Emerging Therapies for the Treatment of MS

Emerging Therapies for the Treatment of MS Currently, there are six new drugs that are being assessed by clinical scientists and some of these drugs have entered or completed phase 2 level and phase 3 level clinical trials. Three of these drugs are oral drugs and they include Lanquinimod, Teriflumomide and Di-methyl fumarate. The other three are monoclonal antibodies (mAb) namely Alemtuzumab, Daclizumab and Rituximab (Borrero et al, 2012). All of these drugs target the immune system in different ways but some of them still present with some side effects as well which are discussed below. Starting with Lanquinimod, it is an immunomodulator that is currently being trialled in patients with RRMS and SPMS. It has a very small recommended dose of 0.6 mg daily and it exhibits anti-inflammatory properties. These properties are believed to support the downregulation of MHC class II transcription factors, stimulation of neurotrophic factors, activation and up-regulation of the IL-4 pathway in CD4+ T cell for anti-inflammatory effects. It also promotes apoptosis in Cytotoxic T-cells (CD8+) and B-cells and also suppresses metabolism in CD14+ and natural killer cells (Thà ¶ne et al., 2016). It is currently undergoing Phase III trials and has resulted in 23% reduction in the rate of relapse of MS while there has been a 37% reduction in contrast enhancing lesions in volunteers (Borrero et al, 2012). Its side effect is only the upregulation of Liver Function Tests (LFTs) The second oral drug that is undergoing phase III clinical trials is Teriflunomide and it is being trialled for patients with RRMS and SPMS. Doses ranging from 7 to 14 mgs daily are recommended to be administered orally in patients. Its mode of action depends on sequestering the production of DNA pyrimidine bases by acting as an inhibitor for the enzyme dihydroorotate dehydrogenase, which is essential in de novo pyrimidine synthesis in T and B cells that are rapidly dividing. This reduces any inflammation that wouldve been caused by those cells and thus immune suppression is achieved. According to Borrero et al, it has a success rate of 61% in reducing contrast enhancing lesions, a rate of 30% in reducing Annualized relapse rates (ARRs) and disability progression was observed to be reduced to 23-30%. Terfilunomidess side effects include Nasopharyngitis; which is the inflammation of the nasopharyngeal duct, diarrhoea, back pain, fatigue, hair thinning, influenza, Urinary Tract Infecti on (UTI), nausea and elevated LFTs (Borrero et al, 2012). The third oral drug is Di-methyl fumarate (DMF) or BG-12. It is also undergoing type III clinical trials for patients with RRMS. Its suggested dose is 120-24 mg three times a day. It has shown a decrease of 69% in contrast enhancing lesions in its phase II trial and its phase III trials have so far showed 53% reduction in ARR, 38% reduction in disability progression and in 2 years, by 49% (Borrero et al, 2012). Di-methyl fumarates mode of action is still being debated but it is believed that it can regulate oxidative pathways which may in turn affect other signalling pathways that are responsible for inducing tissue damage. Studies by Moharregh -Khiabani et al in 2009 showed that DMF had an inhibitory effect on the nuclear factor NFÃŽ ºB dependant, TNF ÃŽ ± induced gene transcription in endothelial cells. It is also believed that DMF can stimulate cells to secrete cytokines such as IL-10, IL-4 and IL_5 which have anti-inflammatory properties thus allowing a more Th2 focused response than a Th1 one (Wierinckx et al., 2005). Moreover, DMF is believed to have a neuroprotective therapeutic effect as well. This occurs as it causes an upregulation in the levels of the detoxification enzyme; NADPH but like other emerging drugs, it has side effects. These side effects include diarrhoea, cramps, elevated LFT, nausea and can cause flushing and in very rare cases, Progressive multifocal leukoencephalopathy (PML) (MS Society 2016). Other novel therapies include the use of monoclonal antibodies (mAb) for the treatment of MS. As of now, there are three that are undergoing phase II and III trials respectively. Alemtuzumab is one such mAb that is in its phase III clinical trial for patients with RRMS and SPMS. Its recommended dosage is Intravenous infusion of 12- 24 mg daily for a course of 5 days every month if its a 1 year course and this can be increased to 24mg on the 12th month. Its mode of action is causing the destruction of circulating immune cells by binding on to CD52 on mature leukocytes which results in the lysis of CD4+ and CD8+ T cells, B cells, eosinophils, NK cells, monocytes and macrophages as well (Hart and Bainbridge 2016). In phase III trials, it has so far shown up to 75% reduction in sustained accumulation disability and up to 74% reduction in relapse rate but has been associated with potentially increasing the risk of autoimmunity which included thyroiditis, idiopathic thrombocytopenic purpur a, autoimmune thyroid-related problems, Goodpastures syndrome and also, can cause flushing and headaches (Borrero et al, 2012) . As of yet, it has not been approved by the FDA as it is still undergoing trials but it is used as a medication for treating a form of blood cancer called B-cell chronic lymphocytic leukaemia (B-CLL) (FDA 2016). References https://www.researchgate.net/profile/Anne_Wierinckx/publication/7750124_Detoxication_enzyme_inducers_modify_cytokine_production_in_rat_mixed_glial_cells/links/0c960534be656953a2000000/Detoxication-enzyme-inducers-modify-cytokine-production-in-rat-mixed-glial-cells.pdf https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2724664/ http://journals.sagepub.com/doi/pdf/10.1177/1756285612450936 https://www.fda.gov/Drugs/DrugSafety/ucm082681.htm http://www.ajmc.com/journals/supplement/2016/cost-effectiveness-multiple-sclerosis/cost-effectiveness-multiple-sclerosis-current-emerging-treatment/P-3 https://www.mssociety.org.uk/what-is-ms/treatments-and-therapies/licensed-disease-modifying-drugs/Tecfidera

Physical books Essay

The answer to this question is a simple yes. We shall prove in our discussion why we have chosen this answer. With advances in technology the word ‘paper’ no longer implies a material made of cellulose pulp, derived mainly from wood. As we make further advances, we see that the definition of paper has changed. Physical books that were made of paper have morphed into digital copies called e-books that are available over various mediums of communication such as the Internet or even our very mobile phones. We know that everything has a certain shelf life and if continue to use it beyond that period we will cause ourselves harm, this is also true for physical paper books, time has come to move over the paper books and to enter the world of e-books. Two of the most important factors supporting the cause of the e-book are that it saves: 1. Time and 2. Money 1. Time: In this rapid moving world we are all constantly on the move and we require information immediately, with e-books we can find the information we want immediately. Money: We all want to save money; e-books will be available at only a fraction of the price of the paper books since it will be cheap for the publishers to produce and this benefit will in turn be passed on to the consumer. Reasons for decline of paper books and the popularity of e-books are obvious: 1. E-books can be view almost instantaneously: One can browse through the thousands of e-books available on the Internet by just typing the keywords and purchase the e-book we want by using our credit cards and download the e-book immediately, thus we are saving a lot of overhead costs. 2. E-books cheaper for the publisher to publish as various overhead costs are minimized: Various overheads costs such as huge and expensive printing machinery and their maintenance will disappear; also there will not be need of a large work force to manufacture e-books. 3. E-books cheaper for the consumer to purchase than physical paper books: Since the manufacturing costs of the publishers will be minimized, this will be passed down to the consumer. Thus the consumer will enjoy great savings. 4. E-books can reach a much larger audience worldwide: E-books can be launched instantaneously through out the world; there will be no waiting to buy our copy of the e-book. Also many times a physical paper book is not available in all parts of the world, but this will not be a problem with e-books. 5. E-books are environment friendly: Unlike physical books made from paper, which is derived from timber, e-books don’t need the resources of nature to be made. Thus we will be saving thousands of trees every year and thus reducing the greenhouse effect and making the earth a green place to live in. 6. We can have thousands e-books in our digital device: We can literally have thousands of e-books in our digital device such as a laptop or a computer. The number of e-books is only limited by the storage capacity of our computer or laptop. This is impossible with physical paper books. Can you imagine a person moving around with a library of paper books? But we can move around with our library of e-books on our laptop anywhere! Conclusion: We as humans should be ready to accept the change of books from the physical to the virtual. Are we truly ready to leave the paper copies of the great novels and instead view them as e-books? Some have even said that if we do this we’ll be disrespecting the great authors and poets, but as we wait, the world around us rapidly changing. In the end we may have no choice but to accept the e-book as it gains popularity and following every passing day. This it’s only a matter of time before the paper books are replaced by e-books. Thus we have observed and noted from the above examples that the books made of paper are on their way out and the time of the e-book has arrived. (Sam Kleinman 2007) Works Cited 1. ZATZ Publishing (2007) Print books vs. e-books by Sam Kleinman, page 1[last updated 2007] [Online] Available from: 2. ZATZ Publishing (2007) ZATZ Publishing (2007) Print books vs. e-books by Sam Kleinman, page 2 [last updated 2007] [Online] Available from:

Antigone: an Assessment of Antigone’s and Creon Essay

How was your understanding of cultural and contextual considerations of the work developed through the interactive oral? After taking part in the interactive oral presentation carried out by Sonia’s group, I now believe that I have gained a much greater understanding of the play Antigone. Themes commented on by the presentation were women, religion and tragedy; further examining their place in society at the time the play was written by contrasting it to society today. Obstacles hindering my understanding of the play, including its time and setting, have been removed. After comparing so vividly the society of Ancient Greece and that of the one I live in, I can now empathize with Antigone and the rest of the characters in the play, consequently broadening my understanding of the hard times that they had to endure. Many of the issues regarding women, religion and politics in the country during the period were observed in Sophocles’ Antigone, clearly displaying their importance. The contemporary issues that shaped the play deserve further exploration. Women’s roles in ancient Greek society were shockingly different in comparison to that of today. Before the presentation, I was aware of some differences between their society and ours but I was unaware that they were so extreme. Although she seems extremely negative and erratic, Ismene was shown to be a leading example of a woman at the time – the first difference between their society and ours. Although she is elevated in society she doesn’t hear about anything important – â€Å"No one has told me anything, Antigone, I have heard nothing†¦Ã¢â‚¬  Before the presentation, the irrelevant positions of women were unknown to me. As well as seen to be worthless, women were also presented as being a negative influence on men – â€Å"Don’t let any woman ensnare you†¦Ã¢â‚¬  was Creon’s advice to Haemon, displaying the general consensus on women. We examined Creon’s motives, prospecting that if Antigone weren’t a wom an, would the punishment be the same? Another important theme that was brought to my attention during the interactive oral presentation was that of religion. The religious laws in this time and country were incredibly significant. This society’s view on religion is a major influence in the play Antigone. It would have affected how the people in the country (the characters in the play) acted and what they thought, a large contrast to today. The themes examined by Antigone would have been incredibly shocking to the original audience as they were the social norms. After being informed, I was then able to make connections in the text, as to why certain things were said and insinuated about being rewarded in the afterlife and why specific acts were committed – all under the influence of religion. Prior to the presentation, I was completely uninformed as to the religion and many other cultural aspects of Ancient Greece. Antigone: An Assessment of Antigone’s and Creon’s Deeply Held Beliefs and Views On Familial and State Responsibilities In his play Antigone, Sophocles explores the ethical integrity of familial and state ties through the opposing viewpoints and beliefs of the central characters, Antigone and Creon. By pitching these two individuals against each other, Sophocles also successfully reveals the raw and multi-faceted nature of humanity. The tragic consequences that conclude Antigone emphasize the deadly differences between each character’s views on the unwritten duty towards family and the binding laws of the city-state, a conflict that would very likely be less of an issue in modern society. Sophocles promotes Antigone’s character, as she is the traditional protagonist of the play. By doing so, Sophocles succeeds in building the audience’s compassion towards her. The audience is influenced therefore, through this empathy created towards Antigone, to view Creon’s ethical actions as being less moral than her own. However, it must be added that Creon’s points of view and actions can nevertheless also be justified. By studying the destiny of each character, and how each of their fates come to pass, one can get a clearer understanding of how and why Sophocles influences the audience into favoring Antigone and her domestic role, rather than Creon and his cold inflexibility. The contrasting views and principles that drive each character deserve assessment as the opposing passions driving each of them, lead to the play’s tragic, dramatic and poignant conclusion. Sophocles brings to life the characters of Antigone and Creon, developing for each, a sense of responsibility and a set of morals, which clash dramatically with the opposite character’s. By pitting these two characters against one another, Sophocles not only successfully contrasts the ethical views of each, but also cleverly exposes the true face of humanity. Antigone is placed as both lead character and heroine of the play, as she holds a domestic, reasoned and more acceptable stance; any audience would name her as heroine. A.E. Haigh, author of ‘An analysis of the play by Sophocles – The Tragic Drama of the Greeks’ clearly states that Antigone lives a more familial motivated lifestyle, saying, â€Å"Antigone, however, seems to have been of a more domestic type.†1 Antigone’s resilient, and somewhat egotistical, feeling of responsibility toward family is what drives her to publicly violate Creon’s new decree and to question his judgment on, and knowledge of, divine law. Antigone does this without question, so deep is her respect of the gods over the state. She clearly feels more obligated towards her religious responsibilities and ties than anything else. This somewhat defiant character believes that the gods alone determine her fate; she will do whatever is necessary to appease them. â€Å"I shall die in the knowledge that I have acted justly. What greater satisfaction than that †¦ We have too little time to waste it on men, and the laws they make. The approval of the dead is everlasting, and I shall bask in it as I lie among them.†2. Here Antigone’s use of language shocks the audience as she has clearly prioritized her existence in accepting death and rejecting mortal life. This strong and deeply held belief drives Antigone to stand by her familial responsibilities with steely determination and to perform the burial rights for her deceased brother that were callously denied him by Creon. Her acceptance of death shocks the audience as it almost seems as if she desires it. She remains certain throughout the play that the gods will reward her devotion and her heroic actions in the afterlife. Although she says differently, it appears that Antigone also strives for public acclaim in Thebes. When Ismene mentions that she won’t inform anyone of Antigone’s plans, Antigone responds strongly, â€Å"Don’t you dare! You must tell everybody, shout it in the streets.† This rebellious response from Antigone seems to indicate that her actions are not only divinely, but also somewhat egotistically motivated. The second central character, Creon, shares Antigone’s determinism in abiding by principles and beliefs. However, contrary to Antigone, Creon remains certain that humans can in fact dictate the moral laws of society and that the state should and can handle its own matters by asking, â€Å"Is it likely, remotely likely that the gods will think twice over that stinking pile of meat?† Rather than fearing the immortal gods and their unwritten laws, Creon strives to uphold those of man and of state. His stubborn punishment of Antigone, a woman whose only desire is to bury her brother, shows a lack of respect and contempt for all family values and ties. Although Creon could justify his actions as being those required of a king, it is evident that they are too extreme. G.H. Gellie in ‘Sophocles: A Reading’ states, â€Å"He reminds us repeatedly of the physical nastiness of the [body’s] exposure †¦ We are made to feel in our stomachs that this is no way to treat the body of a human being.†3 Any empathy that the audience may have felt towards Creon quickly vanishes at this point in the play. However, this is somewhat redressed later when, ironically he loses his family members: his wife and son. Throughout Antigone, Creon appears to be unable to grasp the key traits of ruling and living in an ethical society. This is evident when he states, â€Å"I’ve just seen her inside in fury, not like someone in full control of her senses. The heart of one who weaves wickedness in darkness is usually convicted beforehand. I, for my part, hate anyone caught in the act who tries to beautify his crimes thereupon.†2 Statements of this nature show Creon’s cold and callous assessments of the morally upright Antigone – the effect on the audience is unambiguous: One can feel nothing but disdain for such a harsh and unfeeling character. It is Creon’s own rules and regulations that publicly expose his apparent lack of respect for family values and duties. This is evident when he introduces his new decree, stating that Polynices cannot be buried. Creon’s secondary flaw is that he continually acts on his own self interest. His motivations are driven by his selfishness and not by the opinions or interest of his people. Egotistical traits such as these are neither honorable nor wise for a successful ruler. Creon’s son, Haemon, challenges his father, informing him that he neglects to serve the people of Thebes and fails to pay attention to their cries. He argues, â€Å"How the city weeps for this girl, says she’s the least worthy of all women to die so badly for such noble deeds.†2 Creon responds, with an outrageous outburst, displaying his arrogance through his strong views. He asks, â€Å"The city will tell me how I ought to rule it? †¦ Isn’t the city thought to be her rul er’s?†2 His blatantly conceited claims, coupled with his unconcealed disregard for fair judgment, build tension towards a seemingly inevitable clash with Antigone, who is filled with equal tenacity but whose views are diametrically opposed to his. The viewpoints of each character can be interpreted as quite ironic and at odds: Although Antigone strives to defend family values by violating the state’s laws, she remains a prominent and functioning member of Theban society. Likewise, even though Creon remains a loving husband and father, his ability to completely disregard familial ties in support of state laws is shocking. As the two are directly opposed, it is interesting to see how the characters cope in the same culture. Antigone and Creon are of such determined characters, that the irony considering each of their particular devotions to family and state becomes even more alarming. Antigone appears the most ethical of the two as she is willing to risk her life over her decision to uphold family rights; Creon can also appear morally just, because, as king, he is motivated solely by his duty to serve Thebes. It could also be argued that neither Creon nor Antigone are wrong in their convictions: they are two sides that are simply conflicting. As the two protagonists stubbornly remain true to their deeply held beliefs and responsibilities, they are driven to make decisions that ultimately lead to their mutual destruction. This destruction in itself demonstrates the ethical validations of both Antigone’s and Creon’s opposing characters. As well as highlighting the problems with society at that time, Sophocles through the characters of Antigone and Creon, reveals the true face of humanity, in all its ugliness. Sophocles cleverly manipulates the emotions of his audience in order to expose humanity’s true nature. G.H. Gellie identifies the depth of the audience’s feelings when he says that we feel this response â€Å"in our stomachs†3 Our response is almost instinctive: we cannot help but react deeply in this way. Sophocles successfully plays with our emotions and makes us feel outraged. Although Creon’s flaws reflect the flaws of humanity, Antigone herself is not without flaws. Like her king, Antigone demonstrates strong opinions and, at times, acts in her own interest. She passionately defies the state’s dominance over domestic values. These obstinate principles are what lead Antigone down the path of destruction, glorified nonetheless. Sophocles portrays Antigone’s reasons, as being nobler than Creon’s who is profoundly selfish and possesses a frightening persistence to carry out his brutal deed. Tiresias, another character, provides an omen when he sternly warns king to be more understanding and to consider the impact of what he is doing, â€Å"You don’t protect it when you trample the honors of the gods!†2 Haemon and the chorus also warn the king, impartially informing him that his actions may not be as ethical as he imagines they are. Each character’s warnings are disregarded, amid wild accusations of bribery and foul play. Consequently, the audience is encouraged to feel less sympathy for Creon than they do for Antigone, a woman whose only desire is to bury her slain brother. Antigone is prepared to lose her life trying to uphold family values and feels she has no choice but to accept her fate. On the other hand, after pleas from numerous characters, Creon repeatedly fails to see sense and strives to avoid his dark fate. To conclude, in the play Antigone, the catastrophic conflict of beliefs that occurred between family and state in ancient Thebes is carefully demonstrated in the disastrous events that take place. Questions of morality and duty are challenged throughout the play as the two central characters, Antigone and Creon, clash violently in their battle to uphold the views they so diligently and resolutely stand behind. The views and deeply held beliefs of Antigone and Creon are of key significance in the play; they are what drive the plot to its tragic conclusion. However, they are not simply the driving force of the play, but the vehicle through which Sophocles exposes the many facets of humanity: its beauty and its ugliness. Through the tragic events that conclude the story, Sophocles was likely indicating that an amalgamation of the two characters’ contrasting approaches would be the best way to operate in ancient Greek society. Bibliography 1. An analysis of the play by Sophocles – The Tragic Drama of the Greeks – A.E. Haigh -Oxford: Clarendon Press 1896 2. Sophocles – Antigone 3. Sophocles: A Reading – G. H. Gellie – Melbourne University Press 1972

How Cyber Security Is Compromised - 1431 Words

Today cyber security causes huge problems for Society: personally, financially and even in matters of national security. Just in the last two years, hundreds of millions of credit card numbers have been stolen. Tens of millions of Social Security numbers and health care records were compromised and even nuclear energy centers have been hacked. Also unmanned drones have been hijacked. This is all done by exploiting vulnerabilities in hardware and software, or more often by taking an advantage of unintentional decisions made by the people using the software. The people committing these cybercrimes don’t fit a single profile or motivation, it could be anyone from an international terrorist to a teenager competing for bragging rights. Today the largest countries not only have a regular army but also have a well-armed Cyber Army, in fact the next World War may not be fought with traditional weapons but with computer used to shut down a nation’s water supplies, energy grid an d transportation systems. This essay will discuss how cyber security is compromised, what systems are in place to defend cyber-attacks and also how to remain safe when using the internet. In biology and life, a virus is an organism that is spread through coughing, wheezing or physical contact. Viruses work by infecting cells and injecting their genetic material and using the cells to replicate themselves. They can make people really sick and spread it to other people. A computer virus works a bit similarly. AShow MoreRelatedHow Online Business And Communication Is An Indispensable Part Of Today s Merging Era Essay1650 Words   |  7 Pagesan indispensable part of today’s merging era. 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