The day on which this took place was a Sabbath, and so the Jewish leaders said to the man who had been healed, “It is the Sabbath; the law forbids you to carry your mat.” But he replied, “The man who made me well said to me, ‘Pick up your mat and walk.’ ” So they asked him, “Who is this fellow who told you to pick it up and walk?” The man who was healed had no idea who it was, for Jesus had slipped away into the crowd that was there. Later Jesus found him at the temple and said to him, “See, you are well again. Stop sinning or something worse may happen to you.” The man went away and told the Jewish leaders that it was Jesus who had made him well.
The chap who was healed was not healed because he was a good man. Indeed he seems to be a bit of a coward. When the Pharisees catch him carrying his mat on the Sabbath he quickly passes the blame and he can't even remember who healed him. Later when he meets Jesus again he tells tales.
So much for those who believe you just need a little more faith and you will be healed. So much for those who believe healing is part of salvation. The healing here was an act of grace. Given out of compassion, not deserved, not a reward for faith. Some may have called it wasted on him. We sing a hymn "Jesus thou art all compassion..." and so he is. Grace, grace upon grace; it is never exhausted.
Jesus admonishes the man, "Stop sinning or something worse may happen to you." He emphasizes that simply healing is not enough; those who are saved must show a change in their behavior if it is genuine salvation.
Sunday, June 26, 2011
Saturday, June 25, 2011
Scientific snippets
The following are in this week's new Scientist:
RABIES may not deserve its reputation.
It looks like the immune system sometimes defeats the disease on its own.
This month 8-year-old Precious Reynolds of California became only the sixth person known to survive rabies without receiving a vaccine within a few days. Doctors treated her with the experimental Milwaukee protocol, plunging her into a drug-induced coma to take her brain “offline” while immune cells scrubbed away the virus. But the protocol is no miracle cure: tried with at least 35 people, only five had previously survived.
On 15 June, Iran put its second ever satellite, Rasad-1, into orbit
It is 260 kilometres above the Earth. Iran hopes to use the experience to launch a monkey into space this year and, by 2019, a human. The worry is that such rockets could also be used to fire missiles at targets on Earth.
At 15 kilograms, Rasad-1 may be tiny, but it is a boost to Iran's space capabilities, says Brian Weeden of the Secure World Foundation think tank, headquartered in Washington DC. “Now that they've put two satellites up there, that indicates perhaps it wasn't a fluke the first time. It demonstrates that their rocket technology is pretty good.”
Rasad-1 is reportedly taking low resolution images of Earth. Its purpose seems mainly to gain experience in launching and operating satellites. Iran's state-run television company says the country will launch a monkey into orbit on a one-way trip “later this year”.
There has been concern in western countries, especially in the US, about Iran's space programme, enhanced by suspicions that the country is trying to develop nuclear weapons, which it denies. However, the rocket that launched Rasad-1 (pictured) appears to be very similar in capability to the Safir-2 rocket used to launch Iran's first satellite in 2009, which is not powerful enough to send a nuclear warhead as far as the US.
More Nuclear ReactorsI
In the wake of the nuclear meltdown at the Fukushima Daiichi power plant in Japan in March, several countries have announced plans to reject nuclear power. Japan will not build any more reactors. Germany plans to phase out its nuclear power plants, Switzerland will not replace its reactors, and last week Italy voted against starting a nuclear programme. But the UK has announced plans to replace another 7 of its nuclear power stations.
The International Atomic Energy Authority lists 65 reactors under construction, and those figures are just the tip of the iceberg because they do not include reactors that are contracted to be built, or those being planned. Neither do they acknowledge the significance of the United Arab Emirates being on course to become the first country to go nuclear since China in 1985: the UAE has signed a deal with a consortium led by the Korea Electric Power Corporation to build four reactors. Saudi Arabia is following suit, having announced earlier this month that it will build 16 reactors by 2030. Turkey plans to build two new plants.
Of 52 countries that have recently asked the IAEA to help them start a nuclear programme only 10 meet all of their criteria, Jewell says. Another 10 had the motivation and resources but were politically unstable. That second group includes Egypt, the most likely to gain nuclear power of the five north African countries with stated intentions. Continuing political uncertainty in Egypt makes nuclear an unlikely option there in the near term, however.
Meanwhile, the plants already under construction in established nuclear countries are feeling the ripples of Fukushima. Just under half of the reactors listed as under construction by the IAEA are in China – but following events in Japan, the Chinese government has suspended approvals for new plants while it reviews their safety.
Can we sense magnetism?
Sea turtles, pigeons and honeybees are among the animals that have an incredibly useful skill that we do not – they can sense the Earth's magnetic field with their bodies. But perhaps our magnetovision is just latent – when a light-sensitive protein was transferred from humans to fruit flies, the insects adopted the protein for their own magnetovision.
Steven Reppert of the University of Massachusetts in Worcester and his colleagues study cryptochromes – light-sensitive proteins that regulate the circadian clocks of many creatures. Reppert knew that cryptochromes also help fruit flies and birds sense the Earth's magnetic fields, and he wanted to see whether human cryptochromes could do the same thing. To find out Reppert replaced those found in fruit flies with a human version, hCRY2, which is found in the retina.
The mutant flies could be trained to associate a sugar reward with a magnetic field. When given the option to fly down either a magnetised or non-magnetised arm of a maze they opted for the magnetised one. Flies genetically engineered to lack cryptochrome altogether were indifferent to the magnetic field in one arm and were evenly distributed down both arms of the maze. Apparently, fruit flies have no problem using human cryptochrome to sense magnetic fields, which implies humans have the hardware to do the same, but for some reason do not activate the ability.
Gains form Chinese Medicine?
For more than 2000 years Chinese doctors have treated Parkinson's-like symptoms with gou teng, a herb with hook-like branches. Early this year, 115 people with Parkinson's were given a combination of Chinese medical herbs, including gou teng, or a placebo for 13 weeks. At the end of the study, volunteers who had taken the herbs slept better and had more fluent speech. Li Min, a traditional Chinese doctor at Hong Kong Baptist University who was not involved in the study, thinks she knows how it works. Parkinson's is caused by the destruction of brain cells that produce dopamine. Studies have suggested this destruction is caused by an abundance of a protein called alpha-synuclein, triggering interest in substances that get rid of the protein by encouraging the programmed cell death – autophagy – of the cells that contain it.
Li's team has found one such substance, the alkaloid isorhy, in gou teng. It induced autophagy at a similar rate to rapamycin, which has recently been touted as a candidate for Parkinson's treatment. However, because rapamycin depresses the immune system, it would have serious side effects, whereas gou teng has been taken for centuries with no apparent ill effects. Li, who presented her results at last month's Keystone Symposia on Molecular and Cellular Biology in Whistler, British Columbia, will begin trials of synthesised isorhy in rodents later this year.
Meanwhile, Zhaoxiang Bian, also at Hong Kong Baptist University, is developing a drug called JCM-16021 for Irritable bowel syndrome using seven herbal plants, based on a formulation called tong xie yao fang, which has been used to treat IBS in China since the 1300s.
In 2007, Bian gave 80 people with IBS either JCM-16021 with Holopon – a drug that interrupts nerve impulses responsible for digestion – or Holopon alone. After eight weeks, 52 per cent of those given JCM-16021 with Holopon had reduced IBS symptoms, compared with 32 per cent of those given just Holopon.
IBS is partly caused by high levels of serotonin in the gut. Last year, Bian found that giving JCM-16021 to rats with IBS-like symptoms broke down serotonin in their bowel faster than normal, reducing their discomfort. His team has since isolated several compounds in JCM-16021 that block serotonin's activity in the rat gut, including magnolol, a herb taken from magnolia trees.
RABIES may not deserve its reputation.
It looks like the immune system sometimes defeats the disease on its own.
This month 8-year-old Precious Reynolds of California became only the sixth person known to survive rabies without receiving a vaccine within a few days. Doctors treated her with the experimental Milwaukee protocol, plunging her into a drug-induced coma to take her brain “offline” while immune cells scrubbed away the virus. But the protocol is no miracle cure: tried with at least 35 people, only five had previously survived.
On 15 June, Iran put its second ever satellite, Rasad-1, into orbit
It is 260 kilometres above the Earth. Iran hopes to use the experience to launch a monkey into space this year and, by 2019, a human. The worry is that such rockets could also be used to fire missiles at targets on Earth.
At 15 kilograms, Rasad-1 may be tiny, but it is a boost to Iran's space capabilities, says Brian Weeden of the Secure World Foundation think tank, headquartered in Washington DC. “Now that they've put two satellites up there, that indicates perhaps it wasn't a fluke the first time. It demonstrates that their rocket technology is pretty good.”
Rasad-1 is reportedly taking low resolution images of Earth. Its purpose seems mainly to gain experience in launching and operating satellites. Iran's state-run television company says the country will launch a monkey into orbit on a one-way trip “later this year”.
There has been concern in western countries, especially in the US, about Iran's space programme, enhanced by suspicions that the country is trying to develop nuclear weapons, which it denies. However, the rocket that launched Rasad-1 (pictured) appears to be very similar in capability to the Safir-2 rocket used to launch Iran's first satellite in 2009, which is not powerful enough to send a nuclear warhead as far as the US.
More Nuclear ReactorsI
In the wake of the nuclear meltdown at the Fukushima Daiichi power plant in Japan in March, several countries have announced plans to reject nuclear power. Japan will not build any more reactors. Germany plans to phase out its nuclear power plants, Switzerland will not replace its reactors, and last week Italy voted against starting a nuclear programme. But the UK has announced plans to replace another 7 of its nuclear power stations.
The International Atomic Energy Authority lists 65 reactors under construction, and those figures are just the tip of the iceberg because they do not include reactors that are contracted to be built, or those being planned. Neither do they acknowledge the significance of the United Arab Emirates being on course to become the first country to go nuclear since China in 1985: the UAE has signed a deal with a consortium led by the Korea Electric Power Corporation to build four reactors. Saudi Arabia is following suit, having announced earlier this month that it will build 16 reactors by 2030. Turkey plans to build two new plants.
Of 52 countries that have recently asked the IAEA to help them start a nuclear programme only 10 meet all of their criteria, Jewell says. Another 10 had the motivation and resources but were politically unstable. That second group includes Egypt, the most likely to gain nuclear power of the five north African countries with stated intentions. Continuing political uncertainty in Egypt makes nuclear an unlikely option there in the near term, however.
Meanwhile, the plants already under construction in established nuclear countries are feeling the ripples of Fukushima. Just under half of the reactors listed as under construction by the IAEA are in China – but following events in Japan, the Chinese government has suspended approvals for new plants while it reviews their safety.
Can we sense magnetism?
Sea turtles, pigeons and honeybees are among the animals that have an incredibly useful skill that we do not – they can sense the Earth's magnetic field with their bodies. But perhaps our magnetovision is just latent – when a light-sensitive protein was transferred from humans to fruit flies, the insects adopted the protein for their own magnetovision.
Steven Reppert of the University of Massachusetts in Worcester and his colleagues study cryptochromes – light-sensitive proteins that regulate the circadian clocks of many creatures. Reppert knew that cryptochromes also help fruit flies and birds sense the Earth's magnetic fields, and he wanted to see whether human cryptochromes could do the same thing. To find out Reppert replaced those found in fruit flies with a human version, hCRY2, which is found in the retina.
The mutant flies could be trained to associate a sugar reward with a magnetic field. When given the option to fly down either a magnetised or non-magnetised arm of a maze they opted for the magnetised one. Flies genetically engineered to lack cryptochrome altogether were indifferent to the magnetic field in one arm and were evenly distributed down both arms of the maze. Apparently, fruit flies have no problem using human cryptochrome to sense magnetic fields, which implies humans have the hardware to do the same, but for some reason do not activate the ability.
Gains form Chinese Medicine?
For more than 2000 years Chinese doctors have treated Parkinson's-like symptoms with gou teng, a herb with hook-like branches. Early this year, 115 people with Parkinson's were given a combination of Chinese medical herbs, including gou teng, or a placebo for 13 weeks. At the end of the study, volunteers who had taken the herbs slept better and had more fluent speech. Li Min, a traditional Chinese doctor at Hong Kong Baptist University who was not involved in the study, thinks she knows how it works. Parkinson's is caused by the destruction of brain cells that produce dopamine. Studies have suggested this destruction is caused by an abundance of a protein called alpha-synuclein, triggering interest in substances that get rid of the protein by encouraging the programmed cell death – autophagy – of the cells that contain it.
Li's team has found one such substance, the alkaloid isorhy, in gou teng. It induced autophagy at a similar rate to rapamycin, which has recently been touted as a candidate for Parkinson's treatment. However, because rapamycin depresses the immune system, it would have serious side effects, whereas gou teng has been taken for centuries with no apparent ill effects. Li, who presented her results at last month's Keystone Symposia on Molecular and Cellular Biology in Whistler, British Columbia, will begin trials of synthesised isorhy in rodents later this year.
Meanwhile, Zhaoxiang Bian, also at Hong Kong Baptist University, is developing a drug called JCM-16021 for Irritable bowel syndrome using seven herbal plants, based on a formulation called tong xie yao fang, which has been used to treat IBS in China since the 1300s.
In 2007, Bian gave 80 people with IBS either JCM-16021 with Holopon – a drug that interrupts nerve impulses responsible for digestion – or Holopon alone. After eight weeks, 52 per cent of those given JCM-16021 with Holopon had reduced IBS symptoms, compared with 32 per cent of those given just Holopon.
IBS is partly caused by high levels of serotonin in the gut. Last year, Bian found that giving JCM-16021 to rats with IBS-like symptoms broke down serotonin in their bowel faster than normal, reducing their discomfort. His team has since isolated several compounds in JCM-16021 that block serotonin's activity in the rat gut, including magnolol, a herb taken from magnolia trees.
Chronic fatigue.
I still have a degree of fatigue following my chemotherapy. It is getting better, but I am still apt to fall asleep during the day. Next week I am going to restart some graduated exercises.
There are studies that show that graduated exercise following chemotherapy not only improves one's clinical situation, but also makes one live longer. Last time I started this program in the middle of my chemotherapy, I collapsed and had to abandon it. I was suffering from postural hypotension from an autonomic neuropathy. Since I have started on dexamethasone 4mg, my autonomic neuropathy has improved, as has my peripheral neuropathy. One strange effect has been that whenever I eat, salivation leads to my nose running.
In the world of chronic fatigue syndrome there has been uproar at the apparent proof that the suggestion that it is all due to a mouse retrovirus was down to a laboratory error and that CFS existed long before this fusion virus was created in a laboratory.
I feel a bit responsible for the idea that a virus might cause chronic fatigue, because I published a paper in the British Medical Journal in 1983. Here is the abstract:
Immunological reason for chronic ill health after infectious
mononucleosis T J HAMBLIN, J HUSSAIN, A N AKBAR, Y C TANG, J L SMITH, D B JONES BRITISH MEDICAL JOURNAL VOLUME 287: 85-88 9 JULY 1983
In a group of patients who suffered from chronic ill health after an attack of acute infectious mononucleosis a disorder of T cell regulation was found. By means of cytochemical reactions the staining pattern associated with T suppressor cells was found in a greater percentage and that associated with T helper cells in a smaller percentage than in normal subjects. In a few patients this finding was confirmed in a functional suppressor assay. The patients were unwell for at least a year but most later made a complete recovery, which was associated with return to normal of the lymphocyte subsets.
I was quite interested in this subject at that time and even conducted a small clinical trial with the anti-worm drug, Levamisole, which had been shown to boost some aspects of the immune response in a non-specific way. There was no effect.
I was being referred patients from my esteemed colleague, Chris Moran, and I was surprised at the variety of patients I saw who all had this catch all diagnosis, ME or CFS. Some were indeed post-glandular fever. I estimated that most patients with infectious mononucleosus caused by EBV got better within 6 weeks of catching the disease. A small group were unwell for about 6 months and an even smaller group remained unwell more of less permanently.
But in the majority of patients with ME/CFS the condition had nothing to do with EBV. Some had had CMV or toxoplasmosis, some were clearly depressed, occasionally there was a strong family history and I remember one woman who developed the syndrome after being bitten by a grey squirrel.
The symptomatology was different, too. Some patients just complained of tiredness; in some of these exercise made it worse. Some complained of painful muscles but not all did. Some complained of an inability to concentrate and some had all three symptoms.
My conclusion when I left the field was that this was not one syndrome, that some of the symptoms were similar to those seen with treatment with interferon so that cytokines may be involved, that since viruses are one way of triggering cytokine release, in some cases there might be a chronic viral infection, that in some cases there was chronic depression whether as the cause or the effect of the syndrome, and that there were a lot of cranks associated with the syndrome who were convinced that they were right and everybody else was wrong. In my view everybody was right and everybody was wrong and those who were most switched on were those who admitted their ignorance about the field.
When I got involved in CLL it was clear that there were similarities in the fatigue associated with CLL and the topic of 'chemo-brain' as well. (Perhaps cytokines were involved again). When I started on chemotherapy I appreciated the reality of both these conditions. I also recognized that high doses of steroids gave me mood swings and that the knowledge that I had an incurable cancer sometimes made me depressed.
There was a big ME/CFS conference in Lons=don in May 2011 called "Invest in ME". Even the title of the Conference gives away that this was very self-centered. There has recently been a large clinical trial on this condition published in the Lancet which concluded that the only effective treatment for this syndrome is cognitive behavioral therapy (CBT) with graduated exercise. This paper has roused the ire of patients who see that they are being labeled as nutcases, CBT being the preferred therapy for chronic depression. Psychiatrists who follow this line have been subjected to outrageous persecution by patient groups, even being reported to the General Medical Council, which has behaved in its usual callous and unthinking manner. (I shall be very glad next month when I resign from being a licensed doctor and no longer have to pay any more fees to this disgusting organisation).
If you have access to the current BMJ you will be able to read several articles on this topic. You could start here
There are studies that show that graduated exercise following chemotherapy not only improves one's clinical situation, but also makes one live longer. Last time I started this program in the middle of my chemotherapy, I collapsed and had to abandon it. I was suffering from postural hypotension from an autonomic neuropathy. Since I have started on dexamethasone 4mg, my autonomic neuropathy has improved, as has my peripheral neuropathy. One strange effect has been that whenever I eat, salivation leads to my nose running.
In the world of chronic fatigue syndrome there has been uproar at the apparent proof that the suggestion that it is all due to a mouse retrovirus was down to a laboratory error and that CFS existed long before this fusion virus was created in a laboratory.
I feel a bit responsible for the idea that a virus might cause chronic fatigue, because I published a paper in the British Medical Journal in 1983. Here is the abstract:
Immunological reason for chronic ill health after infectious
mononucleosis T J HAMBLIN, J HUSSAIN, A N AKBAR, Y C TANG, J L SMITH, D B JONES BRITISH MEDICAL JOURNAL VOLUME 287: 85-88 9 JULY 1983
In a group of patients who suffered from chronic ill health after an attack of acute infectious mononucleosis a disorder of T cell regulation was found. By means of cytochemical reactions the staining pattern associated with T suppressor cells was found in a greater percentage and that associated with T helper cells in a smaller percentage than in normal subjects. In a few patients this finding was confirmed in a functional suppressor assay. The patients were unwell for at least a year but most later made a complete recovery, which was associated with return to normal of the lymphocyte subsets.
I was quite interested in this subject at that time and even conducted a small clinical trial with the anti-worm drug, Levamisole, which had been shown to boost some aspects of the immune response in a non-specific way. There was no effect.
I was being referred patients from my esteemed colleague, Chris Moran, and I was surprised at the variety of patients I saw who all had this catch all diagnosis, ME or CFS. Some were indeed post-glandular fever. I estimated that most patients with infectious mononucleosus caused by EBV got better within 6 weeks of catching the disease. A small group were unwell for about 6 months and an even smaller group remained unwell more of less permanently.
But in the majority of patients with ME/CFS the condition had nothing to do with EBV. Some had had CMV or toxoplasmosis, some were clearly depressed, occasionally there was a strong family history and I remember one woman who developed the syndrome after being bitten by a grey squirrel.
The symptomatology was different, too. Some patients just complained of tiredness; in some of these exercise made it worse. Some complained of painful muscles but not all did. Some complained of an inability to concentrate and some had all three symptoms.
My conclusion when I left the field was that this was not one syndrome, that some of the symptoms were similar to those seen with treatment with interferon so that cytokines may be involved, that since viruses are one way of triggering cytokine release, in some cases there might be a chronic viral infection, that in some cases there was chronic depression whether as the cause or the effect of the syndrome, and that there were a lot of cranks associated with the syndrome who were convinced that they were right and everybody else was wrong. In my view everybody was right and everybody was wrong and those who were most switched on were those who admitted their ignorance about the field.
When I got involved in CLL it was clear that there were similarities in the fatigue associated with CLL and the topic of 'chemo-brain' as well. (Perhaps cytokines were involved again). When I started on chemotherapy I appreciated the reality of both these conditions. I also recognized that high doses of steroids gave me mood swings and that the knowledge that I had an incurable cancer sometimes made me depressed.
There was a big ME/CFS conference in Lons=don in May 2011 called "Invest in ME". Even the title of the Conference gives away that this was very self-centered. There has recently been a large clinical trial on this condition published in the Lancet which concluded that the only effective treatment for this syndrome is cognitive behavioral therapy (CBT) with graduated exercise. This paper has roused the ire of patients who see that they are being labeled as nutcases, CBT being the preferred therapy for chronic depression. Psychiatrists who follow this line have been subjected to outrageous persecution by patient groups, even being reported to the General Medical Council, which has behaved in its usual callous and unthinking manner. (I shall be very glad next month when I resign from being a licensed doctor and no longer have to pay any more fees to this disgusting organisation).
If you have access to the current BMJ you will be able to read several articles on this topic. You could start here
Galatians 6:12-13. Evangelism: a lifetime commitment
Those who want to impress people by means of the flesh are trying to compel you to be circumcised. The only reason they do this is to avoid being persecuted for the cross of Christ. Not even those who are circumcised keep the law, yet they want you to be circumcised that they may boast about your circumcision in the flesh.
Now we get to the nub of the motive of the Judaizers. They have no concern for the Galatian Christians - they simply want to keep in well with the unconverted Jews. They are hypocrites. They see the Galatians as a series of scalps to be taken.
We should be wary of our evangelism that we don't have the same attitude. Winning souls for Christ is not a numbers game, but implies a love of people who are lost and a lifetime commitment to them.
Now we get to the nub of the motive of the Judaizers. They have no concern for the Galatian Christians - they simply want to keep in well with the unconverted Jews. They are hypocrites. They see the Galatians as a series of scalps to be taken.
We should be wary of our evangelism that we don't have the same attitude. Winning souls for Christ is not a numbers game, but implies a love of people who are lost and a lifetime commitment to them.
13 elements: Dysprosium
Dysprosium
Rare earth element
Atomic number: 66
Used in: High-temperature magnets
Criticality rating: critical
Like neodymium, dysprosium is prized for its magnetic properties – not least, when mixed with terbium and iron to form the alloy Terfenol D. It has the peerless ability to change shape in response to a magnetic field.
This “magnetostrictive” property has led to some far-out uses. The US navy has used Terfenol-D to develop an advanced active sonar transducer, producing and then picking up high-powered “pings” underwater.
Dysprosium's greatest selling point, however, is how it handles the heat. Magnets made from a pure neodymium-iron-boron alloy lose their magnetisation at temperatures above 300 °C. Adding in a small amount of dysprosium, at about 5 per cent by weight, solves that problem, making the element a vital component in high-performance magnets found in countless technologies from turbines to hard discs.
According to the US DoE, the wide range of its current and projected uses, together with the lack of any immediately suitable replacement, makes dysprosium the single most critical element for emerging clean energy technologies. China is the only country with significant known deposits, with the new mines opening in Australia and Canada only containing small quantities of the element in their rare earth ores. Even the US DoE's most conservative projections predict a shortfall of dysprosium before 2015.
Rare earth element
Atomic number: 66
Used in: High-temperature magnets
Criticality rating: critical
Like neodymium, dysprosium is prized for its magnetic properties – not least, when mixed with terbium and iron to form the alloy Terfenol D. It has the peerless ability to change shape in response to a magnetic field.
This “magnetostrictive” property has led to some far-out uses. The US navy has used Terfenol-D to develop an advanced active sonar transducer, producing and then picking up high-powered “pings” underwater.
Dysprosium's greatest selling point, however, is how it handles the heat. Magnets made from a pure neodymium-iron-boron alloy lose their magnetisation at temperatures above 300 °C. Adding in a small amount of dysprosium, at about 5 per cent by weight, solves that problem, making the element a vital component in high-performance magnets found in countless technologies from turbines to hard discs.
According to the US DoE, the wide range of its current and projected uses, together with the lack of any immediately suitable replacement, makes dysprosium the single most critical element for emerging clean energy technologies. China is the only country with significant known deposits, with the new mines opening in Australia and Canada only containing small quantities of the element in their rare earth ores. Even the US DoE's most conservative projections predict a shortfall of dysprosium before 2015.
John 5: 5-9a. Do you even want to be healed?
One who was there had been an invalid for thirty-eight years. When Jesus saw him lying there and knew that he had been in this condition for a long time, he asked him, “Do you want to get well?” “Sir,” the invalid replied, “I have no one to help me into the pool when the water is stirred. While I am trying to get in, someone else goes down ahead of me.” Then Jesus said to him, “Get up! Pick up your mat and walk.” At once the man was cured; he picked up his mat and walked.
We are back to the theme of water again with the same implication; the ritual of water is insufficient: the power of Christ is sufficient. We do not know what caused this man's invalidity, but we must assume it is some form of paralysis that had lasted a very long time. Indeed, Jesus questions his faith, "Don't you even want to get well?" From the rest of teh story we do not get the impression that this man was a very nice sort. But there we are; it isn't just nice people that are saved.
There is no written record elsewhere of this first come-first served dispensation of healing and it may have been mere superstition. Just as the Christian faith can lapse into superstition, so could Judaism. Jesus' healing does not use the pool or water at all, merely the word of command. and like the man let down through the roof, he picked up his bed and walked.
The healing was complete and instantaneous. The muscles regrew to make him strong enough to carry the mat and any contractions stretched to make him able to walk.
We are back to the theme of water again with the same implication; the ritual of water is insufficient: the power of Christ is sufficient. We do not know what caused this man's invalidity, but we must assume it is some form of paralysis that had lasted a very long time. Indeed, Jesus questions his faith, "Don't you even want to get well?" From the rest of teh story we do not get the impression that this man was a very nice sort. But there we are; it isn't just nice people that are saved.
There is no written record elsewhere of this first come-first served dispensation of healing and it may have been mere superstition. Just as the Christian faith can lapse into superstition, so could Judaism. Jesus' healing does not use the pool or water at all, merely the word of command. and like the man let down through the roof, he picked up his bed and walked.
The healing was complete and instantaneous. The muscles regrew to make him strong enough to carry the mat and any contractions stretched to make him able to walk.
Blinotumamab 3. Adult ALL
I want to concentrate on two papers which describe the treatment of acute lymphoblastic leukemia with blinatumomab. The first is published in J Clin Oncol this week (June 20th 2011) and descrbes a study of treatment of patients with minimal residual disease detected by PCR following their induction and consolidation treatment. These were all adult patients who carry a bad prognosis. I have a few remaining patients with this disease, but most have quite bad GVHD having required a transplant to salvage them. Most who have not have really bee young adults with what amounts to the same disease that occurs in childhood, which has a much better prognosis.
Although about 80% of adult ALLs have a CR after induction chemotherapy, 50% experience relapse and chemoresistant disease. In this trial patients were treated with Blinatumomab 15 microgm/sq m/24 hours by iv infusion for 4 weeks if they had MRD by PCR following the completion of their induction and consolidation treatment. In patients with an allogeneic donor transplant was offered at any time after the first course of blinatumomab. Responders were permitted to receive three further cycles of blinatumomab.
21 patients entered the trial of whom 20 were evaluable for response and 16 converted to MRD negative, all at the end of the first cycle of treatment. At a median of 405 days follow-up 16/20 patients eligible for follow up remained in ongoing hematological remission. 8 patients had allografts and remain in remission with no treatment associated mortality. 4 patients who did not have allografts have had a clinical relapse in the first 200 days post blinatumomab. In 2 cases the relapse was extramedullary (CSF, testis) and two had marrow relapse (one an initial responder to blinatumomab).
81% had transient grade 3 or 4 adverse events most commonly lymphopenia (this was really an intended event) and hypogammaglobulinemia. There were no drug associated deaths. There were 4 cases of infection. There was no cytokine storm and although there were transient increases in serum levels of some inflammatory cytokins, these increases were of short duration.
This was trial of patients with a more than 90% risk of relapse whose only chance of cure was an allograft (about a 30% success rate).
The second paper was an abstract presented at the recent meeting of EHA (abstract 552) This was a phase 2 study in adult patients with relapsed/refractory ALL of the same treatment detailed above for a first cohort of 5 patients and a second cohort had a dose reduction for the first 7 days to 5 microgm/sq m/24 hours, presumably while there were large numbers of circulating blasts.
Of the first 5 evaluable patients, 2 had CRs and 2 CRis within the first cycle. 3 had become MRD negative. One responder had an extramedullary relapse during cycle 3.
The commonest adverse events were fever and chills and one patient with a high leucocyte count had reversible cytokine storm. the second non-evaluable patient had a reversible event of encephalopathy and disorientation. Despite discontinuation of treatment, he reached MRD negativity. Recruitment of the second cohort is ongoing.
In essense this is the same study as the first, only given after relapse, not before it. I am sure there is a lot of impatience among CLL patients to see this drug used in CLL, but for now adult ALL, although less common, is a more urgent problem. The company involved here is Micromet Inc. of Munich and I guess if there were patient power to get this drug there might be a result.
Although about 80% of adult ALLs have a CR after induction chemotherapy, 50% experience relapse and chemoresistant disease. In this trial patients were treated with Blinatumomab 15 microgm/sq m/24 hours by iv infusion for 4 weeks if they had MRD by PCR following the completion of their induction and consolidation treatment. In patients with an allogeneic donor transplant was offered at any time after the first course of blinatumomab. Responders were permitted to receive three further cycles of blinatumomab.
21 patients entered the trial of whom 20 were evaluable for response and 16 converted to MRD negative, all at the end of the first cycle of treatment. At a median of 405 days follow-up 16/20 patients eligible for follow up remained in ongoing hematological remission. 8 patients had allografts and remain in remission with no treatment associated mortality. 4 patients who did not have allografts have had a clinical relapse in the first 200 days post blinatumomab. In 2 cases the relapse was extramedullary (CSF, testis) and two had marrow relapse (one an initial responder to blinatumomab).
81% had transient grade 3 or 4 adverse events most commonly lymphopenia (this was really an intended event) and hypogammaglobulinemia. There were no drug associated deaths. There were 4 cases of infection. There was no cytokine storm and although there were transient increases in serum levels of some inflammatory cytokins, these increases were of short duration.
This was trial of patients with a more than 90% risk of relapse whose only chance of cure was an allograft (about a 30% success rate).
The second paper was an abstract presented at the recent meeting of EHA (abstract 552) This was a phase 2 study in adult patients with relapsed/refractory ALL of the same treatment detailed above for a first cohort of 5 patients and a second cohort had a dose reduction for the first 7 days to 5 microgm/sq m/24 hours, presumably while there were large numbers of circulating blasts.
Of the first 5 evaluable patients, 2 had CRs and 2 CRis within the first cycle. 3 had become MRD negative. One responder had an extramedullary relapse during cycle 3.
The commonest adverse events were fever and chills and one patient with a high leucocyte count had reversible cytokine storm. the second non-evaluable patient had a reversible event of encephalopathy and disorientation. Despite discontinuation of treatment, he reached MRD negativity. Recruitment of the second cohort is ongoing.
In essense this is the same study as the first, only given after relapse, not before it. I am sure there is a lot of impatience among CLL patients to see this drug used in CLL, but for now adult ALL, although less common, is a more urgent problem. The company involved here is Micromet Inc. of Munich and I guess if there were patient power to get this drug there might be a result.
Friday, June 24, 2011
How BiTE antibodies work
Blinatumomab is a bispecific molecule of very small size made from a single polypeptide chain comprising the variable heavy chain and light chain of an anti-CD3 monoclonal antibody joined to the variable heavy chain and light chain of an anti-CD19 monoclonal antibody. The idea is that the antibody redirects the T-cell lysis to the tumor B-cell.
The BiTE antibody transiently creates a cytolytic synapse between a cytotoxic T-cell and the cancer target cell; in this case a B-cell lymphoma cell. Granules containing granzymes and the pore-forming protein, perforin, fuse with the T-cell membrane and discharge their toxic content leading to the death of the target cellBlinatumomab has a very short serum half-life of only 2-3 hours and therefore must be administered by continuous infusion over 4-8 weeks using portable minipumps.
Has the French trial put an end to ASCT?
The French group has looked at autologous stem cell transplant in CLL It is unusual for transplanters to do a randomized trial so we must take it seriously.
It is a complicated trial. Patients aged between 18 and 65 with Binet stage B or C disease diagnosed according to NCI 1996 guidelines were entered. Exclusions included AIHA, another uncured malignancy, severe concomitant disease, Richter’s syndrome, PLL, impaired renal, hepatic, cardiac or respiratory function or HIV seropositivity.
All patients were first treated with3 monthly courses of mini-CHOP followed by 3 courses of fludarabine. Patients then in CR were randomized between ASCT and observation. Those not in CR were rescued with 1 or 2 cycles of DHAP were then randomized to ASCT or 3 courses of FC. Transplant conditioning was with cyclo/TBI (10 Gy). CRs were determined after a CT scan and with bone marrow lymphocytes counted on an aspirate not a trephine (therefore they missed out on nodular PRs).
There were 105 in the CR group and 94 in the non-CR group. In the former 37 had ASCT and 68 observation (15 failed to mobilize stem cells or refused treatment); in the latter group, 34 had ASCT (7 failed to randomize, and a further 5 defaulted through death, progression or refusal) and 41 FC.
In the CR group the 3 year event-free survival was 79.8% v 35.4% in favour of ASCT. By multivariate analysis unmutated IGHV and del 11q were predictors of poor survival. However, at 3 years there was no difference in overall survival between the two arms. In the non-CR group there was no difference in event-free survival or overall survival. Unmutated IGVH and del 17p were predictors of poor outcome.
Mobilization after the 6 courses of preliminary chemotherapy failed in 40% of cases. Mobilization after mini-CHOP and before the fludarabine failed in only 8.3% of cases. This mirrors previous experience that fludarabine influences stem cell mobilization.
These results are broadly in line with the phase 2 data on ASCT. Do they now show that ASCT should be abandoned? I do not think so. The follow-up is too short to ascertain whether there will be an overall survival advantage. It does suggest that obtaining a CR before ASCT is vital, but this trial was started before rituximab was widely available in France and with it more CRs should be obtained. I suspect that for bulky or extensive CLL with mutated IGHV genes ASCT might still be the best treatment out there
It is a complicated trial. Patients aged between 18 and 65 with Binet stage B or C disease diagnosed according to NCI 1996 guidelines were entered. Exclusions included AIHA, another uncured malignancy, severe concomitant disease, Richter’s syndrome, PLL, impaired renal, hepatic, cardiac or respiratory function or HIV seropositivity.
All patients were first treated with3 monthly courses of mini-CHOP followed by 3 courses of fludarabine. Patients then in CR were randomized between ASCT and observation. Those not in CR were rescued with 1 or 2 cycles of DHAP were then randomized to ASCT or 3 courses of FC. Transplant conditioning was with cyclo/TBI (10 Gy). CRs were determined after a CT scan and with bone marrow lymphocytes counted on an aspirate not a trephine (therefore they missed out on nodular PRs).
There were 105 in the CR group and 94 in the non-CR group. In the former 37 had ASCT and 68 observation (15 failed to mobilize stem cells or refused treatment); in the latter group, 34 had ASCT (7 failed to randomize, and a further 5 defaulted through death, progression or refusal) and 41 FC.
In the CR group the 3 year event-free survival was 79.8% v 35.4% in favour of ASCT. By multivariate analysis unmutated IGHV and del 11q were predictors of poor survival. However, at 3 years there was no difference in overall survival between the two arms. In the non-CR group there was no difference in event-free survival or overall survival. Unmutated IGVH and del 17p were predictors of poor outcome.
Mobilization after the 6 courses of preliminary chemotherapy failed in 40% of cases. Mobilization after mini-CHOP and before the fludarabine failed in only 8.3% of cases. This mirrors previous experience that fludarabine influences stem cell mobilization.
These results are broadly in line with the phase 2 data on ASCT. Do they now show that ASCT should be abandoned? I do not think so. The follow-up is too short to ascertain whether there will be an overall survival advantage. It does suggest that obtaining a CR before ASCT is vital, but this trial was started before rituximab was widely available in France and with it more CRs should be obtained. I suspect that for bulky or extensive CLL with mutated IGHV genes ASCT might still be the best treatment out there
Galatians 6:11. Reading glasses
See what large letters I use as I write to you with my own hand!
We know that Paul had a Secretary to write his letters for him. Perhaps this was the 'thorn in the flesh' that he complained about. Perhaps it was just presbyopia. Perhaps he had macular degeneration.
We should thank God for the invention of reading glasses that help old men to pass on their wisdom.
We know that Paul had a Secretary to write his letters for him. Perhaps this was the 'thorn in the flesh' that he complained about. Perhaps it was just presbyopia. Perhaps he had macular degeneration.
We should thank God for the invention of reading glasses that help old men to pass on their wisdom.
John 5:3: Scripture does not need defending
Here a great number of disabled people used to lie - the blind the lame, the paralyzed and they waited for the moving of the waters
Less reliable Ms have the second clause about the moving of the waters and also verse 4 From time to time an angel of the Lord would come down and stir up the waters. The first one into the pool after each such disturbance would be cured of every disease he had.
How should we deal with the fact that there are discrepancies in the different Ms that we have our translations from? Carson suggests that this might have started life as a marginal note that explained the popular belief at the time. We know that the two Bethesda pools were fed from a larger Solomon's pool and the stirring of the waters might have a purely natural explanation.
It hardly matters to John's narrative whether the second half of verse 3 and verse 4 are in at all. So it's not worth making a fuss about. Trying to defend every last phrase in the KJV is likely to lead us into dark alleys. that's why most confessions of faith contain the words 'as originally given'.
Less reliable Ms have the second clause about the moving of the waters and also verse 4 From time to time an angel of the Lord would come down and stir up the waters. The first one into the pool after each such disturbance would be cured of every disease he had.
How should we deal with the fact that there are discrepancies in the different Ms that we have our translations from? Carson suggests that this might have started life as a marginal note that explained the popular belief at the time. We know that the two Bethesda pools were fed from a larger Solomon's pool and the stirring of the waters might have a purely natural explanation.
It hardly matters to John's narrative whether the second half of verse 3 and verse 4 are in at all. So it's not worth making a fuss about. Trying to defend every last phrase in the KJV is likely to lead us into dark alleys. that's why most confessions of faith contain the words 'as originally given'.
13 Elements: Tellurium
Tellurium
Metalloid
Atomic number: 52
Used in: solar cells
Criticality rating: near-critical
In 2009, solar cells made from thin films of cadmium telluride became the first to undercut bulky silicon panels in cost per watt of electricity generating capacity. That points to a cheaper future for solar power – perhaps.
Both cadmium and tellurium are mining by-products – cadmium from zinc, and tellurium from copper. Cadmium's toxicity means it is in plentiful supply: zinc producers are obliged to remove it during refining, and it has precious few other uses. “The people who manufacture cadmium telluride photocells often say one of the best things you can do with cadmium is to put it between two sheets of glass and leave it there,” says Robert Jaffe, a physicist at the Massachusetts Institute of Technology.
For tellurium, the situation is reversed. Because the global market for the element has been minute compared with that for copper – some $100 million against over $100 billion – there has been little incentive to extract it. That will change as demand grows, but better extraction methods are expected to only double the supply, which will be nowhere near enough to cover the predicted demand if the new-style solar cells take off. The US DoE anticipates a supply shortfall by 2025.
The US DoE puts a “critical” alarm on supplies of indium for the next five years, but will reduce this to “near-critical” for the period 2015 to 2025 as we get better at extracting the element or develop indium-free technologies such as conductive polymers or nanowires (New Scientist, 23 October 2010, p 40). Even so, without expanded production after 2015, the DoE says reductions in “non-clean energy demand” will be needed “to prevent shortages and price spikes”. In other words, we might need to choose which is the more important – smartphones or solar cells.
Metalloid
Atomic number: 52
Used in: solar cells
Criticality rating: near-critical
In 2009, solar cells made from thin films of cadmium telluride became the first to undercut bulky silicon panels in cost per watt of electricity generating capacity. That points to a cheaper future for solar power – perhaps.
Both cadmium and tellurium are mining by-products – cadmium from zinc, and tellurium from copper. Cadmium's toxicity means it is in plentiful supply: zinc producers are obliged to remove it during refining, and it has precious few other uses. “The people who manufacture cadmium telluride photocells often say one of the best things you can do with cadmium is to put it between two sheets of glass and leave it there,” says Robert Jaffe, a physicist at the Massachusetts Institute of Technology.
For tellurium, the situation is reversed. Because the global market for the element has been minute compared with that for copper – some $100 million against over $100 billion – there has been little incentive to extract it. That will change as demand grows, but better extraction methods are expected to only double the supply, which will be nowhere near enough to cover the predicted demand if the new-style solar cells take off. The US DoE anticipates a supply shortfall by 2025.
The US DoE puts a “critical” alarm on supplies of indium for the next five years, but will reduce this to “near-critical” for the period 2015 to 2025 as we get better at extracting the element or develop indium-free technologies such as conductive polymers or nanowires (New Scientist, 23 October 2010, p 40). Even so, without expanded production after 2015, the DoE says reductions in “non-clean energy demand” will be needed “to prevent shortages and price spikes”. In other words, we might need to choose which is the more important – smartphones or solar cells.
Thursday, June 23, 2011
Melanoma and bran
While most cancers seem to have an environmental cause that is diminished by rising on the social scale, melanoma becomes commoner the more upper class you are. The role of ultra violet rays is well established and the upper classes take more foreign holidays. The blame is put on hair spray and oven cleaner. It is supposed that their fluorocarbon propellants have punched a hole in the ozone layer at the South Pole, which has allowed the UV to seep through.
Now, I think this is all Baloney. For a start there’s not much melanoma in Antarctica, and for another hair spray has been around much longer than the hole in the ozone. Remember those bouffant hairstyles of the fifties? That was when hair spray was at its zenith.
The social phenomenon that correlates best with the loss of the ozone is bran. I tried it once. Not only do you almost choke trying to swallow the vile little particles, you certainly choke if you stand down wind of anyone on the stuff. Methane is the link. Vegetarians chewing on cabbage, artichokes and endives, but most of all on bran, are producing millions of litres of methane. Until the vegetarians came along the chief methane producers were the termites chewing down the trees in the tropical rain forest, but thank goodness someone has had the wisdom to chop the wretched trees down and deny the termites their feast.
If you remember your chemistry, the formula for methane is CH4. What that carbon and hydrogen cry out for is oxygen. They are trying to become carbon dioxide and water. And where do they get their oxygen from? That’s right, the ozone layer. After all why make do with O2 when you can get hold of O3?
All those open-toed-sandled, hairy, corduroyed, lib-dem-voting, bran-eating vegetarians are sucking the ozone out of the atmosphere and giving the rest of us melanoma.
I have proof of this. Before we even knew that ozone had a layer, the only place you found it was at the seaside. Of course, the pundits told us that it wasn’t ozone we could smell but rotting seaweed. The truth is it was both. The methane produced by the decaying seaweed drew in the ozone for the benefit of the bathers. But this inordinate and unnatural consumption of vegetables has thrown the environment into a fearful imbalance. It’s time to act. Ban bran now.
Now, I think this is all Baloney. For a start there’s not much melanoma in Antarctica, and for another hair spray has been around much longer than the hole in the ozone. Remember those bouffant hairstyles of the fifties? That was when hair spray was at its zenith.
The social phenomenon that correlates best with the loss of the ozone is bran. I tried it once. Not only do you almost choke trying to swallow the vile little particles, you certainly choke if you stand down wind of anyone on the stuff. Methane is the link. Vegetarians chewing on cabbage, artichokes and endives, but most of all on bran, are producing millions of litres of methane. Until the vegetarians came along the chief methane producers were the termites chewing down the trees in the tropical rain forest, but thank goodness someone has had the wisdom to chop the wretched trees down and deny the termites their feast.
If you remember your chemistry, the formula for methane is CH4. What that carbon and hydrogen cry out for is oxygen. They are trying to become carbon dioxide and water. And where do they get their oxygen from? That’s right, the ozone layer. After all why make do with O2 when you can get hold of O3?
All those open-toed-sandled, hairy, corduroyed, lib-dem-voting, bran-eating vegetarians are sucking the ozone out of the atmosphere and giving the rest of us melanoma.
I have proof of this. Before we even knew that ozone had a layer, the only place you found it was at the seaside. Of course, the pundits told us that it wasn’t ozone we could smell but rotting seaweed. The truth is it was both. The methane produced by the decaying seaweed drew in the ozone for the benefit of the bathers. But this inordinate and unnatural consumption of vegetables has thrown the environment into a fearful imbalance. It’s time to act. Ban bran now.
Coincidences
You could distinguish them: one was tall and gaunt and the other short and putting on weight. But Brown is a very common name and Browns of this age were quite likely to have been named after the old queen’s consort. They both attended my clinic regularly and for a very long time, for one had chronic lymphocytic leukaemia and the other polycythaemia rubra vera.
They were both born, in different parts of the country, on the same day in October 1896. It was a coincidence that they should at different times have bought the same house in the very same street, though not, I should hasten to add, from each other. It was a coincidence that they should both have lost their prostates to the very same surgeon. But what do you call it when I discover that for the three years that they had been attending my clinic they had been sharing the same hospital number and the very same set of case notes?
They were both born, in different parts of the country, on the same day in October 1896. It was a coincidence that they should at different times have bought the same house in the very same street, though not, I should hasten to add, from each other. It was a coincidence that they should both have lost their prostates to the very same surgeon. But what do you call it when I discover that for the three years that they had been attending my clinic they had been sharing the same hospital number and the very same set of case notes?
Shooting America
Despite the public revulsion with guns over here, there are more than 120 million firearms in private hands in the USA. About half the homes in America contain one or more gun. If you ask an American why he keeps a handgun in his house he will likely tell you that it’s to protect his property, or perhaps for self defence.
The real reason is less obvious. In a classic study Kellerman and Reay reviewed all the gunshot deaths in a five-year period in and around Seattle. Among one and a quarter million people there were 743 firearms-related deaths, of which just over half occurred at the residence where the gun was kept.
Only two of these 398 involved an intruder shot while attempting entry to the premises while another seven people were killed in self defence. There were 12 accidental deaths and 41 criminal homicides. In both categories the victim was usually a family member or friend.
But by far the largest group of firearms related deaths, accounting for 80% of the total, were suicides, often alcohol related. So the real reason that Americans keep a gun in the house is to shoot themselves with.
The real reason is less obvious. In a classic study Kellerman and Reay reviewed all the gunshot deaths in a five-year period in and around Seattle. Among one and a quarter million people there were 743 firearms-related deaths, of which just over half occurred at the residence where the gun was kept.
Only two of these 398 involved an intruder shot while attempting entry to the premises while another seven people were killed in self defence. There were 12 accidental deaths and 41 criminal homicides. In both categories the victim was usually a family member or friend.
But by far the largest group of firearms related deaths, accounting for 80% of the total, were suicides, often alcohol related. So the real reason that Americans keep a gun in the house is to shoot themselves with.
Is this the truth about the Arab Spring?
From a Syrian Christian friend:
I have hesitated many times to write about Syria. Yesterday a friend encouraged me to write something to help friends have a better understanding of the situation. It has been very sad to hear and see what is happening but sadder still to see the contradictions between what is said on the news and what I hear from friends within the country. On Tuesday the streets of each city was full to bursting with hundreds of thousands who were Pro Assad demonstrators. He is to some of you a dictator, but he isn’t to the majority of the people of Syria, to us he is someone who allowed different groups and different religions to coexist in harmony without allowing one to dominate the others! This must be said. He has protected the Christians since the time his father took power and continues to do so. Where in the world does the government give you a free land to build your churches, where do they call you in only to say that they are proud of you and of your community? This happened there. I spent the first few years in my life there. It was such a lovely life and such freedom to live our faith and to be who we are. After living in other countries I now appreciate that even more. He also allowed the Muslims, Alaouits, Drouz... and others to exercise their religions in freedom. Syria is not a Muslim state. It signed to laïcity many decades ago. And this is unacceptable to some parties. What we hear on the news is not the real picture at times, like the incident that happened in 1985 in Hamma. What happened there was punishing a radical group that killed hundreds of innocent people by placing bombs in every bus and train to go off at the same day and hour! No one heard of this. In that incident I lost my best friend! As people of Syria we were so pleased he held back extremist and radicals under control. Today most people I talk to – not just the Christians – in Syria are urging him not to allow the extremists to take power!
Today what is going on is not in search of democracy. The problems started in cities that are the hub of radicals, and if you watch carefully things are worse on the Friday as there are those who go in the mosques and preach a message against the West, Israel and the president of Syria.
What baffles me that the West supports the people that will hurt Syria and the West in the future. If they take the power in that region then the church will suffer more than you could imagine, not forgetting the seriousness of the political situation of the region and who or what else might suffer.
When the twin towers were bombed in the United States we all tasted the power of evil. I pray that this evil won’t prevail against any peoples or country... please pray for Syria
I have hesitated many times to write about Syria. Yesterday a friend encouraged me to write something to help friends have a better understanding of the situation. It has been very sad to hear and see what is happening but sadder still to see the contradictions between what is said on the news and what I hear from friends within the country. On Tuesday the streets of each city was full to bursting with hundreds of thousands who were Pro Assad demonstrators. He is to some of you a dictator, but he isn’t to the majority of the people of Syria, to us he is someone who allowed different groups and different religions to coexist in harmony without allowing one to dominate the others! This must be said. He has protected the Christians since the time his father took power and continues to do so. Where in the world does the government give you a free land to build your churches, where do they call you in only to say that they are proud of you and of your community? This happened there. I spent the first few years in my life there. It was such a lovely life and such freedom to live our faith and to be who we are. After living in other countries I now appreciate that even more. He also allowed the Muslims, Alaouits, Drouz... and others to exercise their religions in freedom. Syria is not a Muslim state. It signed to laïcity many decades ago. And this is unacceptable to some parties. What we hear on the news is not the real picture at times, like the incident that happened in 1985 in Hamma. What happened there was punishing a radical group that killed hundreds of innocent people by placing bombs in every bus and train to go off at the same day and hour! No one heard of this. In that incident I lost my best friend! As people of Syria we were so pleased he held back extremist and radicals under control. Today most people I talk to – not just the Christians – in Syria are urging him not to allow the extremists to take power!
Today what is going on is not in search of democracy. The problems started in cities that are the hub of radicals, and if you watch carefully things are worse on the Friday as there are those who go in the mosques and preach a message against the West, Israel and the president of Syria.
What baffles me that the West supports the people that will hurt Syria and the West in the future. If they take the power in that region then the church will suffer more than you could imagine, not forgetting the seriousness of the political situation of the region and who or what else might suffer.
When the twin towers were bombed in the United States we all tasted the power of evil. I pray that this evil won’t prevail against any peoples or country... please pray for Syria
John 5:1-2. Jesus' Jerusalem ministry begins
Some time later, Jesus went up to Jerusalem for one of the Jewish festivals. Now there is in Jerusalem near the Sheep Gate a pool, which in Aramaic is called Bethesda and which is surrounded by five covered colonnades.
We have completed the first part of Jesus' public ministry; from Cana to Cana. The second part goes from Colonnade to Colonnade (John 10:23). Jesus' ministry in Jerusalem is often associated with Jewish Feast days - Passover, Tabernacles - but here we are given no clue which Jewish Feast is associated with this visit to the capital.
If John is referring here to the same Sheep gate as Nehemiah he means a little opening in the north wall of the city near the north-east corner. . The name of the pool has various spellings in the different manuscripts, but Bethesda is probably most likely to be correct and it means the 'house of outpouring'. We have hard evidence of the existence of this pool. A Bordeaux pilgrim visited Jerusalem in 333 AD and described a pair of pools with five arcades. It was located near the Church of St Anne in the north-east quarter of the Old City. there were two pools lying north and south surrounded by four covered colonnades with a fifth colonnade separating the two pools
We have completed the first part of Jesus' public ministry; from Cana to Cana. The second part goes from Colonnade to Colonnade (John 10:23). Jesus' ministry in Jerusalem is often associated with Jewish Feast days - Passover, Tabernacles - but here we are given no clue which Jewish Feast is associated with this visit to the capital.
If John is referring here to the same Sheep gate as Nehemiah he means a little opening in the north wall of the city near the north-east corner. . The name of the pool has various spellings in the different manuscripts, but Bethesda is probably most likely to be correct and it means the 'house of outpouring'. We have hard evidence of the existence of this pool. A Bordeaux pilgrim visited Jerusalem in 333 AD and described a pair of pools with five arcades. It was located near the Church of St Anne in the north-east quarter of the Old City. there were two pools lying north and south surrounded by four covered colonnades with a fifth colonnade separating the two pools
Galatians 6:7-10. Don't give up.
Do not be deceived: God cannot be mocked. A man reaps what he sows. Whoever sows to please their flesh, from the flesh will reap destruction; whoever sows to please the Spirit, from the Spirit will reap eternal life. Let us not become weary in doing good, for at the proper time we will reap a harvest if we do not give up. Therefore, as we have opportunity, let us do good to all people, especially to those who belong to the family of believers.
There is a false dichotomy in some people's minds between the Law and the Spirit. Sometimes people think that without the Law, it doesn't matter what you do. Let sin abound that grace may more abound! But of all places, here in Galatians we have Paul invoking us to be good. Warning us that the Lord sees everything that we do. We must not become weary in well-doing, doing good to all people especially to Christians.
The other false dichotomy is between doing things ourselves and letting the Holy Spirit do them for us. It's not either/or, it's both/and. There is divine sovereignty and human responsibility here. We are to work out our own salvation by keeping in step with the Spirit.
I've told this story before; it's one of David Pawson's. When he was serving in the RAF in the Middle East, during Ramadan his servant was found hiding in a wardrobe scoffing delicacies, thinking that Allah would not be able to observe him there. Do not be fooled. God is not mocked! Everything is recorded. He is concerned that the death of Christ is sufficient to cover every sin. He would not want any to be missed out on.
Calvinists talk about the final preservation of the Saints. But we have the responsibility here, not to give up. Note also the responsibility that we have to the family of believers. From time to time I post about the work of Open Doors and Barnabas Trust which focus on the plight of Christians in difficult circumstances. Your money would be nice, but they really covet your prayers.
There is a false dichotomy in some people's minds between the Law and the Spirit. Sometimes people think that without the Law, it doesn't matter what you do. Let sin abound that grace may more abound! But of all places, here in Galatians we have Paul invoking us to be good. Warning us that the Lord sees everything that we do. We must not become weary in well-doing, doing good to all people especially to Christians.
The other false dichotomy is between doing things ourselves and letting the Holy Spirit do them for us. It's not either/or, it's both/and. There is divine sovereignty and human responsibility here. We are to work out our own salvation by keeping in step with the Spirit.
I've told this story before; it's one of David Pawson's. When he was serving in the RAF in the Middle East, during Ramadan his servant was found hiding in a wardrobe scoffing delicacies, thinking that Allah would not be able to observe him there. Do not be fooled. God is not mocked! Everything is recorded. He is concerned that the death of Christ is sufficient to cover every sin. He would not want any to be missed out on.
Calvinists talk about the final preservation of the Saints. But we have the responsibility here, not to give up. Note also the responsibility that we have to the family of believers. From time to time I post about the work of Open Doors and Barnabas Trust which focus on the plight of Christians in difficult circumstances. Your money would be nice, but they really covet your prayers.
13 elements: Tantalum
Tantalum
Transition metal
Atomic number: 73
Used in: Almost all handheld electronics
Criticality rating: not rated
Your smartphone or tablet computer is a veritable wonder of modern materials technology, with its touchscreen interface incorporating indium (page 40), compact lithium-ion battery and tiny processors packed with nanoscale transistors (see hafnium).
This also extends to its capacitors, the humble components that store energy and smooth power flow in electronic circuits. It is thanks to two-faced tantalum that they remain so slimline. In its pure form, this metal forms one of two conducting plates on which charge is stored. As an oxide, meanwhile, it makes a highly effective insulator, only a thin layer of which is needed to prevent leakage between the plates. As a bonus, the oxide is self-healing, rapidly reforming to plug any leak that lets current through.
It is fortunate, then, that the US Geological Survey believes that tantalum is in plentiful supply, with known deposits covering projected need. In fact, during the recent global economic slowdown, several mines were temporarily shut down as demand dropped.
Transition metal
Atomic number: 73
Used in: Almost all handheld electronics
Criticality rating: not rated
Your smartphone or tablet computer is a veritable wonder of modern materials technology, with its touchscreen interface incorporating indium (page 40), compact lithium-ion battery and tiny processors packed with nanoscale transistors (see hafnium).
This also extends to its capacitors, the humble components that store energy and smooth power flow in electronic circuits. It is thanks to two-faced tantalum that they remain so slimline. In its pure form, this metal forms one of two conducting plates on which charge is stored. As an oxide, meanwhile, it makes a highly effective insulator, only a thin layer of which is needed to prevent leakage between the plates. As a bonus, the oxide is self-healing, rapidly reforming to plug any leak that lets current through.
It is fortunate, then, that the US Geological Survey believes that tantalum is in plentiful supply, with known deposits covering projected need. In fact, during the recent global economic slowdown, several mines were temporarily shut down as demand dropped.
BiTE technology. Blinatumomab I
The astonishing effect of monoclonal antibodies on B-cell tumors is there for everybody to see, but antibodies are really not designed to kill lymphocytes. They are splendid at killing bacteria, and good for killing cells without nuclei, like red cells and platelets, but nucleated cells have defences against them. Although there are natural autoimmune diseases like ITP and AIHA which are caused by antibody, it is very doubtful whether antibody has anything to do with autoimmune diseases where the damaged tissue has nucleated cells. Take pernicious anemia (PA) for example. A large proportion of the female population had natural antibodies against gastric parietal cells, but very few go down with PA. It’s the same with thyroid disease. Antibodies against thyroid microsomes are common, but myxedema is rare.
On the other hand we have now come to see that stem cell transplants work by T-cells attacking what they see as foreign. Graft versus leukemia is what saves lives, not rescuing the bone marrow following huge doses of chemo- or radiotherapy (as we used to think). The problem with allografts is that along with graft versus leukemia we have graft versus host disease which itself makes the procedure dangerous and gives us death rates of about 20% from the procedure.
It would be nice to use the efficiency of T-cell effectors coupled with the direction finding of monoclonal antibodies. In fact my daughter has just completed 4 years studying for a PhD on this very subject. The obvious way to attempt this is to couple together a monoclonal antibody that attacks the tumor cell with a monoclonal antibody that activates a T cell.
This technology has been in the public domain for nearly three years now and can be accessed through the Science website without charge (though it does require registration.
Briefly we are talking about single chain bispecific antibodies one end of which attacks the tumor cell (in this case an anti-CD19 and the other engages the T cell (an anti-CD3) They have been given the name BiTE (which stands for bispecific T cell engagers). The one that has drawn the interest of CLL patients is blinatumomab.
The Science paper reported on a phase I dose escalation clinical trial in 38 patients with non-Hodgkins lymphoma who had relapsed following standard therapies. They had had a median of three previous chemotherpeutic regimens and 87% had had rituximab. Most of the patients were follicular lymphomas or mantle cell lymphomas, but there were 3 with CLL/SLL. One important factor is that the dose used was minute - about 100,000 times smaller than the dose of rituximab and therefore it ought to be a lot cheaper to make (Ha! Ha!). Patients were offered 8 weeks of daily treatment as long as they had not progressed after four.
The reason for the very low dose was the fear of cytokine storm as happened a few years ago at Northwick Park. We had known that this was a risk when you activated T cells and I give an example our own use of a trispecific antibody back in the 1990s. The illustrations show a 'before and after' shot of a patient’s melanoma recurring in the skin of a previous excision. We treated him with a very low dose of an Anti-CD3/anti-CD2/anti-CD28 trispecific antibody with no attempt to direct the antibody at the melanoma, simply relying on the activated T cells to do their work. We had experience at the time of using systemic IL-2 to activate T cells but although this had been fairly successful with 50% response rates including 20% CRs, the toxicity was severe with cytokine storm like affects. For this reason we began using the trispecific antibody at doses of 200 nanograms – roughly 2 million times smaller than the dose of rituximab.
The Science paper gave two bits of useful information on this subject. First, they actually measured the release of cytokines by their treatment and second they have demonstrated that giving high doses of steroids does not detract from the killing ability of the bispecific antibody. In fact patients were given methylprednisolone and low molecular weight heparin during the first treatment days as prophylaxis against cytokine release problems. The side effects of the treatment were mostly well managed. One patient with a history of near fatal sepsis died after developing an infection on this treatment. Another patient with hypogammaglobulinemia had treatment discontinued because of the development of pneumonia. One patient with a history of renal insufficiency had the drug stopped because of metabolic acidosis accompanied by a seizure. Five patients had the drug stopped because of CNS-related events; two with confusion, two with cerebellar symptoms and one with the seizure already alluded to. Al these events were fully reversible after a couple of days. There has been a suspicion that CD19 might be on some cerebral tissues as a result of these side effects.
TNF-alpha was transiently increased in 6 patients. There was a transient elevation of IL-10 in 25/39 patients of whom 19 also showed transient elevations of IL-6 or gamma interferon.
Those patients with a peripheral lymphocytosis showed rapid and long-lasting clearance of lymphocytes from the blood. There was an increase in blood levels of effector memory CD8+ and CD4+ T cells but no change in naive, central memory and CD45RA+ effector memory T cells.
All seven patients who received more than 0.06 mg/sqm/d responded, with 2 CRs and 5 PRs. At smaller doses there were 2 CRs and 2 PRs (one of the PRs being in CLL/SLL). The three CLLs received very small doses of 5 and 15 micrograms/sq m/d and the one who responded received 150 micrograms/sq m/d. This is very preliminary but we should remember that CD19 is not low on the surface of CLL the way that CD20 is so there is no reason to believe that CLL would behave any differently than other forms of NHL. In fact, the one CLL patient who only received 5 micrograms/sq m/d had a minimal response (25% shrinkage of disease).
On the other hand we have now come to see that stem cell transplants work by T-cells attacking what they see as foreign. Graft versus leukemia is what saves lives, not rescuing the bone marrow following huge doses of chemo- or radiotherapy (as we used to think). The problem with allografts is that along with graft versus leukemia we have graft versus host disease which itself makes the procedure dangerous and gives us death rates of about 20% from the procedure.
It would be nice to use the efficiency of T-cell effectors coupled with the direction finding of monoclonal antibodies. In fact my daughter has just completed 4 years studying for a PhD on this very subject. The obvious way to attempt this is to couple together a monoclonal antibody that attacks the tumor cell with a monoclonal antibody that activates a T cell.
This technology has been in the public domain for nearly three years now and can be accessed through the Science website without charge (though it does require registration.
Briefly we are talking about single chain bispecific antibodies one end of which attacks the tumor cell (in this case an anti-CD19 and the other engages the T cell (an anti-CD3) They have been given the name BiTE (which stands for bispecific T cell engagers). The one that has drawn the interest of CLL patients is blinatumomab.
The Science paper reported on a phase I dose escalation clinical trial in 38 patients with non-Hodgkins lymphoma who had relapsed following standard therapies. They had had a median of three previous chemotherpeutic regimens and 87% had had rituximab. Most of the patients were follicular lymphomas or mantle cell lymphomas, but there were 3 with CLL/SLL. One important factor is that the dose used was minute - about 100,000 times smaller than the dose of rituximab and therefore it ought to be a lot cheaper to make (Ha! Ha!). Patients were offered 8 weeks of daily treatment as long as they had not progressed after four.
The reason for the very low dose was the fear of cytokine storm as happened a few years ago at Northwick Park. We had known that this was a risk when you activated T cells and I give an example our own use of a trispecific antibody back in the 1990s. The illustrations show a 'before and after' shot of a patient’s melanoma recurring in the skin of a previous excision. We treated him with a very low dose of an Anti-CD3/anti-CD2/anti-CD28 trispecific antibody with no attempt to direct the antibody at the melanoma, simply relying on the activated T cells to do their work. We had experience at the time of using systemic IL-2 to activate T cells but although this had been fairly successful with 50% response rates including 20% CRs, the toxicity was severe with cytokine storm like affects. For this reason we began using the trispecific antibody at doses of 200 nanograms – roughly 2 million times smaller than the dose of rituximab.
The Science paper gave two bits of useful information on this subject. First, they actually measured the release of cytokines by their treatment and second they have demonstrated that giving high doses of steroids does not detract from the killing ability of the bispecific antibody. In fact patients were given methylprednisolone and low molecular weight heparin during the first treatment days as prophylaxis against cytokine release problems. The side effects of the treatment were mostly well managed. One patient with a history of near fatal sepsis died after developing an infection on this treatment. Another patient with hypogammaglobulinemia had treatment discontinued because of the development of pneumonia. One patient with a history of renal insufficiency had the drug stopped because of metabolic acidosis accompanied by a seizure. Five patients had the drug stopped because of CNS-related events; two with confusion, two with cerebellar symptoms and one with the seizure already alluded to. Al these events were fully reversible after a couple of days. There has been a suspicion that CD19 might be on some cerebral tissues as a result of these side effects.
TNF-alpha was transiently increased in 6 patients. There was a transient elevation of IL-10 in 25/39 patients of whom 19 also showed transient elevations of IL-6 or gamma interferon.
Those patients with a peripheral lymphocytosis showed rapid and long-lasting clearance of lymphocytes from the blood. There was an increase in blood levels of effector memory CD8+ and CD4+ T cells but no change in naive, central memory and CD45RA+ effector memory T cells.
All seven patients who received more than 0.06 mg/sqm/d responded, with 2 CRs and 5 PRs. At smaller doses there were 2 CRs and 2 PRs (one of the PRs being in CLL/SLL). The three CLLs received very small doses of 5 and 15 micrograms/sq m/d and the one who responded received 150 micrograms/sq m/d. This is very preliminary but we should remember that CD19 is not low on the surface of CLL the way that CD20 is so there is no reason to believe that CLL would behave any differently than other forms of NHL. In fact, the one CLL patient who only received 5 micrograms/sq m/d had a minimal response (25% shrinkage of disease).
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