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  • A mess of its own making: Google nerfs second Pixel phone battery this year

    A mess of its own making: Google nerfs second Pixel phone battery this year

    Not all batteries age the same way. Some problems will appear quickly, but others won’t be noticeable until after many charge/discharge cycles. A few years back, Samsung released the Galaxy Note 7 with a slightly larger battery than the previous model. Within weeks, the phones started to catch fire, and even after swapping in a different battery pack, the issue persisted. It was a huge mess that led to a recall and steep financial losses.

    Samsung’s battery missteps may have prompted manufacturers to take possible battery defects more seriously. So when Google detected problems with aging Pixel 4a batteries, it didn’t take any chances. It decided to degrade the experience on the remaining Pixel 4a units out there, even if the lower capacity and slower charging upset users. When Pixel 6a units started to catch fire again, Google decided to simply limit battery performance.

    The mandatory Android 16 July update will limit battery charging speed and capacity on affected phones.

    Credit:
    Ryan Whitwam

    The mandatory Android 16 July update will limit battery charging speed and capacity on affected phones.


    Credit:

    Ryan Whitwam

    Pixel 4a units contained one of two different batteries, and only the one manufactured by a company called Lishen was downgraded. For the Pixel 6a, Google has decreed that the battery limits will be imposed when the cells hit 400 charge cycles. Beyond that, the risk of fire becomes too great—there have been reports of Pixel 6a phones bursting into flames.

    Clearly, Google had to do something, but the remedies it settled on feel unnecessarily hostile to customers. It had a chance to do better the second time, but the solution for the Pixel 6a is more of the same.

    A problem of Google’s making

    Like other smartphone manufacturers, Google moved away from offering removable batteries in the 2010s to make phones slimmer and more durable. Smartphone makers largely dismissed the concerns of repair advocates who pointed out that lithium-ion batteries degrade over time, and making them difficult to remove wasn’t the best idea. However, this was a time when people only kept smartphones for a year or two before upgrading, but we have since entered an era in which people use phones for much longer. The way phones are marketed has changed to reflect that—Google has enacted longer support windows, topping out at seven years for its latest phones.

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  • Pakistan reaffirms regional engagement, condemns rights violations in IIOJK: FO Spox

    Pakistan reaffirms regional engagement, condemns rights violations in IIOJK: FO Spox

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    ISLAMABAD, Jul 11 (APP):Foreign Office Spokesperson Ambassador Shafqat Ali Khan Friday in his weekly media briefing shed light on Pakistan’s diplomatic engagements, regional security concerns, and reiterated its condemnation of human rights violations in Indian Illegally Occupied Jammu and Kashmir (IIOJK).

    The Spokesperson, highlighted the country’s active multilateral diplomacy, evolving bilateral relations, and firm positions on key foreign policy issues.

    He mentioned that the Deputy Prime Minister and Foreign Minister Senator Mohammad Ishaq Dar was currently leading the Pakistani delegation at the 32nd ASEAN Regional Forum (ARF) Ministerial Meeting in Kuala Lumpur, Malaysia. The forum was discussing political and security issues impacting the Asia-Pacific region with the goal of fostering peace and cooperation through dialogue, he said.

    On the sidelines of the ARF meeting, he said Senator Dar held bilateral meetings with leaders from Malaysia, Canada, Australia, Laos, Sri Lanka, Russia, the European Union, Switzerland, and the United Kingdom. These interactions focused on strengthening economic ties, trade, education, and cultural exchanges, as well as addressing regional and global challenges.

    The Foreign Office Spokesperson also highlighted the visit of Turkish Foreign Minister Hakan Fidan and Minister of National Defence Yasar Güler to Islamabad. Co-chairs of the Joint Commissions under the High-Level Strategic Cooperation Council (HLSCC), the Turkish officials discussed expanding bilateral cooperation in trade, energy, and investment. The inaugural meeting of the Joint Commission reviewed the progress of twelve standing committees under the HLSCC, he added.

    In parallel, he said a Pakistani delegation led by Special Assistants to the Prime Minister, Ambassador Syed Tariq Fatemi and Haroon Akhtar Khan, met with Russian Deputy Prime Minister Alexei Overchuk in Moscow. Discussions covered wide-ranging cooperation including trade, energy, agriculture, and investment. Pakistan reiterated its desire to deepen ties with Russia, recognizing its stabilizing role in global affairs.

    He added that a key development was the inaugural round of Additional Secretary-level talks between Pakistan and Afghanistan held in Islamabad on July 7. The talks, he said focused on trade, refugee repatriation, regional connectivity, and security cooperation. “Pakistan underscored its concerns over terrorist sanctuaries in Afghanistan and urged Kabul to take concrete actions against groups threatening Pakistan’s security,” he said.

    He also shed light on the 9th round of Bilateral Political Consultations between Pakistan and Poland took place in Warsaw on July 4. Delegations reviewed cooperation across various sectors including energy, defence, mobility, and higher education. Both countries agreed to enhance engagement through high-level visits and multilateral cooperation, with the next round to be held in Islamabad in 2026, he said.

    The spokesperson announced that July 13 will mark the 94th Youm-e-Shuhada-e-Kashmir (Kashmir Martyrs Day), commemorating the 1931 massacre of 22 Kashmiris in Srinagar. He denounced ongoing human rights abuses in IIOJK, including recent restrictions on Ashura preparations and the humiliating treatment of a Kashmiri youth by Indian forces.

    “Indian armed forces are operating with impunity, with license to kill,” Ambassador Shafqat Ali Khan said, reiterating Pakistan’s call for an end to extrajudicial killings and for the international community to take notice of the situation.

    Commenting on Indian National Security Advisor Ajit Doval’s claim of attacking 13 Pakistani airbases, the FO Spokesperson termed the remarks “distortions and misrepresentations” and a “violation of international law.” He reminded that Pakistan had downed multiple Indian aircraft and rejected India’s attempts to glorify aggression.

    On Afghanistan, the Spokesperson acknowledged ongoing concerns about terrorist sanctuaries and stressed that Pakistan continues to engage with Kabul in good faith, hoping for more responsible action from the Afghan side.

    In response to questions about declassified U.S. documents on Pakistan’s role during the Soviet-Afghan war, the spokesperson noted, “What is in the past is in the past,” emphasizing Pakistan’s current efforts to chart a peaceful and cooperative future for the region.

    Addressing climate change, the Spokesperson said Pakistan remains one of the most vulnerable nations despite its negligible contribution to global emissions. He reiterated Islamabad’s leading role in advocating for climate finance and justice for developing countries.

    Responding to questions on remarks made by PPP Chairman Bilawal Bhutto Zardari regarding the potential extradition of individuals of concern, the Spokesperson clarified: “He did not name anyone. The government’s position remains consistent and unchanged.” He directed inquiries to the PPP’s official spokesperson for further clarification.

    The Spokesperson deferred a direct response on the status of U.S. aid under former President Donald Trump but indicated that dialogue with Washington on all matters, including aid and cooperation, is ongoing.

    Asked about hypothetical global conflict scenarios involving China, the Spokesperson declined to speculate but reaffirmed the strength of Pakistan-China relations, describing China as “our iron brother” and a strategic partner.

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  • Earth will spin unusually quickly in July and August

    Earth will spin unusually quickly in July and August

    Earth does not always spin at the exact same speed. In fact, in recent years, Earth has been spinning a bit more quickly. Scientists are unsure why. Image via NASA.
    • Not all days are created equal. Some days are actually a millisecond shorter than other days.
    • Since 2020, Earth has notched up unprecedentedly short days midway through the year. It happens again in 2025 around July 9, July 10, July 22 and August 5.
    • So why has Earth accelerated? Many factors affect Earth’s spin. But as of now, no one knows for sure.

    TimeandDate published this original post on June 16, 2025. Edits by EarthSky.

    Earth does not quite spin at a constant rate

    Our planet is an almost-but-not-quite-perfect timekeeper. On average, from the point of view of the sun, Earth completes one full rotation on its axis in exactly 86,400 seconds, give or take a millisecond or so.

    So, 86,400 seconds is another way of saying 24 hours. A millisecond (ms) is 0.001 seconds. That’s considerably less than a blink of an eye, which lasts around 100 milliseconds.

    The only way to measure these tiny day-to-day variations in Earth’s spin speed is with atomic clocks. The first practical atomic clocks began their timekeeping in the 1950s. The number of milliseconds above or below 86,400 seconds is what we call the length of day.

    Earth speeds up

    Until 2020, the shortest length of day that atomic clocks ever recorded was -1.05 ms. This means Earth completed one rotation with respect to the sun in 1.05 milliseconds less than 86,400 seconds.

    Since then, however, Earth has managed to shatter this old record every year by around half a millisecond. The shortest day of all was -1.66 ms on July 5, 2024. Earth should get close to this again in 2025 around July 9, July 10, July 22 and August 5. The newest estimates from July 10 confirm these as the shortest days of 2025. Also, the latest figures suggest the shortest day of the year overall may in fact turn out to be July 10. But this still needs to be confirmed.

    Chart showing days of 2025 with predicted negative milliseconds for each.
    New estimates released on July 10 confirm the shortest days of 2025 should fall around July 9, July 10, July 22 and August 5. The latest figures suggest the shortest day of the year overall may in fact turn out to be July 10. But this is still to be confirmed. Image via TimeandDate.
    Chart showing years past with the shortest length of day.
    This table shows the shortest length of day in every year for the past five years. Image via TimeandDate.

    Why multiple possible dates?

    The orbit of the moon affects the short-term variations in the length of day. Our planet spins more quickly when the moon’s position is far to the north or south of Earth’s equator.

    The moon will be around its maximum distance from Earth’s equator on these dates. Input the date into TimeandDate’s Moon Light World Map. This will show you the moon’s position – indicated by the moon symbol – at the time and date you choose.

    Why is all this happening?

    Why has Earth accelerated, and when will it slow down again? These are difficult questions. Long-term variations in Earth’s spin speed are affected by a long list of factors that includes the complex motion of Earth’s core, oceans and atmosphere. Leonid Zotov, a leading authority on Earth rotation at Moscow State University, said:

    Nobody expected this. The cause of this acceleration is not explained.

    Most scientists believe it is something inside the Earth. Ocean and atmospheric models don’t explain this huge acceleration.

    Early last year, there were indications Earth might be slowing down, and Dr. Zotov predicted that Earth would decelerate. Zotov said at the time:

    But the future will show if that’s right.

    That prediction turned out to be premature. Yet Dr. Zotov is striking a similar note in 2025:

    I think we have reached the minimum. Sooner or later, Earth will decelerate.

    Bottom line: The shortest days on Earth for 2025 will be in July and August. But why is Earth spinning faster? It’s a bit of a mystery.

    Via TimeandDate

    Read more: Why don’t we feel Earth’s spin?

    Graham Jones

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    About the Author:

    Graham Jones is an astrophysicist and science communicator at timeanddate.com. He is part of the timeanddate team that produces live streams of eclipses and transits, including the May 26 lunar eclipse and June 10 solar eclipse. Graham has a BSc in astrophysics from Royal Holloway, University of London, and an MSc in science communication from the University of Edinburgh.

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  • Association Between Fractional Exhaled Nitric Oxide (FeNO) and Cogniti

    Association Between Fractional Exhaled Nitric Oxide (FeNO) and Cogniti

    Introduction

    Obstructive sleep apnea (OSA) is a widespread sleep disorder that involves repeated partial or complete blockage of the upper airway during sleep, causing intermittent oxygen deprivation and sleep disruption.1 The prevalence of OSA is particularly on the rise in developed nations.2 OSA is associated with numerous neurological cognitive deficits, such as deficits in memory, executive function and concentration,3,4 which can significantly enhance the probability neurodegenerative diseases.5,6

    Although the exact mechanisms of cognitive dysfunction in OSA remain unclear, chronic intermittent hypoxia, oxidative stress, and systemic inflammation are thought to play critical roles.7 Airway inflammation in OSA may result from mechanical trauma due to recurrent upper airway obstruction, as well as the impact of intermittent hypoxia.8 Additionally, there is evidence of systemic inflammation in OSA.9 Persistent airway inflammation in OSA might be involved in the disorder’s complex pathophysiology, indicating the necessity for a comprehensive examination of this relationship.

    Fractional exhaled nitric oxide (FeNO) provides a rapid and non-invasive method for evaluating airway inflammation,10–12which has been extensively studied in asthma, chronic obstructive pulmonary disease, OSA, and COVID-19.13–15 NO is produced by endothelial and epithelial cells, as well as macrophages, providing insights into respiratory tract inflammation.16 FeNO has been recognized as a noninvasive biomarker of airway inflammation.17

    Increased levels of exhaled NO may predict moderate-to-severe OSA.18 Transcriptomic analysis revealed that peripheral inflammation triggers neuroinflammation within the central nervous system, leading to cognitive decline.19 However, the mechanisms linking exhaled NO to cognition in OSA remain to be elucidated.

    Therefore, the primary aim of this research is to explore the characteristics of exhaled NO in individuals with OSA and to examine its association with cognitive function.

    Methods

    Participants

    This prospective study was conducted at the Affiliated Nantong Hospital 3 of Nantong University from December 2023 to December 2024. Initially, individuals who underwent polysomnography (PSG) for snoring were recruited for the study.

    According to the clinical practice guideline for diagnostic testing of adult OSA,20 the apnea-hypopnea index (AHI) was used as the diagnostic indicator. Ultimately, 102 individuals were included. Participants with AHI≥15/h were classified as moderate/severe OSA (n = 62); while those with AHI<15/h were classified as snoring/mild OSA (n = 40)4,21 (Figure 1).

    Figure 1 Flow chart illustrating the process of selecting patients for this study.

    Inclusion criteria: (1) participants must be aged between 18 and 65 years; (2) participants with at least 9 years of education; (3) participants who have not received OSA treatment. Exclusion criteria: (1) participants with asthma, chronic obstructive pulmonary disease, cancer, cardiopulmonary failure, stroke, hepatic dysfunction, renal dysfunction, anxiety, Parkinson’s disease, or Alzheimer’s disease; (2) sleep disorders such as insomnia or central sleep apnea; (3) current use of psychotropic medications and corticosteroids; (4) total sleep duration< 5 hours during PSG; (5) smoking in the past three months or active upper airway infection.

    The research was performed in compliance with the Declaration of Helsinki, and all procedures were conducted after obtaining written informed consent from the participants. Ethical approval for the study was granted by the Ethics Committee of the Affiliated Nantong Hospital 3 of Nantong University (EK2023115).

    Measurement

    Fundamental Information

    Comprehensive demographic and previous health history information were gathered from all patients. This included age, sex, educational level, body mass index (BMI), neck circumference (NC), history of alcohol consumption and smoking habits, history of hypertension and diabetes, and the presence of symptoms such as nocturnal snoring, nocturnal awakenings, excessive daytime sleepiness, dreaming, memory impairment, morning tiredness, headaches, and dry mouth.

    Epworth Sleepiness Scale (ESS)

    We utilized the validated Chinese version of the ESS.22,23 Scores range between 0 and 24, a score of 10 or higher indicating significant sleepiness. The ESS assessments for the patients were administered by experts at the sleep center.

    The validated Chinese version of the ESS was used in this study with proper authorization from the Mapi Research Trust (license ID: 116777).

    Cognitive Function Assessment

    Cognitive assessments were performed 1 hour before PSG to avoid the influence of sleep deprivation on performance. Tests included the Digit Ordering Test (DOT) for working memory, the Logical Memory Test (LMT) for logical memory, and the Rey-Osterrieth Complex Figure Test (RCFT) for visual memory.24,25 The RCFT involved three phases:Firstly, participants were asked to copy the geometric shape to assess their copying ability (P1). Secondly, without prior notice, participants were asked to immediately redraw the figure from memory on a blank sheet, assessing their immediate visual memory (P2). Thirdly, participants were required to redraw the figure again after 30 minutes to evaluate their delayed visual memory (P3).26,27 All cognitive tests were conducted approximately one hour before PSG to avoid fatigue or confounding effects from sleep monitoring. Assessors were blinded to participants’PSG and FeNO results to reduce bias.

    Polysomnography

    Overnight PSG recordings were conducted in a sound-insulated room. Recording began at 9:00 pm and ended at 6:00 am, ensuring at least 7 hours of data. Signals were acquired by the Nox A1 system (ResMed, Australia). The PSG data included eight electroencephalogram channels (F3, F4, C3, C4, O1, O2, M1, M2), electrocardiogram, electromyograms of both anterior tibialis muscles, bilateral electrooculograms, finger pulse oximetry for oxygen saturation, a nasal pressure monitor, a thermistor for airflow, and thoracic/abdominal movements via inductance plethysmography. All data were scored according to the American Academy of Sleep Medicine.28 Recorded parameters included sleep stages (N1, N2, N3, REM), AHI, oxygen desaturation index (ODI), total sleep time (TST), sleep efficiency (SE), lowest arterial oxygen saturation (LSpO2), percentage of sleep time with arterial oxygen saturation below 90% (TS90%), and sleep latency.

    FeNO Measurements

    FeNO measurements adhered to the American Thoracic Society’s guidelines29 and were consistently performed immediately after PSG by a skilled technician. The measurements were taken using a nitric oxide analyzer (Wuxi Shangwo, China) and results were recorded in parts per billion (ppb). FeNO levels were assessed at two flow rates: 50 mL/s (FeNO50) and 200 mL/s (FeNO200), with measurement errors below 10%. Participants refrained from smoking, eating, vigorous exercise, and pulmonary function testing for at least 1 hour, and avoided consuming nitrogen-rich food for at least 3 hours before the test. Participants took a deep breath, then exhaled steadily at 50 mL/s for at least 6 seconds or at 200 mL/s for at least 4 seconds. Each flow rate was measured 2–3 times, and the mean value of each was recorded. The alveolar NO concentration (CaNO) was estimated using a two-flow rate linear regression model based on FeNO measurements at 50 and 200 mL/s.30 FeNO50 reflects NO from the central airways, FeNO200 from the distal airways, and JawNO from the nasal cavity. These measures represented different airway regions and provided complementary information.

    Although FeNO was measured post-PSG while cognition was assessed pre-PSG, this design reflects standard clinical practice and minimizes sleep deprivation’s potential effects on cognition. The temporal gap was less than 12 hours.

    Statistical Analysis

    Statistical analyses were conducted with SPSS (version 25.0; SPSS Inc, Chicago, IL, USA), GraphPad Prism (version 9.0; GraphPad Software, San Diego, CA, USA) and the beanplot package (version 1.2).31 Continuous variables were presented as mean ± standard deviation (M ± SD), and group differences were evaluated using the independent samples t-test. Categorical variables were analyzed using the chi-square (χ²) test. Spearman’s rank correlation analysis was used to assess the relationship between cognitive function and clinical or FeNO-related variables. A mixed-design repeated measures ANOVA was used to evaluate cognitive function over time. Group (moderate/severe OSA vs snoring/mild OSA) served as the between-subjects factor, and cognitive domains (copying, immediate, and delayed visual memory) as the within-subjects factor. The Greenhouse-Geisser correction was applied when necessary, and multiple comparisons were adjusted using the Bonferroni correction. Hierarchical regression analysis further explored the relationship between cognitive function and exhaled NO levels. Hierarchical regression analysis was conducted to explore the relationship between cognitive function and exhaled NO levels. Potential confounders—including age, sex, educational level, BMI, and ESS score—were selected based on prior literature and clinical relevance, and were included in the regression models to minimize bias and enhance interpretability. Although no formal a priori power analysis was conducted, the sample size was comparable to previous studies in this field. P < 0.05 was considered statistically significant.

    Results

    Demographic, Clinical, and Sleep Characteristics of All Patients Stratified by AHI

    In Table 1, the demographic, clinical, and sleep characteristics are outlined. There were no notable differences between the moderate/severe OSA group and the snoring/mild OSA group in terms of age, gender, years of education, smoking history, drinking history, history of hypertension or diabetes, dreaming, morning fatigue, morning headache, TST, SE, proportion of non-rapid eye movement (NREM) 2 sleep, or proportion of REM sleep (P > 0.05). However, BMI, NC, witnessed apnea, drowsiness, dry mouth, memory deterioration, ESS score, proportion of NREM1 sleep, ODI, TS90%, longest apnea duration, and arousal index (ArI), and LSpO2 were significantly higher in the moderate/severe OSA group than in the snoring/mild OSA group (P < 0.05).

    Table 1 Comparison of Demographic and Clinical Traits Between the Snoring/Mild and Moderate/Severe OSA Group

    The Cognitive Function and Exhaled NO Parameters in OSA Patients

    The results of the cognitive function and exhaled NO parameters between the snoring/mild OSA group and the moderate/severe OSA group are presented in Table 2. There were no notable differences between the two groups regarding DOT, LMT delay, copying ability scores (P1), or CaNO (all P > 0.05). However, the LMT immediate, immediate visual memory (P2) and delayed visual memory (P3) were significantly higher in the snoring/mild OSA group compared to the moderate/severe OSA group (P < 0.05). Additionally, FeNO50 and FeNO200 were significantly higher in the moderate/severe group than in the snoring/mild OSA group (P < 0.05). Additionally, FeNO50 and FeNO200 were significantly higher in the moderate/severe group than in the snoring/mild OSA group (P < 0.001). FeNO200 was included to assist in CaNO estimation, not as a standalone marker. While CaNO levels slightly exceeded normal values (6 ppb), no significant group difference was observed.(Table 2 and Figure 2).

    Table 2 Cognitive Function and Exhaled NO Parameters for the Snoring/Mild OSA and Moderate/Severe OSA

    Figure 2 The Cognitive Function and Exhaled NO Parameters in OSA patients. (A) Bean plot for the comparison of fractional exhaled NO values between the snoring/mild OSA group and the moderate/severe OSA group. (B) Bean plot for the comparison of RCFT scores (P1, P2, P3) between the snoring/mild OSA group and the moderate/severe OSA group. The green distributions present results for the snoring or mild OSA group, and the Orange distributions present results for the moderate or severe OSA group. Horizontal black lines denote the averages of each experiment-specific distribution, while dashed lines indicate the overall averages.

    Correlation of Exhaled NO with Cognitive Function

    Firstly, results showed a significant negative correlation between immediate visual memory and FeNO50 (r = −0.286, P = 0.039), AHI (r = −0.088, P = 0.036), and witnessed apnea (r = −0.211, P = 0.034). Furthermore, delayed visual memory (P3) showed a negative relationship with FeNO50 (r = −0.302, P = 0.037) and AHI (r = −0.103, P = 0.031) (Figure 3). FeNO200 and CaNO were not significantly correlated with cognitive test scores (P > 0.05).

    Figure 3 Correlation of Exhaled NO with Cognitive Function. (A) Correlation between RCFT scores at various time points and FeNO50. (B) Correlation between RCFT scores at various time points and AHI.

    Secondly, The RCFT scores at three different time points (P1, P2, P3) for patients in both the snoring/mild OSA group and the moderate/severe OSA group followed a normal distribution. In the moderate/severe OSA group, P2 and P3 were significantly lower than those in the snoring/mild group (P < 0.05), indicating statistically significant differences. A one-way repeated measures ANOVA revealed that the immediate visual memory and delayed visual memory in the moderate/severe OSA group differed significantly from those in snoring/mild group (P < 0.05). Moreover, multiple comparisons using the LSD method demonstrated significant differences in RCFT scores across all time points.

    The main effect of time was significant, F = 271.171, P < 0.001, indicating that P1, P2, and P3 scores changed significantly over time. Furthermore, the group-by-time interaction was significant, with F = 3.065, P < 0.05, suggesting that the RCFT scores in the moderate/severe OSA group decreased more rapidly over time. The between-subjects main effect revealed a significant difference, F = 6.041, P < 0.05, indicating that the reduction in P1, P2, and P3 scores differed significantly between the two groups according to Table 3.

    Table 3 RCFT Scores Comparison Between the Moderate/Severe OSA and Snoring/Mild OSA Group at Different Time Points

    Impact of Exhaled Nitric Oxide on Cognitive Function

    To investigate the effect of FeNO on cognitive function, a hierarchical regression analysis was conducted with immediate memory as the dependent variable. We employed a two-step modeling approach. Model 1: We first included the following covariates: age, gender, longest apnea duration, ArI, witnessed apnea, BMI, ODI, TS90%, LSpO2, and AHI, constituting Model 1. The results indicated that ArI and AHI were positively associated with immediate visual memory (P < 0.05). Model 2: Building upon Model 1, FeNO50 and FeNO200 were added as predictors. The findings showed that FeNO50 had a significant negative impact on immediate visual memory (P < 0.05), while FeNO200 did not show a significant association (P > 0.05) (Table 4).

    Table 4 Hierarchical Regression Analysis of Exhaled Nitric Oxide Levels on Cognitive Function

    We also included delayed visual memory as a dependent variable in the hierarchical regression analysis; however, no significant effect of exhaled NO on delayed visual memory was observed. These findings suggest that higher FeNO50 are associated with poorer immediate visual memory in OSA, independent of other factors.

    Discussion

    Earlier research, including our own, has demonstrated that cognitive function is impaired in patients with OSA.4,32 In this study, we quantified proximal and distal airway inflammation by chemiluminescence analysis and assessed dynamic cognitive trajectories via multi-phase RCFT. Our findings revealed that elevated FeNO50 independently predicted impaired visual memory. Furthermore, a significant group × time interaction indicated that RCFT scores declined more rapidly over time in the moderate/severe OSA patients than those in the snoring/mild OSA group. These results underscore the specificity of airway inflammation in driving OSA-related cognitive impairment.

    This study provides significant insights into the relationship between FeNO and cognitive function in OSA patients. Notably, we are the first to report that FeNO50, a marker of proximal airway inflammation, independently predicts immediate visual memory deficits in OSA. In contrast, FeNO200, reflecting distal airway inflammation, showed no significant correlation with cognition. This distinction highlights that proximal airway inflammation may have a more direct cognitive impact than distal inflammation.

    Furthermore, our findings reveal that individuals suffering from moderate/severe OSA exhibit a more rapid decline in RCFT scores over time. The significant group-by-time interaction highlights the progressive nature of cognitive decline in OSA, which is often overlooked in traditional single time point studies. Through multi-time point assessments, we delineated the dynamic trajectory of cognitive deterioration, offering a comprehensive understanding of cognitive impairment in OSA.

    Studies have focused on the link between exhaled NO and cognitive function. The RCFT is widely used to assess visual memory, including both copying and recall tasks,25,33 and is applied to evaluate cognitive function in OSA patients. Ribeiro34 demonstrated that in OSA patients following weight loss treatment, the RCFT effectively captures changes in cognitive function, particularly improvements in executive function, memory, and information processing speed. Our study extends these findings by using the RCFT to assess dynamic cognitive trajectories. We observed that immediate and delayed visual memory were negatively correlated with AHI and FeNO50, suggesting that FeNO50 may be associated with cognitive impairment in OSA.

    A meta-analysis found elevated post-sleep FeNO levels in OSA, a pattern absent in controls. Furthermore, long-term continuous positive airway pressure (CPAP) therapy markedly reduces FeNO.17 In obese OSA patients, this post-sleep FeNO increase is particularly pronounced, likely due to obesity-related oxidative stress and comorbidities.17 Elevated NO has been recognized as a risk factor for Alzheimer’s disease.35 These findings support FeNO as a marker related to cognitive deficits in OSA. Accordingly, we hypothesized that elevated FeNO50 indicates inflammation in OSA patients, contributing to cognitive decline.

    Despite progress, inconsistencies remain regarding the relationship between FeNO and cognitive function. Some studies have reported higher bronchial NO and lower alveolar NO in OSA, with CPAP enhancing alveolar NO.36 Conversely, others have found elevated alveolar NO without bronchial NO level differences,37 likely due to variations in study design and sample size. Furthermore, a study on vehicle pollution found cognitive impairment in the high-pollution group despite no difference in FeNO.38 Our analysis of FeNO50, FeNO200, and CaNO, clarifies their distinct roles.

    The negative correlation between FeNO50 and immediate visual memory can be explained by proximal airway inflammation triggering systemic inflammation. Gramiccioni39 reported that exhaled NO increases with age and correlates with systemic oxidative stress and neurocognitive dysfunction, supporting eNO as a biomarker for cognitive impairment in OSA. In contrast, the absence of an association between FeNO200 and cognitive function suggests that distal airway inflammation has a limited systemic impact and fewer neurotoxic effects.

    FeNO and CaNO primarily reflect inducible nitric oxide synthase (iNOS) activity in the airway, indicating inflammation. In contrast, neuronal nitric oxide synthase (nNOS), expressed in the brain, regulates synaptic plasticity and memory. Dysregulated nNOS impair cognition through disrupted neurotransmission and neurotoxicity. Although FeNO50 is a peripheral marker, it may reflect systemic inflammation that affects central nNOS activity. This suggests interaction between iNOS and nNOS, warranting further investigation, ideally combining FeNO with neuroimaging or cerebrospinal fluid biomarkers.

    NO is essential for vascular regulation and neurotransmission.40 However, in inflammation, excessive NO can worsen neurodegeneration by promoting neuronal apoptosis and oxidative stress.41,42 Elevated NO levels have been linked to cognitive decline,35 and patients with OSA are prone to repeated hypoxia-reoxygenation cycles, which trigger oxidative stress and systemic inflammation, further impacting neurocognitive function.43 FeNO50, a marker of proximal airway inflammation, may exacerbate this process by increasing oxidative stress, impairing neuronal integrity and synaptic plasticity, particularly in memory-related regions like the hippocampus.44

    The observed interaction between OSA severity and cognitive trajectory supports this hypothesis. Studies indicate that high concentrations of NO can lead to the formation of reactive nitrogen species.45 This aligns with neuroimaging studies demonstrating that severe OSA is associated with structural brain changes, including reduced gray matter volume in the prefrontal cortex and hippocampus, regions critical for memory and executive function.46 Our findings linking FeNO50 to impaired memory reinforce the notion that airway inflammation contributes to neurocognitive dysfunction. Studies on RCFT indicate that memory is closely tied to hippocampal integrity, whereas familiarity-based recognition is associated with the medial temporal cortex.47,48

    Although cognitive tests were conducted before PSG and FeNO was measured after PSG, this sequence was chosen to minimize fatigue-related interference with cognitive assessments. Since FeNO may reflect acute airway inflammation influenced by nocturnal hypoxia and arousals, post-PSG measurement helps capture relevant physiological changes. We acknowledge this time gap as a methodological limitation.

    This study has several limitations. First, its cross-sectional design restricts causal inferences between FeNO and cognitive decline. Second, although the sample size was acceptable for exploratory analysis, it was relatively small, which may limit the generalizability of the findings. Although our regression models adjusted for key covariates including age, sex, education, BMI, and ESS score, we acknowledge that not all significantly different clinical or sleep-related variables (eg, ODI, TS90%) were included. This decision was made to avoid overfitting and maintain model stability given the sample size. Future studies with larger cohorts may incorporate a broader range of variables to further clarify the independent contribution of FeNO to cognitive impairment in OSA. Third, while we measured FeNO, we did not assess other inflammatory markers, which could offer a more comprehensive understanding of the inflammatory processes underlying cognitive decline in OSA. Finally, investigating the effects of OSA treatment on exhaled NO and cognitive function could provide further insights into the reversibility of cognitive impairment in OSA.

    Conclusions

    This study enhances understanding of the association between exhaled NO and cognitive impairment in patients with OSA. Our results indicate that FeNO50, a marker of proximal airway inflammation, is independently associated with poorer immediate visual memory. Additionally, patients with moderate to severe OSA exhibited a faster decline in cognitive function over time. These findings suggest that FeNO50 may serve as a potential non-invasive indicator of cognitive dysfunction in OSA; however, as a cross-sectional study, causality cannot be inferred. The time gap between cognitive testing (pre-PSG) and FeNO measurement (post-PSG) may affect the temporal interpretation of this association. In addition, although key covariates were adjusted for, the possibility of residual confounding remains. Further studies are needed to confirm its diagnostic and prognostic value of FeNO in this population.

    Data Sharing Statement

    To access the data supporting this study’s findings, one must make a reasonable request to Qilin Zhu and obtain permission from the Third Hospital of Nantong University, Jiangsu, China.

    Ethics Approval and Consent to Participate

    This study adhered to the guidelines set by the Declaration of Helsinki, and approved by the Ethics Committee of the Third Hospital of Nantong University (protocol code K2023115). Informed consent was obtained from all subjects involved in the study.

    Acknowledgments

    We acknowledge all the patients involved in this study.

    Author Contributions

    Qilin Zhu (QZ): Conceptualization; Data curation; Formal analysis; Writing–original draft. Lili Huang (LH): Methodology; Investigation; Writing–review & editing. Licheng Zhu (LZ): Formal analysis; Visualization. Xiaobai Zhang (XZ): Investigation; Resources. Honghua Ji (HJ): Data curation. Donghua Niu (DN): Data curation. Wangfei Ji (WJ): Data curation. Qingqing Ma (QM): Data curation. Rong Chen (RC): Data curation. Haiyan Shi (HS): Data curation. Yihua Wang (YW): Supervision; Writing–review & editing. Lina Xu (LX): Funding acquisition; Project administration; Supervision.

    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.

    Funding

    This work was supported by Jiangsu Science and Technology Think Tank Program (JSKX24017) and Scientific Research Project of Nantong Health Committee (JCZ20080).

    Disclosure

    The authors declare that they have no conflicts of interests.

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  • Billionaire private astronaut Jared Isaacman donating $15 million for Space Camp programs

    Billionaire private astronaut Jared Isaacman donating $15 million for Space Camp programs

    Jared Isaacman is donating a big chunk of change to help inspire the astronauts and space scientists of tomorrow.

    The billionaire tech entrepreneur and private astronaut, who until recently was on track to become NASA administrator, announced today (July 11) that he’s gifting $15 million to the U.S. Space & Rocket Center in Alabama for its Space Camp programs.

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  • Circular Debt of Pakistan: Understanding the Crisis

    Circular Debt of Pakistan: Understanding the Crisis

    Circular debt is a major financial problem in Pakistan’s energy sector, created by a mismatch between the cost of generating electricity and the revenue collected from consumers. It involves a complex chain of payments between different stakeholders, including power generation companies (IPPs), suppliers, distributors (Discos), gas utilities, and the government.

    As of now, Pakistan’s energy sector faces a massive deficit, with circular debt accumulating to around Rs2.3 trillion. This growing debt has significant economic implications, leading to inefficient power supply, higher electricity costs, and fiscal stress on the government.

    What is Circular Debt?

    Circular debt refers to the financial shortfall in Pakistan’s energy sector, where various entities involved in electricity generation, supply, and distribution owe large amounts of money to each other. The problem is rooted in poor management, delayed payments, and inefficiencies in revenue collection.

    The key players involved in this circular chain include the federal government, independent power producers (IPPs), government-owned power supply companies (Gencos and Discos), energy suppliers, and the financial institutions that finance the sector. These players often fail to pay one another on time, causing the debt to spiral out of control.

    How Circular Debt Has Grown

    Circular debt in Pakistan’s energy sector has grown significantly over the years due to several factors:

    Low Recoveries & Theft: Power companies struggle to recover payments from consumers, and widespread theft further exacerbates financial losses.

    Unreimbursed Tariff Subsidies: The government has failed to fully compensate power companies for the tariff subsidies, increasing the debt burden.

    Misaligned Billing Cycles: Billing inefficiencies and long delays in the collection process lead to a backlog of unpaid dues.

    Capacity Payments: IPPs are required to make large capacity payments, regardless of whether electricity is generated or consumed. This contributes to the increasing debt as power plants get paid without generating enough electricity to cover costs.

    As a result, the total circular debt has reached staggering amounts, leading to an unbalanced energy market where costs are passed down to consumers and institutions that are unable to meet their obligations.

    Key Components of Circular Debt

    The circular debt issue in Pakistan is divided into three main components:

    Payables of PSC (Power Supply Chain): These are the costs incurred by the power supply chain, including losses from electricity theft, unpaid bills, and support for life-line consumers.

    Payables of ESC (Energy Supply Chain): The ESC is burdened by unpaid fuel bills, especially for gas and other essential energy resources.

    Payables of GOP (Government of Pakistan): The government owes significant amounts due to subsidies for power generation and distribution, as well as unpaid payments to energy companies.

    Government’s Response and Proposed Solutions

    To address the growing circular debt, the Government of Pakistan has begun implementing several measures to resolve the issue. These steps focus on managing the debt more effectively, streamlining payments, and negotiating better terms with stakeholders.

    Debt Settlement Efforts: The finance ministry has started discussions with IPPs and other stakeholders to settle the existing circular debt. Negotiations include restructuring payment terms and adjusting tariffs to lower the debt.

    Debt Service Surcharge (DSS): A new DSS of Rs3.23 per kWh has been introduced, which will be added to electricity bills. This surcharge will help generate funds to pay off the outstanding debt to banks and other financial institutions.

    Interest Rate Adjustments: The KIBOR (Karachi Interbank Offered Rate) has been adjusted to ease the debt burden, which will reduce the overall financial pressure on the sector.

    Improving Cash Flow Management: The government has stressed the importance of transparent and real-time tracking of financial flows to better manage the circular debt and ensure timely payments.

    Why Circular Debt Has Spiraled

    The circular debt crisis in Pakistan’s energy sector has spiraled out of control for several reasons:

    Low Payment Recoveries: One of the main causes of the growing debt is the inability of power companies to recover payments from consumers. This is exacerbated by inefficiencies in billing and distribution.

    Theft and Mismanagement: Power theft is rampant across the country, leading to significant financial losses. Poor management and a lack of accountability have only worsened the situation.

    Structural Inefficiencies: The energy sector suffers from misaligned tariff structures, inadequate infrastructure, and weak planning, which causes delays in generating sufficient revenue to cover costs.

    Governance Failures: A lack of effective governance and sector regulation has led to inflation in power tariffs and inefficiencies that have compounded the financial crisis.

    Solutions and Future Roadmap

    Moving forward, the Pakistani government must focus on comprehensive reforms to tackle circular debt in the energy sector:

    Improving Billing and Collection Systems: The government needs to reform the billing process to ensure timely payments and minimize losses due to inefficient systems.

    Better Financial Management: Effective cash flow management, including real-time tracking of payments, will help reduce inefficiencies and increase accountability.

    Addressing Structural Inefficiencies: Tariffs must be reviewed and aligned with actual costs to ensure the sector remains financially viable in the long term.

    Governance Reforms: Stronger governance and accountability measures will help improve sector management, reduce financial mismanagement, and ensure that funds are used effectively.

    The circular debt problem in Pakistan’s energy sector is a complex challenge that requires a multi-pronged solution. While the government has made strides in addressing the issue, long-term success depends on structural reforms, improved financial management, and better governance. By implementing these measures, Pakistan can begin to reduce its circular debt, improve energy supply, and create a more sustainable energy market for the future.

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  • Former swimming coach to be extradited to Ireland

    Former swimming coach to be extradited to Ireland

    BBC George Gibney has thinning hair, glasses, a blue shirt, and a green fleece and is walking across a car park. He looks down at the groundBBC

    George Gibney left Ireland more than 30 years ago

    Former Irish national swimming coach George Gibney, who is wanted in the Republic of Ireland to face historical sexual abuse charges, is to be extradited there, a court in the United States has ruled.

    A US district magistrate made the order at a hearing in Orlando, Florida, on Friday.

    The Irish government has sought Mr Gibney’s return to face 78 counts of indecent assault and one count of attempted rape against four girls aged between eight and 14 at the time of the alleged offences.

    Mr Gibney had consented to his extradition and asked the court to expedite his departure to Ireland.

    He left Ireland more than 30 years ago and has not been back since.

    Mr Gibney was arrested in Florida by US Marshals at the start of this month.

    He has been remanded in the custody of the US Marshals at Orange County Jail, pending arrangements being made to transport him to Ireland.

    Mr Gibney sat in a wheelchair in the courtroom and was dressed in a uniform issued by Orange County Jail, Irish national broadcaster RTE said..

    The judge asked Mr Gibney a series of questions about the affidavit he signed giving up his right to contest his detention and his right to contest the extradition request.

    Mr Gibney replied “yes” to the questions.

    It was previously reported that gardaí (Irish police) reopened an investigation into Mr Gibney after a number of people made allegations against him on the BBC podcast Where is George Gibney? five years ago.

    The criminal investigation was commenced in 2020 by a specialist team within the Garda National Protective Services Bureau.

    A file was sent to the Director for Public Prosecutions (DPP) three years later.

    The DPP examined the file and recommended that Mr Gibney was charged.

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  • Sperry x Colbo Deconstructs the Authentic Original Boat Shoes

    Sperry x Colbo Deconstructs the Authentic Original Boat Shoes

    Sperry has teamed up with New York-based brand and retailer Colbo on its latest shoe.

    For this tie-up, the duo deconstructed Sperry’s Authentic Original boat shoe and rebuilt it into a soft, flexible silhouette. They style is made of premium materials and produced in muted earth tones for a shoe made for the summer.

    More specifically, the silhouette features distressing techniques and carefully pre-washed materials for a timeworn patina. The result is a shoe available in two rich, buttery leather colorways: Distressed Taupe and Weathered Sahara. Plus, leather outsoles are inspired by Sperry’s archival designs of the ‘70s and ‘80s, while a collapsible heel can be styled up or down for any occasion.

    And the attention to detail extends itself onto the shoes’ packaging. Each pair is wrapped in thick butcher paper and comes with a jute dust bag inside a co-branded shoe box.

    Tal Silberstein, co-founder and designer of Colbo, said in a statement that he has been wearing the same pair of Sperry Authentic Original boat shoes for years.

    “Down to the wash, wear, and suppleness, I mimicked the elements of my own boat shoes to create something that felt comfortable right off the bat but elevated enough to wear out,” Silberstein said.

    The Sperry x Colbo Authentic Original boat shoes.

    Courtesy of Sperry

    “Reflecting on 90 years of craftsmanship, innovation was always at the root of Sperry’s success,” Jonathan Frankel, president of Sperry, added. “Colbo’s unprecedented approach to men’s and womenswear offers a fresh interpretation of style, making this crossover a true embodiment of what Paul Sperry envisioned for the brand when he founded it in 1935.”

    The Sperry x Colbo Authentic Original boat shoes, which retail for $225, are now available exclusively via Colbo (online and in-store). A general release on Sperry.com will follow on July 14. And a second, limited edition collab style will be announced in fall 2025.

    This is the latest collaboration for the 90-year-old footwear brand. In June, Sperry released its latest collection with Todd Snyder, which featured new versions of the CVO sneaker and the Authentic Original boat shoe.

    Other recent collaborations from Sperry include shoes with Aritzia, J.Crew, Colour Plus Companie and Beams Plus.

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  • EMA Lifts Chikungunya Vaccine Restriction – With Care

    EMA Lifts Chikungunya Vaccine Restriction – With Care

    The European Medicines Agency (EMA)’s Pharmacovigilance Risk Assessment Committee (PRAC) has issued a safety update on the chikungunya vaccine after review of the Ixchiq live-attenuated jab. It said that it would now lift the temporary restriction put in place in May on vaccinating people aged 65 years and above as a result of reports of serious side effects.

    However, the committee emphasized that the vaccine should only be used after careful consideration of risks and benefits when there is significant risk of chikungunya infection.

    Chikungunya is a viral disease that is most common in Africa, Asia, the Caribbean, and South and Central America, with a few cases also reported in Europe and the US. It is carried by mosquitoes, most often Aedes aegypti and Aedes albopictus, that may also transmit dengue and Zika viruses. Person-to-person transmission does not occur, though rarely the infection may be passed on via blood.

    Crippling Joint Pain 

    The incubation period is 3-7 days. Common symptoms are fever, rash, muscle pain, and severe arthralgia. The name chikungunya comes from a Tanzanian word to describe the way severely affected patients often assume a stooped appearance due to crippling pain. Most infections are mild, with only about 2% leading to severe symptoms. There may be a risk of encephalitis, but this is rare and unclear.

    Most of those affected recover within a week to 10 days of the start of symptoms. But 30%-40% of those affected develop ongoing chronic joint pain and chronic arthritis that can last for months or even years. Treatment is largely symptomatic.

    Side Effect Risk Groups

    Ixchiq was authorized in the EU in June 2024. When the recent PRAC review began, around 36,000 doses of the vaccine had been used worldwide. Safety data recorded 28 cases of serious side effects, mainly in people aged 65 years and older and those with multiple underlying comorbidities, particularly chronic or uncontrolled medical conditions such as cardiovascular diseases, diabetes mellitus, or chronic kidney disease. There had been three deaths.

    Although serious vaccine side effects most often affected this group, these were also the people at highest risk of severe chikungunya infection, the PRAC noted. Many of the serious side effects reported were similar to symptoms of chikungunya infection itself, the committee said. These could include fever, malaise, anorexia, and confusion, which can lead to falls. In some cases, vaccine side effects had worsened patients’ medical conditions or caused deterioration in their general health, in some instances resulting in hospitalization.

    Avoid Vaccinating Immunocompromised People

    The committee also reminded healthcare professionals that Ixchiq must not be given to people whose immune system is weakened because of disease or medical treatment, as they are at greater risk of having complications from vaccines containing live-attenuated viruses. This contraindication remains in place following the review.

    The product information for Ixchiq will be updated with the latest recommendations following the review. A direct healthcare professional communication will be sent to healthcare professionals prescribing, dispensing, or administering Ixchiq and will be published on a dedicated page on the EMA website.

    The PRAC recommendations will now be sent to the Committee for Medicinal Products for Human Use, which will adopt the agency’s opinion before adoption by the European Commission of a legally binding decision applicable in all EU Member States.

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  • The Surprising Royal Table Rules The British Royal Family Follows

    The Surprising Royal Table Rules The British Royal Family Follows

    This week, French President Emmanuel Macron and his wife Brigitte visited the U.K. for the first time in 17 years. The Macrons stayed at Windsor Castle as guests of King Charles III and Queen Camilla, and on July 8th, a banquet was held in their honor at St. George’s Hall.

    The state banquet included three courses—at least one of which was prepared by chef Raymond Blanc—plus dessert, and so many different beverages that each table setting had to have five glasses. Which made us wonder—why? What exactly does a royal table setting entail? Here’s what we found out:

    The Food

    According to the Independent, the table took staff six days to prepare. Typically, the menu for a State Banquet leans heavily on local ingredients, procured on royal properties. For the Macron visit, the banquet included vegetables and herbs from the garden, as well as “Supreme of Rhug Estate Chicken with Norfolk Asparagus and Tarragon Cream, followed by Iced Blackcurrant Parfait on a Blackcurrant-soaked Sponge with Elderflower Jelly for dessert.” The menu, per tradition, was written in French.

    Pool//Getty Images

    The Setting

    Typically, when a State Banquet is held at St. George’s Hall, a 164-foot, horseshoe shaped table is set using the Grand Service, made from silver-gilt when George IV was the Prince of Wales–from 1762–1830. However, for the Macron visit, the royals eschewed the horseshoe shape in favor of one long 50-meter mahogany table with guests sitting on either side. But, the china was still on display.

    The China

    In the set are “140 dishes, 288 dinner plates, 118 salts, 12 ice pails, 58 dessert stands and centrepieces and 107 candelabra,” according to the Royal Collection Trust, and the “service is so large and so magnificent that it has never been replaced.” Though a few updates have been made over the years, like the addition of Kings Charles’s cipher to the gold-edged side plates.

    state visit by the president of the french republic day one

    Pool//Getty Images

    The Glasses

    When the table is set, the space between each item is measured, inspected by staff (and, historically, by the Queen), and the napkins are folded in the Dutch bonnet style. As for all those glasses? They’re for wine, red and white, water, a bespoke, event-specific cocktail, and champagne for a toast. Though we’re seeing five glasses, typically, there’s a sixth. Did someone go without port? Perhaps. Times change.


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