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The Week in Movie News: Here's What You Need to Know

Need a quick recap on the past week in movie news? Here are the highlights:

BIG NEWS

Wonder Woman rumored for Flashpoint: With Wonder Woman now the biggest DC Extended Universe movie at home, there’s no suprise the title superhero will be appearing in many more of the franchise’s installments. Apparently she’ll appear alongside The Flash and Cyborg in the recently announced Flashpoint, too. Read more here.

MUST-WATCH TRAILERS

Mother! teases just enough: Jennifer Lawrence brings her incredible acting chops to a psychological thriller in the trailer for Darren Aronofsky’s latest, which also stars Javier Bardem, Michelle Pfeiffer and Ed Harris. Watch it here:

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Trophy teases a winner: One of the best documentaries of the year, Trophy, finally got a trailer ahead of its release next month. This one will really make you think. Check it out here:

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Wonder looks full of heart: Little Jacob Tremblay stars opposite Julia Roberts and Owen Wilson in Wonder, a movie about a boy with facial differences starting in his first mainstream school. Watch the latest trailer below.

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North Korea Has Markets Nervous But Not Panicked

Traders and financial professionals work the floor of the New York Stock Exchange ahead of the opening bell on Friday.

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Drew Angerer/Getty Images

Global stock markets ended their worst week in months amid rising tensions between the U.S. and North Korea, though U.S. stock indexes steadied on Friday to close up slightly.

Nervous investors drove shares lower earlier in the week, after President Trump declared Tuesday that the U.S. would react with “fire and fury” to further nuclear provocations from North Korea. North Korea responded with threats to launch missiles into the Pacific Ocean near Guam, a U.S. territory.

Amid the hot rhetoric, U.S. stocks sold off sharply on Thursday, with the S&P 500 falling more than 1 percent. By the end of the day nearly $1 trillion in equity had been lost globally. Asian and European stocks continued the sharp decline Friday.

But U.S. stocks regained some lost ground, despite Trump’s comments Friday that U.S. weapons are “locked and loaded,” ready to respond if North Korea acts “unwisely.”

The Dow Jones industrial average closed up 14 points, a gain of 0.07 percent, the Nasdaq composite rose nearly 40 points or 0.64 percent and the S&P 500 gained 3 points or 0.13 percent. But for the week the S&P 500 lost 1.3 percent, its worst weekly showing since March.

The North Korea situation isn’t the only thing weighing on stocks. Major U.S. indices had posted record highs in recent weeks. Those highs were supported by strong corporate earnings, but lofty market valuations and a prolonged period without a significant market pullback had some analysts predicting a sell-off.

While stocks have declined this week, the sell-off has not been dramatic. BNY Mellon FX strategist Neil Mellor told Reuters that in recent years, “the market hasn’t really reacted to things on the Korean Peninsula” because in the past “it [has been] largely North Korean sabre-rattling.” But Mellor notes the rhetoric has reached a “different level.”

The Wells Fargo Investment Institute describes the market response, so far, as “tepid.” In a note to investors, Paul Christopher, head global market strategist, and Tracie McMillion, head of global asset allocation, suggest, “the threat of a nuclear weapon is certainly more serious than previous threats, but that threat also may increase the probability of a diplomatic solution.” They suggest the U.S. and China, a North Korean ally, could work together to de-escalate the situation.

So far the measured decline in global stocks suggests investors buy that scenario.

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From Alaska To Florida, States Respond To Opioid Crisis With Emergency Declarations

Overdoses from heroin and other opioids have led six states to declare public health emergencies.

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Marianne Williams/Getty Images

Public health officials and others concerned about the nation’s opioid crisis are hailing President Trump’s decision to declare it a national emergency. A Presidential commission on opioids said in its interim report that an emergency declaration would allow the administration to take immediate action and send a message to Congress that more funding is needed.

But while the Trump administration prepares the presidential order, governors in six states have already declared emergencies to deal with opioids. They range from Alaska and Arizona in the West to Florida, Virginia, Maryland and Massachusetts in the East.

In Maryland, where 550 overdose deaths were reported in just the first three months of this year, Gov. Larry Hogan declared opioids a public health emergency in March.

“It’s a call to order and a call to action,” says Clay Stamp, head of Maryland’s Opioid Operational Command Center. Stamp comes to the job with a background as an emergency manager and compares this effort to the state’s response to a hurricane.

“We need all the right people in the room to make sure we can make a decision in time to move people out of harm’s way, shelter them and everything else,” he says. “This is no different.”

Since declaring an emergency, Maryland has tightened practices for those prescribing opioids and received a waiver to allow Medicaid to pay for residential drug treatment.

Massachusetts was the first state to declare opioids a public health emergency in 2014. Then-Gov. Deval Patrick acted on the recommendations of a special task force, says Michael Barnett, an assistant professor of health policy and management at the Harvard T.H. Chan School of Public Health.

The recommendations were “to open up funding for the Department of Public Health — for instance, to open up more treatment beds, to create funding and make it easier for … first responders to use naloxone, which reverses opioid overdoses in the field,” he says.

Making naloxone freely available and putting it in the hands of more people has helped save lives. That has been one of the most immediate impacts of emergency declarations in states that have issued them.

Arizona Gov. Doug Ducey declared a public health emergency in June. Will Humble, executive director for the Arizona Public Health Association says with that declaration, the state began gathering badly needed data on the crisis.

“Who it’s hitting, where it’s hitting, who is doing the prescribing, what portion of it are fentanyl and heroin and what portion are prescribed pills,” he says. “And, as you get that more complete information, it allows you to craft better public policy.”

In Florida, the emergency declaration issued in May enabled Gov. Rick Scott to quickly allocate some $27 million in federal funds for drug treatment and prevention.

Palm Beach County, Fla., saw nearly 600 fatal overdoses last year, mostly related to opioids. Alton Taylor, executive director of the county’s Drug Abuse Foundation says although the emergency declaration was welcome, Palm Beach County and the rest of the state still don’t have enough publicly-funded beds available to treat people with opioid addictions.

“Today as I’m talking to you, we have over 200 people on a waiting list,” he says. “These are people where we’ve done a clinical assessment of them and determined them to be in need of that service.”

Despite the emergency declaration, Florida, unlike some other states, hasn’t tapped Medicaid to help pay for drug treatment. Taylor says he’s hopeful President Trump’s emergency declaration, when finalized, will free up more money to treat people in recovery from opioid addictions.

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Angelique Kidjo Has Been Waiting A Long Time To Sing This Song

Angelique Kidjo lends her Grammy-winning voice to a new song that protests child marriage.

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When three-time Grammy-winning singer Angelique Kidjo was a 12-year-old schoolgirl in her native Benin, her best friend suddenly disappeared from school. Kidjo went to her friend’s house and asked her father what had happened. The reason shocked Kidjo: Her friend Awaawou had become a child bride, and that meant that her friend’s education — and her girlhood — were at an end.

That was about 35 years ago. But according to UNICEF, one in 10 girls in Benin still marries before the age of 15, and in Central and Western Africa, 41 percent of all girls marry before they turn 18. Marrying — and having children — at a young age leads to increased risks of domestic abuse and of dying due to childbirth complications. Since child brides often cease their education, they also lack the skills to earn a living later on.

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Now Kidjo, who is a UNICEF goodwill ambassador, has collaborated with eight musical colleagues and UNICEF to sing out against child marriage, with a refrain that goes “A little girl is still a child. She cannot be a mother or a bride. Let her grow up to live a fulfilling life. Say NO to child marriage!” The message is serious but the music has a get-up-and-dance vibe.

In addition to being on YouTube and social media, the song is being broadcast several times a day on Beninese TV and more than 40 local radio stations reaching into remote areas.

We spoke to Kidjo about the song and her advocacy for girls and women. The interview has been edited for length and clarity.


Interview Highlights

What happened to your friend?

She lived across the street from my house. We played together, we laughed together and then one day I waited for her to walk to school together, but she didn’t come. Then when I went to school, she wasn’t there, either. I went to her family to ask. They told me she was married! I was so angry!

Five years later I saw her, but when I tried to talk to her, she said she could not talk to me. She was so ashamed of not finishing school. She wasn’t the happy person I remembered. She was no longer cracking jokes; it was as if the light in her was shattered. She had two children, and she looked like she was 40. I went home and I cried.

What did this experience teach you about child marriage?

This said to me this is not a good tradition. How can you think that marrying your child at 12 can be good for her? When you finish elementary school and you start going to junior high, you’re no longer a child, but you are also not yet an adult. Women staying in school is crucial for their future, so stopping child marriage is crucial. And I was very vocal about it from the age of 12.

And now you’re vocal about it with a song. How did it come about?

I have been waiting for so long to do this. I started seeing the weakness in having a program [against child marriage] in just English or French because the [people] in the villages may not speak English or French. So the announcements and marketing have to be done in the local languages. That is why we decided we were going to use the main languages of the different parts of the countries [Benin, Burkina-Faso, Ghana, Nigeria and Togo].

You and your colleagues sing in seven local African languages, including Fon, Goun, Bariba, Yoruba, Mahi, Sahoue and Mina — with a refrain in French. How did that collaboration work?

I wrote my part [in Fon, the national language spoken in Benin and also in Togo and Nigeria, as well as the refrain in French] then sent it to Zeynab Abib [a popular singer in Benin with whom Kidjo co-wrote the song], and we went back and forth with each other and with the other performers, who were coming from different regions [where the different languages are spoken].

The group of nine singers is a mix of women and men.

We have to solve the problem without a gender agenda — women and men need to hear this message.

Can one song make a difference?

Silence is what has allowed child marriage to continue. I think the first impact of this song is that the silence has been broken on the subject. So from the north to the south to the west and to the east — the song is going to the villages and saying this tradition is not right. It is communicating that to men and women, boys and girls. And when someone asks questions in school about what happened to a girl who is no longer coming to class, they can get answers and they can become agents of change.

What has been the response so far to the song?

We already have a million people in Africa who have commented on or “liked” the song on my Facebook page. And we are all of us planning on performing the song live in a concert in Benin.

Diane Cole writes for many publications, including The Wall Street Journal and The Jewish Week, and is book columnist for The Psychotherapy Networker. She is the author of the memoir After Great Pain: A New Life Emerges. Her website is dianejcole.com.

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Today in Movie Culture: Wonder Woman vs. Thor, Alternate 'Guardians of the Galaxy Vol. 2' Endings and More

Here are a bunch of little bites to satisfy your hunger for movie culture:

Superhero Crossover of the Day:

Thor and Wonder Woman are such similar movies that it makes sense for their heroes to battle. Alex Luthor imagines the crossover in this fan-made trailer:

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Alternate Endings of the Day:

Guardians of the Galaxy Vol. 2 could have ended in a variety of other ways. Here are a handful of alternatives in funny cartoon fashion:

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Custom Build of the Day:

Fans of Looney Tunes cartoons would probably love for this fan-made Wile E. Coyote and Roadrunner Lego set to be real:

#RoadRunner vs Wile E. Coyote #LEGO Build: Beep Beep Zip Bang!: Road Runner… The coyote’s after you… Road Runner,… https://t.co/xtIGqrEkw4pic.twitter.com/LELgf5BT0j

— Technabob (@technabob) August 6, 2017

Filmmaking Lesson of the Day:

In this video essay, Patrick Willems uses Brick, Die Hard and other movies to show how to execute a great, original punch in a movie (via Geek Tyrant):

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Vintage Image of the Day:

Today is the 85th anniversary of the premiere of the Marx Brothers comedy Horse Feathers, so here’s a photo of Harpo and some friend during its production:

Actor in the Spotlight:

Learn all about Channing Tatum, star of the new series Comrade Detective and the new movie Logan Lucky with ScreenCrush’s latest trivia video:

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Filmmaker in Focus:

Speaking of Logan Lucky, Fandor presents a video on Steven Soderbergh’s use of color in his movies:

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Cosplay of the Day:

We may never get that sequel to Leon (aka The Professional), but at least we’ll always have great Mathilda cosplayers:

Mathilda cosplay ?? ig: kieraplease pic.twitter.com/3HgzXMSDoc

— Kiera Please (@Kieraplease) August 10, 2017

Movie Food of the Day:

Learn how to make the puerco pibil from Once Upon a Time in Mexico in the latest edition of Binging with Babish:

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Classic Trailer of the Day:

This weekend marks the 50th anniversary of the release of Bonnie and Clyde. Watch the original trailer for the classic crime film below.

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and

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Baseball Hopes Players Weekend Will Bring New Spark To The Traditional Game

Uniforms of the New York Yankees will be among those getting a personality infusion during Major League Baseball’s Players Weekend later this month.

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Ron Schwane/AP

Bryce Harper is getting his wish.

At least for one weekend this month.

In March 2016, Harper, the Washington Nationals’ superstar outfielder, said in an ESPN interview that baseball is “tired.”

“It’s a tired sport, because you can’t express yourself,” the then-23-year-old said.

This week, Major League Baseball and the players union jointly announced a new event called Players Weekend. It’ll take place Aug. 25–27, and it will, according to a statement, give major leaguers a chance to “let their personalities and passions shine.”

Flair, personality and merchandise

One can only imagine the visual feast as a traditionally conservative sport busts loose — players will get the chance to wear “uniquely colored and designed spikes, batting gloves, wristbands, compression sleeves, catcher’s masks, and bats.”

There will be nontraditional uniforms, including buttonless pullovers rather than buttoned jerseys — in other words, Little League style. And the players have the opportunity to put their nicknames on the backs of those jerseys. Imagine the jolt when you train your binoculars on home plate and see “Herrm the Worm” up to bat. Or “Nightmare,” “The Doof” or “Dat Dude.”

“It adds flair, it adds personality and I assure you, it’ll sell merchandise,” says sports marketing expert Marc Ganis.

Indeed, jersey-maker Majestic Athletic and baseball cap designer New Era are mentioned in the first few paragraphs of the joint MLB/MLBPA statement on Players Weekend. Jerseys are expected go for around $200 each.

But Ganis, president of Sportscorp Ltd., says there’s more involved than just a cash grab.

“It was brought up because players genuinely wanted to show individuality,” he says.

Baseball officials agree. Players have been aware of how in other sports, particularly the NBA, athletes’ shoes have a big impact on fans and help create a connection. Baseball players have been itching to express themselves in a similar fashion because of the sport’s strict uniform regulations. Players and owners talked about it during last year’s contract talks, and the plans for Players Weekend started coming together a few months ago.

What about the Yankees?

The New York Yankees will make the biggest departure by sporting all this gear. The Yanks are a tradition-bound franchise — the only major league team that never has had names on the backs of uniforms, let alone nicknames.

And Tyler Norton loves the change.

“Baseball is a game; it should be fun,” says Norton, a 25-year-old editor for the Yankees-themed website pinstripealley.com. “Having this showcase for players is a good way to promote that. And maybe the Yankees can take a look and say, ‘Yeah, y’know what? This is a little bit of fun. We can approach this in a different way.’ “

Norton, who roots for and writes about the Yankees from his home in Albany, N.Y., hopes Players Weekend shows the Yanks it’s time to revisit some of their stricter traditions for hair length and facial hair.

“I think there are opportunities the Yankees could take and run with,” Norton says. “They could’ve gotten on board with marketing opportunities, sort of like what the [New York] Mets are doing with Noah Syndergaard [whose nickname is “Thor”] and the wigs going around [the Mets’ home stadium] Citi Field.”

Rest assured, though, there are many Bronx Bomber fans who are saying, “Pump the brakes.”

Manhattan resident June Murakami is a lifelong Yankees fan. She organizes get-togethers for fellow fans around the city. She says when the news hit this week about jerseys and nicknames, Facebook was “blowing up.”

“Some saying, ‘Oh come on, lighten up’; some saying, ‘It’s breaking tradition’ and that George Steinbrenner [the former Yankees owner who instituted team grooming rules in the 1970s] is spinning in his grave.”

Murakami falls more on the side of keeping things the same.

“It’s breaking that long-standing tradition we have,” she says. “I’m very old-fashioned in those things. I like the tradition to go on. I don’t want them doing it once a year. If this really is a one-time-only thing and doesn’t become a habit, who cares? I mean, let them have fun.”

Reaching for a young generation

Beyond a rainbow of color and individuality, baseball of course hopes Players Weekend is a bridge to a younger audience. The game has been losing that demographic in a sped-up world.

“Baseball’s pace is the single biggest reason why youth turns off baseball,” says marketing expert Ganis. “It is so slow, when everything else is picking up pace. When kids are multitasking with multiple screens in front of them at any given time, and baseball is still played at a pace that a snail would be proud of.”

Ganis says Players Weekend is a small step forward.

“There’ll be some impact,” he says, adding that “some of the nicknames will be unexpected. There’ll be some social media interaction on that and mainstream interaction on that. More merchandise sold so there’ll be people wearing ‘All Rise’ [a nickname for budding Yankees star Aaron Judge] on the back of a Yankee T-shirt that looks very different than their existing uniform. And all other teams as well.”

This won’t move the needle much, says Ganis. Speeding up the game will. Baseball is fully aware of that and taking steps.

But until that happens, baseball will rely on events like Players Weekend to try to bring in new fans. According to one baseball official, many of the players are putting a lot of meaning into the upcoming, colorful weekend.

As a way to connect. As a way to express themselves and show that baseball isn’t such a tired sport after all.

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Seltzer's Popularity Bubbles Up In The U.S.

One particular brand of seltzer is having a moment among millennials: LaCroix.


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Iam Nicole/Flickr/Creative Commons

We may be in the middle of a seltzer bubble.

Americans are drinking nearly 170 million gallons of the fizzy stuff each year, and sales have gone up 42 percent over the past five years with no signs of slowing down. There’s even a restaurant in Boston offering a $40 flight of limited-edition seltzers.

“We’re now at a point in American history where seltzer is more popular than it’s ever been,” Barry Joseph, author of Seltzertopia, tells All Things Considered. He says today’s obsession with seltzer has its roots in 1971, when Perrier launched in the U.S.

“A new drink comes over from Europe in 1971 called Perrier, and suddenly people aren’t only interested in flat water anymore,” Joseph says. “Now, they like maybe a mineral water. They like the idea of sparkling water, and people rediscover this thing we’ve had around for a while: seltzer.”

Joseph says today people are turning to seltzer as a healthier option than soda. One brand in particular is having a moment among millennials: LaCroix.

Rapper Big Dipper’s YouTube hit “LaCroix Boi” is an ode to the sensual possibilities of seltzer.

It’s somewhat mysterious how a brand that was cool with Midwestern soccer dads in the 1980s has caught on with today’s 20-somethings. But it’s not just LaCroix that is gaining new popularity.

Seltzer brand Polar has carved out a space in a crowded fizzy water market with seasonal, limited-run flavors.

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Rapper Big Dipper’s YouTube hit, “LaCroix Boi,” is an ode to the sensual possibilities of seltzer.

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Hard seltzer has also recently taken off, with popular brands White Claw and Truly. Sweet Cheeks, a barbecue joint in Boston, offers a $40 seltzer flight. Diners get four cans of Polar with four nips of vodka.

Owner Tiffani Faison points out that $10 vodka sodas aren’t rare in the city. And she says it’s supposed to be fun. The flight comes as a kit packed in ice that includes four cups with crazy straws.

“I mean, the whole thing is ridiculous,” Faison says.

The seltzer flavors are pretty silly, too, with names like Dragon Whispers, Mermaid Songs, Yeti Mischief and Unicorn Kisses.

And if you’re wondering what Yeti Mischief could possibly taste like, Faison says it’s like lemon-lime with a handful of Skittles thrown in.

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Democrats Fear Medicare-For-All Plan Could Sharpen Party Divisions

Sen. Bernie Sanders is promoting a Medicare-for-all health care plan, and some Democrats are worried it could sharpen divisions in the party.

AUDIE CORNISH, HOST:

When Congress returns to Washington next month, Vermont Senator Bernie Sanders will introduce a bill creating a single-payer government-run health care system. He calls it Medicare for All. More and more progressive voters want the Democratic Party to fully embrace the idea. As NPR’s Scott Detrow reports, party leaders are wary of doing that.

SCOTT DETROW, BYLINE: Bernie Sanders has been ready to introduce his single-payer bill all year. He’s just been waiting for Republicans to finish their effort to repeal and replace the Affordable Care Act, which means Sanders has been waiting for a while.

BERNIE SANDERS: Look, I have no illusions that under a Republican Senate and a very right-wing Republican House and an extremely right-wing president of the United States that suddenly we’re going to see a Medicare-for-all, single-payer passed. You’re not going to see it. That’s obvious.

DETROW: The point of the bill, Sanders says, is to force a conversation.

SANDERS: Excuse me, why is the United States the only major country on earth not to guarantee health care to all people? Why are we spending far, far more per capita on health care than any other nation? Why do we pay the highest prices in the world for prescription drugs?

DETROW: The bill will likely force a conversation within the Democratic Party, too, a party Sanders now acts as a leader of despite not being a member. Polls do show more and more voters like the idea of government-run health care. But top Democrats are keeping it at arm’s length. DNC Chairman Tom Perez typically pivots to this broader answer when he’s asked whether he would push for single payer.

(SOUNDBITE OF ARCHIVED RECORDING)

TOM PEREZ: We believe that health care is a right for all and not a privilege for a few. And right now in Washington, D.C., in the political climate in which we live, preserving the Affordable Care Act is a major victory.

DETROW: House Minority Leader Nancy Pelosi is more direct.

(SOUNDBITE OF ARCHIVED RECORDING)

NANCY PELOSI: The comfort level with a broader base of the American people is not there yet. Doesn’t mean it couldn’t be. States are a good place to start.

DETROW: The resistance is tactical, not ideological. It took decades to pass something like Obamacare. And the fear is that despite what polls might suggest, something as aggressive as single-payer just isn’t politically feasible right now. In fact, the congressional leaders you hear talking about single-payer are often Republicans, not Democrats. House Speaker Paul Ryan and other Republicans regularly float it as a worst-case Democratic alternative.

(SOUNDBITE OF ARCHIVED RECORDING)

PAUL RYAN: Ultimately, it’s very clear that they’re more interested in a single-payer system, which means government-run health care. Government-run health care is not in our nation’s interest.

DETROW: Senate Republicans even forced a vote on a single-payer option on the Senate floor last month, hoping to get Democrats on record supporting the idea. Most Democratic senators voted present. No one voted yes. Still, more than half of the House Democrats sponsored a separate single-payer bill this year. A longtime aide to Bernie Sanders, Jeff Weaver, argues the broad public opposition to the Republican Obamacare repeal should spur Democrats to become more aggressive on health care.

JEFF WEAVER: This is a very powerful issue in that people are prepared to be mobilized in support of their health care.

DETROW: Like Sanders admits, this bill isn’t going anywhere anytime soon. The whole thing is more about political framing, getting Democrats to the point where this would be a top priority whenever the day comes where the party is back in power. Scott Detrow, NPR News.

(SOUNDBITE OF HENRI-PIERRE NOEL’S “AZAKA”)

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Today in Movie Culture: 'Guardians of the Galaxy Vol. 2' Goes Retro, 'Annabelle' vs. 'Child's Play' and More

Here are a bunch of little bites to satisfy your hunger for movie culture:

Mashup of the Day:

Josh Brolin plays Cable in Deadpool 2 and Thanos in Avengers: Infinity War, so BossLogic shows us what he looks like as both characters at once:

Titan from the future 😀 @VancityReynolds#Deadpool2pic.twitter.com/WipLopBwWE

— BossLogic (@Bosslogic) August 7, 2017

Music Video of the Day:

Speaking of Thanos, here’s a music video for David Hasselhoff’s song from Guardians of the Galaxy Vol. 2, which features most of the cast:

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Retro Trailer of the Day:

Speaking of Guardians of the Galaxy Vol. 2 and retro visuals, here’s an ad imagining a VHS release for the Marvel sequel:

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Fake Trailer of the Day:

Speaking of Chris Pratt movies, if Jurassic World hadn’t made a bazillion dollars, maybe its sequel would look as cheap as this fan-made trailer promises:

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Movie Takedown of the Day:

Alien: Covenant hits home video this month, so Honest Trailers goes full chestburster on its plot:

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Vintage Image of the Day:

Melanie Griffith, who turns 60 today, visits with her mother, Tippi Hedren, and Paul Newman on the set of The Drowning Pool in 1974:

Actor in the Spotlight:

With a new Robert Pattinson movie out this week, Fandor highlights his career post-Twilight:

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Movie Comparison of the Day:

With Annabelle: Creation out this weekend, Couch Tomato shows 24 reasons the first Annabelle is the same movie as Child’s Play:

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Movie Trivia of the Day:

Speaking of the Conjuring franchise, here’s a bunch of trivia about the original movie, care of ScreenCrush:

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Classic Trailer of the Day:

This week is the 75th anniversary of the premiere of Disney’s Bambi. Watch the original trailer for the classic animated feature below.

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and

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47 Hospitals Slashed Their Use Of Two Key Heart Drugs After Huge Price Hikes

Valeant Pharmaceuticals, based in Bridgewater Township, N.J., bought two specialty heart drugs used in emergency treatment from Marathon Pharmaceuticals in 2015, and then dramatically increased each drug’s price.

Ron Antonelli/Bloomberg via Getty Images

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Ron Antonelli/Bloomberg via Getty Images

Even before media reports and a congressional hearing vilified Valeant Pharmaceuticals International for raising prices on a pair of lifesaving heart drugs, Dr. Umesh Khot knew something was very wrong.

Khot is a cardiologist at the Cleveland Clinic, which prides itself on its outstanding heart care. The health system’s internal monitoring system had alerted doctors about the skyrocketing cost of the drugs, nitroprusside and isoproterenol. But these two older drugs, frequently used in emergency and intensive care situations, have no direct alternatives.

“If we are having concerns, what is happening nationally?” Khot wondered.

As it turned out, a lot was happening.

Following major price increases, use of the two cardiac medicines has dramatically decreased at 47 hospitals, according to a research letter Khot and two others published Wednesday in the New England Journal of Medicine.

The number of patients in these hospitals getting nitroprusside, which is given intravenously when a patient’s blood pressure is dangerously high, decreased 53 percent from 2012 to 2015, the researchers found. At the same time, the drug’s price per 50 milligrams jumped more than 30-fold — from $27.46 in 2012 to $880.88 in 2015.

The use of isoproterenol, key to monitoring and treating heart-rhythm problems during surgery, decreased 35 percent as the price per milligram rose from $26.20 to $1,790.11.

The two drugs, which are off patent, have long been go-to medicines for doctors.

“This isn’t like a cholesterol medicine; these are really, very specialized drugs,” says Khot, who is lead author on the peer-reviewed research letter. When patients get the drugs, he says, “they are either sick beyond sick in intensive care or they’re under anesthesia [during] a procedure.”

Valeant bought the drugs in early 2015 from Marathon Pharmaceuticals.Last year, Valeant announced a rebate program to lower the price hospitals paid for the drugs.

And Valeant’s Lainie Keller, a vice president of communications, says the company is committed to limiting price increases.

“The current management team is committed to ensuring that past decisions with respect to product pricing are not repeated,” Keller says.

Pharmacist Erin Fox, the director of drug information at University of Utah Health Care, said the findings by Khot and his colleagues reveal “exactly what a lot of pharmacists have been talking about. When prices are unsustainable, you have to stop using the drug whenever you can. You just can’t afford it.”

Fox says her Utah health system has removed isoproterenol from its bright-red crash carts, which are stocked for emergencies like heart attacks. But Nitroprusside is more difficult to replace.

“If you need it, you need it,” Fox says. “That’s exactly why the usage has not gone down to zero, even with the huge price increases.”

Cleveland Clinic leaders spent months investigating each drug’s use and potential alternatives, Khot says.

“We’re not going to ration or restrict this drug in any way that would negatively impact these patients,” Khot says, adding that he hopes to do more research on how the decreased use of both drugs has affected patients.

Dr. Richard Fogel is a cardiologist and electrophysiologist at St. Vincent, an Indiana hospital that’s part of Ascension, a large nonprofit chain with facilities in 22 states and the District of Columbia. He told a Senate committee last year that the cost of the two drugs alone drove a nearly $12 million increase in Ascension’s spending over one year.

“While we understand a steady, rational increase in prices, it is the sudden, unfounded price explosions in select older drugs that hinder us in caring for patients,” Fogel told the committee.

The NEJM letter also analyzed the use of two drugs that remained stable in price over that time period, as a control group — nitroglycerin and dobutamine. The number of patients treated with nitroglycerin, a drug used for chest pain and heart failure, increased by 89 percent. Khot warns that the drugs can’t always be used as substitutes.

Kaiser Health News, a nonprofit health newsroom, is an editorially independent part of the Kaiser Family Foundation. Sarah Jane Tribble is a senior correspondent at KHN.

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