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  • Cheryl Kyinn, PA-C, on Personalizing On-Demand Therapies for OFF Episodes in Parkinson Disease

    Cheryl Kyinn, PA-C, on Personalizing On-Demand Therapies for OFF Episodes in Parkinson Disease

    Cheryl Kyinn, PA-C

    (Credit: OCParkinsons.com)

    Although levodopa is considered the cornerstone treatment in Parkinson disease (PD), its long-term use may be limited by motor complications and the inability to slow neurodegeneration. Early in treatment, motor control is strong, but over time, striatal changes can cause dopamine levels to rely entirely on external sources, leading to OFF episodes. Current strategies aim to optimize dopaminergic stimulation to better mimic natural, tonic dopamine activity through pharmacologic, nonpharmacologic, adjunctive, rescue, and device-aided approaches.1

    At the recently concluded 4th Annual Advanced Therapeutics in Movement and Related Disorders (ATMRD) Congress, held by the PMD Alliance from June 27-30, 2025, movement disorder expert Cheryl Kyinn, PA-C, gave a talk about on-demand therapies that can help offer relief for OFF episodes in patients with PD and how to go about using them. In this session, Krinn, a physician assistant specializing in PD in Orange County, California, placed an emphasis on recent findings from clinical trials that documented the timing and optimal use of these medications.

    In a new iteration of NeuroVoices, Kyinn discussed her clinical approach to selecting on-demand therapies for patients with PD experiencing OFF episodes. She highlighted the importance of considering comorbidities, patient preferences, and proper administration education to ensure treatment efficacy. Kyinn also underscored the advantages of therapies that bypass the gastrointestinal tract and the value of open-label data supporting options like inhaled levodopa. Additionally, she advocated for early adoption of extended-release levodopa to help reduce motor fluctuations and stressed shared decision-making to optimize patient quality of life.

    NeurologyLive: How should clinicians approach determining which on-demand therapy may be best suited for a patient experiencing OFF episodes?

    Cheryl Kyinn, PA-C: It’s very similar to how you would make any medication choice for a patient. The first thing is the baseline characteristics of a patient. Do they have other comorbidities? Because, let’s say, the 2 options are quite different and have different adverse effect profiles, so you want to first look at that.

    For instance, if you’re doing an apomorphine subcutaneous injection, that might have a little bit more susceptibility to hypotension and nausea. If someone’s already hypotensive, like many of our patients with PD, you probably wouldn’t go for that one. But let’s say a patient has a comorbidity of COPD, you’re probably not going to go with inhaled levodopa powder, because they probably can’t inhale it. That’s 1 key factor.

    Of course, you also have patient preference. Maybe patients are needle-phobic, or maybe patients honestly, they can’t get over the administration adverse effects. I think the number one thing is patient choice. First of all, I get a lot of needle-phobic patients, so that’s easy off the bat. And then again, their comorbidities as well.

    What findings have maybe most influenced decision-making when it comes to on-demand treatment for PD-related off periods?

    The key thing is that we know all of our oral medications run into the gastrointestinal dysfunction issues. Of course, seeing how these are delivered and that they bypass the GI tract that’s a huge thing.

    I think one of the most interesting studies was the open-label study for morning akinesia. I mean, that’s huge. We don’t have a lot of stuff—actually hardly anything—that helps with that, right? I actually tell my patients, just put your first pill on your bedside, and as soon as you get up, just reach over and swallow it. But again, you have the gastrointestinal dysfunction. The study with morning akinesia was very helpful and great for us clinicians to know that there is an option for this very tough symptom that patients experience.

    For the inhaled levodopa powder, I think it’s a little bit easier to use because you don’t have to do a needle. I did make a joke that it’s kind of similar to smoking but it kind of is. When I’ve seen patients do it, I’m like, it kind of looks like that. But I think the ease of use is helpful, and you see the improvement in the UPDRS score quickly, within 10 minutes. But I guess that’s the other point:, both of them show that T-max concentration within 10 to 20 minutes, and that’s a big factor in wanting to use these on-demand therapies for OFF times.

    In your experience, what key factors could help with ensuring effective and consistent use of these on-demand therapies for patients?

    I think education, education, education, and setting expectations. For instance, if you don’t tell a patient that they might have the cough issue with the inhaled levodopa powder, they will—when they first encounter that cough. First, they’re going to do it wrong, and they’re going to assume it’s like any other inhaler that they’ve seen like an asthma inhaler where you take a big puff and they’ll cough it all out. Not only, 1, do they have the adverse effect, 2, they’re going to cough it all out and not even get the therapeutic effect of the medication.

    Same thing with apomorphine. I think if you set the precedent that, yes, there’s a possibility you can have hypotension and nausea, especially because there’s no current antiemetic therapy that we can give to counter that, at least if they know about it and it happens. They’re not going to be completely caught off guard and then just choose to discontinue either of the medications.

    Setting good expectations, educating the patient on what could happen, and letting them know that if it happens, it’s okay it’s not going to be permanent. It’s going to be very short and brief and mild to moderate, I guess, based off of clinical trials. You’ll get over it, and if you don’t like it, then you don’t have to do it again. That’s the first part of it. And luckily, the companies also I think send nurses to the patient’s home to educate them about that as well, and to help them administer their first couple of doses. So hopefully there’s that continuity of care.

    What clinical signs would prompt you to consider switching a patient with PD to a different levodopa formulation?

    Honestly, I think from the get-go, based off all the clinical data that we have now, the preference is showing that ER formulations are much preferred. All the data suggests that, unfortunately, even though IR levodopa is great and cheap and effective, long-term use of this volatile pulsing of the medication is going to cause issues over time.

    We definitely see that with our patients who’ve had long-standing PD where we feed into the motor fluctuations. I think presenting patients with that data, if we can, we should start them on an ER formulation. But let’s say they are on an IR formulation then, when they start experiencing these motor fluctuations because we know it’s a question of when, not a question of if that, for sure, is a reason. If accessibility wasn’t an issue and cost wasn’t an issue, for sure, as soon as they start experiencing motor fluctuations, we should switch to an ER formulation if possible.

    How do you go about the decision-making process with the patient for treatment?

    I always try to tell my patients when we’re together, I’m here to provide you with the information, and I will guide you on what I think might work best for you but ultimately, they’re in the driver’s seat. It’s a full-on conversation that we’re having. It’s not a one-sided, “I tell you what to do” situation. I’ll even tell patients, “I’m not your mom—I can’t make you do anything,” It’s all up to you. This is your life, the life that you’re living. But it is an open discussion between clinical provider and patient. And I tell them, we’re trying to optimize your quality of life. And the decision-making process is 2-fold. I provide information, and then we, together, pick what’s best for your life, what fits into your lifestyle, with the ultimate goal of improving quality of life.

    Transcript edited for clarity. Click here for more coverage of ATMRD 2025.

    REFERENCES
    1. Masood N, Jimenez-Shahed J. Effective Management of “OFF” Episodes in Parkinson’s Disease: Emerging Treatment Strategies and Unmet Clinical Needs. Neuropsychiatr Dis Treat. 2023;19:247-266. Published 2023 Jan 25. doi:10.2147/NDT.S273121
    2. Kyinn, C. Conquering Off Episodes With On-Demand Therapies. Presented at: ATMRD; June 27-30, 2025; Washington, DC.

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  • Northern lights may be visible in these 13 US states on July 2

    Northern lights may be visible in these 13 US states on July 2

    Northern lights could put on a show tonight (July 2) as an incoming coronal mass ejection (CME) could spark a geomagnetic storm, according to the National Oceanic and Atmospheric Administration (NOAA).

    A CME released on June 28 is due to impact Earth sometime today. It’s possible that this CME could sweep up a slower CME released the day prior, on June 27, according to the U.K. Met Office. The resulting solar storm could disrupt Earth’s magnetic field, which in turn can lead to geomagnetic storms and striking auroras.

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  • Around 250 million years ago, Earth was near-lifeless and locked in a hothouse state. Now scientists know why

    Around 250 million years ago, Earth was near-lifeless and locked in a hothouse state. Now scientists know why

    Some 252 million years ago, almost all life on Earth disappeared.

    Known as the Permian–Triassic mass extinction – or the Great Dying – this was the most catastrophic of the five mass extinction events recognised in the past 539 million years of our planet’s history.

    Up to 94% of marine species and 70% of terrestrial vertebrate families were wiped out. Tropical forests – which served, as they do today, as important carbon sinks that helped regulate the planet’s temperature – also experienced massive declines.

    Scientists have long agreed this event was triggered by a sudden surge in greenhouse gases which resulted in an intense and rapid warming of Earth. But what has remained a mystery is why these extremely hot conditions persisted for millions of years.

    Our new paper, published today in Nature Communications, provides an answer. The decline of tropical forests locked Earth in a hothouse state, confirming scientists’ suspicion that when our planet’s climate crosses certain “tipping points”, truly catastrophic ecological collapse can follow.

    A massive eruption

    The trigger for the Permian–Triassic mass extinction event was the eruption of massive amounts of molten rock in modern day Siberia, named the Siberian Traps. This molten rock erupted in a sedimentary basin, rich in organic matter.

    The molten rock was hot enough to melt the surrounding rocks and release massive amounts of carbon dioxide into Earth’s atmosphere over a period as short as 50,000 years but possibly as long as 500,000 years. This rapid increase in carbon dioxide in Earth’s atmosphere and the resulting temperature increase is thought to be the primary kill mechanism for much of life at the time.

    On land it is thought surface temperatures increased by as much as 6°C to 10°C – too rapid for many life forms to evolve and adapt. In other similar eruptions, the climate system usually returns to its previous state within 100,000 to a million years.

    But these “super greenhouse” conditions, which resulted in equatorial average surface temperatures upwards of 34°C (roughly 8°C warmer than the current equatorial average temperature) persisted for roughly five million years. In our study we sought to answer why.

    The forests die out

    We looked at the fossil record of a wide range of land plant biomes, such as arid, tropical, subtropical, temperate and scrub. We analysed how the biomes changed from just before the mass extinction event, until about eight million years after.

    We hypothesised that Earth warmed too rapidly, leading to the dying out of low- to mid-latitude vegetation, especially the rainforests. As a result the efficiency of the organic carbon cycle was greatly reduced immediately after the volcanic eruptions.

    Plants, because they are unable to simply get up and move, were very strongly affected by the changing conditions.

    Before the event, many peat bogs and tropical and subtropical forests existed around the equator and soaked up carbon

    However, when we reconstructed plant fossils from fieldwork, records and databases around the event we saw that these biomes were completely wiped out from the tropical continents. This led to a multimillion year “coal gap” in the geological record.

    These forests were replaced by tiny lycopods, only two to 20 centimetres in height.

    Enclaves of larger plants remained towards the poles, in coastal and in slightly mountainous regions where the temperature was slightly cooler. After about five million years they had mostly recolonised Earth. However these types of plants were also less efficient at fixing carbon in the organic carbon cycle.

    This is analogous in some ways to considering the impact of replacing all rainforests at present day with the mallee-scrub and spinifex flora that we might expect to see in the Australian outback.

    Post-extinction lycopod fossils.
    Zhen Xu

    Finally, the forests return

    Using evidence from the present day, we estimated the rate at which plants take atmospheric carbon dioxide and store it as organic matter of each different biome (or its “net primary productivity”) that was suggested in the fossil record.

    We then used a recently developed carbon cycle model called SCION to test our hypothesis numerically. When we analysed our model results we found that the initial increase in temperature from the Siberian Traps was preserved for five to six million years after the event because of the reduction in net primary productivity.

    It was only as plants re-established themselves and the organic carbon cycle restarted that Earth slowly started to ease out of the super greenhouse conditions.

    Maintaining a climate equilibrium

    It’s always difficult to draw analogies between past climate change in the geological record and what we’re experiencing today. That’s because the extent of past changes is usually measured over tens to hundreds of thousands of years while at present day we are experiencing change over decades to centuries.

    A key implication of our work, however, is that life on Earth, while resilient, is unable to respond to massive changes on short time scales without drastic rewirings of the biotic landscape.

    In the case of the Permian–Triassic mass extinction, plants were unable to respond on as rapid a time scale as 1,000 to 10,000 years. This resulted in a large extinction event.

    Overall, our results underline how important tropical and subtropical plant biomes and environments are to maintaining a climate equilibrium. In turn, they show how the loss of these biomes can contribute to additional climate warming – and serve as a devastating climate tipping point.


    Zhen Xu was the lead author of the study, which was part of her PhD work.

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  • Assistant commissioner Nawagai among four killed in Bajaur

    Assistant commissioner Nawagai among four killed in Bajaur

    Listen to article

    A deadly bomb blast struck Nawagai area of Bajaur district on Wednesday, killing at least four people and injuring 11 others, according to local officials.

    The explosion occurred on Nawagai road near Sadiqabad Phatak in Khar Tehsil, and reportedly targeted a government vehicle.

    Among those killed were Assistant Commissioner Nawagai, Tehsildar Nawagai, identified as Waqil, a police subedar, and a police constable, police sources said.

    The wounded were shifted to Khar Hospital, where emergency treatment is underway. Rescue operations are ongoing at the blast site.

    Officials have yet to release details on the type of explosive used. No group has claimed responsibility for the attack so far.

    This is a developing story…

     

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  • Nepra slashes electricity rate by Rs1.15 per unit

    Nepra slashes electricity rate by Rs1.15 per unit



    Power transmission towers are pictured in Karachi. — Reuters/File 

    ISLAMABAD: In order to ensure uniform power tariff in the country, the National Electric Power Regulatory Authority (Nepra) has reduced the electricity rate by Rs1.15 per unit for all but lifeline consumers with the change also applicable to K-Electric consumers.

    The development follows Nepra’s hearing of the Power Division’s motion seeking a uniform basic tariff, contending that tariff rationalisation is not aimed at raising any revenues for the federal government but in fact enables the fulfilment of parameters set forth in the Constitution as well as the policy.

    In its decision, the regulator has maintained the tariff for lifeline consumers using 50 units at Rs3.95 per unit, whereas those using 100 units will continue to pay Rs7.74 per unit.

    Protected consumers with 100 units on their bill will now pay at rate of Rs10.54 per unit, whereas an Rs13 per unit rate will apply to those consuming 200 units a month.

    Breakdown of change in electricity tariff. — Nepra
    Breakdown of change in electricity tariff. — Nepra

    With regards to non-protected consumers, the electricity tariff has been slashed by Rs1.15 per unit for all categories — and the same reduction is applicable on commercial consumers as well, bringing their new average basic tariff to Rs45.43 per unit.

    The Rs1.15 per unit reduction also applies to the general services whose existing rate now stands at Rs43.17 per unit.

    For industries, the new electricity tariff is now fixed at Rs33.48 per unit after the Rs1.15 per unit reduction. Meanwhile, the new basic tariff for bulk electricity consumers has been set at Rs41.76 per unit.

    Agricultural consumers on the other hand will also benefit from the reduction and will now pay at a rate of Rs30.75 per unit.

    During the Nepra hearing a day earlier, the government had attributed the reduction to rupee stability, falling capacity payments, and declining global fuel prices — offering rare fiscal relief amid ongoing economic challenges.

    Interestingly, the government’s renegotiated deal with independent power producers (IPPs) would help shave Rs236 billion off capacity payments in FY26.

    During the hearing Power Division officials estimated that national electricity consumption in FY2025-26 will hover around 103 billion units, slightly lower than the 106 billion units projected for the current fiscal year. The revenue requirement for FY26 has also been revised down to Rs3.521 trillion, from Rs3.768 trillion a year earlier, documents presented at the hearing show.

    “The decline in power generation costs by Rs1.27 per unit and capacity charges by Rs1.34 per unit has created room for tariff reduction,” a Power Division official told Nepra.

    Despite the proposed tariff cut, capacity payments — fixed payments to power producers — will remain a heavy burden on consumers. The total capacity payments for FY26 are projected at Rs1.766 trillion, translating into Rs17.06 per unit.

    On an annual basis, it is a Rs1.34 per unit cut in these charges. In the FY 2024-25 the total capacity payments were Rs1.952 trillion, the official added. When asked about the impact of terminating/hybrid Take & Pay agreement with the IPPs on the capacity payments, the official said that the total reduction in capacity payments will be Rs236 billion.

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  • Diagnostic dilemma: Shingles popped a hole in a man’s bladder

    Diagnostic dilemma: Shingles popped a hole in a man’s bladder

    The patient: A 77-year-old man in China

    The symptoms: Seven hours before being admitted to a hospital, the patient developed shortness of breath, abdominal pain and “obvious” abdominal distension, meaning his belly appeared very bloated and stretched out, doctors wrote in a report of the case. He’d had trouble urinating and defecating for about four days, and one week prior to admission, he’d been given antiviral and pain-relieving medicines for a case of shingles that was affecting his lower back, around the sacrum, or the base of the spine.

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  • Bruce Springsteen’s European stadium concerts harness rock’s ‘righteous in ‘dangerous times’

    Bruce Springsteen’s European stadium concerts harness rock’s ‘righteous in ‘dangerous times’

    BERLIN — In a country that saw its democracy die in 1933, the more than 170,000 people crowding into three of Germany’s biggest soccer stadiums for Bruce Springsteen’s rock concerts in recent weeks have been especially receptive to his message and dire warnings about a politically perilous moment in the United States, one that has reminded some of Adolf Hitler’s power grab in the ’30s.

    At these gigantic open-air concerts in Berlin, Frankfurt and Gelsenkirchen, which have been among the largest concerts to date in Springsteen’s two-month-long, 16-show Land of Hope & Dreams tour across Europe, the 75-year-old rock star from New Jersey has interspersed short but poignant political speeches into his exhausting, sweat-drenched performances to describe the dangers he sees in the United States under the Trump administration.

    “The mighty E Street Band is here tonight to call upon the righteous power of art, of music, of rock ’n’ roll in dangerous times,” Springsteen says to cheers at the start of each concert. “In my home — the America I love, the America I have written about — the America that has been a beacon of hope and liberty for 250 years is currently in the hands of a corrupt, incompetent and treasonous administration. Tonight, we ask all who believe in democracy and the best of our American experience to rise with us, raise your voices against authoritarianism and let freedom ring.”

    Springsteen’s words have had special resonance in Germany, where memories of the Nazi past are never far from the surface and the cataclysmic demise of the Weimar Republic, which led directly to Hitler’s takeover, is studied in great detail in schools and universities. With that Nazi past embedded in their DNA, German fears of President Trump’s tactics probably run higher than anywhere else.

    “Germans tend to have angst about a lot of things and they are really afraid of Trump,” said Michael Pilz, a music critic for the Welt newspaper, who agrees that the death of German democracy in 1933 is a contributing factor to the popularity of Springsteen’s anti-Trump concerts this summer. “A lot of Germans think Trump is a fool. It’s not only his politics but the way he is, just so completely over the top. Germans love to see Trump getting hit. And they admire Springsteen for standing up and taking it to him.”

    “The mighty E Street Band is here tonight to call upon the righteous power of art, of music, of rock ’n’ roll in dangerous times,” Springsteen says to cheers at the start of each concert.

    (Markus Schreiber / Associated Press)

    The crowds in Germany have been as large as they are enthusiastic. More than 75,000 filled Berlin’s Olympic Stadium on June 11; 44,500 were in Frankfurt on June 18; and another 51,000 watched his concert in the faded Ruhr River industrial town of Gelsenkirchen on June 27. All told, more than 700,000 tickets have been sold for the 16 shows in Springsteen’s tour (for concerts that last three or more hours), which concludes on July 3 in Milan, Italy.

    “The German aversion to Trump has now become more extreme in his second term — Germans just don’t understand how the Americans could elect someone like Trump,” said Jochen Staadt, a political science professor at the Free University in Berlin who is also a drummer in an amateur Berlin rock band. Staadt believes Springsteen’s 1988 concert may well have helped pave the way for the Berlin Wall to fall a little over a year later in 1989. “Germans are drawn to Springsteen as someone who played an important role in our history when Germany was still divided and as someone who may have helped overcome that division with rock music.”

    Springsteen has been filling stadiums across Europe in the warm summertime evenings with his high-energy shows that not only entertain the tremendous crowds but also take on Trump’s policies on civil liberties, free speech, immigrants and universities in thoughtfully constructed messages. To ensure nothing is lost in translation, Springsteen’s brief forays into politics of about two to three minutes each are translated for local audiences in German, French, Spanish, Basque and Italian subtitles on the giant video walls onstage.

    To ram the message home to more people, Springsteen also released a 30-minute recording from the first stop of the tour in Manchester, England, that contains three songs and three of his speeches onstage.

    “I’ve always tried to be a good ambassador for America,” said Springsteen while introducing “My City of Ruins,” a song he wrote after the 9/11 terror attacks that has taken on a new meaning this summer. “I’ve spent my life singing about where we have succeeded and where we’ve come up short in living up to our civic ideals and our dreams. I always just thought that was my job. Things are happening right now in my home that are altering the very nature of our country’s democracy and they’re simply too important to ignore.”

    Springsteen’s first speech during the tour’s Manchester show on May 17 prompted a sharp rebuke from Trump on his Truth Social platform. “Springsteen is ‘dumb as a rock’… and this dried out ‘prune’ of a rocker (his skin is all atrophied!) ought to KEEP HIS MOUTH SHUT until he gets back into the Country, that’s just ‘standard fare’. Then we’ll all see how it goes for him!”

    Springsteen did not respond directly. Instead, he repeated his messages at every concert across Europe. He delivered more political commentary in introducing his song “House of a Thousand Guitars” by saying: “The last check on power, after the checks and balances of government have failed, are the people. You and me. It’s the union of people around a common set of values. That’s all that stands between democracy and authoritarianism. So at the end of the day, all we’ve really got is each other.” In the song, Springsteen sings about “the criminal clown has stolen the throne / He steals what he can never own.”

    His concerts also included the live debut of “Rainmaker,” about a con man, from his 2020 “Letter to You” album. At the concerts in Europe, Springsteen dedicates the song to “our dear leader,” with a line that goes: “Rainmaker says white’s black and black’s white / Says night’s day and day’s night.”

    Springsteen addresses a massive stadium crowd in Germany.

    More than 75,000 filled Berlin’s Olympic Stadium on June 11, 44,500 were in Frankfurt on June 18, and another 51,000 watched his concert in the faded Ruhr River industrial town of Gelsenkirchen on June 27.

    (Markus Schreiber / Associated Press)

    He also changed one line in the song from “they don’t care or understand what it really takes for the sky to open up the land,” to “they don’t care or understand how easy it is to let freedom slip through your hands.”

    Springsteen’s enormous popularity across Europe has long been on a different level than in the United States, and that gap could grow even wider in the future. Springsteen’s close friend and the band’s lead guitarist, Steve Van Zandt, recently observed in an interview with the German issue of Playboy magazine that the E Street Band may have lost half of its audience back home because of the group’s unabashed opposition to Trump. (The band’s concerts in the United States are often held in smaller indoor arenas.)

    Bruce Springsteen performs with Steven Van Zandt: at the Olympic Stadium in Berlin, Germany, Wednesday, June 11, 2025.

    Bruce Springsteen, left, performs with Steven Van Zandt: at the Olympic Stadium in Berlin, Germany, Wednesday, June 11, 2025.

    (Markus Schreiber / Associated Press)

    But in Europe, Springsteen and his band have been reliably filling cavernous stadiums during the long, daylight-filled summertime evenings for decades with improbably enthusiastic crowds that sing along to the lyrics of his songs and spent most of the concerts on their feet dancing and cheering. There are also large numbers of hearty Springsteen fans from scores of countries who use their entire yearly allotment of vacation to follow him from show to show across the continent. This summer, Springsteen’s message has been amplified even more, sending many in the boomer-dominated crowds into states of near-ecstasy and attracting considerable media attention in countries across Europe.

    “The message of his music always touched a deep nerve in Europe and especially Germany, but ever since Trump was elected president, Springsteen’s voice has been incredibly important for us,” said Katrin Schlemmer, a 56-year-old IT analyst from Zwickau who saw five Springsteen concerts in June — from Berlin to Prague to Frankfurt and two in San Sebastián, Spain. All told, Schlemmer has seen 60 Springsteen concerts in 11 countries around the world since her first in East Berlin in 1988 — a record-breaking, history-changing concert with more than 300,000 spectators that some historians believe may have contributed to the fall of the Berlin Wall just 16 months later.

    “A lot of Germans can’t fathom why the Americans elected someone like Trump,” said Schlemmer, who had the chance to thank Springsteen for the 1988 East Berlin concert at a chance meeting after a 2014 concert in Cape Town, South Africa. “We saw for ourselves how quickly a democracy was destroyed by an authoritarian. The alarm bells are ringing about what a danger Trump is. People love [Springsteen] here because he tells it like it is and because he is standing up to Trump.”

    Stephan Cyrus, a 56-year-old manager from Hamburg, said Germans view Springsteen as a trustworthy American voice during a period of uncertainty.

    “When Germans hear Springsteen speaking about his worries about the United States, they listen, because so many of us have so much admiration and longing for the United States and are worried about the country’s direction too,” said Cyrus, who saw the June 11 concert in Berlin. “He definitely touched us with his words.”

    In one of his concert speeches, Springsteen goes after Trump without mentioning his name.

    Spectators watch Bruce Springsteen and the E Street Band perform at the Olympic Stadium

    Spectators watch Bruce Springsteen and the E Street Band perform at the Olympic Stadium, in Berlin, Germany, Wednesday, June 11, 2025.

    (Markus Schreiber / Associated Press)

    “There is some very weird, strange and dangerous s— going on out there right now. In America, they are persecuting people for using their right to free speech and voicing their dissent. This is happening now. In America, the richest men are taking satisfaction in abandoning the world’s poorest children to sickness and death. This is happening now.”

    Springsteen then adds: “In my country, they’re taking sadistic pleasure in the pain they are inflicting on loyal American workers. They’re rolling back historic civil rights legislation that led to a more just and plural society. They are abandoning our great allies and siding with dictators against those struggling for their freedom. They’re defunding American universities that won’t back down to their ideological demands. They’re removing residents off American streets and, without due process of law, are deporting them to foreign detention centers and prisons. This is all happening now. A majority of our elected representatives have failed to protect the American people from the abuses of an unfit president and a rogue government.”

    He tells the audiences that those in the administration “have no concern or idea of what it means to be deeply American.”

    But Springsteen ends on a hopeful note, promising his audiences: “We’ll survive this moment.”

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  • Google undercounts its carbon emissions, report finds | Google

    Google undercounts its carbon emissions, report finds | Google

    In 2021, Google set a lofty goal of achieving net-zero carbon emissions by 2030. Yet in the years since then, the company has moved in the opposite direction as it invests in energy-intensive artificial intelligence. In its latest sustainability report, Google said its carbon emissions had increased 51% between 2019 and 2024.

    New research aims to debunk even that enormous figure and provide context to Google’s sustainability reports, painting a bleaker picture. A report authored by non-profit advocacy group Kairos Fellowship found that, between 2019 and 2024, Google’s carbon emissions actually went up by 65%. What’s more, between 2010, the first year there is publicly available data on Google’s emissions, and 2024, Google’s total greenhouse gas emissions increased 1,515%, Kairos found. The largest year-over-year jump in that window was also the most recent, 2023 to 2024, when Google saw a 26% increase in emissions just between 2023 and 2024, according to the report.

    “Google’s own data makes it clear: the corporation is contributing to the acceleration of climate catastrophe, and the metrics that matter – how many emissions they emit, how much water they use, and how fast these trends are accelerating – are headed in the wrong direction for us and the planet,” said Nicole Sugerman, a campaign manager at Kairos Fellowship.

    The authors say that they found the vast majority of the numbers they used to determine how much energy Google is using and how much its carbon emissions are increasing in the appendices of Google’s own sustainability reports. Many of those numbers were not highlighted in the main body of Google’s reports, they say.

    Google did not immediately respond to a request for comment on the figures.

    The authors behind the report, titled Google’s Eco-Failures, attribute the discrepancy between the numbers they calculated and the numbers Google highlights in its sustainability reports to various factors, including that the firm uses a different metric for calculating how much its emissions have increased. While Google uses market-based emissions, the researchers used location-based emissions. Location-based emissions is the average energy the company consumes from local power grids, while market-based emissions include energy the company has purchased to offset its total emissions.

    “[Location-based emissions] represents a company’s ‘real’ grid emissions,” said Franz Ressel, the lead researcher and report co-author. “Market-based emissions are a corporate-friendly metric that obscures a polluters’ actual impact on the environment. It allows companies to pollute in one place, and try to ‘offset’ those emissions by purchasing energy contracts in another place.”

    The energy the tech giant has needed to purchase to power its data centers alone increased 820% since 2010, according to Kairos’ research, a figure that is expected to expand in the future as Google rolls out more AI products. Between 2019 and 2024, emissions that came primarily from the purchase of electricity to power data centers jumped 121%, the report’s authors said.

    “In absolute terms, the increase was 6.8 TWh, or the equivalent of Google adding the entire state of Alaska’s energy use in one year to their previous use,” said Sugerman.

    Based on Google’s current trajectory, the Kairos report’s authors say the company is unlikely to meet its own 2030 deadline without a significant push from the public. There are three categories of greenhouse gas emissions – called Scopes 1, 2 and 3 – and Google has only meaningfully decreased its Scope 1 emissions since 2019, according to the Kairos report. Scope 1 emissions, which include emissions just from Google’s own facilities and vehicles, account for only 0.31% of the company’s total emissions, according to the report. Scope 2 emissions are indirect emissions that come primarily from the electricity Google purchases to power its facilities, and scope 3 accounts for indirect emissions from all other sources such as suppliers, use of Google’s consumer devices or employee business travel.

    “It’s not sustainable to keep building at the rate [Google is] building because they need to scale their compute within planetary limits,” said Sugerman. “We do not have enough green energy to serve the needs of Google and certainly not the needs of Google and the rest of us.”

    Thirsty, power-hungry data centers

    As the company builds out resource-intensive data centers across the country, experts are also paying close attention to Google’s water usage. According to the company’s own sustainability report, Google’s water withdrawal – how much water is taken from various sources – increased 27% between 2023 and 2024 to 11bn gallons of water.

    The amount is “enough to supply the potable water needs for the 2.5 million people and 5,500 industrial users in Boston and its suburbs for 55 days”, according to the Kairos report.

    Tech companies have faced both internal and public pressure to power their growing number of data centers with clean energy. Amazon employees recently put forth a package of shareholder proposals that asked the company to disclose its overall carbon emissions and targeted the climate impact of its data centers. The proposals were ultimately voted down. On Sunday, several organizations including Amazon Employees for Climate Justice, League of Conservation Voters, Public Citizen, and the Sierra Club, published an open letter in the San Francisco Chronicle and the Seattle Times calling on the CEOs of Google, Amazon and Microsoft to “commit to no new gas and zero delayed coal plant retirements to power your data centers”.

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    “In just the last two years alone, your companies have built data centers throughout the United States capable of consuming more electricity than four million American homes,” the letter reads. “Within five years, your data centers alone will use more electricity than 22 million households, rivaling the consumption of multiple mid-size states.”

    In its own sustainability report, Google warns that the firm’s “future trajectories” may be impacted by the “evolving landscape” of the tech industry.

    “We’re at an extraordinary inflection point, not just for our company specifically, but for the technology industry as a whole – driven by the rapid growth of AI,” the report reads. “The combination of AI’s potential for non-linear growth driven by its unprecedented pace of development and the uncertain scale of clean energy and infrastructure needed to meet this growth makes it harder to predict our future emissions and could impact our ability to reduce them.”

    The Kairos report accuses Google of relying “heavily on speculative technologies, particularly nuclear power”, to achieve its goal of net zero carbon emissions by 2030.

    “Google’s emphasis on nuclear energy as a clean energy ‘solution’ is particularly concerning, given the growing consensus among both scientists and business experts that their successful deployment on scale, if it is to ever occur, cannot be achieved in the near or mid-term future,” the report reads.

    The Kairos report alleges the way that Google presents some of its data is misleading. In the case of data center emissions, for example, Google says it has improved the energy efficiency of its data centers by 50% over 13 years. Citing energy efficiency numbers rather than sharing absolute ones obscures Google’s total emissions, the authors argue.

    “In fact, since 2010, the company’s total energy consumption has increased 1,282%,” the report concluded.

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  • Michael C. Hall on reviving his killer role for ‘Dexter: Resurrection’

    Michael C. Hall on reviving his killer role for ‘Dexter: Resurrection’

    Death becomes Michael C. Hall.

    In HBO’s signature drama “Six Feet Under,” Hall was consistently praised for his role as David Fisher, the closeted gay member of a dysfunctional family operating a funeral home.

    His star status was secured with his portrayal of Dexter Morgan, a Miami-based blood spatter analyst who moonlighted as a serial killer in “Dexter.” The drama flavored with dark comedy was Showtime’s most popular series during its eight-season run, which ended in 2013. And a 2021 reboot, “Dexter: New Blood,” scored solid ratings.

    That limited series was most notable for its finale, in which Dexter Morgan was shot and killed by his emotionally damaged son Harrison (Jack Alcott). Acknowledging that devoted fans would likely be upset by Morgan’s demise, Hall was still eager to end the “Dexter” saga.

    “It feels justifiable,” said Hall of the conclusion in a 2022 Times interview. “As upsetting as it may be, I hope audiences will appreciate the resonance of Dexter dying this way at the hands of his son.”

    He also signaled at that time that he was more than ready to shelve the character he had inhabited on and off since 2006: “Playing Dexter … was a kick. It was an experience I’ve never had before and can’t imagine ever having again. But the desire for closure had to do with wanting to move on.”

    Michael C. Hall as Dexter Morgan in “Dexter: Resurrection,” which is set in New York City.

    (Zach Dilgard / Paramount+ with Showtime)

    But instead of winding up six feet under, Dexter now lives to kill another day. It turns out he miraculously survived that “fatal” gunshot, and is ready to resume his deadly vigilante campaign in “Dexter: Resurrection,” premiering July 11 with two episodes on Paramount+ with Showtime.

    Leading the hurrahs for Dexter’s return is Hall: “I feel excited about his story continuing, and I think people will like it.”

    During a video interview from New York before leaving for the last day of shooting, Hall’s upbeat demeanor was a clear indication that Dexter’s life after death agrees with him. He is already primed to keep playing Morgan for the foreseeable future.

    “All I can say is I don’t think we embark on this season imagining it as a one-off,” Hall said. “Without giving away too much, I think the door will be open at the end of this.”

    Sharing Hall’s enthusiasm is series creator Clyde Phillips, who is resuming his “Dexter” duties as showrunner and executive producer.

    “When Michael called me, it was exhilaration,” Phillips said in a phone interview. “He said, ‘Dexter is in my blood, and he’s in your blood. Can you unkill me?’”

    A man in dark clothing sits on the floor with a red light cast on him.

    “All I can say is I don’t think we embark on this season imagining it as a one-off,” said Michael C. Hall of “Dexter: Resurrection.” “Without giving away too much, I think the door will be open at the end of this.”

    (Justin Jun Lee / For The Times)

    The series kicks off with Morgan waking from a 10-day coma. After his recovery, he flees the fictional upstate New York hamlet of Iron Lake, where he had been living under an alias, and heads to New York City to track down — and hopefully reconnect — with Harrison, who is working at a hotel.

    It’s not long before Morgan’s killer instincts resurface, eventually joining a group of fellow serial killers. The cast in the 10-episode series includes Uma Thurman, Peter Dinklage, Neil Patrick Harris and Eric Stonestreet.

    Morgan’s resurrection had already been previewed in “Dexter: Original Sin,” which premiered last December and has been renewed for a second season. The prequel features Patrick Gibson as a younger Dexter Morgan who starts to indulge his sinister urges while working as a forensics intern at Miami Metro. As he did in “Dexter,” Hall provides the voice-over for his inner thoughts.

    Returning from the original cast of “Dexter” for the new drama is James Remar as the ghost of Harry Morgan, Dexter’s adoptive father, and David Zayas as Det. Angel Batista. The series will have a different vibe than the first “Dexter.”

    “New York is a completely new environment — different climate, different job,” said Hall, who is also an executive producer. Dexter’s “death” in “New Blood” actually gives the character a new lease on life, literally and figuratively, he added.

    1

    A man in a hat and dark coat stands in a lit room.

    2

    A man in with a beard and short curly hair stands in a wood-paneled room. A blonde woman in black stands in the background.

    3

    A man in glasses and a green sweater sits on a chair.

    1. David Zayas will reprise his role as Det. Angel Batista in “Dexter: Resurrection.” 2. Joining the cast are Uma Thurman as Charley and Peter Dinklage as Leon Prater. (Zach Dilgard/Paramount+ with SHOWTIME) 3. Also guest starring is Eric Stonestreet.

    “The fact that Dexter didn’t die liberated the character to a degree,” he said. “He can’t go back to who he was, but he can reclaim some of the essential magic of who he is. He is not blind to his past, but he’s not dragging it around in the same way. He’s able to let it be.”

    Phillips said there’s a notable difference between the two series when it comes to Hall’s character: “We acknowledge that Dexter is in his 50s. In the pilot of ‘Dexter,’ he was a fit 33-year-old. Now he’s recovering from a gunshot wound. He’s slower and needs to be even smarter.”

    Still central to Dexter’s mission is the code inherited from his father, which is to murder only criminals who have escaped punishment. “The code is vital to his integrity and the show,” Phillips said.

    The violation of that code sealed Morgan’s fate in “New Blood.” After being arrested as a murder suspect in Iron Lake, Dexter, during a jail escape, killed a police sergeant who had formed a close bond with Harrison.

    “He was backed into a corner,” said Hall of Dexter’s dilemma. “He found the consideration of the reality of the wreckage, having played fast and loose with his father’s code, excruciating. He encourages his son to do him in. There was something about what Dexter had come to be that demonstrated that he needed to be taken out.”

    But the purpose of “New Blood” was also to correct the biggest stumble in the trajectory of “Dexter” — the series finale.

    In that episode, Morgan took his foster sister Debra (Jennifer Carpenter) off life support after she suffered a stroke. After taking her body out to sea to dispose of it, a distraught Morgan steered his vessel into an approaching hurricane in an apparent suicide attempt. The closing moments revealed that he had survived, winding up in a remote community far from Miami and starting a new life as a lumberjack.

    Legions of fans were furious, blasting the ending as perplexing and open-ended. Hall later echoed their unhappiness, stressing that the closure in “New Blood” was much more appropriate and definitive.

    “Narratively, it made sense,” Hall said. “But emotionally, it seemed that it was difficult for people to see him go out like that.”

    A man in dark clothing standing with his hands in his pocket. A long shadow is seen beside him.

    Michael C. Hall on choosing to step away from Dexter for a time: “It was about catching my breath, doing other things, having life go on as it does.”

    (Justin Jun Lee / For The Times)

    The key to Hall’s interest in reviving the beloved character was getting distance from him.

    “It was about catching my breath, doing other things, having life go on as it does,” he said. His post-”New Blood” projects included starring in Broadway’s revival of “Hedwig and the Angry Inch” and performing in his band, Princess Goes to the Butterfly Museum, now known as Princess Goes.

    Despite those endeavors and others, the possibility of reviving Dexter never completely vanished for Hall, the show’s fan base, or executives at Paramount, which produces the franchise.

    The first significant spark ignited a few years ago during a guerrilla-style video shoot in Times Square for Princess Goes that was directed by Marcos Siega, who had helmed several episodes of “Dexter.”

    “Seeing Siega and remembering the amazing collaborators we had over the years got me thinking, ‘I know this sounds crazy, but what if Dexter didn’t die?’ ” Hall recalled. “I was compelled by the idea, and once I shared that with others, I realized there was an openness to that notion.”

    The studio conducted its own research which revealed that fans found it more plausible that Morgan did not die in “New Blood,” Hall said.

    “The fans went crazy after ‘New Blood’ because they love this character so much,” Phillips said. “I’m gratified that Michael wanted to come back.”

    Asked about the durability of his character, Hall smiled: “Dexter is cherished or loved for different reasons, but he is nothing if not resilient. It’s undeniable that people relish spending time with someone who is taking responsibility for his darkness. We all have our share of darkness. It’s just not as formidable as Dexter’s.”

    Phillips credited Hall’s artistry for the character’s popularity. “Whenever Michael is on screen, there is a power and connection with him,” he said. “As handsome and fit as he is, he’s also an everyman. That is appealing to an audience. This isn’t the Jeffery Dahmer or Ted Bundy story. Dexter has been referred to as America’s favorite serial killer.”

    The least of Hall’s challenges was getting back into “Dexter” mode.

    “My cycle of cellular regeneration has happened three times over since I started doing this,” he said. “So if Dexter is not in my bones, he’s somewhere in there.”

    He smiled again: “The weirdest thing about returning to Dexter is how weird it doesn’t feel. That has to do with the scripts and the stories. I just surrender to it. Whether I return to Dexter or not, it is and will remain at the top of my resume … or obituary.”

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  • How Mamdani connects climate policy to his affordability agenda as he runs for New York mayor | Zohran Mamdani

    How Mamdani connects climate policy to his affordability agenda as he runs for New York mayor | Zohran Mamdani

    As she canvassed for Zohran Mamdani in New York City on Tuesday last week, Batul Hassan should have been elated. The mayoral candidate – a 33-year-old state assemblymember – was surging in the polls and would within hours soundly defeat Andrew Cuomo on first preference votes in the Democratic primary election.

    But Hassan’s spirits were hampered by record-breaking temperatures. In Crown Heights, where she was the Mamdani campaign’s field captain, the heat index soared into the triple digits.

    “I couldn’t think about anything but the heat,” she said. “It was so dangerous.”

    Early that Tuesday morning, Hassan visited a public school polling site, where elderly workers sweltered without air conditioning. The city board of elections sent over paper fans, but they were no match for the heat.

    If Mamdani is elected, that school could be retrofitted with air conditioning and green space to bring down temperatures as part of his green schools plan, or could even be transformed into a resilience hub for communities shelter amid extreme weather events.

    A fan under the US flag at a polling station during the New York City mayoral Democratic primary in the Brooklyn borough of New York on 24 June 2025. Photograph: Bloomberg/Getty Images

    “Seeing total infrastructural failure on election day emphasized the stakes of what’s happening with the climate crisis and the importance of the election,” said Hassan, who took time off from her day job at the leftist thinktank Climate and Community Institute to canvass.

    Mamdani’s green schools plan is just one of his schemes to slash carbon emissions and boost environmental justice. If elected mayor, his plans for New York City would make residents “dramatically more safe” from extreme weather, said Hassan.

    But the democratic socialist, who was endorsed by the national youth-led environmental justice group Sunrise Movement and student-led climate group TREEAge, did not place the climate crisis at the center of his campaign, instead choosing to focus relentlessly on cost-of-living issues. The model could help build popular support for climate policies, supporters say.

    “Climate and quality of life are not two separate concerns,” Mamdani told the Nation in April. “They are, in fact, one and the same.”

    Over the past two decades, Democrats increasingly focused on the climate. But often, their proposed schemes have been technocratic, Hassan said. Carbon taxes, for instance, can be impenetrably complex, making them difficult candidates for popular support. They can also be economically regressive, with “working class people experiencing them as an additional cost”, Hassan said.

    More recently, Joe Biden coupled climate plans with green industrial policy and plans to boost employment. But even those projects can take years to affect tangible change, critics say. As president, for instance, Biden achieved historic climate investments in the Inflation Reduction Act (IRA). But its green incentives disproportionately benefited the wealthy, and its job creation remains invisible to most people around the country. One poll found only a quarter of Americans felt the IRA benefited them.

    “Now with Trump, we see the pitfalls of the IRA, where there is real difficulty in consolidating enough political support to defend those climate policy achievements,” said Hassan.

    Mamdani “learned from some of the mistakes” of the Biden administration, said Gustavo Gordillo, a co-chair of the New York City chapter of the Democratic Socialists of America, which supported Mamdani’s campaign. His housing plan, for instance, aims to lower planet-heating pollution by boosting density, but his signature promise is a rent freeze.

    That pledge could ensure residents are not priced out of New York City and forced to move to more carbon-intensive suburbs, and prevent landlords from passing the costs of energy efficiency upgrades or air conditioning installation to renters, preventing displacement, said Hassan.

    Similarly, Mamdani’s headline transit goal was to make buses faster and free, which could boost ridership and discourage the use of carbon-intensive cars.

    “Public transit is one of the greatest gifts we have to take on the climate crisis,” Mamdani said at a February mayoral forum.

    Biden’s IRA placed little focus on boosting public transit, said Gordillo. This was a missed opportunity to cut emissions and also lower Americans’ fuel costs, he said.

    “We need to expand mass transit to fight the climate crisis, which hasn’t been a priority for the Democratic establishment,” said Gordillo, who is an electrician by day. “But we also need to expand it because we want to improve people’s lives right now.”

    As a New York assemblymember, Mamdani has backed explicitly green policies. He was a key advocate for a boosting publicly owned renewable energy production. The effort aimed to help New York “live up to the dream of our state as being a climate leader”, he said in 2022.

    He also fought fossil fuel buildout. He coupled that climate focus with efforts to keep energy bills low, consistently opposing local utilities’ attempts to impose rate hikes, said Kim Fraczek, director of the climate nonprofit Sane Energy Project.

    “His growing political influence is a clear win for communities demanding a just transition: renewable power, democratic control and relief from crushing energy costs,” said Fraczek.

    Progressive cities like New York are often climate leaders. But if they price out working people, only the wealthy get to see the benefits of their green policies, Mamdani’s backers say.

    By crafting popular climate policies, the Democratic nominee is also building a base of New Yorkers who will work to defend those plans in the face of threats from the Trump administration, they say.

    “New Yorkers want an affordable city, clean and green schools, fast and free buses, and a rent freeze,” said Daniel Goulden, a co-chair of the New York City Democratic Socialists of America ecosocialist working Group. “But most importantly, New Yorkers want a future – one where they can live and thrive in New York.”

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