipilimumab, or investigator’s choice of lenvatinib or sorafenib.

The primary end point is OS, and safety comprised an exploratory end point.

“These approvals mark important progress for both the [CRC] and liver cancer communities. For those facing aggressive disease, time matters,” Filomena Servidio-Italiano, president and chief executive officer of Colorectal Cancer Resource & Action Network, stated in the news release.¹ “Expanding access to first-line immunotherapy—particularly with combination strategies that enhance the immune system engagement—responds to an important unmet need.”

References

1. Health Canada approves dual immunotherapy Opdivo plus Yervoy for colorectal and liver cancers. News release. Bristol Myers Squibb. August 19, 2025. Accessed August 20, 2025. https://www.bms.com/ca/en/media/press-release-listing/2025-08-19-press-release.html
2. André T, Elez E, Lenz HJ, et al. Nivolumab plus ipilimumab versus nivolumab in microsatellite instability-high metastatic colorectal cancer (CheckMate 8HW): a randomised, open-label, phase 3 trial. Lancet. 2025;405(10476):383-395. doi:10.1016/S0140-6736(24)02848-4
3. Yau T, Galle PR, Decaens T, et al. Nivolumab plus ipilimumab versus lenvatinib or sorafenib as first-line treatment for unresectable hepatocellular carcinoma (CheckMate 9DW): an open-label, randomised, phase 3 trial. Lancet. 2025;405(10492):1851-1864. doi:10.1016/S0140-6736(25)00403-9

By Steve Gelsi

Cosmetics company has approved layoffs of 3,200 staff based on a previously disclosed restructuring plan and may reduce head count by another 3,800, with expected restructuring charges of up to $1.6 billion

Estée Lauder posted a wider loss due partly to severance costs as its Asia-Pacific sales fell 3% in the fourth quarter.

This story has been updated to reflect that Estée Lauder announced 5,800 to 7,000 job cuts in February, not on Wednesday.

Estée Lauder Cos.’ stock dropped about 5% Wednesday after the maker of beauty products warned of a full-year profit miss and said it has approved 3,200 job cuts based on a previously announced restructuring plan.

Estée Lauder said that it approved the 3,200 layoffs as of Aug. 13, with severance and other charges of $747 million, but that it may ultimately lay off another 2,600 to 3,800 people under a plan initially laid out in February. The total number of job cuts could represent up to about 12% of the company’s workforce.

“I’ve said it multiple times – this is the biggest organizational transformation that we have done in our history,” Chief Executive Stéphane de La Faverie said on the company’s quarterly investor call, according to a FactSet transcript. “The culture is evolving and it’s changing, but we are really pushing on ambition and accountability.”

All told, the company expects restructuring and other changes to range from $1.2 billion to $1.6 billion for employee costs, asset-related costs, contract terminations and other costs.

Estée Lauder’s stock (EL) was down 4.8% in late morning trading, partially recovering from wider losses in premarket action.

The restructuring will generate $800 million to $1 billion of annual cost savings to boost its operating margin and “fuel reinvestment in consumer-facing areas to drive sustainable sales growth,” the company said.

Looking ahead, Estée Lauder said it expects about $100 million in tariff-related headwinds to affect its fiscal 2026 profitability as it weighs potential price increases.

For fiscal 2026, Estée Lauder said it expects adjusted profit of $1.90 to $2.10 a share, below the current FactSet consensus estimate of $2.20 a share.

For its fiscal fourth quarter to June 30, Estée Lauder said it faced sales “deterioration” mostly due to a double-digit-percentage decline in its global travel retail business, which includes sales of luxury items at duty-free shops in airports and cruise-ship terminals. The company also cited softness in mainland China from “ongoing subdued consumer sentiment and tighter inventory management by some retailers.”

Sales of the company’s skin-care products – its largest line of business – fell 16% in the fourth quarter to $1.71 billion, while makeup sales dropped 11% to $982 million.

The company’s fourth-quarter loss widened to $546 million, or $1.51 a share, from a loss of $284 million, or 79 cents a share, in the year-ago quarter. The latest quarter included $527 million of combined restructuring intangible-asset impairment charges, or about $1.12 a share.

On an adjusted basis, which excludes nonrecurring items, earnings per share fell to 9 cents from 64 cents in the year-ago period and matched the FactSet consensus.

Revenue dropped 12% to $3.41 billion but came in ahead of the analyst estimate of $3.39 billion.

Asia-Pacific sales fell 3% to $1.17 billion, while Middle East and Africa sales fell 22% to $1.29 billion and Americas sales dropped 6% to $949 million.

The company said it decided to cut its exposure to reseller activity, which also impacted revenue.

“Retailer shifts in strategies toward more profitable duty free business models in both Korea and mainland China … led to lower replenishment orders,” the company said.

On the plus side, Estée Lauder said it’s expecting a return of mid-single-digit sales growth in China as well as improved shipments as it reduces its exposure to reseller activity.

CEO de La Faverie said Estée Lauder has faced “continued volatility” but sees signs of momentum, with plans to grow organic sales in fiscal 2026 after three years of declines.

“This is only the beginning of the momentum that we are just going to see going forward,” he said.

-Steve Gelsi

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