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10月18日 星期五

I Grew Up on Brighton Beach. Anora Helped Me See My Neighborhood Differently

Background: People walk along the boardwalk in the Brighton Beach neighborhood in Feb. 2022; A still from the film Anora

“I don’t speak Russian, but I understand it.” The line hits me like a gut punch as the first act of director Sean Baker‘s new movie Anora unfolds. It’s a line purred, albeit reluctantly, by the titular protagonist, Anora (Mikey Madison), a Russian-speaking, Uzbek-American sex worker—who prefers to be called the more Americanized nickname Ani—as her boss at a Manhattan strip club asks her to meet a new client: Ivan (Mark Eydelshteyn), the twenty-something son of a Russian oligarch.

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This line kicks into gear a modern Cinderella story gone horribly wrong (spoilers ahead): a torrid affair between Ani and Ivan (Vanya, for short) that explores systems of power, safety, love (ultimately), and the Russian diaspora of New York City.

It’s also a line I know well; I have said it more times than I can count. 

Like Ani, I grew up on Brighton Beach, the Russophone neighborhood in south Brooklyn, N.Y., and the backdrop of Baker’s film, in theaters Oct. 18. And like Ani, for the longest time, I despised absolutely everything about it. A hometown is a hometown, after all.

[video id=4OIdQml5 autostart="viewable"]

Filmed in the winter, so much of Anora is a joyride around different nooks and crannies of this neighborhood and its surroundings. After Vanya hires Ani to be his “very horny girlfriend” for a week for $15,000, they spend a brief, debaucherous weekend in Vegas and spontaneously marry each other. Upon returning to New York and thinking she has finally “caught her whale,” Ani and Vanya’s marital bliss is cut short when his parents find out about the union and send his godfather, an Armenian man named Toros (Karren Karagulian), Toros’ younger brother Garnik (Vache Tovmasyan), and their henchman, a Russian named Igor (Yuriy Borisov), to force Vanya and Ani to get an annulment. After a brief altercation, Vanya runs away, forcing the three men to search for him, with a reluctant Ani in tow.

Read More: ‘Anora’ Is a Glorious Strip-Club Fairytale With a Generous Spirit

It’s here that Baker introduces Brighton Beach in all its glory—and with it, not only the vast cultural melting pot once bound by a shared history of Soviet rule, but also and perhaps more crucially, the unique outsider status that consumes first-generation Americans like me.

About 16 miles from Manhattan, Brighton Beach has been a safe haven for immigrants from the former Soviet Union to create a new life in America since the mid-1970s. Among them were my parents, who immigrated from Odesa, Ukraine, to the U.S. in the early ‘90s after the dissolution of the USSR. After a stint in another south Brooklyn neighborhood, they settled in Brighton Beach when I started the first grade.

Like other first-gen kids, I’ve never felt all too comfortable here or there—not totally American but certainly not Russian. In fact, my Russian is cobbled together from stilted conversations with family (them speaking Russian, me often responding in English) and imaginary conversations in my head where I practice what I say in Russian before I open my mouth. I’m not so confident at rolling my R’s, but I try my best.

For much of my childhood, I wanted out. Especially during the winter, as the blustering windchill would hit the Atlantic coastline, making it so cold it would rattle your brain loose. Why do people stay here, I wondered. Why can’t we just leave, I grumbled. The sooner, the faster, the better, I pleaded to my parents, and everyone else who would listen.

It’s funny how one generation’s safety can become the next generation’s stifling boredom—a feral need to shed a place like old skin and grow into something more exciting, glossier. This tension is laid bare in Anora. What Ani thinks of Brighton Beach and what Baker—who grew up just across the river in Summit, N.J.—thinks of it feels starkly different: the former can’t wait to escape it, and the latter sees, despite its cracks, its undeniable beauty.

Read more: The 33 Most Anticipated Movies of Fall 2024

Anora is propulsive and anxious—its characters consistently in search of what’s next, what’s new. Ani isn’t interested in being called by her full name, nor is she interested in staying in Brighton Beach. She doesn’t want to be the stereotype of the neighborhood girl who stays. She, too, wants out, and she’s doing what she must to get there.

Baker, though, has other plans. With every moment, despite the frenzy of the search party, Baker hangs his camera back, just slightly, to provide stillness. We see it when Ani walks along the boardwalk to the Brighton Beach Russian restaurant staple, Tatiana, where she and the gang of three think they might find Vanya. The orange radiance of the sun as it begins to set on the water. The boardwalk glowing from the rays and stretching out seemingly forever. The array of colors along the horizon, even as the posse slumps out of the restaurant, heads hung low, unable to find their mark, wind gusts thrashing against them. It’s another dead end and yet, the sky behind them bursts with vivid reds, greens, yellows, blues as night falls. Brighton Beach can be a relentless show-off that way, your feelings be damned.

Perhaps that’s the most important thing Anora cemented for me. Sometimes, it can feel so shocking when someone can see you and your story more clearly, or more tenderly, than you can ever see yourself. It creates a sense of depth that helps things become less two-dimensional. That’s what Baker does for Ani, for Igor (who eventually falls for her), and for this little enclave of Brooklyn that’s often forgotten, cast aside, or worse, stereotyped. There were plenty of jokes in the film, but Brighton Beach never felt like the punchline. It felt in control of its own narrative.

Over the years, I’ve started to change my tune on Brighton Beach and swung around to see Baker’s side of things a bit more. I’m less afraid of using my broken Russian. I’m also beginning to appreciate the neighborhood in its wintry splendor. When the sky is cloudless and the sun’s rays beat down on the calm, rippling waves, making them sparkle. The boardwalk—far from the bustling scene it usually is during the summertime—is barren, save, of course, for the elderly Russian ladies wrapped up in winter puffers or fur coats (real ones), swinging their arms around in furious circles to get their exercises in. Manhattan is behind you. The beach is in front. I’ve stopped fighting it.

At the end of Anora, Vanya and Ani get their marriage annulled. Ani is heartbroken and feels powerless. Vanya couldn’t seem to care less. Toros is back in Vanya’s parents’ good graces. Igor, increasingly infatuated with Ani, tries to take care of her. The natural order has been restored; the wealthy get their way and the striver, officially out of luck, is knocked all the way back down to where she started.

The last we see of the movie is Ani, broken by all that she has experienced, sitting in Igor’s car. Ani tries to seduce him and begins to have sex with him in the driver’s seat. Igor tries to kiss her. She, at first resisting, finally gives into her emotions and wails deeply, as if to say she’s stopped fighting, too.

I can’t stop thinking about what happens in the moments after the screen fades to black. Or at least what I hope happens to Ani weeks, months, years after this. I hope she finds what home means to her. I hope knowing more about where she’s from feels less burdensome. I hope that stillness doesn’t feel like death, but rather, like a breath of fresh air. I hope the tinsel in her hair continues to sparkle when she twerks, like the sun’s rays hitting the sea water on an icy day.

I’m hopeful for her. For all of us.



source https://time.com/7094019/anora-brighton-beach/

The Death of Yahya Sinwar

People are reflected in a window displaying a poster of newly appointed Hamas leader Yahya Sinwar in the Palestinian camp of Bourj al-Barajneh on Aug. 8, 2024.

The corpse of Yahya Sinwar was found in the landscape he envisioned—the dusty rubble of an apocalyptic war ignited by the sneak attack he had planned in secret for years, and launched on Oct. 7, 2023. The catch was that the fighting extended only 25 miles east and at most four miles south from the shattered villa in southern Gaza where the Hamas leader died one year and nine days later. “The big project,” as Hamas called Sinwar’s plan, had not engulfed the whole of the Middle East as hoped, nor brought about the collapse of Israel. Ground zero for the apocalypse remains the Gaza Strip, the Palestinian enclave Sinwar governed when he unleashed the attack that led to its destruction.

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Terror aims to provoke an over-reaction. If the first phase of Oct. 7—breaching the fence erected by Israel and overrunning its military bases—was an audacious military operation, the assault on the civilian settlements beyond was something else. During his 22 years in Israeli prison, Sinwar was an avid student not only of Hebrew but also of Jewish history, including pogroms. His 2011 release brought another lesson: Sinwar, known at the time as the “Butcher of Khan Yunis” for his brutality in dispatching suspected informers, returned to Gaza among more than 1,000 Palestinian prisoners that Israel traded for the freedom of a single Jewish soldier. As Israeli hostage negotiator David Meidan has observed: “The matter of captives is our soft underbelly.”

Yahya Sinwar Time Magazine X cover

Sinwar’s death may open the door to a cease-fire that frees the dozens of Israeli hostages who remain in Gaza. Prime Minister Benjamin Netanyahu, having resisted a deal while the architect of the worst terrorist attack in the nation’s history remained at large, was described in reports as more open to one in a call with President Joe Biden on Thursday. What has moved beyond imagination is negotiations of any other kind.

Read More: The Families of Hostages On Life After Oct. 7.

By Sinwar’s grim math of mass murder, the primary calculation is body counts. The Palestinian question is back on the world agenda, and Israel’s global reputation, already suffering with its half-century occupation of Palestinian territories, is deeply stained. Most polls over the last year have shown Palestinians more inclined to embrace the militancy of Hamas, an Arabic acronym for Islamic Resistance Movement. But those things matter most in the realm of negotiated peace that Hamas rejects: Camp David and Oslo were the prism through which the world viewed the Israeli-Palestinian conflict. Oct. 7 shattered it.

Hamas leader Ismail Haniya and freed Palestinian prisoner Yahya Sinwar, a founder of Hamas' military wing, wave as supporters celebrate the release of hundreds of prisoners following a swap with captured Israeli soldier Gilad Shalit in Khan Yunis, southern Gaza Strip, on Oct. 21, 2011.

In the ruins of Gaza, however, where 1.9 million people have fled their homes and the risk of famine grows, support for the Oct. 7 attack shows signs of slipping. Confronting Israel on military terms allows Israel to frame the Palestinian question as a question not of national aspiration, or of justice, but as a question of security. And, especially with the $17.9 billion in U.S. military aid this year, security is Israel’s strong suit. Caught flat footed by Sinwar’s assault, it has since moved methodically against the forces Hamas had hoped would come to its aid—Hezbollah in Lebanon, the Houthis in Yemen, and their common sponsor, Iran. This month Israeli columns were also heading back to Gaza’s north, shutting down food aid and warning residents to evacuate or be regarded as targets.

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Read More: Exclusive: Netanyahu At War.

By the count of the Hamas government he led, Sinwar, 61, was preceded in death by 42,438 of his constituents, more than half of them women and children. The whereabouts of his own family was unknown, but thought to appear briefly in surveillance footage recovered earlier this year from an underground redoubt Israeli forces said was located beneath a cemetery. In it, Sinwar moves single file into a tunnel, behind a girl clutching a doll and a boy using a flip phone as a flashlight.

Leader of Hamas in the Gaza Strip, Yahya Sinwar takes part in the "Great March of Return" demonstration near Israel-Gaza border, in Khan Yunis, Gaza on Sept. 28, 2018.

source https://time.com/7094298/yahya-sinwar-hamas-israel/

2024年10月17日 星期四

Harris Intensifies Pitch to Disaffected Republicans

US-VOTE-POLITICS-HARRIS

With less than three weeks until Election Day, Vice President Kamala Harris is ramping up her pitch to a core group of voters who could help flip a coin-toss election: anti-Trump Republicans.

In a speech backed by Republican supporters on Wednesday and an interview on Fox News that evening, Harris made a bid to invite disaffected conservatives into her coalition. Speaking in Bucks County, Penn., not far from where George Washington crossed the Delaware River, the Democratic nominee urged them to put country over party, and to unify against an opponent who has demonstrated a disregard for the U.S. Constitution.

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“At stake in this race are the democratic ideals that our founders, and generations of Americans, have fought for. At stake in this election is the Constitution itself,” Harris said, joined by more than 100 Republicans from Pennsylvania and other swing states.

Donald Trump “considers any American who doesn’t support him, or bend to this will, an enemy of our country,” Harris said. “It is clear: Donald Trump is increasingly unstable and unhinged and seeking unchecked power.”

Ever since Trump was elected in 2016, Democrats have hoped that Republicans would abandon a politician who has trampled many of their party’s core ideals. It hasn’t happened—at least not in significant numbers. Yet Harris believes there are enough conservatives who have serious doubts about Trump that winning them over could be enough to swing a tight election.

Read More: What Kind of President Would Kamala Harris Be?

There’s some evidence the strategy could work. More than 150,000 Republican voters voted for Nikki Haley in the Pennsylvania GOP primary, weeks after she dropped out of the race. President Biden won the state in 2020 by only about half that number. According to Haley Voters for Harris, a SuperPAC that is seeking to convince center-right voters to vote for Harris, the number of people who voted for former South Carolina Governor Nikki Haley in the 2024 GOP primary, both before and after she exited the race, is enough to swing battleground states like North Carolina, Georgia, and Arizona. “The number of folks who voted for Haley after she dropped out of the primaries, particularly in places like Pennsylvania, is a potentially decisive number of votes,” says Craig Snyder, a former GOP Congressional Chief of Staff who now runs Haley Voters for Harris.

Haley herself has since endorsed Trump. But according to a poll conducted by Haley Voters for Harris, a significant portion of her voters are holding out against him: only 45% of Haley voters now say they’ll vote for Trump, while 36% say they’ll vote for Harris. Nearly 20% remain undecided, and those are the voters Harris appears to be speaking to now. “This is real erosion of Trump’s support within the party,” Snyder says. According to a recent New York Times/Siena poll, Harris is winning 9% of Republican voters; Snyder says he thinks if she can crack 10%, it would win her the electoral college.

To reach those voters, Harris is also going to Trump’s home turf: Fox News. She sat for a 25-minute interview with Fox’s Bret Baier on Wednesday evening, during which she emphasized the number of Republicans who are supporting her. “It is clear to me, and certainly the Republicans who were on stage with me,” she said, “that he is unfit to serve, that he is unstable, that he is dangerous, and that people are exhausted.”

Harris again brought up Trump’s use of the phrase “enemy within” to refer to his opponents. “This is a democracy, and in a democracy, the President of the United States, in the United States of America, should be willing to be able to handle criticism without saying he’d lock people up,” she said.

The escalating pitch to waffling conservatives comes after stints of campaigning with Trump’s Republican critics. Former Rep. Liz Cheney endorsed Harris at an event earlier this month. Some former Trump officials have come out in support of Harris. One Harris-Walz ad uses the words of Trump’s own Vice President, Defense Secretary, National Security Adviser, and Chairman of the Joint Chiefs of Staff to argue that Trump is not fit to be President again.

Read More: The Reintroduction of Kamala Harris.

Rob Gleason, who was the Republican state party chair in Pennsylvania when Trump won it in 2016, said that Harris appears to be trying to grow her vote share in the suburbs to counteract large expected losses in rural areas. “At the end of the day, what’s this election about: Do you like Trump or not?” says Gleason. “It’s not about Kamala Harris.”

On Thursday, Republican Voters Against Trump will start a swing-state bus tour throughout Pennsylvania and Michigan, designed to create a so-called “permission structure” for Republicans to break from the former President. Each stop—in Philadelphia, Pittsburgh, and Detroit—will feature former Trump voters who are now supporting Harris. The group will also be spending more than $4 million in a new Pennsylvania ad campaign, including 55 new billboards featuring erstwhile Trump supporters explaining why they can’t support him anymore. Republican Voters Against Trump is on track to spend a total of $32 million on ads featuring former Trump supporters.

While it’s nearly certain that the vast majority of Republicans will support their nominee, in a razor-thin race, even small defections can make the difference. “When it’s as close as it is here,” says Gleason, “every vote counts.”



source https://time.com/7093796/harris-republican-outreach/

What We Know—and Don’t Know—About the Possible Death of Hamas Leader Yahya Sinwar

Yahya Sinwar, head of the Palestinian Islamic movement Hamas

On Thursday, the Israeli army stated that it is “checking the possibility” that they killed Hamas top leader Yahya Sinwar, who is said to have orchestrated the Oct. 7 terror attacks on Israel, in the Gaza Strip. 

Three militants were killed during an exchange of fire between the Israel Defense Force (IDF) and soldiers in Gaza on Wednesday, but Sinwar’s death hasn’t been confirmed.  

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“During IDF operations in Gaza, 3 terrorists were eliminated,” The IDF said in a statement Thursday. “The IDF and ISA are checking the possibility that one of the terrorists was Yahya Sinwar.”

The statement also said that there were “no signs of the presence of hostages in the area,” though it has often been believed that Sinwar surrounds himself with hostages in order to lessen the likelihood of being killed.

Who is Yahya Sinwar?

Sinwar, 62, was raised to the role of Hamas’ top leader following the assassination of previous Hamas leader Ismael Haniyeh in July in Tehran, Iran, by a strike that Iran and Hamas say was carried out by Israel. Since then, Sinwar has been regarded as by far the most influential leader in power in Gaza and has been called the “mastermind” behind the Oct. 7 attacks in Israel that left 1,200 people dead and saw more than 250 people taken as hostages, marking the beginning of the Israel-Hamas war.

Sinwar was born in the Khan Younis refugee camp in southwestern Gaza, and joined Hamas at a young age. In 1989, he was convicted of abducting and killing two Israeli soldiers and four Palestinians he suspected were in cahoots, and served 22 years. The Times reports that the DNA of the bodies killed in Gaza will be compared to the DNA collected during his time incarcerated.

Sinwar was eventually released in a 2011 prisoner exchange that freed Israeli soldier Gilad Shalit, at which point Sinwar returned to his role with Hamas. He then ascended to a leadership position in Gaza in 2017.

Sinwar’s death is a main objective for Israel

After prisoner and hostage exchange deals have fallen apart multiple times since Oct.7, Israeli President Benjamin Netanyahu and his office have stated that the search for Hamas leaders and ending their “governing capabilities” have been at the forefront of their operations in Gaza—operations which, according to Gaza health officials, have killed 41,000 Palestinians, mostly civilians, since the war began. Further, Israeli attacks have driven 90 percent of the Palestinian population from their homes and brought over 1.8 million people to crisis levels of hunger, according to the Integrated Food Security Classification.

Sinwar specifically has been at the center of Israel’s hunt, though his elusive whereabouts have been a secret well-kept; still both the United States and Israel have been pouring resources into finding the Hamas leader.

Though Sinwar’s death is not confirmed, Israeli Defense Minister Yael Gallant took to X to provide a vague, but pointed, post in the immediate aftermath of the news, quoting Leviticus, the third book in the Torah: “You will pursue your enemies and they will fall before you by the sword.”

“Our enemies cannot hide. We will pursue and eliminate them,” Gallant wrote. 



source https://time.com/7094047/yahya-sinwar-possibly-killed/

9 Things You Should Do for Your Brain Health Every Day, According to Neurologists

Brain Health

Taking care of your cognitive health ought to be—well, a no-brainer. According to a survey published in March, 87% of Americans are concerned about age-related memory loss and a decline in brain function as they grow older, yet only 32% believe they can take action to help control that trajectory.

“All of us want to be cognitively intact for as long as possible,” says Dr. Seemant Chaturvedi, a neurologist and stroke specialist at the University of Maryland Medical Center. The good news, he adds, is that “there are definitely risk factors that can be modified.” Prioritizing healthy behaviors can increase the likelihood that, when we reach our 70s and 80s, we’re still able to summon important memories, drive a car, and engage in a wide variety of activities, Chaturvedi says. And there’s no such thing as “too young” to start taking these steps.

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With that in mind, we asked four neurologists what we should all do every day for better brain health.

Manage your chronic illnesses

If you have high blood pressure, high cholesterol, or diabetes, it’s essential to make sure it’s under control. Each condition can “damage the blood vessels in the brain and increase the risk of stroke and dementia,” while diminishing cognitive function, Chaturvedi says. In one study, for example, people who had hypertension in their 40s to early 60s had a 6.5% steeper decline in cognitive skills—including mental processing speed and executive function—in their 70s, 80s, and 90s, compared to those with normal blood pressure. Other research has found that people with higher levels of LDL cholesterol and lower levels of HDL cholesterol tend to have more amyloid plaque in their brain, which is linked with Alzheimer’s disease. 

Read More: 7 Metrics Everyone Should Know About Their Own Health

That’s why it’s important to get your numbers checked regularly, and to work with your doctor to establish a treatment regimen, Chaturvedi says. The sooner you do that, the better: “If you’re 35 or 40 and have high cholesterol, the current belief is that it’s better to start treatment early,” rather than waiting until you’re 65 or 70 and have a heart attack, he says. “If you get started early, maybe you could either postpone or never even have the heart attack,” which would be doing your brain a big favor.

Exercise for 30 minutes

Your entire body will benefit if you work out at least a few days a week—and that includes your brain. Research suggests that exercising improves cognitive processes and memory, while increasing the thickness of your cerebral cortex, which is responsible for tasks like language, thinking, and emotions. “We’re learning more and more about the benefits of regular exercise for brain health,” Chaturvedi says. “Even in patients who have mild dementia, it’s recommended they engage in exercise three to five times a week.”

Whatever activity you choose—walking, biking, swimming—make sure you’re operating at a moderate intensity, or about 50% to 80% of your maximum heart rate. “A rule of thumb I give my patients is that if you and I were going for a walk, we’d want to be walking at a pace where we’d be pretty out of breath, but we’d still be able to have a conversation,” says Dr. Carolyn Fredericks, an assistant professor of neurology at Yale School of Medicine. One type of cardiovascular exercise doesn’t appear to be better than any other, she adds: “It’s just getting your heart into that range and keeping it there for a while.”

Rest up

Not getting enough sleep is a key risk factor for dementia, says Dr. Augusto Miravalle, a neurologist and multiple sclerosis specialist at Rush University Medical Center. Research suggests that people in their 50s and 60s who get six hours of sleep or less per night are 30% more likely to be diagnosed with dementia than those who log at least seven hours of Z’s. Another study found that sleep-initiation insomnia, or trouble falling asleep, is associated with a 51% increased dementia risk. 

Read More: The Best Way to Treat Insomnia

What should you do if you lie awake at night counting sheep? Invest time in improving your sleep hygiene, which means taking steps like avoiding caffeine and alcohol in the evening, limiting naps, and putting away electronics before bed, Miravalle advises. If that doesn’t work, schedule an appointment with a sleep specialist to figure out if you need a more aggressive approach. Options like cognitive behavioral therapy for insomnia can help some people achieve more restful slumber.

Eat like you’re vacationing on the Italian coast

Fredericks always recommends her patients follow a Mediterranean diet, which emphasizes fruits, veggies, whole grains, fish, nuts, seeds, and healthy fats. “We’ve tried over the years to find the secret ingredient that makes the Mediterranean diet work,” she says. “Like, could it be the omega-3’s in the fish, or the vitamin E in the nuts? But every time we try to study an individual ingredient, we don’t actually see that big of a difference at a large group level.” What appears to be most impactful, she adds, is the style of eating and emphasis on whole foods.

In addition to prioritizing certain ingredients, Miravaelle recommends avoiding those that negatively impact brain health, like trans fats and too much salt. In one study, young and middle-aged men who followed a diet heavy in trans fat remembered 11 fewer words out of 104 than those who didn’t consume as much. And excessive salt intake is linked with stroke, cognitive impairment, and cerebrovascular disease, which affects the brain’s blood vessels and circulation.

Challenge your mind

People often ask Dr. Roy Hamilton what kind of intellectual stimulation is best: Should they put together puzzles or play Sudoku every day? What about video games? He tries not to be overly prescriptive, but offers a few guidelines. Brain-boosting activities should be “mildly challenging,” says Hamilton, who’s a professor of neurology, psychiatry, and physical medicine and rehabilitation at the University of Pennsylvania Perelman School of Medicine. If they’re too easy, your return-on-investment will shrink; too hard, and you might give up before benefitting. “It’s got to be somewhere in the sweet zone, and it has to be something that you want to do,” he says. 

Read More: How to Make Friends as an Adult—at Every Life Stage

Rather than focusing on one pursuit—playing games, learning a new language, reading classic literature—Hamilton recommends curating a “diet of intellectual activities.” “You’re probably not going to get optimal effects just by picking Wordle and being like, ‘I do Wordle every day, and that’s how I maintain my cognition,’” he says. “The brain’s a lot more complicated than that.” He compares it to asking a nutritionist what you should eat for a healthy diet: The answer wouldn’t be carrots, more carrots, and only carrots. Make it a point to exercise your brain in a variety of ways, he encourages, just like you feast on lots of different snacks and meals every day.

Chat with a friend (or two)

There’s no single metric for how much time we should spend around other people. Yet research is clear that social engagement strengthens the neural networks involved with attention and memory. In one study, adults ages 70 to 90 who said they had pleasant social interactions on a given day had better cognitive performance on that day and the following two, compared to when they didn’t have any such encounters. “Our brains aren’t meant to exist in isolation,” Fredericks says. “I think COVID drove home to all of us that we’re not meant to be alone in our apartments or houses—it just doesn’t feel good.” To boost your social life, consider reaching out to old friends, joining a birdwatching club or another group, volunteering, or video-chatting with a long-distance family member.

Skip the beer and cigarettes

Drinking excessively isn’t good for brain health. Research suggests it can damage the parts of the brain involved in important functions like memory, decision-making, impulse control, and attention. “The more you drink, and the longer period of time over which you’re doing that volume of drinking, the worse it is for your brain,” says Hamilton, who’s on the board of trustees of the McKnight Brain Research Foundation. Think about it: When you overimbibe, you lose your inhibitions because the circuits that control your behavior go offline. “You’re literally causing temporary brain dysfunction,” Hamilton says, and over the long term, that damage takes a toll.

Smoking is similarly perilous: It can lead to cognitive decline and dementia, while increasing the risk of stroke. If you’ve already tried to quit and failed, don’t let that dissuade future attempts. “Just keep going, because there’s no healthy amount of smoking,” Hamilton says. “It’s terrible for your cardiovascular health and, therefore, your brain vascular health, too.”

Wear a mask on bad air-quality days

You already know air pollution can make your eyes sting and trigger a coughing attack. Perhaps more surprising: It’s linked to an increased likelihood of developing dementia. “Dementia in this country is pretty much following the map of air pollution,” Miravalle says. One way to protect yourself: Check daily air quality reports for your town, and if pollution is particularly high, wear a reusable face mask outside, like an N95 or KN95. As Miravalle puts it, “Anything you can do to decrease exposure to certain environmental toxins is a good, common-sense strategy.”

Lower your stress 

Minimizing stress can be an effective way to protect your brain health—but Hamilton acknowledges it’s no easy feat. “In my opinion, in the 21st century, maybe this is the hardest thing to do,” he says. “But there’s evidence that chronic stress is not great for cognition.” In one study, for example, people with elevated stress levels had a 37% higher risk of experiencing cognitive issues, including trouble with memory and thinking.

Some people find that meditation or mindfulness help tame stress; others like doing yoga or booking a massage. Hamilton gets up at 5 a.m. every day to squeeze in a trip to the gym before his work day. “It’s not about my body so much as it is about my stress,” he says. Spend some time brainstorming what relaxes you, and after putting those strategies into action, you’ll likely benefit from head to toe.



source https://time.com/7081407/brain-health-neurologist-tips/

Should You Use Retinol and Retinoids?

It’s no surprise that the skin care industry is having a moment. Instagram influencers are hawking expensive products left and right, and young TikTok users are continuously sharing their latest “must-have” products from Sephora.

Two terms that consistently get mentioned when people talk about their skin care routines online are “retinoids” and “retinol.” These products are touted for their ability to reduce fine lines and wrinkles and stimulate collagen production for younger looking skin. But are they as effective as everyone says? 

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Below, we cover everything you need to know about retinoids and retinol so you can figure out if they’re a good addition to your skin care routine. 

What are retinoids and retinol?

Retinoids are a class of prescription medications that are derived from vitamin A, says Dr. Alexis Livingston Young, a dermatologist at Hackensack University Medical Center. Retinol is a type of retinoid that is available over the counter. 

The main difference between the two is that prescription retinoids are already active, whereas over-the-counter retinol has to be converted by the body into the active form. Because prescription retinoids are already in their active form, they likely work faster and better, Young says. She notes that the actual effectiveness of retinol is hard to assess since it isn’t regulated by the U.S. Food and Drug Administration (FDA).

Read More: Do At-Home Red Light Masks Really Work?

Retinoids are the gold standard product for anti-aging, Young says. There is decades of academic research supporting its ability to stimulate collagen production, reduce fine lines and wrinkles, diminish hyperpigmentation, and unclog pores. “Of all the anti-aging products that have ever been talked about, we have the most data for retinoids—really solid, decades-long data to back up the claims,” Young says.

After sunscreen use, many dermatologists actually recommend retinoids as the best thing adults can use every day for their skin health. “I think of sunscreen as brushing your teeth, and retinoid use as flossing your teeth,” says Dr. Heather Goff, director of cosmetic dermatology and associate professor of dermatology at UT Southwestern Medical Center in Dallas. 

Beware of side effects

Retinoids can be very effective, but they can also come with side effects like irritation, redness, peeling, and dry, flaky skin. “The stronger the retinoid is, the more likely it is to cause that sort of initial irritation,” says Dr. Shayan Cheraghlou, a dermatologist at Zitelli and Brodland Skin Cancer Center in Pittsburgh. This means that, for example, the prescription retinoid tretinoin could lead to more intense side effects than an over-the-counter retinol product. These side effects are typically temporary, Young says, and tend to improve after about three months of use.

Read More: Why Do Some People Need More Sleep Than Others?

People with darker skin tones might also experience a temporary increase in pigmentation with retinoid use, says Dr. Asmi Sanghvi, a dermatologist at Bethany Medical Clinic in New York City and a clinical instructor of dermatology at the Icahn School of Medicine at Mount Sinai. Eventually, she says, this side effect will go away and the skin will improve.

Irritation from retinoids happens because the skin is changing on a cellular level, Goff says. Retinoids thin out the stratum corneum, which is the outermost layer of the skin that’s composed of dead skin cells. This can cause a lot of exfoliation in the early stages of use, Goff says. 

If the side effects you experience are mild, you don’t have to give up: it can take up to 12 weeks to see an improvement in hyperpigmentation, fine lines, and wrinkles with retinoid use, Cheraghlou says. “You don’t necessarily need to stop when that happens,” he says. “Obviously if it’s too much then you should, but you can usually get over that hump.”

Young adds that although patients with rosacea, eczema, and atopic dermatitis can use retinoids, they might not be able to break through the initial irritation phase. “It might just be too much for them,” she says. 

You should exercise caution if you use chemical exfoliants, like AHAs and BHAs, in your skin care routine. “Those are peeling agents so they can make the irritation even worse,” Cheraghlou says. And if you’re pregnant or trying to conceive, you should stay away from using both prescription retinoids and over-the-counter retinol, Sanghvi says. 

Age matters

Experts are concerned about a recent uptick in teenagers and children having elaborate skin care routines that include products with retinol. In fact, there was a proposed California bill that would have prevented the sale of products with retinol to children under 13, though it failed to advance as of June 2024.

There is no reason for children and teenagers to use over-the-counter products with retinol, Cheraghlou says. Retinoids protect our collagen and stimulate new collagen production, he says, but “teenagers don’t need to use it cosmetically for the collagen effects because we don’t start losing collagen in our skin until our mid- to late 20s.”

Read More: What’s the Best Skin-Care Routine?

Although kids should not use over-the-counter beauty products with retinol for cosmetic purposes, prescription retinoids are used in teenagers and pre-teens with acne, Sanghvi says. (The well-known medication Accutane is a retinoid.) But children and teenagers should only be using retinoids if they’re prescribed by a dermatologist to treat acne. 

Most people can begin using a retinoid or retinol around age 25 or 30, Young says. Goff adds that it’s safe to use retinoids consistently over the course of one’s life. 

Keep these best practices in mind

If you plan on adding a retinoid or retinol to your skin care routine, here are a few things you should keep in mind. 

  • Consider your skin type. If you have sensitive skin or conditions like eczema or rosacea, Young recommends beginning with a topical retinol product. If your skin tolerates it well, then you can switch to a prescription retinoid down the road. If you don’t have particularly sensitive skin, she recommends beginning with a prescription retinoid since they’re typically more effective. 
  • Ease in. Because of the side effects of retinoids, start slowly. Sanghvi recommends using a product twice a week for a couple of weeks to start, then increasing to three times a week and gradually using it more as your skin tolerates the medication. 
  • Apply products at night. The stratum corneum (the outermost layer of the skin) helps protect our skin from the sun’s UV rays. “But when you thin that out [with retinoid use], the skin is more sensitive to UV light,” Goff says. Because of this, you should always apply retinoids and retinol at night. 
  • Wear sunscreen daily. When you wake up in the morning, you should always wash your face to get rid of any product that’s still on the skin and then moisturize and apply sunscreen, Sanghvi says.  
  • Apply using the sandwich method. Moisturizing is a key component of retinoid use. Cheraghlou recommends the sandwich method: apply a layer of moisturizer, then the retinoid or retinol product, and then another layer of moisturizer. “This can help with some of that retinoid irritation,” he says. 
  • Use caution in cold climates. It’s not unusual for retinoid irritation to improve in the summertime and then worsen in the wintertime, even after the initial three-month adjustment period. If you develop sudden irritation, Young recommends taking a break from the retinoid or retinol and using a gentle moisturizer and cleanser. “Give it a few days to calm down, and then slowly reintroduce the product,” she says. “I’m in the northeast, and some patients in the winter can only [use retinoids] twice a week, and that’s fine. It’s better than nothing.”


source https://time.com/7086203/should-you-use-retinol-retinoids-skin-care/

2024年10月16日 星期三

‘American Malaria’ Is on the Rise

A tick is viewed atop a pencil eraser in the laboratory of researcher Erik Foster during a tour of the Center for Disease Control laboratory in Fort Collins, Colo., on April 4, 2024.

Few things will leave you feeling quite so grossed out as returning from a jaunt outside and finding a tick clinging to your skin. Not only is the unwelcome parasite sucking the blood from your body, but it may also be leaving something behind: bacteria, viruses, or parasites that can cause at least 15 different diseases, according to the U.S. Centers for Disease Control and Prevention (CDC). Lyme disease, Powassan virus, Rocky Mountain spotted fever, and Heartland virus are just a few of them.

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Another, babesiosis, is causing particular concern. The disease is colloquially known as “American malaria,” partly because of its ever-widening spread and partly because of its clinical profile. Like malaria, the disease is caused by a parasite (carried by ticks instead of mosquitoes) that infects red blood cells. And like malaria, it can lead to headache, fever, chills, nausea, vomiting, altered mental state, anemia, low blood pressure, respiratory distress, and more. 

Now, a new paper published in the journal Open Forum Infectious Diseases found that more Americans are getting babesiosis—often alongside other tick-related infections.

Paddy Ssentongo, an infection disease fellow at Penn State Health Milton S. Hershey Medical Center, and his colleagues studied more than 3,500 Americans with babesiosis from 2015 to 2022. Their first striking finding is how fast the disease is exploding across the U.S. population. In the seven-year span of the survey, cases of babesiosis increased an average of 9% per year—due, the researchers concluded, to a warming world which is expanding the range of the black-legged tick, the principal babesiosis vector. In the Northeast, the spread has been astronomical: babesiosis grew by 1,422% in Maine from 2011 to 2019, and 1,602% in Vermont during the same period, for example.

Read More: We Used to Have a Lyme Disease Vaccine. Are We Ready to Bring One Back?

The ticks are not making their way to new habitats on their own, but rather are hitching rides aboard one of their principal hosts—the white-tailed deer, who are expanding their own range, drawn by warmer temperatures and reduced snowpack.

Geography isn’t the only problem. Ticks are also carrying more pathogens. The ticks may travel on deer, but they pick up disease by feeding on mice and other small mammals; if those hosts are carrying Lyme disease or babesiosis or other infectious agents, the parasite will pick them up too—and pass them on to a human it bites. That’s a big problem, as the researchers found.

Of the people in the sample group who were found to be carrying babesiosis, 42% were also infected with one or more tick-borne diseases. Of those, 41% also had Lyme disease; 3.7% had ehrlichiosis; and 0.3% had anaplasmosis.

On its face, that seems like bad news. The wide-ranging symptoms of babesiosis can be especially dangerous in people with compromised immune systems or those who have had their spleen removed during treatment for some cancers, blood diseases, or cirrhosis of the liver. Ehrlichiosis also leads to fever, chills, nausea, vomiting, diarrhea, and confusion, and in later stages can cause brain damage, uncontrolled bleeding, respiratory failure, and death. Anaplasmosis can lead to similar symptoms and potentially fatal breakdowns, including respiratory failure and bleeding problems.

Paradoxically, however, the researchers found that infection with more than one of these pathogens at the same time may actually have something of a protective effect. The risk of death from babesiosis turned out to be higher among the people who were infected with that disease alone, as opposed to those who had coinfections.

Read More: Here’s Exactly What to Do If You Find a Tick on You

“Having both babesiosis and Lyme disease seemed not to be associated with worse mortality,” Ssentongo said in a statement accompanying the release of the study. “It’s speculated that the concurrent presence of other tick-borne infections in the blood could alter the immune response by possibly ‘boosting’ it to effectively fight infections.”

That’s not the only reason people with co-infections may do better than those with babesiosis alone. The typical treatment for babesiosis is a combination dose of the antibiotics azithromycin and atovaquone. The front-line treatment for Lyme disease, anaplasmosis, and ehrlichiosis is a different antibiotic, doxycycline. People who are co-infected with one or more of those diseases along with babesiosis are more likely to be treated with doxycycline as well. That, says Ssentongo, raises the question as to whether that antibiotic is effective against the babesia parasite—a question that requires more research.

Of course, the best way to deal with any of these tick-borne diseases is not to get infected with them in the first place. Wearing long-sleeved shirts and full-length pants, tucking pant cuffs into socks, wearing insect repellant, showering after coming inside, and running a full-body check for ticks are all proven infection preventives. 



source https://time.com/7086273/american-malaria-babesiosis-ticks-lyme-disease/

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