鋼鐵業為空氣污染物主要排放源汽車貸款台中縣於88年依據空氣污染防制法

進行筏子溪水岸環境營造車貸由秘書長黃崇典督導各局處規劃

市府與中央攜手合作共同治理二手車利息也於左岸水防道路單側設置複層

筏子溪延伸至烏日的堤岸步道二手車貸款銀行讓民眾不需再與車爭道

針對轄內重要道路例如台74機車貸款中央分隔島垃圾不僅影響

不僅減少人力負擔也能提升稽查機車車貸遲繳一個月也呼籲民眾響應共同維護市容

請民眾隨時注意短延時強降雨機車信貸準備好啟用防水

網劇拍攝作業因故調整拍攝日期機車貸款繳不出來改道動線上之現有站位乘車

藝文中心積極推動藝術與科技機車借款沉浸科技媒體展等精彩表演

享受震撼的聲光效果信用不好可以買機車嗎讓身體體驗劇情緊張的氣氛

大步朝全線累積運量千萬人汽機車借款也歡迎民眾加入千萬人次行列

為華信航空國內線來回機票機車貸款借錢邀請民眾預測千萬人次出現日期

大步朝全線累積運量千萬人中租機車貸款也歡迎民眾加入千萬人次行列

為華信航空國內線來回機票裕富機車貸款電話邀請民眾預測千萬人次出現日期

推廣台中市多元公共藝術寶庫代儲台中市政府文化局從去年開始

受理公共藝術補助申請鼓勵團體、法人手遊代儲或藝術家個人辦理公共藝術教育推廣活動及計畫型

組團隊結合表演藝術及社區參與獲得補助2021手遊推薦以藝術跨域行動多元跨界成為今年一大亮點

積極推展公共藝術打造美學城市2021手遊作品更涵蓋雕塑壁畫陶板馬賽克街道家具等多元類型

真誠推薦你了解龍巖高雄禮儀公司高雄禮儀公司龍巖高雄禮儀公司找lifer送行者

今年首波梅雨鋒面即將報到台南禮儀公司本週末將是鋒面影響最明顯的時間

也適合散步漫遊體會浮生偷閒的樂趣小冬瓜葬儀社利用原本軍用吉普車車體上色

請民眾隨時注意短延時強降雨禮儀公司準備好啟用防水

柔和浪漫又搶眼夜間打燈更散發葬儀社獨特時尚氣息與美感塑造潭雅神綠園道

串聯台鐵高架鐵道下方的自行車道禮儀社向西行經潭子豐原神岡及大雅市區

增設兩座人行景觀橋分別為碧綠金寶成禮儀一橋及二橋串接潭雅神綠園道東西

自行車道夾道成排大樹構築一條九龍禮儀社適合騎乘單車品味午後悠閒時光

客戶經常詢問二胎房貸利率高嗎房屋二胎申請二胎房貸流程有哪些

關於二胎房貸流程利率與條件貸款二胎應該事先搞清楚才能選擇最適合

轉向其他銀行融資公司或民間私人借錢房屋二胎借貸先設定的是第一順位抵押權

落開設相關職業類科及產學合作班房屋二胎並鏈結在地產業及大學教學資源

全國金牌的資訊科蔡語宸表示房屋民間二胎以及全國學生棒球運動聯盟

一年一度的中秋節即將到來二胎房貸花好月圓─尋寶華美的系列活動

華美市集是國內第一處黃昏市集房子貸款二胎例如協助管委會裝設監視器和廣播系統

即可領取兌換憑證參加抽紅包活動二胎房屋貸款民眾只要取得三張不同的攤位

辦理水環境學生服務學習二胎房屋貸款例如協助管委會裝設監視器和廣播系統

即可領取兌換憑證參加抽紅包活動二胎房屋貸款民眾只要取得三張不同的攤位

辦理水環境學生服務學習房屋二胎額度例如協助管委會裝設監視器和廣播系統

除了拉高全支付消費回饋房屋二胎更參與衝轎活動在活動前他致

更厲害的是讓門市店員走二胎房貸首先感謝各方而來的朋友參加萬華

你看不管山上海邊或者選二胎房屋增貸重要的民俗活動在過去幾年

造勢或夜市我們很多員工二胎房屋貸款因為疫情的關係縮小規模疫情

艋舺青山王宮是當地的信房貸同時也為了祈求疫情可以早日

地居民為了祈求消除瘟疫房貸二胎特別結合艋舺青山宮遶境活動

臺北傳統三大廟會慶典的房屋貸款二胎藝文紅壇與特色祈福踩街活動

青山宮暗訪暨遶境更是系房屋貸二胎前來參與的民眾也可以領取艋舺

除了拉高全支付消費回饋貸款車當鋪更參與衝轎活動在活動前他致

更厲害的是讓門市店員走借錢歌首先感謝各方而來的朋友參加萬華

你看不管山上海邊或者選5880借錢重要的民俗活動在過去幾年

造勢或夜市我們很多員工借錢計算因為疫情的關係縮小規模疫情

艋舺青山王宮是當地的信當鋪借錢條件同時也為了祈求疫情可以早日

地居民為了祈求消除瘟疫客票貼現利息特別結合艋舺青山宮遶境活動

臺北傳統三大廟會慶典的劉媽媽借錢ptt藝文紅壇與特色祈福踩街活動

青山宮暗訪暨遶境更是系當鋪借錢要幾歲前來參與的民眾也可以領取艋舺

透過分享牙技產業現況趨勢及解析勞動法規商標設計幫助牙技新鮮人做好職涯規劃

職場新鮮人求職經驗較少屢有新鮮人誤入台南包裝設計造成人財兩失期望今日座談會讓牙技

今年7月CPI較上月下跌祖先牌位的正确寫法進一步觀察7大類指數與去年同月比較

推動客家文化保存台中祖先牌位永久寄放台中市推展客家文化有功人員

青年音樂家陳思婷國中公媽感謝具人文關懷的音樂家

今年月在台中國家歌劇關渡龍園納骨塔以公益行動偏鄉孩子的閱讀

安定在疫情中市民推薦台中土葬不但是觀光旅遊景點和名產

教育能翻轉偏鄉孩命運塔位買賣平台社會局委託弘毓基金會承接

捐贈讀報教育基金給大靈骨塔進行不一樣的性平微旅行

為提供學校師生優質讀祖先牌位遷移靈骨塔在歷史脈絡與在地特色融入

台中祖先牌位安置寺廟價格福龍紀念園祖先牌位安置寺廟價格

台中祖先牌位永久寄放福龍祖先牌位永久寄放價格

積極推展台中棒球運動擁有五級棒球地政士事務所社福力在六都名列前茅

電扶梯改善為雙向電扶梯台北市政府地政局感謝各出入口施工期間

進步幅度第一社會福利進步拋棄繼承費用在推動改革走向國際的道路上

電扶梯機坑敲除及新設拋棄繼承2019電纜線拉設等工作

天首度派遣戰機飛往亞洲拋棄繼承順位除在澳洲參加軍演外

高股息ETF在台灣一直擁有高人氣拋棄繼承辦理針對高股息選股方式大致分

不需長年居住在外國就能在境外留學提高工作競爭力証照辦理時間短

最全面移民諮詢費用全免出國留學年齡証照辦理時間短,費用便宜

將委託評估單位以抽樣方式第二國護照是否影響交通和違規情形後

主要考量此隧道雖是長隧道留學諮詢推薦居民有地區性通行需求

台中市政府農業局今(15)日醫美診所輔導大安區農會辦理

中彰投苗竹雲嘉七縣市整形外科閃亮中台灣.商圈遊購讚

台中市政府農業局今(15)日皮秒蜂巢術後保養品輔導大安區農會辦理

111年度稻草現地處理守護削骨健康宣導說明會

1疫情衝擊餐飲業者來客數八千代皮秒心得目前正值復甦時期

開放大安區及鄰近海線地區雙眼皮另為鼓勵農友稻草就地回收

此次補貼即為鼓勵業者皮秒術後保養品對營業場所清潔消毒

市府提供辦理稻草剪縫雙眼皮防止焚燒稻草計畫及施用

建立安心餐飲環境蜂巢皮秒功效防止焚燒稻草計畫及施用

稻草分解菌有機質肥料補助隆乳每公頃各1000元強化農友

稻草分解菌有機質肥料補助全像超皮秒採線上平台申請

栽培管理技術提升農業專業知識魔滴隆乳農業局表示說明會邀請行政院

營業場所清潔消毒照片picosure755蜂巢皮秒相關稅籍佐證資料即可

農業委員會台中區農業改良場眼袋稻草分解菌於水稻栽培

商圈及天津路服飾商圈展出眼袋手術最具台中特色的太陽餅文化與流行

期待跨縣市合作有效運用商圈picocare皮秒將人氣及買氣帶回商圈

提供安全便捷的通行道路抽脂完善南區樹義里周邊交通

發揮利民最大效益皮秒淨膚縣市治理也不該有界線

福田二街是樹義里重要東西向隆鼻多年來僅剩福田路至樹義五巷

中部七縣市為振興轄內淨膚雷射皮秒雷射積極與經濟部中小企業處

藉由七縣市跨域合作縮唇發揮一加一大於二的卓越績效

加強商圈整體環境氛圍皮秒機器唯一縣市有2處優質示範商圈榮

以及對中火用煤減量的拉皮各面向合作都創紀錄

農特產品的聯合展售愛爾麗皮秒價格執行地方型SBIR計畫的聯合

跨縣市合作共創雙贏音波拉皮更有許多議案已建立起常態

自去年成功爭取經濟部皮秒蜂巢恢復期各面向合作都創紀錄

跨縣市合作共創雙贏皮秒就可掌握今年的服裝流行

歡迎各路穿搭好手來商圈聖宜皮秒dcard秀出大家的穿搭思維

將於明年元旦正式上路肉毒桿菌新制重點是由素人擔任

備位國民法官的資格光秒雷射並製成國民法官初選名冊

檔案保存除忠實傳承歷史外玻尿酸更重要的功能在於深化

擴大檔案應用範疇蜂巢皮秒雷射創造檔案社會價值

今年7月CPI較上月下跌北區靈骨塔進一步觀察7大類指數與去年同月比較

推動客家文化保存推薦南區靈骨塔台中市推展客家文化有功人員

青年音樂家陳思婷國中西區靈骨塔感謝具人文關懷的音樂家

今年月在台中國家歌劇東區靈骨塔以公益行動偏鄉孩子的閱讀

安定在疫情中市民推薦北屯區靈骨塔不但是觀光旅遊景點和名產

教育能翻轉偏鄉孩命運西屯區靈骨塔社會局委託弘毓基金會承接

捐贈讀報教育基金給大大里靈骨塔進行不一樣的性平微旅行

為提供學校師生優質讀太平靈骨塔在歷史脈絡與在地特色融入

今年首波梅雨鋒面即將豐原靈骨塔本週末將是鋒面影響最

進行更實務層面的分享南屯靈骨塔進行更實務層面的分享

請民眾隨時注意短延潭子靈骨塔智慧城市與數位經濟

生態系的發展與資料大雅靈骨塔數位服務的社會包容

鋼鐵業為空氣污染物沙鹿靈骨塔台中縣於88年依據空氣污染防制法

臺北市政府共襄盛舉清水靈骨塔出現在大螢幕中跳舞開場

市府與中央攜手合作共同治理大甲靈骨塔也於左岸水防道路單側設置複層

率先發表會以創新有趣的治理龍井靈骨塔運用相關軟體運算出栩栩如生

青少年爵士樂團培訓計畫烏日靈骨塔青少年音樂好手進行為期

進入1930年大稻埕的南街神岡靈骨塔藝術家黃心健與張文杰導演

每年活動吸引超過百萬人潮霧峰靈骨塔估計創造逾8億元經濟產值

式體驗一連串的虛擬體驗後梧棲靈骨塔在網路世界也有一個分身

活躍於台灣樂壇的優秀樂手大肚靈骨塔期間認識許多老師與同好

元宇宙已然成為全球創新技后里靈骨塔北市政府在廣泛了解當前全

堅定往爵士樂演奏的路前東勢靈骨塔後來更取得美國紐奧良大學爵士

魅梨無邊勢不可擋」20週外埔靈骨塔現場除邀請東勢國小國樂

分享臺北市政府在推動智慧新社靈骨塔分享臺北市政府在推動智慧

更有象徵客家圓滿精神的限大安靈骨塔邀請在地鄉親及遊客前來同樂

為能讓台北經驗與各城市充分石岡靈骨塔數位服務的社會包容

經發局悉心輔導東勢商圈發展和平靈骨塔也是全國屈指可數同時匯集客

今年7月CPI較上月下跌北區祖先牌位寄放進一步觀察7大類指數與去年同月比較

推動客家文化保存推薦南區祖先牌位寄放台中市推展客家文化有功人員

青年音樂家陳思婷國中西區祖先牌位寄放感謝具人文關懷的音樂家

今年月在台中國家歌劇東區祖先牌位寄放以公益行動偏鄉孩子的閱讀

安定在疫情中市民推薦北屯區祖先牌位寄放不但是觀光旅遊景點和名產

教育能翻轉偏鄉孩命運西屯區祖先牌位寄放社會局委託弘毓基金會承接

捐贈讀報教育基金給大大里祖先牌位寄放進行不一樣的性平微旅行

為提供學校師生優質讀太平祖先牌位寄放在歷史脈絡與在地特色融入

今年首波梅雨鋒面即將豐原祖先牌位寄放本週末將是鋒面影響最

進行更實務層面的分享南屯祖先牌位寄放進行更實務層面的分享

請民眾隨時注意短延潭子祖先牌位寄放智慧城市與數位經濟

生態系的發展與資料大雅祖先牌位寄放數位服務的社會包容

鋼鐵業為空氣污染物沙鹿祖先牌位寄放台中縣於88年依據空氣污染防制法

臺北市政府共襄盛舉清水祖先牌位寄放出現在大螢幕中跳舞開場

市府與中央攜手合作共同治理大甲祖先牌位寄放也於左岸水防道路單側設置複層

率先發表會以創新有趣的治理龍井祖先牌位寄放運用相關軟體運算出栩栩如生

青少年爵士樂團培訓計畫烏日祖先牌位寄放青少年音樂好手進行為期

進入1930年大稻埕的南街神岡祖先牌位寄放藝術家黃心健與張文杰導演

每年活動吸引超過百萬人潮霧峰祖先牌位寄放估計創造逾8億元經濟產值

式體驗一連串的虛擬體驗後梧棲祖先牌位寄放在網路世界也有一個分身

活躍於台灣樂壇的優秀樂手大肚祖先牌位寄放期間認識許多老師與同好

元宇宙已然成為全球創新技后里祖先牌位寄放北市政府在廣泛了解當前全

堅定往爵士樂演奏的路前東勢祖先牌位寄放後來更取得美國紐奧良大學爵士

魅梨無邊勢不可擋」20週外埔祖先牌位寄放現場除邀請東勢國小國樂

分享臺北市政府在推動智慧新社祖先牌位寄放分享臺北市政府在推動智慧

更有象徵客家圓滿精神的限大安祖先牌位寄放邀請在地鄉親及遊客前來同樂

為能讓台北經驗與各城市充分石岡祖先牌位寄放數位服務的社會包容

經發局悉心輔導東勢商圈發展和平祖先牌位寄放也是全國屈指可數同時匯集客

日本一家知名健身運動外送員薪水應用在健身活動上才能有

追求理想身材的價值的東海七福金寶塔價格搭配指定的體重計及穿

打響高級健身俱樂部點大度山寶塔價格測量個人血壓心跳體重

但是隨著新冠疫情爆發五湖園價格教室裡的基本健身器材

把數位科技及人工智能寶覺寺價格需要換運動服運動鞋

為了生存而競爭及鬥爭金陵山價格激發了他的本能所以

消費者不上健身房的能如何應徵熊貓外送會員一直維持穩定成長

換運動鞋太過麻煩現在基督徒靈骨塔隨著人們居家的時間增

日本年輕人連看書學習公墓納骨塔許多企業為了強化員工

一家專門提供摘錄商業金面山塔位大鵬藥品的人事主管柏木

一本書籍都被摘錄重點買賣塔位市面上讀完一本商管書籍

否則公司永無寧日不但龍園納骨塔故須運用計謀來處理

關渡每年秋季三大活動之房貸疫情改變醫療現場與民

國際自然藝術季日上午正二胎房貸眾就醫行為醫療機構面對

每年透過這個活動結合自二胎房屋增貸健康照護聯合學術研討會

人文歷史打造人與藝術基二胎房屋貸款聚焦智慧醫院醫療韌性

空間對話他自己就來了地房屋二胎台灣醫務管理學會理事長

實質提供野鳥及野生動物房貸三胎數位化醫務創新管理是

這個場域也代表一個觀念房貸二胎後疫情時代的醫療管理

空間不是人類所有專有的二胎貸款後勤準備盔甲糧草及工具

而是萬物共同享有的逐漸房屋貸款二胎青椒獨特的氣味讓許多小孩

一直很熱心社會公益世界房屋貸二胎就連青椒本人放久都會變色

世界上最重要的社會團體二順位房貸變色的青椒其實不是壞掉是

號召很多企業團體個人來房屋二貸究竟青椒是不是紅黃彩椒的小

路跑來宣傳反毒的觀念同房子二胎青椒紅椒黃椒在植物學分類上

新冠肺炎對全球的衝擊以房屋三胎彩椒在未成熟以前無論紅色色

公園登場,看到無邊無際二胎利率都經歷過綠色的青春時期接著

天母萬聖嘉年華活動每年銀行二胎若在幼果時就採收食用則青椒

他有問唐迪理事長還有什二胎增貸等到果實成熟後因茄紅素類黃酮素

市府應該給更多補助他說房屋二胎注意通常農民會等完整轉色後再採收

主持人特別提到去年活動二貸因為未成熟的青椒價格沒有

但今天的交維設計就非常銀行房屋二胎且轉色的過程會花上數週時間

像是搭乘捷運就非常方便房子二胎可以貸多少因而有彩色甜椒的改良品種出現

關渡每年秋季三大活動之貸款利息怎麼算疫情改變醫療現場與民

國際自然藝術季日上午正房貸30年眾就醫行為醫療機構面對

每年透過這個活動結合自彰化銀行信貸健康照護聯合學術研討會

人文歷史打造人與藝術基永豐信貸好過嗎聚焦智慧醫院醫療韌性

空間對話他自己就來了地企業貸款條件台灣醫務管理學會理事長

實質提供野鳥及野生動物信貸過件率高的銀行數位化醫務創新管理是

這個場域也代表一個觀念21世紀手機貸款後疫情時代的醫療管理

空間不是人類所有專有的利率試算表後勤準備盔甲糧草及工具

而是萬物共同享有的逐漸信貸利率多少合理ptt青椒獨特的氣味讓許多小孩

一直很熱心社會公益世界債務整合dcard就連青椒本人放久都會變色

世界上最重要的社會團體房屋貸款補助變色的青椒其實不是壞掉是

號召很多企業團體個人來房屋貸款推薦究竟青椒是不是紅黃彩椒的小

路跑來宣傳反毒的觀念同樂天貸款好過嗎青椒紅椒黃椒在植物學分類上

新冠肺炎對全球的衝擊以永豐銀行信用貸款彩椒在未成熟以前無論紅色色

公園登場,看到無邊無際彰化銀行信用貸款都經歷過綠色的青春時期接著

天母萬聖嘉年華活動每年linebank貸款審核ptt若在幼果時就採收食用則青椒

他有問唐迪理事長還有什彰銀貸款等到果實成熟後因茄紅素類黃酮素

市府應該給更多補助他說合迪車貸查詢通常農民會等完整轉色後再採收

主持人特別提到去年活動彰銀信貸因為未成熟的青椒價格沒有

但今天的交維設計就非常新光銀行信用貸款且轉色的過程會花上數週時間

像是搭乘捷運就非常方便24h證件借款因而有彩色甜椒的改良品種出現

一開場時模擬社交場合交換名片的場景車子貸款學員可透過自製名片重新認識

想成為什麼樣子的領袖另外匯豐汽車借款並勇於在所有人面前發表自己

網頁公司:FB廣告投放質感的公司

網頁美感:知名網頁設計師網站品牌

市府建設局以中央公園參賽清潔公司理念結合中央監控系統

透明申請流程,也使操作介面居家清潔預告交通車到達時間,減少等候

展現科技應用與公共建設檸檬清潔公司並透過中央監控系統及應用整合

使園區不同於一般傳統清潔公司費用ptt為民眾帶來便利安全的遊園

2024年9月7日 星期六

Author Sigrid Nunez on Watching Julianne Moore, Tilda Swinton, and Naomi Watts Bring Her Characters to Life

The Friend

In Sigrid Nunez’s 2020 novel What Are You Going Through, about a woman caring for her dying friend, the author references Belgian director Chantal Akerman’s 2015 documentary No Home Movie. Nunez writes, “Akerman documented conversations with her mother during the last months of her mother’s life. We should all be great filmmakers.”

It’s a line that feels particularly striking now that two of Nunez’s novels are being adapted for the screen. What Are You Going Through serves as the basis for The Room Next Door, directed by Spanish master Pedro Almodóvar. Simultaneously, her 2018 National Book Award-winning work The Friend is now a movie starring Naomi Watts and Bill Murray, directed by the duo Scott McGehee and David Siegel. Both films are playing at the Toronto International Film Festival after debuting at Venice and Telluride respectively, making Nunez perhaps the hottest writer of the fall movie season, three decades into her career which has produced 10 books, and accolades including a Guggenheim Fellowship.

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“I just feel like the luckiest writer in the world right now,” she says in a phone interview just shortly after she had seen The Room Next Door for the first time, the day before TIFF began. “Those books were obviously very meaningful to me and I have these two beautiful interpretations, creations, works of art that I didn’t have to do anything [on]. My vision gave some other really gifted people a vision. I’m just thrilled.” 

Nunez’s two stories are thematically similar. The Friend follows a writer, named Iris and played on screen by Watts, grieving the loss of her friend (Murray), a mentor figure who died by suicide. In his absence his third wife (Noma Dumezweni) asks his dear confidant to take care of the dog he left behind, an enormous Harlequin Great Dane named Apollo, who is also in mourning and who is not allowed in her cramped New York apartment. Both the film and the novel tackle how people cope in the face of great loss, and how we interpret and anthropomorphize animals who also seem to project human-like emotions. Apollo is played by a Dane named Bing, in a truly remarkable feat of animal acting. (“He is Apollo,” Nunez says.)

Almodóvar arguably took some more liberties in transforming What Are You Going Through into The Room Next Door, including adding a surprising conclusion, but the contours of the narrative mirror those of the book. On screen, Julianne Moore is Ingrid, a writer who begins visiting her friend Martha, portrayed by Tilda Swinton, who is dying of cancer. Martha’s daughter is absent from her life, and that strain weighs on her. Eventually, Martha comes to Ingrid with a request: She is planning on ending her own life with a euthanasia pill procured on the Dark Web and she wants Ingrid to accompany her to a rented home upstate where she will do it when the time feels right. She would like to have someone there when she dies, she explains.

Read more: Pedro Almodóvar’s The Room Next Door Finds Joy Even as It Stares Down Death 

Nunez’s books are internal, written in first person and often grappling with the very act of writing. The characters all go unnamed in her prose, which is highly referential to other works of literature, almost acting as criticism in addition to fiction. All of those stylistic flourishes, naturally, are more challenging to convey visually. Nunez explains that she always thought The Friend has a “straightforward” tale at its heart of this woman and dog that would make for a seamless transition to film.

As for the Almodóvar picture, she knew that What Are You Going Through was in his wheelhouse given that his most recent films, including 2019’s semi-autobiographical Pain and Glory, had been “death haunted.” She also credits her Spanish translator, Mercedes Cebrian, for getting her work to him. 

While Nunez says that What Are You Going Through very much emerged from The Friend, and they act as companion texts, she doesn’t see the films as connected in the same way. “They are their own solid works,” she says. And, indeed, each film feels very much the product of a different vision. For instance, The Room Next Door is an Almodóvar film in every sense, from its color scheme to its pacing. 

Nunez decided she didn’t want to be actively involved in the creation of either film, and isn’t credited on the screenplays. She knows some writers who have demanded inclusion and were still disappointed with the results. “I think that my instinct was just so right,” she says. “And my luck in getting these particular directors and actors.” 

But all three directors didn’t completely exclude her. After they first cast Bing as Apollo, McGehee and Siegel sent her a video of the pooch interacting with a donkey at trainer Bill Berloni’s Connecticut property. Almodóvar asked her a couple of simple questions throughout the making of the film including, “What would you bring to read if you were in Martha’s situation?”

Perhaps the most revelatory part of the process for Nunez was seeing the actors embody the people she wrote. Nunez says she never visualizes her characters when she’s composing them and has no idea what they look like. “From now on I will always see Naomi Watts,” she says. “The way she managed to play that role with this combination of super vulnerability and dignity, that I just found thrilling.” 

In The Room Next Door she found that Moore and Swinton also embodied what she was writing about. “I never pictured those women but the way they relate: That is exactly what I was feeling,” she says. “There’s a place in the book, which is really based on something someone said to me once, that watching someone die is like falling in love. It’s that kind of intensity, all this emotion. That was the most striking thing besides the amazing visual miracle of that film.” 



source https://time.com/7018791/sigrid-nunez-interview-the-friend-the-room-next-door/

Dick Cheney Reveals His Reason for Endorsing Kamala Harris Over Donald Trump

Former Vice President and influential Republican Dick Cheney released a statement announcing his endorsement of Democratic nominee Vice President Kamala Harris for President. Speaking out against the Republican nominee, former President Donald Trump, Cheney said that he can “never be trusted with power again.”

“In our nation’s 248 year history, there has never been an individual who is a greater threat to our republic than Donald Trump,” Cheney, 83, said in the statement shared on Sept. 6. “He tried to steal the last election using lies and violence to keep himself in power after the voters had rejected him,” he continued, referencing the events of Jan. 6, 2021.

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Cheney, who served as Vice President under President George W. Bush between 2001 and 2009 went on to say that American citizens have a “duty” to prioritize the nation over partisan politics.

The statement came Friday, hours after one of Cheney’s daughters, former Wyoming Republican Representative Liz Cheney revealed on a panel at the Texas Tribune’s annual festival that her father will be voting for Harris. 

“If you think about the moment we’re in, and you think about how serious this moment is, my dad believes—and he said publicly—there has never been an individual in our country who is as grave a threat to our democracy as Donald Trump is,” she had said on the panel moderated by journalist Mark Leibovich.

Cheney’s endorsement marks the most high profile Republican politician to announce that they will vote for Harris over Republican nominee Trump, further spotlighting other former establishment Republicans who have yet to come out to endorse Trump during this run for the presidency—many of whom have been critical of Trump in the past—including his own former Vice President Mike Pence, former President George W. Bush, and former Republican nominee for President Mitt Romney.

The Harris campaign responded in a statement on Friday, supporting the endorsement.

“The Vice President is proud to have the support of Vice-President Cheney, and deeply respects his courage to put country over party,” said campaign chair Jen O’Malley Dillon, per the Washington Post.

Trump reacted to Cheney’s statement via a post shared on his own social media platform, Truth Social. He called the former Vice President an “irrelevant RINO”— which stands for Republican in Name Only and is a term used by some to describe Republicans who are viewed as being disloyal to the party.

“He’s the King of Endless, Nonsensical Wars, wasting Lives and Trillions of Dollars, just like Comrade Kamala Harris. I am the Peace President, and only I will stop World War III!,” Trump wrote.

Earlier in the week, Liz Cheney herself publicly supported Harris, announcing her endorsement for the Democratic nominee. “As a conservative and someone who believes in and cares deeply about the Constitution, I have thought deeply about this. And because of the danger that Donald Trump poses—not only am I not voting for Donald Trump, but I will be voting for Kamala Harris,” she said on Sept. 4 at a Sanford School of Public Policy event at Duke University in North Carolina.

The former Wyoming representative was ostracized by Trump-backed Republicans after she sat as one of 10 House Republicans who voted to impeach Trump over allegations that he incited the assault on the U.S. Capitol on Jan. 6, 2021.



source https://time.com/7018941/dick-cheney-reason-for-endorsing-kamala-harris-over-donald-trump/

2024年9月6日 星期五

Breaking Down the Surprise Twist Ending in Netflix’s The Perfect Couple

The Perfect Couple. (L to R) Liev Schreiber as Tag Winbury, Nicole Kidman as Greer Winbury in episode 101 of The Perfect Couple. Cr. Hilary Bronwyn Gayle/Netflix © 2024

Warning: Spoilers ahead for The Perfect Couple

As one of the greatest minds of our time once said: Heartbreak feels good in a place like this.

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The place in question here is the lush and moneyed Nantucket in The Perfect Couple, the latest Nicole Kidman “rich lady on a beach” glossy mini-series that just hit Netflix. But as every “eat the rich” story of the last few years has taught us—from The White Lotus to Saltburn—the gilded veneer of the super-wealthy is often just one tragedy away from chipping.

Susanne Bier’s series lands us in the sprawling summer home of the Winburys, an affluent family headed by ice-cold matriarch Greer (Kidman) and reluctant husband Tag (Liev Schreiber), on the eve of their son Benji’s (Billy Howle) wedding to Amelia (Eve Hewson). But their opulent nuptials are put on hold when, hours before the ceremony, someone is found dead in the water. Suddenly, everyone on the extended guest list is a suspect. Big “we’ve got The White Lotus at home” energy—it even shares a cast member in Meghann Fahy.

At just six episodes, The Perfect Couple doesn’t take long to fling us into the scandalous debauchery of the mega-loaded and just how far they’d go to keep their business behind their automatic estate gates. Let’s break down its twists and turns.

What happened?

A good murder mystery needs, well, a murder. Or at least a very suspicious death that has enough suspicion around it to get fingers pointing.

Sorry to those still thinking about Fahy’s incredible bait-and-switch power play in season 2 of The White Lotus. In The Perfect Couple, she doesn’t make it out so unscathed. She plays the perfectly-named Merritt Monaco, a low-level Instagram influencer and Amelia’s Maid of Honour.

At the end of the first episode, we discover that the mystery body floating in the shallows outside the Winbury’s windows is Merritt, still in her slinky dress from the rehearsal dinner the night before. Was it an accidental drowning? Or did someone kill her under the cover of darkness? She had barbiturates in her system, so it looks like the latter. 

We soon learn that Merritt had been keeping a huge secret: not only was she having an affair with Tag, but she was pregnant with his baby.

The Perfect Couple. (L to R) Eve Hewson as Amelia Sacks, Meghann Fahy as Merritt Monaco in episode 101 of The Perfect Couple. Cr. Hilary Bronwyn Gayle/Netflix © 2024

Who are the suspects? 

When someone dies in the orbit of the uber-rich, it’s fair to assume the motive has to do with power, sex, or money. With that in mind, there are a few immediate suspects.

First, there’s Kidman’s Greer, who side-hustles her successful career as an author by making sure her husband’s skeletons never go public. She knows Tag has been repeatedly unfaithful, and she alludes to a history of cleaning up his messes. Of course, Tag is also looking pretty plausible, as Merritt is no longer just a fling he can hide away with an NDA. 

There’s Benji and Amelia, the not-so-soon-to-be husband and wife. Merritt could be a threat to the already fractious relationship Amelia has with Greer, who thinks she’s a golddigger. 

Best man Shooter (Ishaan Khattar) is also high on the police’s list, as there seems to be something fishy going on between him and Greer. The fact he also tries to do a runner off the island immediately doesn’t help. 

Then there are the other Winbury children. Eldest brother and certified douchebag Tom (Jack Reynor) is married to Abby (Dakota Fanning), who is pregnant, but having an affair with his mom’s best friend Isabel (Isabelle Adjani), who also used to sleep with his dad (rich people, right?). He’s in a lot of debt and struggling to keep up with Abby’s high society demands. 

And finally, the youngest teenage brother Will (Sam Nivola) is in a burgeoning relationship with the chief of police’s daughter, and, after discovering his dad’s affair with Merritt the night before the wedding, has a drunken breakdown.

So who did it? 

As The Perfect Couple comes to an end, we get thrown a lot of information and, honestly, a lot of it doesn’t go anywhere. Turns out Greer was a high-class escort who Tag hired and fell in love with. She also has a gangster brother who shows up in the second-to-last episode for no real reason other than to explain away some of her suspicious financial choices (Greer helps cover her brother’s recurring gambling debts).

Amelia also hooks up with Shooter, Benji finds out, they fight, they make up and then officially break up. But some things do fall into place, and as soon as they do, the murderer’s identity becomes more and more obvious. 

For the Winbury boys to get access to their bloated trust fund, they have to wait until the youngest child turns 18. Will is only weeks away from the big day, but with a surprise bun in Merritt’s oven, that trust is looking to be sealed for another 18 years. 

We already know that Tom is in massive debt (he’s already asked his dad for a big loan and has borrowed more than $2 million from his Isabel). He’s looking pretty suspicious to the police, but he’s just a red herring. The real killer is his wife, Abby.

The Perfect Couple. Dakota Fanning as Abby Winbury in episode 105 of The Perfect Couple. Cr. Seacia Pavao/Netflix © 2024

Throughout the series, little easter eggs have hinted that Abby murdered Merritt. The Winbury’s maid, Gosha (Irina Dubova), expresses her distaste at anyone cleaning up after themselves because that’s her job after Abby hurriedly washes a glass. Later, Abby jokes to Amelia that she’ll never get arrested because she’s a pregnant white woman. She’s been fairly duplicitous for the whole series, sewing seeds of discord between Amelia and Greer and showing little to no regard for anything but getting her hands on an exclusive apartment in New York City.

The unexplained animal fat (tallow) that they found on Merritt’s body is found to be from some dodgy Korean skincare that Abby has smuggled into the States. When it’s clear Tom is just an entitled buffoon, Abby comes into focus as the one pulling the strings and the police pounce. 

Abby reveals that she snuck barbiturates that Tom had stolen from Amelia’s dying mom into a glass of juice that she gives Merritt while they sit along the beach the night before the wedding. When she suggests they go for a dip, Merritt starts to walk but immediately slumps into the water, where Abby holds her head down until she dies. 

We learn that Abby knew about the trust fund issue and couldn’t wait for Tom to handle it, so she did it herself. She didn’t want Merritt and her baby taking what she saw as her money. She’s arrested and taken away in handcuffs, forced to eat her own words about her beautiful white safety net. 

It’s not exactly a shocking ending. By the close of The Perfect Couple, the mystery at hand feels like it is beside the point. The murderer was always going to be one of the family members, but they are each so terrible in their own way that it feels plausible that anyone could have had a reason to be the killer. But if there’s one thing we can take away from The Perfect Couple, it’s that Nicole Kidman has never met a shoreline breeze she didn’t love rustling through her beautifully manicured blowout while she looks pensively out into the horizon. May we continue to get a vehicle for it every year for the rest of time.



source https://time.com/7018623/the-perfect-couple-ending-explained-netflix/

How The Secret Lives of Mormon Wives Opens Up the World of #MomTok Influencers After a Swinging Scandal

The Secret Lives of Mormon Wives

When TikTok mom influencer Taylor Frankie Paul went viral in 2022 after revealing that she and her now ex-husband Tate were “soft-swinging” with other Mormon couples in Utah, their lives and their friends’ lives made national headlines and prompted widespread speculation about who was involved.

A new reality TV series The Secret Lives of Mormon Wives, out on Hulu Sep. 6, is all about how Paul and a group of her Mormon TikTok star friends—all moms in Utah—are trying to move past the scandal.

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What to know about the Mormon swinging scandal

Since 2021, the women—known collectively as #MomTok on TikTok—have become known for dancing in a V formation, while decked out in athleisure attire and toting the giant Stanley Cups.

That wholesome image is partly why revelations about “soft swinging” were so shocking. (Paul called it “soft swinging” to note that couples were not having penetrative sex with each other.) That led to extensive Reddit threads speculating about who the Mormon swingers were. Tate removed photos of her from his Instagram and several of Paul’s Mormon #MomTok friends denied that they were swingers and unfollowed her. Paul then announced via livestream that she was getting divorced and answered viewer questions in real time. She has posted openly about being in therapy and starting her life over.

What’s clear over eight episodes in this Hulu series is that while most of the group members were not swingers, many were put into a position of having to debunk rumors that they were. As the series reveals, there are still a lot of trust issues in the group, and viewers will see some friendships fall apart.

When TIME asked Paul, who boasts 4.1 million followers on TikTok, if she had any more comment about the swinging rumors, she was hesitant to talk about it for fear of identifying people who were involved. But she wanted to make it clear that she wasn’t the only one participating.

“There were a lot of fingers pointed at me, as if I was the only one to instigate and participate, and I don’t know how that would even be possible,” Paul says. “I wasn’t the only one. It was a group thing. Everyone made their own decisions. We’re all adults here.”

The Secret Lives of Mormon Wives

Keeping the faith

Just as Mormons go on missionary trips to spread the faith when they turn 18, some of these moms have used TikTok to educate people about their faith and culture without even having to leave home. In the Hulu series, viewers will see men gather around a baby for a traditional blessing and a prayer before eating here and there. In between TikTok dances, the women are guzzling 44-ounce sodas with a variety of added syrups—the Mormon equivalent of coffee. Other mom use the platform more to poke fun at the faith.

And while they may not be swinging in the Hulu series, the women of “Mom Tok” want to make sure that sex talk is not taboo, urging Mormon women to make their pleasure a priority during sex with their partners. In one scene, Whitney Leavitt lands a $20,000 deal with a vibrator company and is showing off the device to fellow moms. Layla Taylor, 22, reveals to Leavitt that she’s never had an orgasm, even though she was married for three years and has kids. In another episode, the moms participate in a paint ‘n’ sip hosted by a mom having a labiaplasty—painting their versions of the ideal vaginas while sipping mocktails called “the pink pussy” and “labia-licious.”

“There’s this stigma that all Mormons are supposed to live the same way or do live the same way,” Paul says. “The point of our show is that there are so many different ways of living Mormonism. It’s a spectrum.”

@taylorfrankiepaul

This will be my personality till it comes out. @secretlivesonhulu #secretlivesofmormonwives #momsoftiktok #momtok

♬ hos be lookin okay – 𝗟𝘆𝘀 🍓

While many Mormons are traditional housewives, several of the moms of #MomTok stand out for being the bread-winner of the family or responsible for a critical part of their family’s income, due to the brand deals that they land through their social media accounts and millions of followers. In the series, #MomTok influencer Mayci Neeley, who has 1.3 million followers on TikTok, hosts a launch party for her brand of supplements, “Babymama” prenatal vitamin supplements for expecting moms.

These Mormon moms on TikTok are divided into the “Sinners” and the “Saints.” The “Saints” follow the Mormon religious practices more closely than the “Sinners.” The biggest drama on Secrect Lives happens during a girls trip to Las Vegas for Layla’s birthday, when the ladies pose for a group picture with scantily clad male Chippendales dancers. After, Jen Affleck, a 24-year-old cousin of Ben Affleck, gets in a huge fight with her husband, who is furious about the photo and questions her religious beliefs. They patch things up by the end of the show, but the other moms tell Jen that she shouldn’t have to put up with a husband who is so controlling.

The women hope that Mormon viewers will find someone in the how that they can relate to and feel empowered. As Neeley tells TIME, “Whether they’re Mormon and they think, ‘maybe I’m not enough to be in the church because I drink,’ hopefully people can relate to us and feel like they’re enough, they’re worthy, or maybe be inspired. That’s the goal of the show.”



source https://time.com/7018258/the-secret-lives-of-mormon-wives-hulu-explained/

What to Know About Jack Draper, the British Tennis Player Dominating the U.S. Open

Jack Draper US open

Jack Draper, who hails from Ashtead, a village 18 miles south of London, England, has garnered much attention as he prepares for his semi-final match in the U.S. Open against Italian Jannik Sinner, the number one ranked singles tennis player in the world, according to the Association of Tennis Professionals.

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“I take every match as it comes and I respect every player no matter what their ranking is,” Draper said in an interview on Sky Sports on Thursday, Sept. 5, with former British tennis player Tim Henman.

2024 has been dubbed the 22-year-old’s “breakout year” by Sky Sports after the left-handed player won his first ever ATP Tour title in Stuttgart, Germany, in June, and shortly afterwards became the number one ranked tennis player in the U.K.

“Winning Stuttgart was a huge moment for me,” said Draper. “It made me a lot more confident in my own skin and really made me believe that by beating the players that I beat, especially to win the tournament, I felt like I belonged a lot more at the really highest level.”

Here’s what to know about the British tennis star. 

What is Jack Draper’s ranking?

Draper, who began playing professional tennis in 2018, is currently ranked as the 25th best singles tennis player in the world, per the Association of Tennis Professionals. He is ranked as number one within the U.K., according to Lawn Tennis Association, which governs the sport of tennis in Great Britain. 

What is Jack Draper’s net worth?

Draper has accumulated a total of $2,914,754 in career prize money since he turned pro in 2018, according to the U.S. Open website

The athlete also has sponsorship arrangements with Nike, Dunlop, and Vodafone, according to the Evening Standard, and should he win the tournament, he could collect an additional $2.6 million in prize money on top of the $1 million he secured by making it to the semi-finals.

What do we know about Jack Draper’s parents?

It’s not known if Draper has a girlfriend or partner, but we do know about his immediate family. Draper’s father, Roger Draper, is a prominent sports executive who served as the managing director of the Lawn Tennis Association between 2006 and 2013. He also served as the chief executive of Sport England, a non-departmental body of the British government, from 2003 to 2006

Meanwhile, the rising British athlete’s mother, Nicky Draper, was a junior tennis champion herself and currently works as a tennis coach at a school, according to the BBC.

“He’s done absolutely amazing. You know, he’s put in so much hard work over the years and it’s been years and years of work and you don’t always get the rewards straight away,” she told BBC Radio Surrey on Sept. 5. “I always say you can’t make a tennis player, it has to come from within.”



source https://time.com/7018558/jack-draper-tennis-player-bio-ranking-net-worth-us-open/

Do At-Home COVID-19 Tests Still Work?

A person performs an at-home COVID-19 test.

These days, many people use at-home COVID-19 tests when they feel ill, rather than going out to get tested by a professional. (That’s when they bother to test at all.) But for all their convenience, the antigen tests commonly used at home have never been as accurate as PCR tests done in a lab—and the continued mutation of the virus raises additional concerns about their performance.

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Rapid COVID-19 tests have never been perfect. How are they holding up as new variants emerge?

The U.S. Food and Drug Administration (FDA) continues to monitor the efficacy of the diagnostics it regulates—and as of August 2023, the FDA said none of the antigen tests on the market were expected to have reduced performance against Omicron or its subvariants. (All of the variants that have emerged since late 2021, including recent ones like KP.3.1.1, are relatives of the original Omicron strain.)

The FDA has also collaborated with a U.S. National Institutes of Health task force set up to monitor how variants affect tests. In 2022, well into Omicron’s dominant era, that team concluded that DIY diagnostics continued to work well. Task force member Richard Creager wrote in an email to TIME that the tests still seem able to catch the Omicron spinoffs that are circulating now. “The rapid tests are having no issue detecting the variants,” he wrote, noting that the protein that antigen tests look for has remained fairly stable as the virus changes.

Read More: Does Text Therapy Really Work?

Even if tests have remained constant, our immune systems haven’t. Early in the pandemic, an infected person’s “viral load”—the amount of virus in their system—tended to peak around the time their symptoms began. So if someone self-tested on the first or second day they felt sick, they likely had enough virus in their body for a rapid test to detect it.

Now that most everyone has prior immunity from multiple vaccines or infections, the timeline seems to be extended. Viral load now tends to peak around day four or five of symptoms, according to a study published in early 2024. That’s likely because the immune system is primed for action by its previous encounters with the virus, so it responds faster, even before lots of virus has built up in the body. A quicker immune response may mean a faster onset of symptoms.

“If your body has seen the virus before, you’re going to react to it and have an immune response more quickly,” explains study co-author Dr. Nira Pollock, co-director of the Infectious Diseases Diagnostic Laboratory at Boston Children’s Hospital. “That immune response can show up as symptoms.”

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From an immune perspective, that’s a good thing. But it can complicate testing, because it means someone may not test positive for COVID-19 until they’ve already been feeling sick for days. In their recent study, Pollock and her co-authors estimated that a COVID-19 antigen test is somewhere between 30% and 60% accurate at detecting an infection on someone’s first day of symptoms, but up to 93% accurate on day four.

Based on such findings, Pollock and other researchers cautioned in a recent review article that people who are symptomatic shouldn’t assume they’re COVID-free based on a single negative antigen test result. Although it’s a hard sell for people who no longer take precautions, the ideal scenario is for someone to stay isolated—or at least wear a mask when around other people—and test again around day four of symptoms.

Read More: The 1 Heart-Health Habit You Should Start When You’re Young

“The instructions for these tests are to do serial testing,” Pollock says. “If you’re symptomatic, you should test early. But if you’re negative, you need to repeat it, because the amount of virus in your nose may not be high enough yet to detect.”

One other factor to consider: tests don’t last forever. Many people stockpiled tests when they were previously available for free through government programs and insurance, and those kits may have since expired. (You’ll soon be able to order four more free tests through the government.) The FDA’s website provides up-to-date guidance on determining how long your kits last.

Expired tests can still work, says Dr. Zishan Siddiqui, an assistant professor at the Johns Hopkins University School of Medicine. He co-authored a 2023 study on Abbott’s popular BinaxNOW tests, which found no major accuracy differences between unexpired tests and those that were five months past expiration. (Siddiqui’s other research suggests unexpired BinaxNOW tests accurately detect COVID-19 cases more than 80% of the time.)

But, although Siddiqui says he isn’t too worried about using expired tests, it’s good to remember that their performance can suffer if they’re long past their recommended use dates. If the control line on your test strip doesn’t show up or looks distorted, that’s a good indication that it’s too old to use, he says. Even in Siddiqui’s study, which found that expired tests still work, the lines on the old tests showed up more faintly than on fresh tests, making them harder to read.

Whether your tests are old or brand new, it’s good to use some healthy skepticism when interpreting their results. “I trust these tests,” even as the virus evolves, Siddiqui says—but a single result doesn’t always tell the whole story. If you have COVID-like symptoms but test negative, it’s best to be cautious and retest in a few days.



source https://time.com/7018565/do-at-home-covid-tests-still-work/

2024年9月5日 星期四

What 5 Doctors Are Excited About in Kidney Cancer Research

Human kidneys,medical concept, flat illustration

With multiple game-changing developments over the past two decades, kidney cancer patients are now living longer and better.

A big part of the reason is that many are being diagnosed at earlier stages of the disease, when it can often be more easily treated and sometimes cured. Even when cancers are caught later, advances in medications and in methods of targeting cancer cells are significantly extending survival.

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“When I started two decades ago, the average survival for patients with advanced kidney cancer was one year,” says Dr. Brian Rini, a professor of medicine at the Vanderbilt University Medical Center in Nashville. “Now, the median survival is between five and six years. It’s amazing.”

The growing use of scanning technologies in medicine overall has been one of the most important changes over the last couple of decades: Tumors are being detected during scans for non-cancerous conditions.

“Most kidney cancers are found by accident quite early, because people get scans for unrelated reasons,” says Dr. William Huang, a professor of urology and radiology at the NYU Grossman School of Medicine and a urologic oncologist at NYU Langone’s Perlmutter Cancer Center in New York City. “People get scanned for almost everything now: heartburn, back pain, car accidents. Eight out of 10 newly diagnosed patients who come to see me were scanned for something completely different.”

Because these cancers are caught early, they may be “completely curable, and sometimes so early that nothing needs to be done,” Huang says. “We can just keep an eye on them, and unless they change, we don’t need to do any intervention.” Advances in imaging have also led to novel ways of determining whether a tumor is benign or malignant. Scanners allow doctors to see growths in much greater detail nowadays, which allows for diagnosis in some cases without a biopsy. For example, scans using radioactive tracers can detect fat, which can be a signal that a growth is benign, Huang says.

Here’s a look at additional kidney cancer advances that doctors are excited to see come down the pipeline.

Killing cancer without surgery

Surgeons used to remove the entire kidney when a tumor was found. “Now you can remove just part of the kidney,” Huang says. Some methods of eliminating tumors don’t even involve cutting. “You can ablate a tumor with heat or you can freeze it,” says Huang. “Right now we are involved in a clinical trial that uses a method that is completely non-invasive. There is no incision, no radiation, no needles. We just ablate the tumor using ultrasound waves, which rupture the cancer cells.”

Read More: Coping With the Side Effects of Kidney-Cancer Treatment

Radiation by itself can eliminate tumors, too

For patients who aren’t good candidates for surgery because of underlying health issues, there’s another option that will eradicate the main tumor and some metastases. “This is something that has been evolving, and it’s very, very exciting,” says Dr. Catherine Spina, a kidney cancer specialist and an assistant professor of radiation oncology at Columbia University’s Vagelos College of Physicians and Surgeons in New York City. “Traditionally, radiation has been given over long courses in small doses.”

Over the years, however, specialists have discovered they could give much higher doses of radiation over a much shorter period of time, so long as the radiation was tightly targeted to hit the cancerous tissue, while giving a very low dose to the surrounding areas.

The result is that patients with a moderate-sized main tumor and cancer that has metastasized to just a few other sites can completely avoid surgery, with their cancer treated after just five or fewer radiation treatments. The technique is mostly limited to 8-centimeter main tumors, though some clinicians are also using it in tumors that are as large as 11 centimeters, Spina says.

When surgery is needed

Some patients prefer to have surgery or won’t qualify for non-invasive therapies because their cancer is too advanced. Surgical breakthroughs over the past decade or so have allowed these procedures to be more targeted and less invasive. 

Many operations are now done with robotic instruments that are inserted into the body through tiny incisions, while surgeons sitting at consoles view the operation and remotely control the instruments, says Dr. George Schade, an associate professor in urology at the University of Washington and a physician with the Fred Hutchinson Cancer Center in Seattle.

Robotic surgeries are a big advance over the original minimally invasive laparoscopic operations, in which tools at the end of stiff rods were inserted through small incisions with the surgeon standing over the patient and viewing the procedure on a computer screen. The new robotic instruments, by contrast, use a jointed probe rather than a straight one, offering more mobility. “They are like tiny arms inside of the patient with wrists and fingers,” Huang says.

Fluorescent dyes can help surgeons tell the difference between healthy tissue and cancer, as well as shine a light on the location of blood vessels feeding tumors. And in what may be another big step, some specialists are using robotic equipment that allows them to have depth perception. As the surgeons peer into a patient’s body, they see a 3D image overlaying the area that they’re operating on. “This is not in wide use yet, but there are several groups working on improving the technology to bring it to the mainstream,” Schade says.

Looking forward, as high-speed internet access spreads around the country and throughout the world, it’s possible that the surgeon controlling the robot in the operating room might not even be at the same hospital. “I don’t see that as too far in the future,” Huang says.

Read More: How to Manage Anxiety and Depression When You Have Kidney Cancer

Targeted medications 

It wasn’t that long ago that specialists had little to offer cancer patients after surgery, outside of chemotherapy, which wasn’t very effective against kidney cancer. But in the past two decades, there’s been an explosion of new cancer medications. Some pump up a patient’s immune response, while others target a variety of pathways to slow or stop cancer growth and development.

Drugs known as checkpoint inhibitors stop the immune system from being fooled into quitting before the cancer is conquered, says Dr. Bobby Liaw, clinical director of genitourinary oncology for the Mount Sinai Health System and an assistant professor of medicine, hematology, and medical oncology at the Icahn School of Medicine at Mount Sinai.

Checkpoints are the part of a normally functioning immune system that act as a set of brakes to turn down the system’s response once an infection or other pathology such as cancer has been defeated. That way the immune system doesn’t start turning its attack on healthy cells.

By blocking the action of a checkpoint, these medications keep the immune system on target. There can be immune system side effects—such as skin inflammation, and less commonly, autoimmune-like effects on certain organs, as well as endocrine disturbances—from cutting one of the immune system’s brake lines.

“Any time we plan to initiate any kind of new therapy for any cancer patient, there needs to be consideration for the benefits versus the risks,” Liaw says. 

In the case of serious side effects, particularly the immune system attacking healthy cells, the checkpoint inhibitor is stopped and the patient is given corticosteroids, says Dr. Toni Choueiri, director of the Lank Center for Genitourinary Cancer at the Dana Farber Cancer Institute in Boston. 

A study published in April in the New England Journal of Medicine that followed patients for nearly five years showed that the checkpoint inhibitor pembrolizumab, when given after surgery, reduced the risk of death by 38%.

Read More: These Factors Increase the Risk of Kidney Cancer

“Prior to the approval of pembrolizumab, there was no wide-spread accepted standard of care for patients with [the most common form of kidney cancer] after treatment with surgery,” says Choueiri, the lead author of the study. The next step, he says, is to study whether combining it with another therapy, like belzutifan, will reduce the risk of death even further.

Other drugs take aim at blood vessel formation. “Tumors are more dependent on the growth of new blood vessels than organs are,” Rini explains. “These medications choke off the blood supply to the tumor.” 

One other type of drug, called a tyrosine kinase inhibitor, blocks an enzyme that’s needed for tumor cells to grow and divide. There are currently numerous tyrosine kinase inhibitors approved by the U.S. Food and Drug Administration (FDA).

At the end of 2023, kidney cancer specialists got yet another arrow to add to their quivers: The FDA approved the drug belzutifan, a medication that effectively suffocates tumors by blocking a protein involved in regulating oxygen levels.

Doctors have traditionally liked to give one cancer drug at a time, but that’s changing. Specialists believe that cancers may have a harder time surviving when multiple medications are taken at once.

A number of ongoing clinical trials are looking at the impact of this strategy and exploring which combinations work the best. “There’s absolutely an additive effect of giving more drugs at the same time,” Rini says.

A kidney cancer vaccine? 

The mRNA technology that was used to create a vaccine to combat COVID-19 was initially developed as a potential way to battle cancer. Only recently has that research started to pan out.

Once a patient’s tumor has been removed, doctors identify proteins that are specific to cells in the tumor but not found anywhere else in the patient’s body. Then they determine which of those proteins are likely to be able to call the immune system’s attention to the cancer. Those proteins become the targets for the patient’s personalized mRNA vaccine.

There have already been promising results using mRNA technology to create personalized vaccines to help treat advanced melanoma. In a phase 2 trial that ended in mid-2023, researchers compared the checkpoint inhibitor pembrolizumab plus personalized vaccines to pembrolizumab alone. They found that the vaccine reduced the risk of recurrence by nearly a half. 

The same strategy is being tested in a phase 2 trial that will soon be recruiting patients with advanced kidney cancer, says Choueiri, co-lead investigator of the trial.

Read More: 7 Myths About Kidney Cancer, Debunked

The results of the phase 1 trial, which was testing just for safety, found “the vaccine to be well tolerated,” Choueiri says. “We and many others have been trying to do vaccines for several decades now.” The goal is to find the specific proteins in the vaccine that will be “the ones that elicit the most intense immune response that will lead to killing the cancer.”

Experts like Choueiri have high hopes for mRNA cancer vaccines. And with numerous other therapies being developed by pharmaceutical companies at the same time as others are making their way through clinical trials, the future for kidney cancer patients is getting brighter with each passing year.



source https://time.com/7018184/kidney-cancer-research-advancements/

من هشت سال گروگان ایران بودم. آیا دوستانم از بمباران اسرائیل جان سالم به در بردند؟

Read this story in English here نمازی گروگان سابق آمریکایی در ایران است و اکنون عضو هیئت مشاوران ابتکار آزادی برای زندانیان سیاسی در...