Category Archives: Nihilism

Even after a quarter century and nearly 7 million equivalent album units earned from his bands first five albums, according to Luminate, formerly MRC Data, Third Eye Blinds Stephan Jenkins still feels like hes on the outside looking in. This folk musics fking me up/Makes me think I should quit/Maybe Im just scared of it, he sings on Silverlake Neophyte from the groups 2021 album, Our Bande Apart, a collection Jenkins says is his favorite thing he has ever done.

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Musicians are expected to plug the new one. But in Jenkins case, after years of battling former bandmates, managers and, in some cases, himself during dry spells he has emerged from the most fruitful period of his career with a new attitude and a fresh perspective on what and who his band is.

Fans of 3EB (as the act is commonly known) know that Jenkins, after years of working on his songwriting, burst onto the scene with the bands 1997 self-titled debut, which has generated nearly a billion on-demand streams in the United States (according to Luminate), featuring big-swing alt-pop staples Semi-Charmed Life, Graduate, Hows It Gonna Be and Jumper. His signature mix of NC-17 subject matter and earworm choruses heralded a fresh songwriting voice that blended the underbelly frankness of Janes Addiction with the guitar-forward hooks of peak Smashing Pumpkins.

The band followed up with the more musically adventurous Blue in 1999 and Out of the Vein in 2003, though its next two releases each came after six-year breaks that led to Jenkins most prolific period. Since 2019, the new-look 3EB whose only original members are Jenkins and drummer Brad Hargreaves have been on a tear, releasing two albums, a live set and two EPs in less than four years. To me, its very close to the first album in letting the songs be what they are without any of that nervousness of trying to make them into the thing they should be, Jenkins says of Our Bande Apart.

With 3EB setting out in June on its 25th anniversary Summer Gods Tour, sharing the bill with Taking Back Sunday and Hockey Dad, Jenkins talked with Billboard about how modern folk music messes with his head and the time Kanye West paid him a compliment.

What was the founding concept of 3EB? What did you want the band to be?

I wanted to be freed up from genre. I liked British riff rock and singer-songwriter stuff New Order, Joy Division, Cat Stevens, and I really liked hip-hop. I liked the space that hip-hop gave you for expanding the lyric and being really wordy. I didnt like the ethos of grunge where it was nihilism, everybody not caring and turning inward. I had more of a rage to live, to reshape my world on my own terms. My mindset was more eros, erotic, the ferocity of demanding to live on your terms.

What happens when you go from being unknown to having that kind of chart success with your debut release?

I definitely felt validated in a way to know I was going to be able to make a second record, which was amazing to me. To be a musician is to take a vow of poverty, and I didnt have a drivers license or a bank account. I really bet everything on doing music, with no fallback, so to have a gig was amazing.

You have a moment when you get success where you can turn yourself into the person who is talking loudest in the room and what you have to say is so interesting and youre making jokes and not asking questions. I think were all susceptible to that with success and early on I went through that. But I also decided I wanted to be living in a space where I had impact with people and engaged with them about the real, authentic friction of relationships.

This is what I think of. I have a picture its my favorite photo ever of an autistic boy whose parents brought him backstage and asked if he could meet me. His language was such that he doesnt say something at the time where its appropriate to say it. But he loved Third Eye Blind and his parents hooked me up to talk to him about it. We took a picture and he looked at the camera he also had a problem being touched. We smile for the camera and he made eye contact and for me I hated having photos taken of myself I looked at that photo and I said, Thats my real face, this is me, this is the full expression of myself. His parents were tripping me out because he looked at the camera, which was something he didnt normally do. They were nervous because they were meeting this person who was on MTV and the boy said bye at the right time and at that point they completely stopped caring about me at all. That was really wonderful because they were so fixated on their boy making this little milestone moment. That was a sense of what I was doing, my rendering of reality is traveling to somebody else and I felt that.

You seemed to capture that same explosive first-album energy on Blue, especially on Wounded. That ecstatic woo woo! and the gigantic guitar windup feel triumphant. When you write a song like that, do you know in the moment youve written something special?

Oh, for sure, yes. Its one of my favorite records, and during the making of Blue I felt free, truly free. Then what happens is it goes through mixing and mastering and gets shrunk down to this little fking CD and it all shrinks. But theres a moment where its ocean-sized in your head. That was a song about a friend who got raped and withdrew from our friend group and that made an emotional dent on me. Thats [the place where] I wrote from, and I was able to render something of her rage and triumph of ownership of self.

Youve never made it easy on yourself with your choice of topics: abortion, suicide, a pharmacopeia of drugs, oral sex. Do you ever try to wind it back for the sake of mainstream acceptance or radio?

No. Ive always felt that as an indie-rock artist, there have been very few times where Ive been radio-focused. Its about being in a kitchen under suspect light after midnight when the conversation gets real. For me, writing doesnt come from one particular place, its just about trying to stay in a cultivating space where things can actually make a dent on you emotionally.

There was a six-year break before Ursa Major arrived in 2009. What happened?

I produced and co-wrote a couple other albums [Vanessa Carltons Harmonium], produced for a few [Spencer Barnett], so there was that. I cant really account for myself. To make rock music, theres that, Heres what Im doing and I dont give a fk, fk your opinion. Thats the rocknroll mindset and I didnt have it. I felt judged and misunderstood. I also had been going so hard for so long for years before I got a record deal that I think maybe I was a bit stunned by the idea of going out and being subjected to evaluation and criticism.

You talked about the influence of hip-hop, which pops up across so many of your songs, like Semi-Charmed. Do you feel like a rapper at heart?

I just love the daisy age of hip-hop DeLa Soul, ATribe Called Quest and I just felt like rap music was punk and theres a music aspect to it that just immediately compelled me as someone who tends to be overly wordy.

After another long break, you came back with the EP We Are Drugs in 2016, which felt the least restrained you had ever been. Youre 57 could you have written those same songs at 25?

I think the real question is could I have written it without Drake? Drake is an amazing lyricist. I just stayed in my late 20s, thats what I did. (Laughs.)I dont have any wisdom. Im just interested in the music I hear now, and I pay attention to culture now. I dont have any old stories. Im always looking to go surfing with friends. Thats how I roll and thats the energy that comes back to me.

Third Eye Blind still has a young audience. How do you explain that?

Its a phenomenon, and one I feel like I have no control over. Certainly, I dont have any way of fostering it. Its a result of the socializing of music sharing, and what happens is our band turns into playlists and they dont have date stamps on them. People find songs that illuminate where theyre at and then they share them.

Do you see signs of your influence on bands out there now?

Yes. Theres a frankness and rawness in rap lyrics that inspires and repels me because of a lot of the violence and misogyny that gets a pass. But there is a lot of incredible, exciting raw sh-t in there. I was at a baseball game and Kanye [West] was there and he was talking about how he saw that in my music and found it inspiring. Hes a rapper who can do some really raw, genuine stuff where hes looking for that completely unhinged state of freedom, and to hear a nod [from him] like, I understand what youre on about and I dig it was so cool.

Silverlake Neophyte from Our Bande Apart has you questioning your place in music. Are you still wondering if you should quit after hearing some of the new folk music thats messing with your head?

I took this deep dive into the Los Angeles neo-folk scene [Phoebe Bridgers, Adrianne Lenker] and theres this hyper-realness going on there. It made me go, OK, are you being real? I imagined that feeling of being at an open mic night in Silverlake with other songwriters and really laying it down. You dont discover yourself; you make yourself up. We are inventions. [Our Bande Apart] is kind of my favorite album because, to me, its very close to the first album in just letting the songs be what they are without any of that nervousness of trying to make them into the thing they should be. Its not overthought, not overwrought.

Can we do a lightning round? How does it feel to sing those early songs today? Can you still tap into those emotions?

I tap into the audiences emotions and they keep it alive.

What is Third Eye Blind today? Is it you?

(Pauses.)Yes. Im Third Eye Blind and I have relationships with people who are in this band and they bring something precious and vital to it. Both things are true.

Who are the songs for?

Wow The songs are for themselves. They are for the universe. They are for the purpose of being brought into existence and they come with the hope of traveling to other people and bringing them into connection with each other.

Whats the song that came the quickest and the one that took forever?

[Blue album track] Tattoo of the Sun and Deep Inside of You.

What did you see when you look out now in the crowd?

People who feel the joy of knowing they are not alone.

Do you see signs of your influence on bands out there now?

Yes. There a frankness and rawness in rap lyrics that inspires and repels me because of a lot of the violence and misogyny that gets a pass. But there is a lot of incredible, exciting raw sh-t in there. I was at a baseball game and Kanye [West] was there and he was talking about how he saw that in my music and found it inspiring. The point was hes a rapper who can do some really raw, genuine stuff where hes looking for that completely unhinged state of freedom and to hear a nod [from Ye] like, I understand what youre on about and I dig it was so cool.

Best advice you got from a rock hero?

Bono said, Wait til the live album to buy a house.

Worst advice?

The drummer [in an unnamed band] said enjoy it while it lasts.

Best advice youve given?

I told a new artist, Adam Neff, that if you want to be a good musician, live like an athlete and keep writing songs.

Your favorite show?

There are so many, but there was a moment at Lollapalooza [in 2016] where we didnt know what was gonna happen because people vote with their feet and you can be on stage and there can be no one at your show. We set an attendance record for that afternoon slot for the whole weekend. And then some guys took a guy in a wheelchair and crowd-surfed him to the stage and the security guys were going to put him in the pit and I said, Let him up! They put him on the stage and I looked out at the audience at the end of the show and I said, Look how beautiful you are! And I meant that about everyone there.

You have consistently written songs about getting high/drugs, so I have to ask, do you indulge?

Surprisingly not. I think its so overrated. I like like to get up early and get a cold plunge in and go surfing. I like the feeling of being way, way in my body, but nobody likes a goody two-shoes either, so I certainly dont believe in the taboo. But the writing of the taboo can be a metaphor for other things.

Will you be singing these songs when youre Paul McCartneys age?

I dont see why not.

A version of this story originally appeared in the May 14, 2022, issue of Billboard.

Go here to see the original:

Stephan Jenkins on Third Eye Blind at 25: I Wanted to Be Living In a Space Where I Had Impact - Billboard

The standard of care for pancreatic cancer has not changed drastically in recent years, although more is known about optimal treatment sequencing. However, the nihilism associated with the disease has prevented some patients from seeking treatment that could prolong survival and improve quality of life, according to Jonathan Mizrahi, MD.

Combating nihilism in pancreatic cancer [is a vital issue]. For patients who are diagnosed with pancreatic cancer, have them evaluated by someone who knows how to treat pancreatic cancer and understands what benefits [each] therapy can offer them, particularly in the stage IV setting, Mizrahi said in an interview with OncLive following a State of the Science Summit on gastrointestinal (GI) malignancies.

In the interview, Mizrahi, the chair of the meeting and a medical oncologist at Ochsner Cancer Institute, discussed updates from the meeting in pancreatic cancer and hepatocellular carcinoma (HCC), the growing role of immunotherapy in GI cancer, and the watch and wait protocol seen in rectal cancer.

Mizrahi: Nihilism is an important concept to combat in pancreatic cancer. A lot of it starts with patient education and provider education. It matters what provider a patient sees first, and this is documented by retrospective database studies. If a patient sees a medical oncologist first, theyre more likely to receive systemic therapy that can be life-prolonging. [However], if a patient sees a surgeon first, theyre less likely to get chemotherapy, [although] most of them will. Moreover, some patients dont make it to a surgeon or a medical oncologist, and those are the patients who we are missing out [on treating].

In the primary care community, perhaps in the lay community, people talk to friends and family, and they hear pancreatic cancer [and say], Well, theres nothing we can do about it. That nihilism is something [clinicians] should be aware of so that we can do a better job of promoting that we have treatments that can not only prolong [a patients] life but make them feel better. The first indication for chemotherapy for pancreatic cancer was that it made a patients quality of life better and reduced symptoms. Not only can we prolong patients lives, but we can potentially reduce their symptoms [as well]. We have some tools that can achieve that, so [addressing nihilism] is an incredibly important point.

The NAPOLI-1 study is the only second-line study we have in terms of [large] phase 3 studies looking at pretreated patients with pancreatic cancer. This trial took patients who had prior first-line gemcitabine-based chemotherapy and randomized them to 1 of 3 arms. Ultimately, what was observed is 5-fluorouracil [5-FU] plus nanoliposomal irinotecan was superior to 5-FU alone and to nanoliposomal irinotecan alone. That [combination] has become the de facto standard of care for patients in need of second-line chemotherapy [because it led to] prolongation of overall survival [OS] and progression-free survival in that population.

If you have a patient who starts on gemcitabine and nab-paclitaxel [Abraxane], which is a reasonable and appropriate option for a lot of patients, then an appropriate second-line treatment, [per the] National Comprehensive Cancer Network guidelines category 1 recommendation based on the NAPOLI-1 study, would be 5-FU and nanoliposomal irinotecan.

The special populations in pancreatic cancer are ones that need to be searched for. [These patients] are special because we dont see them very often, but when we do, we do have agents that can be helpful for them. In about 1% or less of patients, we see microsatellite instabilityhigh [MSI-H] or mismatch repairdeficient [dMMR] proteins. For those patients, pembrolizumab [Keytruda] is effective.

[Another special population] is patients who have a TRK fusion. These patients can benefit from NTRK inhibitors, and this fusion is found in about 1% of patients.

[Among] recent studies that weve seen, 1 that came out at the 2022 Gastrointestinal Cancers Symposium [ASCO GI] and an ASCO plenary session [involved] patients with certain KRAS mutations. KRAS is a mutation that is found in virtually all patients with pancreatic cancer, and a subset have a KRAS G12C mutation. Some of these KRAS G12C inhibitors can be effective in this population. Weve seen data on adagrasib and sotorasib [Lumakras]. Both agents seem to have some efficacy in this population [as single agents].

The problem is how infrequently we see these mutations. About 1% of all KRAS mutations seen in the pancreatic cancer population [are KRAS G12C mutations]. However, if we dont look, were not going to find them. If were sequencing patients and finding out they have a KRAS mutation, which most of them will, [we must find out] what their [specific] mutation is and possibly enroll them on a clinical trial, or try to get an off-label treatment with KRAS inhibitors. This is an important option for patients who dont have many good options after standard chemotherapy.

Immunotherapy has been a tough nut to crack with pancreatic cancer. Single-agent PD-1/PD-L1 and CTLA-4 checkpoint inhibitors have not been effective in pancreatic cancer. Combinations of checkpoint inhibitors with chemotherapy have been the next avenue of research. [However], these have not proven to be successful in improving survival in the first-line setting. We saw an example of this at ASGO GI with sintilimab in combination with chemotherapy. Although response rates were improved with the combination of this PD-1 inhibitor and FOLFIRINOX [folinic acid, fluorouracil, irinotecan hydrochloride, oxaliplatin], the survival was not improved. As a first-line combination, this did not seem to be effective.

As single agents or in combination, weve seen data with PD-1 and CTLA-4 [inhibitors] in unselected patients with pancreatic cancer, and that strategy doesnt seem to be effective either.

The reasons [why immunotherapy has been ineffective in pancreatic cancer] are complicated, but a lot of it has to do with the fact that the immune microenvironment for pancreatic cancer is very immune suppressive. It has a large amount of dense fibrotic stroma and a number of immune cells that are creating an environment that is not conducive to CD8 or CD4 cells infiltrating the tumors to provide that immune [activity]. That is one of the reasons that we dont see immunotherapy working that well in pancreatic cancer.

[Immunotherapy] will still be studied in combination with other drugs and other checkpoints. Combining immunotherapy with other targeted agents in the immune microenvironment continues to be an ongoing area of research. But its been a challenge in the pancreatic cancer field and hopefully one that well soon learn how to overcome.

There are a few different areas that are going to be the short-term focus of advancing [treatment for] pancreatic cancer. One is getting answers from the phase 3 NAPOLI-3 study [NCT04083235], as to what the optimal first-line chemotherapy regimen is for patients with metastatic pancreatic cancer. That study is looking at gemcitabine and nab-paclitaxel, an approved standard first-line chemotherapy option vs NALIRIFOX, or liposomal irinotecan plus 5-FU/leucovorin, and oxaliplatin. This is like a modified FOLFIRINOX regimen but using nanoliposomal irinotecan instead of irinotecan. [NAPOLI-3] might give us an answer as to which of these regimens is superior in the first-line setting.

Another cooperative group study thats being done is [the phase 3 ALLIANCE A021806 trial (NCT04340141)] evaluating the optimal sequence of treatment in patients with resectable pancreatic cancer. A more [frequently] used approach is putting patients on neoadjuvant chemotherapy, moving them to surgery, and finishing up chemotherapy, rather than doing up-front resection followed by 6 months of chemotherapy. But thats never been tested in any prospective phase 3 studies, and thats something thats being done the ALLIANCE study:looking at FOLFIRINOX and its optimal sequencing.

Beyond that, expanding our repertoire of targeted therapies [is important]. More patients are getting sequenced, and the recognition that these patients should be genomically and molecularly sequenced [has increased]. We will be seeing more targets and hopefully more drugs will come out. Well see more research and excitement around other targets to hit. That could be KRAS G12D, which is a target thats been elusive. If we made breakthroughs in that arena, we would see an important benefit for these patients who need more treatments.

Whether a patients cancer is resectable needs to be determined in a multidisciplinary manner. A patient will have their pancreatic protocol CT scan, which will evaluate the vascular anatomy well and its relationship to the tumor. Sometimes an endoscopic ultrasound can also be helpful in looking at the vasculature and its relationship to the tumor. Then, a conversation should occur between radiology, surgery, medical oncology, and perhaps radiation oncology, to determine a sequence of therapy.

We have different criteria to determine whether a patients tumor is resectable, borderline resectable, or locally advanced, and we should be utilizing that multidisciplinary discussion to determine the optimal therapeutic sequence.

The role of radiation is a controversial one in resectable and borderline resectable pancreatic cancer, but we know that those patients need chemotherapy regardless. The ALLIANCE A021806 study will help us figure out the optimal sequence of chemotherapy. Is better to do it up front, followed by surgery and more chemotherapy? Or should we do surgery followed by chemotherapy? A lot of institutions are moving toward doing neoadjuvant chemotherapy for a variety of reasons. Whether that truly improves OS is a question that well hopefully have the answer to soon.

The treatment landscape in HCC has evolved dramatically. Four or 5 years ago, there was 1 agent on the market for first-line treatment of HCC: sorafenib [Nexavar]. Now, you are hard pressed to find many people who use sorafenib in the first-line setting.

Lenvatinib [Lenvima] was shown to be noninferior to sorafenib a few years ago. More recently, we saw data from the phase 3 IMbrave150 trial [NCT03434379] with the combination of immunotherapy and VEGF inhibition with bevacizumab [Avastin] and atezolizumab [Tecentriq].That [combination] proved to be a game changer in terms of OS advantage compared with sorafenib.

Most recently, we have data from the phase 3 HIMALAYA trial [NCT03298451], looking at tremelimumab plus regular interval durvalumab [Imfinzi; the STRIDE regimen]. That regimen is a combination of a PD-L1 inhibitor and a CTLA-4 inhibitor. That would be a VEGF inhibitorfree combination, purely immunotherapy. It offers another potential first-line treatment that we did not have just a few years ago. Not only do we have more options, but these options seem to be better than what we had just 4 or 5 years ago.

Its been exciting to see immunotherapy make its way into gastroesophageal cancers. We have seen that with both pembrolizumab and nivolumab. [For example], we saw in the phase 3 CheckMate649 trial [NCT02872116] that the addition of nivolumab to chemotherapy improved patient survival vs chemotherapy alone. That was in all-comers, but we also saw that in patients who had a higher PD-L1 combined positive score [CPS], in particular a PD-L1 CPS greater than 5. High PD-L1 CPS conferred better benefit than lower PD-L1 scores. There is some controversy around whether patients should get [nivolumab plus chemotherapy] regardless of whether they have PD-L1positive tumors or whether they should only receive it in the case of having a PD-L1positive tumor. But nivolumab has proved to be a significant game changer for these patients.

This is also the case in the adjuvant setting. In the adjuvant setting for patients with esophageal cancer who had their chemoradiation according to the CROSS regimen [carboplatin and paclitaxel with concurrent radiotherapy], followed by surgery if they have residual disease, we know that according to the phase 3 Checkmate-577 trial [NCT02743494], the addition of nivolumab in the adjuvant setting for up to 1 year improved patients disease-free survival from 11 months to 22 months. Whether all patients or just patients who are PD-L1 positive are benefiting from that regimen is still up for discussion, but it looked like there was a signal in the PD-L1negative group.

Nivolumab, pembrolizumab, and all checkpoint inhibition has been a game changer in what were able to offer patients with gastroesophageal cancers.

The paradigm of rectal cancer has evolved quite a bit. The sequencing of chemotherapy, radiation, and surgery has gone through all different permutations, and a lot of institutions, including Ochsner Cancer Institute, have moved toward the concept of total neoadjuvant therapy. That is where we are giving chemotherapy and radiation up front for localized rectal cancer, potentially followed by surgery. Surgery is the last step in that process.

When you [discuss the sequence of] radiation vs chemotherapy, people can have disagreements. At our institution, were primarily doing radiation first, whether thats short-course radiation or traditional long-course chemoradiation over 5 weeks, and this depends on some patient variables. But for patients who have their full total neoadjuvant therapy, we then check the response to that treatment.

There is a subset of patients, anywhere from one-quarter to one-third or even higher, who can have a complete clinical response, meaning on their imaging, endoscopically, or on a digital rectal exam, were not seeing, feeling, or detecting any evidence of residual cancer. Based on database studies that have looked at patients who have gone through this watch and wait program, some of those patients can avoid surgery altogether and have just as good of an outcome.

That doesnt mean we dont do surgery [and stop managing the patients disease]. Theres a very close management surveillance protocol for these patients, which involves intensive imaging and endoscopic surveillance to ensure theres no recurrence. For most patients, if they do recur, they recur locally and you can then proceed with surgery. The minority of patients, if they recur, will recur distantly, and one could argue that they would recur distantly regardless of whether they received the surgery.

There are patients who we think can be cured from this cancer without having to undergo surgery. For a lot of patients, thats a good, viable option for them. Obviously, the long-term outcomes on this are still being gathered, but this seems to be a promising option for a number of patients and one that were already utilizing.

The management of GI cancers has gotten very complex in a good way. Our options are not only changing but improving. Were seeing the upper GI space move with the addition of immunotherapy. In pancreatic cancer, although our therapies have not changed dramatically, how we sequence them has. I cant understate the value of having an experienced surgeon and someone who does a high volume of pancreatic surgeries [treat these patients].

As far as colorectal and liver cancer, multidisciplinary care is important, experience is important, and going to high volume centers that see a lot of these cancers and can offer the best management is crucial. Things have gotten complex in a good way, and having the experience in multidisciplinary care is invaluable.

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Nihilism Remains a Barrier to Effective Treatment Delivery in Pancreatic Cancer - OncLive

A movie made by accident that was almost never seen at all, Dennis Hoppers 1980 masterpiece of alienation Out of the Blue opens at the Brattle Theatre this weekend in a stunning new 4K restoration, preserving the picture in all its ragged, unseemly glory. The film stars the miraculous Linda Manz as proto-punk teen CeBe, coming of age in an economically washed out, nowhere suburbia with her alcoholic, ex-con dad (Hopper) fresh from the joint and mom (Sharon Farrell) shooting smack on the living room couch, when shes not sleeping around with her husbands friends. CeBe idolizes Elvis Presley, Johnny Rotten and any other iconoclastic, anti-authority figures she can find, her sneering, no future ethos feeling like the only sane response to being born without one. Hopper frames the film as an almost anthropological study of how 1960s counterculture dreams crashed and burned, conjuring the nihilism of the 1980s. Its in many ways a spiritual sequel to his seminal 1969 Easy Rider, a feature-length elaboration on that pictures cryptic campfire lament, We blew it, man.

Of course, it was never intended to be like this. Originally titled CeBe, Out of the Blue was supposed to be an afterschool TV movie for families cobbled together from Canadian tax-shelter funds, chronicling the rehabilitation of a runaway teen thanks to the efforts of an unconventional therapist played by Raymond Burr. At the time, Hopper was a barely employed actor-for-hire struggling with substance abuse issues of mythic proportions, in the midst of his second stretch in Hollywood exile after the disastrous reception of his semi-inscrutable Easy Rider follow-up, which hed perhaps prophetically titled The Last Movie. (A better film than its reputation might suggest, if a bit lost inside its own head.)

But when original writer-director Leonard Yakir was fired two weeks into production, Hopper swooped in to the rescue and rewrote the screenplay over the weekend, reportedly while listening to his buddy Neil Youngs Rust Never Sleeps nonstop and replacing the old title with a line from the albums opening track. He stepped into the directors chair the following Monday morning having entirely reconceived the film around his own raging personal demons and the strengths he saw in Manzs unique screen presence. This wasnt the first time someone had reshaped a movie after meeting the young actress. Two years earlier, while editing Days of Heaven, Terrence Malick scrapped his whole script and switched the story to take place from the POV of the lead characters little sister, so indelibly played by Manz.

You cant blame them. Theres never been a movie star before or since like Linda Manz. Stubby, tomboyish and brusque, yet capable of an aching vulnerability, she was a Dickensian street urchin crossed with one of the Dead End Kids from a 1930s Bowery serial. Manz spoke in a guttural, Noo Yawk honk that always accented the words you least expect in a sentence and seemed incapable of a false or rehearsed moment on camera. What everyone remembers most about Days of Heaven is the narration Malick brought her back after filming to ad-lib, blunt non sequiturs beguilingly at odds with the films fussy, golden-hour images: You could see people on the shore, but they was far off and you couldn't see what they were doing. They were probably calling for help or something, or they were trying to bury somebody. (35mm prints of "Days of Heaven" and "Easy Rider" will also be screening alongside "Out of the Blue" on selected days during the Brattle engagement.)

Manzs scenes with Hopper in Out of the Blue are marvels of improvisational ingenuity, the alchemy of two artists completely in sync with each others processes. Shes a brute and a bully at school, but sleeps with a teddy bear and sucks her thumb. CeBes always belting out the lyrics to Elvis Heartbreak Hotel like its her autobiography. At night, she stays up late snarling punk catchphrases Subvert normality and Kill all hippies into the CB radio that still hums in the cab of her dads derelict truck, which has been abandoned in the backyard ever since he drunkenly plowed it into a stalled school bus and went to prison for five years. The movie means to be Hoppers reckoning with the legacy his generation has left for their children, and as far as metaphors go, the original Easy Rider wiping out a bus full of kids while he was wasted isnt exactly a subtle one. But then, we never admired Dennis Hopper for his understatement.

Hoppers first film role was famously in Rebel Without a Cause, and Out of the Blue can be seen as a continuation of that movies overwhelming empathy for disaffected youth. Cebes rockabilly affectations, slicked-back hair and clothespin piercings are amalgamations of Elvis and the Sex Pistols and every other outsider perspective with which she can find the common cause shes missing at home. (The closest thing the film has to a reverie is when she runs away to a ratty rock club and is invited to jam on the drums with Vancouver band The Pointed Sticks. But its telling that even the happiest segment of the movie finds her fending off a rapist with a broken bottle.) The picture is full of barbed visual references to Marlon Brando in The Wild One and other rebellious pop-culture icons. But the most subversive might be the visage of the filmmaker himself, once a counterculture god now looking drunk and exhausted in his 40s. Hopper wants us to see our silver screen heroes as sad-sack, abusive dads.

The film languished in litigation for a couple of years before Hopper and producer John Alan Simon were able to wrestle free the rights and release it independently themselves in 1982. Hiring an American director had killed the movies Canadian tax-shelter eligibility, infuriating financiers and leaving the film technically stateless. Out of the Blue remains the only movie to be presented at the Cannes Film Festival without a designated country or national anthem played before the screening, and it feels somehow fitting that this story ended up an orphan. Such a bleak, despairing drama was obviously never going to be a box office bonanza, except for around here where it caught on with college audiences and broke house records playing for 17 weeks at the Coolidge Corner Theatre. This new restoration is being presented by actresses Chlo Sevigny and Natasha Lyonne, who are both around my age and presumably grew up as I did, with those old, hard-to-find VHS tapes of Out of the Blue being shared like a secret among cool older siblings and similarly-minded outcasts.

The Neil Young song that inspired Hopper's new title, My My, Hey Hey (Out of the Blue) is played multiple times throughout the film and cant help but carry with it a sad added resonance now. In 1994, Kurt Cobain quoted Youngs lyrics in his suicide note, and watching the film today its chilling to realize that the late Nirvana frontman was roughly the same age as CeBe when the movie was made, growing up in similarly blighted Northwestern towns, two misunderstood, androgynous kids seeking solace in music from some of the same generational traumas. This makes the harrowing ending even harder to sit through (something I didnt think was possible) but also illustrates the universality of the frustrations and confusions that Hopper and Manz have tapped into here, CeBes struggle still resonating with audiences more than four decades later. Like the songs say, its a denial, a denial, a denial. So lonely she could die.

Out of the Blue is playing at the Brattle Theatre from Friday, May 13 through Thursday, May 19. Days of Heaven screens on Saturday, May 14, and Sunday, May 15 while Easy Rider plays Wednesday, May 18, and Thursday, May 19.

Go here to see the original:

Dennis Hopper's film 'Out of the Blue' is a masterpiece of alienation - WBUR News

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English punk heroes The Clash are one of, if not the most important punk band of all time. Even though they were leather-clad like their peers, their music went far beyond the faux-nihilism and anarchy espoused by the likes of the Sex Pistols.

Frontman Joe Strummer was undoubtedly their secret weapon, a true wordsmith whose prose was coloured by flecks of Kerouac and Ginsberg. In addition to this, he was greatly inspired by the protest anthems of American heroWoody Guthrie, and through writing a myriad of his protest songs, he showed his generation the shape of the future. It was without the prejudice and bigotry of 70s Britain, and all they had to do to realise this utopian vision was to follow him.

Together, Strummer and co-frontman Mick Jones formed a formidable songwriting partnership which was the most potent of the British first wave.

Whilst Strummer, Jones and the band penned many songs that shone a bright light on societys ills, one of the best is Remote Control from their 1977 debut album,The Clash. Its an upbeat number with one of the bands most anthemic choruses and an iconic opening riff to boot.

The track was written after the bands failed Anarchy Tour, where most of the groups planned shows were cancelled last minute after public uproar at the proliferation of punk, thanks in part to the Sex Pistols notorious appearance onTodaywith Bill Grundy.

The song was intended as a rallying cry against oppression and conformity, and whilst this was bread and butter for any punk band, the song contains sharper observations about bureaucracy, record companies and of course, the police than their peers.At the time, the track was the most dynamic that the band had composed, with its numerous changes in time signature and the intro/outro riff, which was lifted from the traditional football chant, Youre Gonna Get Your F**kin Head Kicked In. Looking back, the bands original drummer remembered Strummer exclaiming, Micks written a mini-opera!

Understandably, The Clash were angry at the inertia of 70s Britain and at people in positions of power, which was only exacerbated by the fact thatthe EMI shareholders met on December 7th, 1976, which withdrew the labels financial support for the Anarchy Tour, resulting in the cancellation of their shows. The line, They had a meeting in Mayfair was a direct reference to this momentous moment.

Despite that, at first, the band were very happy with Remote Control as it marked a new creative direction for them, before too long, they were dismissive of the song as it was released without their consent as a single in May 1977, which soured their relationship with it.

It wasnt that they didnt want it as a single, they just didnt want it to be the next single, following the raucous cut White Riot. In the liner notes toThe Vanilla Tapes,Mick Jonesexplained: I think Joe [Strummer] disliked it on a symbolic level, because of what happened with the release. But we always liked the tune.

In an interview given only a matter of weeks before the songs release with the now-defunctMelody Maker, the band confirmed that they expected the next single to be Janie Jones. Many have taken the fact that Remote Control is less aggressive than many of the songs onThe Clashas the reason why the label decided to release it without asking the band. It is alleged that the band were so apoplectic when they found out that they went around London record shops and personally pulled the album from the shelves.

Regardless of the record label ruining the tracks potency for the band, it is still one of their finest moments and will always remain so. Strummer and Jones hit upon something compelling in their lyrics, showing how not much has changed, many of the themes are as pertinent as they were back then.

Listen to Remote Control below.

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The Story Behind The Song: How The Clash created 'Remote Control' - Far Out Magazine

The wheel has turned, writes biologist Michael Denton in his new book, out today,The Miracle of Man. A widening divorce that originated in the 16th century between our understanding of man and of the cosmos has been healed by discoveries in modern science. That is, if were willing to recognize it.

From the heliocentric revolution of Nicolaus Copernicus in 1543, to DarwinsOrigin of Speciesin 1859, science demoted man further and further, to the status of an afterthought in the cosmic scheme. Or not even an afterthought. As it seemed, neither life nor the universe gave evidence of a thinking designer. Rather than reflecting cosmic purpose, man was evidently of no consequence. This thought had profound consequences for Western culture. In 1901, with the science of his day in mind, Nietzsche could write that nihilism stands at the door. That, however, was about to change.

In 1911 and 1913, two pivotal years, there appeared books by Alfred Russell Wallace (co-discoverer of evolution by natural selection) and Harvard chemist Lawrence Henderson. In their work, the extraordinary fine-tuning of chemistry and physics was starting to come into focus. As it advanced, science delivered the news that from the outset of physical existence, at the Big Bang, the universe had planned for a miracle. And the miracle came. It was the rise of our human species in the Pleistocene epoch, proceeding from the use of stone tools to fire to metalworking, giving us, ultimately, our modern world.

For this, a vast suite of chemical and physical parameters were precisely set. These parameters are uniquely fit for creatures like ourselves, as Denton shows:

[O]ur existence as energy-demanding active air-breathing terrestrial organisms critically depends on a wildly improbable ensemble of natural environmental fitness comprising various chemical and physical laws as well as the properties of specific molecules such as oxygen and CO2and specific elements such as the transition metals, properties that must be almost exactly as they are.

The cosmic and planetary environments, in other words the hydrological cycle, the atmosphere, water, oxygen, and more were designed with us in mind our breathing, circulation, vision, muscles, nerves, brain, bones, and much else.

Both lyrical and soberly detailed, Denton writes,

The exquisitely fine-tuned ensembles of environmental fitness described here, each enabling a vital aspect of our physiological design, amount to nothing less than a primal blueprint for our being, written into the fabric of reality since the moment of creation, providing compelling evidence that we do indeed, after all, occupy a central place in the great cosmic drama of being.

This is the miracle of man. We are not positioned in the spatial center of the universe as was believed before Copernicus, but what we have found over the past two centuries confirms the deep intuition of the medieval Christian scholars who believed that in the cognition of nature in all her depths, man finds himself.

The Miracle of Mantakes a story of downfall and recovery full circle.And it does so in a fascinatingly similar way to the story told by Dentons Discovery Institute colleague, philosopher of science Stephen Meyer, in his recent bookReturn of the God Hypothesis. The evidences discussed by Denton and by Meyer are quite different. But they point to the same conclusion. This is so much so that Dentons book could accurately, but not mellifluously, have been titledReturn of the Anthropocentric Hypothesis.

Of course, theres a ready objection. Since humans find ourselves in existence, we must be fit for our environment. This is obviously true, says Denton. But its trivial. The remarkable observation isjust how preciselythe environment wasspecified for us. That is not trivial at all. It is a mark of supreme privilege.

From Dentons superb presentation, other conclusions follow. For one, if the universe harbors intelligent extraterrestrials, they will not be aliens to us. Instead, because of the cosmic design, they will strongly resembleHomo sapiens. Their planet, or planets, will resemble our own, for the same reason. If they find a way to visit us, as UFO believers say, they will feel that they have come home.

The book culminates the series of works in Dr. DentonsPrivileged Speciesseries. And it arrives, I have to add, in a strangely providential manner. In the United States, sputtering nihilists and screaming anarchists have turned their rage on the idea that someone, somewhere, could be thinking that the unborn man or woman is a miracle worth protecting. This is a consequential book and, as the editors could not have predicted, a timely one.

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The Miracle of Man: New Book by Denton - Discovery Institute

Real Life Punks, the viable group of real-life individuals who live a punk rock lifestyle, coming together to create a community, in the digital space announced their new 10000 real-life punks, who left the real world to continue the punk culture, built in the 70s, on the metaverse.

California May 11th, 2022 The continual changes in the digital revolution make it increasingly important every day to stay on top of the new requirements that we must meet in a world dominated by innovation and scientific progress. These changes and advancements make it imperative to take the next step in order to capitalize on the opportunities that each new innovation, discovery, or progress in any field of knowledge brings.

Inspired by the rebellious, fast-paced, mohawk culture of the punk rock world. Real Life Punks project is 10000 Real Life punks carrying on a culture started in the 1970s to the brand new realm of the metaverse. They represent everything that comes with punk culture, ideology, and style. They believe in freedom of choice, nihilism, and a rejection of centralized authority.

Real Life Punks NFT is a punk rock-inspired NFT set of 10000 NFTs aimed at bringing real Life punk fans together on the metaverse. They can interact with one another in person on the metaverse, instead of chatting on discord.

Metaverse is known for its social VR experiences, and with Real Life Punks, punk rock fans finally have a place to come together and interact in person. This allows them to share their love of punk rock music and culture, and to connect with others who share their interests.

The punk rock ideology is built on personal freedom and rejection of mainstream media trends, says NewarGuy, the spokesperson at Real Life Punks, therefore this is a community of 10000 holders allowed to think for themselves, allowed to be different, allowed to be weird. You can always spot us on the metaverse with our Mohawks, tight leather jeans, and anti-establishment quotes are written on our shirts,

This emerging platform will be on the Solana blockchain and has features of transparency and security, which is crucial for long-term feasibility and decentralization. Solana Metaverse Project is a community-oriented platform that provides Solana NFT integration to people where they can pay and invest. Real Life Punks stand for everything associated with punk culture, ideology, and style.

RLP also provides music events for its shareholders. It will increase the efficiency and availability of E-currency to everyone. Solana DAO will create an advanced economic infrastructure consisting of NFT & Metaverse integration in its system and quickly become an unstoppable economic cornerstone to the world. The use of technology will facilitate a financial revolution that will leave everyone more financially connected, empowered, and enabled. In short, RLP provides many facilities under one umbrella.

About Real Life Punks

Real Life Punks NFT (RLP) is a platform that works with and uses Solana. RLP is an NFT project with 10000 NFTs that manages an NFT worlds DAO. Our Platform seeks to increase classic financial creative ideas, confidence, decentralization, and mechanization while private information and data of users. With its growing suite of blockchain infrastructure services and sophisticated resources, businesses can layout the groundwork for emerging domains like digital assets, NFT, Metaverse, and E-currency in the most seamless process while de-risking the development process. A viable group of real-life individuals who live a punk rock lifestyle, coming together to create a community, in the digital space.

Media ContactCompany Name: Real Life Punks Contact Person: KrishEmail: Send EmailCountry: AustraliaWebsite: https://reallifepunk.com/

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Real Life Punks Bringing Real Life Punks fans to the metaverse through NFTs. - Digital Journal

The official synopsis from "Everything Everywhere All at Once" distributor A24 describes the movie as a "hilarious and big-hearted sci-fi action adventure about an exhausted Chinese American woman (Michelle Yeoh) who can't seem to finish her taxes." But no one who actually saw this movie would say that's what it's about.

Yes, the film from directors Daniel Kwan and Daniel Scheinert collectively known as Daniels does feature Yeoh's character, Evelyn, struggling to meet an IRS inspector's deadline. She deals with dissatisfaction from her father, daughter and husband. She finds herself in the middle of a chosen one narrative. There are beautifully edited action sequences and colorfully imagined parallel universes. Still, any conventional conflicts and tensions, emotional or physical, are overshadowed by the not-so-subtle explorations of our existential crises and situational absurdity.

What the film is actually about, though, is perfectly encapsulated in a question from "The Myth of Sisyphus" by philosopher and writer Albert Camus: "Does [life's] absurdity require one to escape it through hope or suicide? This is what must be clarified, hunted down, and elucidated while brushing aside all the rest."

We started making the connection of our work and absurdism, in a philosophical sense, when we did this short film called 'Interesting Ball,''' explained Kwan. "That's when I started reading Camus and being like, 'Oh, this is funny.' I didn't realize we were doing this, or we should try chasing this."

The Daniels leaned into those themes with 2016's "Swiss Army Man," but "Everything Everywhere All at Once" presents a more refined outlook of what Kwan calls optimistic nihilism.

"It's probably absurdism repackaged in a lot of ways; it's very similar," said Kwan. "It's trying to accept the freedom that comes from fully accepting that there is no inherent objective meaning in the universe." He continued: I was watching all the other kids [at university] try to compete with each other. I'm like, What are you doing? This doesn't matter.

Kwan and Scheinert met as undergraduate film students at Emerson College. However, they took a decidedly unorthodox route toward professional filmmaking.

"We did undergrad, we learned a little," explained Scheinert, adding that classes on evolution and the immigrant experience taught him more about filmmaking than a traditional filmmaking class. "And then we were like, 'Oh, what can you learn off YouTube? What can you learn by making things and sharing it, and making connections, and reading the comments, and trying to make a better one next time?'"

The internet, as he sees it, "was like our master's degree." Going all in on the internet absolved the pair of shouldering the burden thats typically found in creative classrooms, where students, as Kwan pointed out, can find themselves in competition with a handful of peers working on their own projects.

Theres a good chance "Everything Everywhere All at Once" will become a portal to the thematic and aesthetic heart of the world in which it was released; we'll approach it the same way we currently look at movies from 2004 (in a post 9/11-era) or 1987 (Gordon Gekko and the excesses of the Reagan '80s come to mind).

Released just the third year into this decade, "Everything Everywhere All at Once" has the feeling of a thoroughly 2020s movie. It's inextricably tied to the COVID-19 pandemic, a time when sudden isolation left many of us asking some combination of the questions "What matters? Does any of this possibly matter?" and "How do we seize our own joys, or create our own meanings?" And the themes the inherent meaninglessness of life, the weight of personal decisions, family conflict and generational trauma couldn't be more fitting.

Even though the film has tapped into the zeitgeist, it was actually conceived in what feels like another era. The Daniels conceptualized the film during the 2016 presidential campaign and wrote it during President Donald Trump's time in office. (The directors have not stated that the film is a response to the Trump years. Coincidences are still a thing.)

"We shot the movie right before the pandemic and edited during lockdowns," recalled Scheinert. "Suddenly it felt like these themes that we were chewing on were relatable as ever, and it was very therapeutic to have this story to work on."

Ultimately, "Everything Everywhere All at Once" was released to a nation weary of the social restrictions in place since the early days of the pandemic. This easily could have been the first movie someone saw in a theater in almost three years.

Fewer than two months after its theatrical debut, "Everything Everywhere All at Once" grossed $35 million against a budget of $25 million. This is an undoubtedly successful movie, but all the elements that make the movie what it is flies in the face of what we assume makes movies popular.

This is a movie centered on the non-European immigrant experience (of an older generation, at that). There are no discernible villains (in the mold of Nazis or Russian spies or Islamic terrorists or Alien threats). The central conflict isn't a good guy-bad guy standoff (it's effectively "parents just don't understand").

Eveyln is harangued by an IRS inspector. Her father, with whom she has a strained relationship, has just arrived from China. Her husband wants out of their marriage. Her daughter, whom she just doesnt get, has a girlfriend. Cue a complicated journey of self-discovery and relationship repair.

"The villain is ourselves, it's our families, it's the way that we interact with each other and hurt each other," said Kwan. "Generational trauma is the most important thing for us to be dealing with right now, because whatever we don't deal with right now is going to be passed on to our kids. And those kids are going to have to solve the world that we f****d up. And if they aren't well balanced, emotionally intelligent, resilient human beings, then I don't know if you manage to survive the next 50 years."

For most thirty-somethings heading to a theater to watch this movie, the dramatis personae break down like this: The hero is your parent, but the villain is also your parent, until the villain becomes you. However, the villain isn't really you; it's your realization of the absurd, and how arbitrary and meaningless this world is.

Along with the arbitrary expectations of society, this generational exchange (and the traumas it fosters) is the central conflict of the movie, and so it speaks to Millennials and Generation Z in a unique way. This is a demographic thats openly talking about repairing the emotional damage wrought by generations present while also wondering about the survival and success of future generations.

I'm constantly thinking 'What am I passing on to my kid?'" said Kwan, who is a new parent. I think it's probably one of the hardest battles any of us will ever have to fight."

Its a relief to know you arent crazy for obsessing over unsustainable futures, and it feels good to see a serious, semi-goofy movie that is plugged into so much contemporary dive bar conversation and dinner party banter. And if the takeaway from this movie is that nothing matters, that might be a good thing. Because if nothing matters, you can make anything matter.

If you or someone you know is having thoughts of suicide, please call the National Suicide Prevention Lifeline at 800-273-TALK (8255) or use the Crisis Text Line by texting Home to 741741. More resources are available at SpeakingOfSuicide.com/resources.

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Why 'Everything Everywhere All at Once' is already the movie of the decade - GBH News

Pick of the weekAmerican MadeTom Cruise and Sarah Wright in American Made. Photograph: Imagine Entertainment/Allstar

With Top Gun: Maverick blasting into cinemas soon, this is the perfect opportunity to revisit Tom Cruises practice run. Doug Limans 2017 action comedy is by Cruise standards, at least relatively low stakes. Cruise plays Barry Seal, a pilot who in real life became a drug runner for the Medelln Cartel. As refreshing as it is to see Cruise indulge in proper character work (rather than simply playing another heroic cypher) and as zippy as the script is, the big appeal of American Made is the aerial photography. Were it not deliberately overshadowed by the Top Gun series, this would rightly be remembered as one of the all-time-great plane films. Thursday 19 May, 9pm, Film4

Smartly scheduled to cheer up anyone who was disappointed by his Doctor Strange movie, this horror represents Sam Raimi firing on all his silliest impulses. The story, not that there is much of one, follows a young woman fending off a curse that threatens to torture her for three days before thats right dragging her to hell. But you dont watch a Raimi horror for plot. You watch it for all the gleeful, whiplash-inducing momentum and laugh-out-loud inventiveness. This movie is a rollercoaster ride. Outside the Evil Dead movies, Raimi has never been better. Saturday 14 May, 10pm, BBC Three

Lisa Barros DSa and Glenn Leyburns devastating drama is a masterpiece of observation. Lesley Manville and Liam Neeson play a couple who find themselves tested when she is diagnosed with breast cancer. While cancer films can err on the melodramatic or worse, the schematic, using the illness as shorthand for character motivation Ordinary Love never once takes its eye off the ball. If youve never been through anything like this, youll empathise. But if you have, you will recognise yourself, and thats the best possible compliment to give. Sunday 15 May, 10pm, BBC Two

Now that hes a newly minted TikTok rapper, it might be the right time to look back at one of Therouxs most ambitious endeavours. After decades on TV, his first theatrically-released documentary was designed to pitch him straight into the dark heart of an infamous religion. If the goal was for Theroux to disassemble Scientology from the inside, it isnt a spoiler to say that the film was a failure. But as a look at one man struggling to land a punch on an intangibly sinister organisation, it ranks among Therouxs best. Sunday 15 May, 11:25pm, BBC Two

With Spider-Man: No Way Home becoming such a sensation this year, its still faintly miraculous to remember that, pre-Spidey, the only film Jon Watts ever directed was Cop Car. Its as small and spare a film as you could imagine two bored kids steal a police car abandoned by a corrupt sheriff, and are forced to outwit his attempts at vengeance but the attention to detail is second to none. Even better, as the evil officer, it features one of Kevin Bacons all-time-greatest performances. Sunday 15 May, 2:15am, Horror Channel

After its instantly iconic first entry, the Predator series has been an exercise in diminishing returns. Predator 2 replaced tension with silliness, and youd be forgiven for forgetting that 2010s dismal Predators was ever made. With 2018s The Predator, though, the balance began to reset. Co-written and directed by Shane Black (who had a small part in the first movie), this is the goriest and funniest of the sequels, which (almost) remembers that the key to a good Predator movie involves simply reacting to the mayhem caused by a merciless alien killer. Not perfect, but a step in the right direction. Friday 20 May, 9pm, Film4

The Jackass movies are produced in a manner that always creates a glut of unseen stunts, so a Jackass 4.5 recut and filled with snippets previously left on the floor was always inevitable. But this doesnt necessarily mean it will be all scraps and offcuts. After all, Jackass 4 was by far the most enjoyable film of the series. With the cast now in middle age, their absurd nihilism came tinged with autumnal melancholy, as if they were finally accepting mortality. If the new clips are as weirdly touching as those in its parent film, this will be terrific. Jackass forever! From Friday 20 May, Netflix

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American Made to Jackass 4.5: the seven best films to watch on TV this week - The Guardian

One in fourAmerican adults(26 percent) live with some form of disability, according to the Centers for Disease Control and Prevention (CDC). Yet, when these individuals suffer a stroke, the fifth leading cause of death in the country, per the American Heart Association (AHA), they often experience delays in treatment or no treatment at all.

Historically, adults with disabilities have been excluded from clinical trials, which explains why there isnt enough data to show how they would respond to stroke treatment. Doctors also tend to determine that a stroke is more severe in these individuals and deem them beyond hope of treatment.

Recognizing this, and the need to improve care and stroke outcomes for this underserved population, the AHA and the American Stroke Association (ASA) issued a statementon March 28 regarding people with existing disabilities or dementia who receive treatment forischemic stroke.

People with dementia or existing disabilities who receive well-timed stroke treatment, such as clot removal therapy, may avoid additional disability and higher costs of care, said the organizations their statement, published in the journalStroke.

The long-term consequences and costs of additional disabilities due to untreated stroke in people with preexisting neurological deficits are staggering, saidMayank Goyal, MD, PhD, the chair of the scientific statement writing committee and a clinical professor in the department of radiology and clinical neurosciences at the University of Calgary in Alberta, in the statement.

Based on an expert analysis of current research, the joint statement suggests that in cases of the most common form of stroke, ischemic stroke, treatments for clot removal were just as safe in adults with these preexisting conditions as in adults without them. The review recognized some evidence suggesting people with prestroke dementia are more likely to die, but found these findings were inconsistent. The statement also notes that treatment risk is different in each patient and risk may increase in patients with a preexisting disability.

Researchers found that certain biases, such as ableism (discrimination against disabled people), ageism, and therapeutic nihilism (believing theres no hope for effective treatment), could influence healthcare decision-making when considering treatment for people with a disability or dementia.

Asystematic study of 42 peer-reviewed articles published between March 2003 and March 2016 found many instances of implicit bias. Implicit bias is a term for attitudes and stereotypes we unconsciously develop toward people based on their gender, age, race, or other factors. These findings show an alarming truth: that healthcare workers are just as susceptible to implicit bias as the general population.

One reason people with disabilities have been largely excluded from stroke data is that the aim of randomized trials is to clearly track the benefit of new treatments, and this can be difficult to assess in disabled patients, explains Dr. Goyal. So, in the past we used patients who were in a reasonably good premorbid status before the stroke. Were [now] finding that many of these [disabled] patients do benefit from treatment. Treatment teams should not have an inherent bias just because [disabled] patients were not included in large randomized trials. That is not a reason to deny treatment, he says.

Bonnielin Swenor, PhD, MPH, the founder and director of the Johns Hopkins Disability Health Research Center and an associate professor at the Johns Hopkins School of Nursing, says the AHA statement is a big first step. Theres such a lack of awareness about the bias in healthcare toward people with disabilities these are issues that have been under the radar for far too long.

She hopes this new awareness will challenge stereotypical views of disability and shed light on how disability is perceived in healthcare spaces. Theres still discourse and pushback against how people with disabilities view themselves, she explains. This is a group that faces inequities, and they need to be recognized, not just as a medical conceptualization, but as a community of people.

The writing group responsible for the joint AHA-ASA statement suggests an increased awareness of these biases by practitioners, which may inform future clinical practice guidelines for stroke treatment for people living with disability or dementia.

What this means for people with disabilities and their families is that the tide is turning. As researchers begin to recognize their own implicit bias, they must adjust their clinical practice to better accommodate a diverse sample of patients. Although there is limited data available on people with disabilities who have suffered from ischemic strokes (including a 2013 clinical trial conducted by Health Economics Research Centre at the University of Oxford), the reality is that more research is needed to better serve a population that is expected to grow in the coming years. According to the Department of Economic and Social Affairs for the United Nations, its estimated that 15 percent of the population worldwide currently live with at least one disability. As the global population ages, the number of people with disabilities will grow. Therefore, the United Nations states that there is a clear need "for countries to take a longer-term approach to investment in the planning, design and construction of their community to ensure environmental inclusiveness and accessibility in moving towards the goal of creating a society which meets the needs and capacities of all users."

The joint AHA-ASA statement cites previous research that indicates that 79 percent of people with prestroke disability lived an average of 16 months after a stroke, with one-third requiring a move to an assisted living facility. In addition, the review reports that these individuals may experience additional disabilities such as decreased mobility, impaired speech, weakness or paralysis in the limbs, or they may not recover to their prestroke strength and mobility. Providing stroke treatment to these patients quickly (or even at all) may improve their quality of life.

For doctors, the proposed protocol for caring for people with disability or dementia includes discussions on all possible treatment options. Doctors should discuss quality of life and medical wishes for future care with patients and their families before the stroke. We need to acknowledge the fact that in this emergency setting [doctors] may not have the best possible information, says Goyal. Until an effective protocol to reduce inherent bias is adopted, disabled people should self-advocate for their care whenever possible. Goyal advises patients to create a living will and have an honest discussion with family about their expectations for care should they become impaired or unable to communicate. Since effective stroke treatment is often a race against time, planning ahead for a potential medical emergency is paramount.

While the statement recommends best practices for doctors, its equally important that patients and their families stay informed about their options for stroke treatment, because doctors are not infallible. In addition, Goyal recommends that healthcare providers adopt a patient-centered point of view by recognizing that individual values and beliefs about stroke aftercare will vary depending on race, ethnicity, religious beliefs, and socioeconomic status.

The people carrying the greatest burden of illness have been traditionally excluded from research, says Goyal. Thats why patients and their families should consider participating in surveys or research studies to accelerate advancements.

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Scientists Say Stroke Treatment and Research Should Include People With Disabilities and Dementia - Everyday Health

TEHRAN Jihad and Death: The Global Appeal of Islamic State by French sociologist Olivier Roy, the author of several highly acclaimed books on religion and politics, has been published in Persian.

Bezangah is the publisher of the Persian edition rendered by Saman Ebrahimzadeh.How has ISIS been able to muster support far beyond its initial constituency in the Arab world and attract tens of thousands of foreign volunteers, including converts to Islam, and seemingly countless supporters online? In this compelling intervention into the debate about ISIS origins and future prospects, the renowned French sociologist, Olivier Roy, argues that while terrorism and Jihadism are familiar phenomena, the deliberate pursuit of death has produced a new kind of radical violence. In other words, were facing not a radicalization of Islam, but the Islamization of radicalism.

Jihad and Death is a concise dissection of the highly sophisticated narrative mobilized by ISIS: the myth of the Caliphate recast into a modern story of heroism and nihilism.

According to Roy, this very contemporary aesthetic of violence is less rooted in the history of Islamic thought than it is entrenched in a youth culture that has turned global and violent.

Roy is a professor at the European University Institute in Florence. Jihad and Death and five of his other books on religion and politics have been published by Hurst in London.

In 2017, when Jihad and Death was published, Roy's assertion that jihadi terrorism is only loosely connected to Islamic fundamentalism was criticized by French scholar Gilles Kepel, who said that Roy neither speaks Arabic nor has looked into the Salafi doctrine behind the Jihadism.

Roy has said, I have been accused of disregarding the link between terrorist violence and the religious radicalization of Islam through Salafism, the ultra-conservative interpretation of the faith. I am fully aware of all of these dimensions; I am simply saying that they are inadequate to account for the phenomena we study, because no causal link can be found on the basis of the empirical data we have available.

Photo: Front cover of the Persian edition of Olivier Roys book Jihad and Death.

MMS/YAW

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Olivier Roy's book on global appeal of ISIS published in Persian - Tehran Times