Insulin-secreting pancreatic beta cells generated from stem cells

Balboa et al. Functional, metabolic and transcriptional maturation of human pancreatic islets derived from stem cells. Nature Biotechnology, March 2022.

Produced in pancreatic beta cells, insulin is a key hormone with a duty to regulate sugar (glucose) levels in the blood. In response to sugar, beta-cells are activated to secrete insulin as a result of which blood glucose levels go down. When beta-cells are diminished or become dysfunctional, blood glucose levels go up beyond normal levels, leading to diabetes. In patients with type 1 diabetes (T1D), pancreatic beta cells are gradually destroyed by the patient’s own immune system. T1D patients can use daily insulin injections, but since it is difficult to precisely regulate glucose levels, repetitive episodes of dysregulated sugar can often lead to organ damage and shorten a patient’s lifespan. Insulin can be also restored by transplanting beta cells from the isolated pancreas of organ donors. However, this treatment has not been feasible or widely used. There have been intense efforts to produce functional beta cells from stem cells for a broad common cell therapy, but these attempts usually ended up with immature beta cells with limited insulin secretion capacity. A recent study demonstrated for the first time that pancreatic cells with a physiologically normal structure and function can be generated from stem cells. Researchers tested their stem cell-derived beta cells in both cell culture and mice studies. In mice, they showed that transplanted stem cell-derived beta cells can take on the duty to robustly manage the glucose metabolism in the context of an organism. Moreover, these cells responded to changes in the glucose level even better than the pancreatic islets isolated from organ donors. The investigation of beta cell function in this study is the most comprehensive in the field so far. The generation of fully functionally mature beta cells at a scalable level may be possible in the next few years and will make diabetes cell therapies more attainable.

Implantable tiny drug factories show promise in cancer immunotherapies

Nash et al. Clinically translatable cytokine delivery platform for eradication of intraperitoneal tumors. Science Advances, March 2022.

Immunotherapy, which uses the body’s own immune system to prevent, control, and eradicate cancer has been increasingly adopted due to its precision. A new study showed that tiny, implantable “drug factories” that produce an immune system protein could offer a new way to treat some cancers. In the new experimental therapy, tested only in mice, pinhead-sized beads are inserted in the vicinity of cancerous growths, and they deliver a continuous dose of interleukin-2 (IL-2) to keep white blood cells activated to detect and fight cancer. IL-2 is an immunotherapy medicine used in treating multiple cancer types. However,  IL-2,  especially at the systemic high doses, can be extremely toxic with serious side effects including low blood pressure, an abnormal heart rate, and chest pain. With this in mind, the new study specifically fabricated tiny IL-2 beads that are designed to target local tumor microenvironments without affecting the rest of the body. Initial results on mice with advanced-stage ovarian cancer showed 100% effectiveness. In addition, mice with bowel cancer showed 87% success only in 6 days. This technology holds a special premise for cancers that occur in closed-off cavities such as ovarian, pancreatic, and colon cancers, as well as certain lung tumors. Furthermore, these tiny drug factories can be loaded with any other drug depending on the tumor and tissue type. Overall, these results provide a strong rationale for designing human trials that are expected to start next year.

Human-induced climate change may make Mt. Everest’s highest glacier disappear by mid-century

Potocki et al. Mt. Everest’s highest glacier is a sentinel for accelerating ice loss. Nature Climate and Atmospheric Science. February 2022.

Mountain glaciers has been melting at increasing rates for several decades, and the resulting loss of water capacity has substantially impacted both local and global ecosystems. A recent study focused on the highest mountain on Earth, Mt. Everest (8848.86 m). The study is based on reviews of past literature, recently acquired data and modeling, changes in temperature, precipitation, glaciers and glacial lakes, water quality of rivers and lakes, atmospheric environment, and vegetation phenology. Their analyses revealed substantial warming in the Mt. Everest region during the 20th century, which caused melting and sublimation. This has caused a chain of events where the more snow cover melts, the more ice is exposed which absorbs more sunshine and in turn accelerates the glacier’s melting rate. The South Col Glacier, located near Mt. Everest’s summit, has lost around 55m of thickness in the last 25 years. Alarmingly, it is now thinning over 80 times faster than the 2,000 years it took to form the ice. While changes in wind and humidity may have slightly contributed to this ice loss, human-induced climate change is the overwhelming cause. Mt. Everest shows its hydrological response to global warming. If the same melting trends continue, then the glacier-stored water that more than 1 billion people depend on for drinking water and irrigation could start to significantly deplete. With an estimated thinning rate around 2 meters per year, glaciers including the South Col may disappear by mid-century.

Question: It is stated that practicing religion is easy, but to many it doesn’t appear to be so. Can you please explain this apparent contradiction?

Ease and difficulty are relative concepts. It differs in accordance with personal perception and understandings. With the influence of one’s habitual lifestyle, some people might find it difficult fulfill certain religious responsibilities which are not at all difficult to observe. As for sincere believers who have reached a level of contentment in faith, they observe without difficulty so many deeds which seem to be difficult.

In many verses, the Qur’an states that religion is ease, and that God will not hold his servants responsible for more than what they can bear. We can give the following verses as an example:

“God burdens no soul except within its capacity” (Baqara 2:286).

“… He has not laid any hardship on you in the Religion” (Hajj 22:78).

The Messenger of God drew attention to two essential qualities of religion: “God sent me with hanifiyya al-samha” (Ahmad ibn Hanbal, al-Musnad, 5/266). The meaning of hanifiyya mentioned here is Islam being distant from unbelief and associating partners with God, and Islam taking Divine Oneness as its basis. The term samha refers to Islam being a religion based on latitude, ease, and lenience. Likewise, another narration states that religion upon hanifiyya al-samha is most lovable to God (Bukhari, Iman, 29).

In another similar hadith, the noble Prophet states: “Indeed, this religion is easy, and no one will ever overburden himself in religion, except that it will overcome him…” (Bukhari, Iman, 29).

God and His Messenger teach that the religion, which is built on ease, should not be made difficult to overburden people. With regard to responsibilities, Islam does bring certain burdens, but these are not impossible to bear. If a person says, “I will observe some five hundred units of prayer a day, I will fast for a lifetime, I will never socialize with people, I will not touch the knob of another house and will not be busied with raising children…” then this means that person is fighting against human nature and trying to make life flow in the wrong way. It is impossible for anyone at war with human nature to succeed. One who does not benefit from the natural direction of human nature but sails against the wind cannot observe the essential requirements of religion. God Almighty who knows best His servants’ position in the world around them as well as what they can or cannot bear held them responsible for certain observances accordingly.

Not eating, not sleeping, complete abstention from lawful worldly pleasures, and spending one’s entire life in a place of worship, etc. are not compatible with human nature—and natural ways in general—and thus are impossible to keep up for a long time. The Qur’an criticizes such practices:

“Thereafter, We sent, following in their footsteps, others of Our Messengers, and We sent Jesus son of Mary, and granted him the Gospel, and placed in the hearts of those who followed him tenderness and mercy. And monasticism, they innovated it only to seek God’s good pleasure – We did not prescribe it to them. But they have not observed it as its observance requires. So We have granted those among them who have truly believed their reward, but many among them have been transgressors” (Hadid 57: 26-27).

Some Christians volunteered for monasticism although they were not ordered to do so, but they were not able to bear it. When some Companions of the Prophet Muhammad, peace be upon him, made resolutions like spending the entire night in devotions, fasting every day, and abstaining from their spouse, the noble Prophet did not allow them to do so. “I am the one who fears God most and avoids evil most among you. This being so, I sometimes fast and sometimes do not. I observe Prayer for some part of the night and I sleep and rest for some part. At the same time I have a familial life. Whoever does not take this path of mine (sunnah) and turns away from it, he is not of me” (Bukhari, Nikah 1; Muslim Nikah 5).

He directed them to ease and the natural way. It is a great blessing and mercy on Muslims that Islam is built upon the natural way, ease, and lenience, and that it has no heavy responsibilities to overburden people.

The balance of blessing and responsibility

According to Bediuzzaman Said Nursi, worship is not done for future blessings, but for the blessings that have already been granted. That is, worship and devotions should not be performed as a means of gaining certain blessings we want but as a gratitude for the blessings we have already been granted. We are very much indebted to God already. So many duties and responsibilities fall to us on account of that. Therefore, no matter how much worship we observe, we will not have paid for His blessings upon us. For instance, God did not leave us in non-existence, but He brought us into the realm of existence. He granted life to us. Not stopping there, He rendered us human beings with reason and consciousness. He honored us with having faith. Each of these is a great blessing with a separate value of its own.

In addition to all of these, God Almighty granted us further blessings beyond count. All of these blessings call for thanksgiving of their own kind. A person has a responsibility of servitude to the Exalted Creator who showered them with interwoven blessings. This point must be logically accepted. A servant should know they have a responsibility toward their Creator. A person who is blessed with certain honors in the world knows that there are certain responsibilities and duties brought by such an honor. Accordingly, believers who received honors beyond everything else—that they are servants of God and took their place behind the Messenger of God—are they aware of the greatness of their own responsibility and liability?

Mukallafiyya (responsibility) and kulfa (burden) are two Arabic words derived from the same root. Every responsibility more or less involves some burden. Namely, a person with a responsibility has to deal with certain challenges. However, the challenges brought by religious responsibilities are nothing beyond a person’s capability. Not imposing “beyond a person’s capacity” is the essential character of religion. Every task in the world has greater or smaller challenges of its own. Religious liabilities are no exception. Despite this, it’s still possible to observe the practices of Islam in accordance with its principles.

To expound a little further on this, there is a certain extent of burden and challenge in observing the commands of religion. For example, the Messenger of God counts “taking ablutions properly even in difficult conditions” among the deeds that expiates one’s sins and elevates the person’s rank in the sight of God (Muslim, Tahara, 41). His other statement pointing out that Paradise is surrounded by certain difficulties and (outwardly) unpleasant things point to the same meaning (Bukhari, Riqaq 28; Muslim, Jannah 1). Each act of worship—such as prayer, fasting, charity, sacrifice, and pilgrimage—has a difficulty of its own. However, none of them is an impossible burden to bear or observe.

On the other hand, what religion enjoins or forbids should not be considered as the sole criterion of whether they bring a burden or not. It should not be forgotten that these practices involve so many benefits and wisdoms related to this world and the next, in both a material and spiritual sense. For example, remembrance of God and observing worship effect such a deep contentment in a person and provide that person’s spirit with such relief that these pleasures can’t be found elsewhere. The Qur’an points out that hearts will only find rest and satisfaction with remembrance of God (Ra’d 13:28).

It is certain that each act of worship has many more benefits with regards to one’s individual, social, and economic life. Beyond all of these, a person attaining eternal blessings in Paradise and gaining the good pleasure of God depend on fulfilling these responsibilities. When worship and other religious commandments are considered together with the entirety of their benefits and wisdoms, it’s impossible to see them as difficult. This is one of the meanings of Islam being hanifiyya al-samha.

“Make things easy, do not make them difficult!”

Although religion is based on ease and promises great benefits—for this world and the next—unfortunately some people do see it as impossible to practice. People of our time are much diseased in terms of their spiritual life. Just as Nursi stated that his works were meant to repair “the incalculable damage that has been inflicted on the all-embracing citadel which contains Islam…” (The Rays, Seventh Ray), we are, too, faced with a citadel exposed to ruin. The basic essentials of faith have undergone quakes. Very strange thoughts about Divinity are commonplace. The teachings of the Messenger of God are not followed. There is gross disrespect against parents. Our families are being shattered, our kinship ties are weakening, and our social relations are shaken. When the actual duties and responsibilities to be observed toward God are not fulfilled, the responsibilities beyond are neglected all the more so. It is as if we are in an overturned ship and things inside it are scattered here and there.

To appreciate the worth of religious commands and to observe them properly without worrying about their difficulty, it is necessary to repair this ruined citadel and to restore the ship whose parts are scattered. In other words, society needs to be given a very serious rehabilitation and be guided on the right path. To achieve this, we must always turn to “Talk of the Beloved” and constantly focus on faith, knowledge of God, love for God, and zeal and enthusiasm for His sake. While representing the faith perfectly, we must utilize every opportunity to tell people about our Lord, His Messenger, and beauties of the faith. While telling about Islam, we should comply with the message to “Make things easy for the people, and do not make it difficult for them; give them glad tidings and do not make them averse” (Bukhari, Ilm 11; Muslim, Jihad, 6). We should rather take the objective principles of religion as our basis.

Together with this, we should not forget that there are also some subjective responsibilities besides the objective principles of religion. Along with fulfilling the basic principles within a certain frame, saintly servants of God also sought to observe the much more difficult sides of religion, too. Some of them took the absolute commands revealed in religion and spent their entire lives with worship and devotions. And this is a matter that relates to a person’s horizons of knowledge of God and consciousness of perfect goodness. However, very few people in our time feel themselves under such responsibility and act accordingly.

In the United States, immigrants often face a crisis of identity that is familiar to many who live abroad. This crisis can be thought of as a struggle between the desire for cultural integration and the fear of cultural assimilation. On the one hand, immigrants usually come to a new country because they want to participate in its culture and economy and, at some level, reap the economic, cultural, or political benefits of this participation. On the other hand, such participation can lead to anxiety if it causes the immigrant to feel alienated from the traditions of his or her home country. In this article, we will look at how immigrant communities navigate this dilemma and how they seek to preserve their identity through shared experiences of language, religion, politics, and the consumption of media, all the while their identity is constantly being revised and altered by their encounters with mainstream American culture.

The three main groups entering the US in recent decades are Latin Americans, Asians, and, in significantly smaller numbers, immigrants or refugees from Muslim countries. These immigrants come to the United States for a variety of reasons, but most come seeking a better life than the one available to them in their home country. And for asylum seekers, life in their home country may not be an option anymore, due to political persecution, violence, or other reasons. They come to find peace and solace as well as opportunities to achieve self-realization. Statistically, immigrants believe in the American Dream more than Americans do. According to the General Social Survey conducted by NORC, almost 70 percent of immigrant parents say their children will prosper relative to themselves, compared with only 50 percent of native-born parents [1]. Clearly such newcomers desire some degree of cultural integration, and in their optimism regarding the possibilities of American life, they could even be considered “more American” than the native-born population.

Whereas immigrants come to the US with great expectations, attitudes toward immigrants vary. The belief that the growing number of immigrants threatens traditional American customs and values is less prevalent (averaging about 43 percent) than the belief that migrants strengthen American society (52 percent) [2]. Another common finding is that Americans clearly want immigrants to be integrated with US society. One indicator of this can be traced in a recent survey in which 76% of Americans said that they support the requirement of English proficiency for legal citizenship (Pew Research Center, 2013) [3]. Since bilingualism is one of the most visible manifestations of cultural difference, this group of Americans sees it as a threat to American culture and native-born leadership. However, some Americans believe that multilingualism among immigrant communities benefits American creativity and dynamism (Huntington, 2004; Alba, 2005). In the professional world, bilingualism is often highly rewarded, so immigrants who are able to maintain fluency in their native language while also gaining proficiency in English may find themselves more qualified for employment than if they had “lost” their first language. This is one example of the possible benefits of cultural integration as opposed to full assimilation into monolingual American culture. According to research, bilingualism has also been linked to other positive cognitive outcomes, including increased attention control, working memory, metalinguistic awareness, and abstract and symbolic representation skills (Adesope et al., 2010). Hence, for immigrants, it is important not to succumb to the pressure to assimilate to monolingual English-speaking culture, as there are many benefits to a more bilingual integration. In light of all of this, the best possible deal would be to retain one’s native language while also becoming proficient in English.

Such an approach would also resolve a major concern of first-generation immigrants: linguistic isolation. There is a strong correlation between the English proficiency level of a first- or second-generation immigrant and his or her level of cultural integration. Many studies show that English proficiency changes marriage patterns and increases a person’s ability to engage in native civic organizations and political discourse, which are very important factors in integration. In 2013, 22 percent of children living in immigrant families lived in linguistically isolated households. These children were observed to struggle in education due to their parents’ difficulty communicating with school staff and monitoring their children’s progress (Batalova and Fix, 2010; Fix and Capps, 2005; Gifford and Valdes, 2006). Data shows that these linguistically isolated kids have higher anxiety.

It’s observed that after the third generation, an immigrant family usually loses their native language to English.

Is there a middle way between cultural integration and isolation? There are some patterns that might prove beneficial to immigrants and families navigating this difficulty. For instance, in the Latino community, families maintain Spanish proficiency for up to five generations on average. While one major reason for this linguistic continuity is the frequent replenishment of the Spanish-speaking population in the United States, the prevalence of and access to Spanish-language media in the United States plays another important role. Immigrants from Latin America reported that they typically watch Spanish TV, unlike other groups who watch primarily English channels. Access to native language TV and a sizable (enough) community of native language speakers can effectively preserve language habits in immigrants, which can allow them to integrate bilingually.

Religion is another important aspect of culture that can face dramatic changes in the process of cultural integration. Even though it is difficult to measure religiosity—we can’t easily determine the strength of people’s beliefs—one reliable indicator could be religious service attendance. According to the data, roughly a quarter (27%) of all Christian immigrants in the survey attended religious service once or twice a month. By comparison, about six in ten (62%) of all Christians in the United States say they attend religious services at least once or twice a month (Pew Research Center, 2013). Muslims also saw a drop in religious attendance after immigration, with only 32% of immigrants attending regular services. According to Massey and Higgings (2001), one reason for the decline could be that some immigrants do not intend to stay permanently, so they may be less motivated to get involved in religious groups. The only exception to this trend is Jewish immigrant communities, where attendance remains essentially unchanged; every other major religious group observed a drop in weekly attendance of services.

Even though evaluating religiosity depending on religious service attendance is plausible, for Muslim communities this might not be a reliable indicator. Since Islam does not strictly require attendance to mosque for women, the data only represents male religiosity. One interesting finding that supports this fact is reflected in a study in which Muslim immigrants are found to be more religious than other major immigrant groups. According to the study, 65% of first generation and 60% of second-generation immigrants perform salah, the daily ritual prayer, every day. Additionally, 30% of Muslim women in immigrant communities wear headcovers when they are in public.

Yet, regardless of what the data on religiosity says, one significant factor to having thriving religious communities is the presence of welcoming religious institutions that offer community outreach and engagement opportunities. For those immigrants who do continue to attend regular religious services, religious institutions play a major role in integration. Membership in religious groups provides an alternative source of respectability for those who feel denied social recognition in the United States. Also, religious communities provide an array of resources for immigrants such as information about jobs, housing, and classes in English. Temples, mosques, synagogues, and churches can help immigrants gain upward social mobility by providing classes like English and SAT preparation. Also, involvement in religious institutions prevents youth from using drugs or joining gangs. For many immigrants, religious institutions are the most welcoming venue by which to get involved in society. It is even noted that some Latin American immigrants left Catholicism for smaller Evangelical churches because these churches provided more opportunity to culturally integrate through personal and supportive relationships.

The question for immigrants is how to maintain their cultural traditions while still integrating into a new social landscape. In addition to changes in linguistic and religious practices, immigrants also face adjustments to their culture and/or lifestyle. These also include changes in their mindset and their political views and attitudes. As immigrants spend time in the US for longer periods, we see that they tend to change their views on various political issues. One interesting finding is their view on the role of federal government [4]. On average, one-third of native-born people think that “the government in Washington is trying to do too many things that should be left to individuals and private businesses,” while a quarter disagree and believe the government should do more to solve the country’s issues. Immigrants differ from native-born citizens on this topic, as they are considerably more likely to feel that the government should do more (36%) rather than believing that it does too much (15%), which is a near reverse of native-born citizens’ views. However, it is observed that immigrant views ideas converge with native-born as they spend more time in America.

Furthermore, immigrants’ cultural integration may also affect their health. According to research, foreign-born immigrants live, on average, 3.4 years longer than the native-born population. The main reason is thought to be their change in eating habits. Immigrants consume less processed food than the native-born population, which lowers their rates of cardiovascular disease, obesity, and cancer.

Another dramatic change and a clear mark of cultural integration is intermarriage, which is becoming more and more common in America. Between 2008 and 2012, more than half of marriages involving immigrants had one native-born partner (Lichter et al., 2015a). In 2010, about one of every seven marriages were found to be interracial or interethnic, which is more than twice the rate in 1980 (Wang, 2012; Frey, 2014). Intermarriage has led a dramatic increase in the mixed-race population. In the United States, the percentage of multiracial babies increased from 1% in 1970 to 10% in 2013.

To turn our attention to American society, there is a group of native-born Americans who oppose immigration of any kind, regardless of how it might benefit society. One reason given for this opposition is the belief that immigrants commit more crimes. However, the data shows that foreign-born males are jailed at one-fourth the rate of native-born men in the 18-39 age group. There is no evidence that immigrants are more dangerous or criminal than native-born Americans. On the other hand, crime rates in the second and third generations of immigrants tend to be similar to those in the native-born population, a finding which some researchers interpret as a negative consequence of integration. Yet, healthy integration is something to aspire to, given its benefits both for immigrants and natives.

Whether one desires it or not, immigrants in America face dramatic changes in their culture, especially after the second generation, which is usually the generation that shows the last remnants of their grandparents’ culture. Indeed, after the second generation, immigrant culture becomes almost identical with American culture. But whether or not these changes result in integration or a more total assimilation has much to do with the support of religious institutions, immigrant support groups, and access to native-language media and communities.

Notes

1. Data from NORC’s General Social Survey (GSS) at http://www3.norc.org/Gss+website/ [September 2015].
2. See http://www.people-press.org/files/legacy-pdf/3-28-13%20Immigration%20Release.pdf [November 2015].
3. See http://www.people-press.org/files/legacy-pdf/6-23-13%20Immigration%20Release%20 Final.pdf November 2015]
4. See NORC’s General Social Survey website for variables and wording of questions at http:// www3.norc.org/GSS+Website/Browse+GSS+Variables/Subject+Index/ [November 2015].                

References

• Fry, R., and Lopez, M.H. (2012). IV. College graduation and Hispanics. Pew Research Center Hispanic Trends. Available: http://www.pewhispanic.org/2012/08/20/iv-collegegraduation-and-hispanics/ [July 2015].
• Burt, L., and Batalova, J. (2014). Refugees and Asylees in the United States. Washington, DC: Migration Information Source. Available: http://www.migrationpolicy.org/article/ refugees-and-asylees-united-states [March 2015].
• Huntington, S.P. (2004). The Hispanic challenge. Foreign Policy, 141(2), 30-45. Iceland, J., and Scopilliti, M. (2008). Immigrant residential segregation in U.S. metropolitan areas, 1990-2000. Demography, 45(1), 79-94.
• Adesope, O.O., Lavin, T., Thompson, T., and Ungerleider, C. (2010). A systematic review and meta-analysis of the cognitive correlates of bilingualism. Review of Educational Research, 80(2), 207-245.
• Massey, D., and Higgins, M.E. (2011). The effect of immigration on religious beliefs and practice: A theologizing or alienating experience? Social Science Research, 40(5), 1371-1389.
• Wang, W. (2012). The Rise of Intermarriage. Washington, DC: Pew Research Center.

As an instructor of statistics, I sometimes cannot help but explain the phenomena of the social sciences through mathematical expressions. This is especially true when there is almost complete correspondence between the two. One such topic is the “powers” of ignorance. When I say “powers,” I obviously do not mean how “mighty” ignorance makes a person. I mean the exponential expressions of ignorance:

Ignorance to the power of one (ignorance¹);

Ignorance to the power of two (ignorance²);

Ignorance to the power of three (ignorance³).

Powers of ignorance

Let us start with the simple definitions of these three powers:

Ignorance¹: Does not know;

Ignorance²: Does not know AND does not know that s/he does not know;

Ignorance³: Does not know AND does not know that s/he does not know AND insists that s/he does know.

Among the three, the first power is the most powerless in terms of leading the person to mistakes. The person is aware that s/he does not know. The solution to this case is simple: the person would go after the needed knowledge and acquire it, remedying this form of ignorance.

The second power is not that bad, either. The person does not know AND is not aware of the knowledge s/he lacks, either. Therefore, this person, when alerted to the necessity and existence of the knowledge in question, would acquire it, successfully ending the ignorance. In this sense, this power is also not that powerful in terms of leading the person to mistakes.

The third power is the most powerful at fooling its owner. The person does not know AND does not realize that s/he lacks certain knowledge. What is more, when alerted to the necessity and existence of the knowledge in question, s/he insists that s/he has nothing to learn. As you can tell, the ignorance cannot be eliminated easily—if at all—in this case. Such ignorance cannot be overcome by alerting the person to the knowledge in question and/or providing it. This is an attitudinal problem that “guards” the person against learning.­ ­

Now, let us return briefly to the math. Just as the magnitude of the difference between the consecutive powers of a mathematical entity increases as the powers increase, the differences between consecutive powers of ignorance are also different. For example, while the difference between the first power of two (2¹) and its second power (2²) is two (four minus two), the difference between the second power (2²) and the third (2³) is four (eight minus four). Likewise, there is a bigger leap in the severity of the problem from the second to the third power of ignorance, compared to the difference between the first and the second.

Known unknowns vs. unknown unknowns

I believe this hierarchical definition of ignorance might provide some insight into the relationship between the teacher and the learner. From the perspective of the constructivist theory of learning, the best scenario for a learner is to be the architect of his/her own knowledge palace. In this approach, the teacher is a facilitator of the learning process while the learner builds his/her knowledge palace piece by piece. For a learner who smoothly goes through this process, the first power of ignorance can easily be eliminated without much assistance, especially in this information age. In other words, in this kind of ignorance, there are “known unknowns” that can be learned.

Some initial guidance might be needed to eliminate the second power of ignorance. The learner might successfully decorate the existing rooms of her/his palace by herself/himself, yet might be unaware that there might be brand new rooms that can be added. At this point, the teacher might provide guidance and vision to the learner, so that s/he might start sailing in these uncharted territories. Once new land is discovered, the teacher might return to the role of facilitator. While there are “unknown unknowns” in this case, there is no resistance to the realization and acknowledgement of this situation by the learner.

The biggest challenge we face nowadays is undoubtedly around the third power. The teacher facing the third power of ignorance is helpless in helping the learner. In addition to “unknown unknowns”, there is this denial of the “unknowing”. In old times, the difficulty in overcoming ignorance was mostly about accessing knowledge. People who appreciated knowledge used to get very happy when they attained it. They also mostly exhibited the attitude that the more they learned, the more they realized how ignorant they were. In this sense, it is very odd that we can now access knowledge in seconds, yet we do not appreciate it. Nor do we have the wisdom that the more we learn, the humbler we should become about our knowledge.

Such an attitude also has a high potential of hurting the teacher-learner relationship, since the learner denies the fact that s/he sometimes needs guidance. Such learners only seek “depositories” of information, with the thinking that they, by themselves, can correctly and sufficiently process and digest all the information taken in. In this sense, they are closed to any advice, guidance, perspective, or vision provided by the teacher. Their approach implicitly says, “Just give me the information I am asking for and shut up!” This is where wisdom is lost between generations.

The missing link: wisdom

This might remind some readers of movies or TV series that depict the wisdom exhibited by a Far Eastern master of martial arts. The master would accept a Western person as his apprentice. Yet, he asks the apprentice to do extremely difficult and exhausting chores that are seemingly unrelated to the martial arts. Moreover, these chores appear as if they are geared towards the comfort of the master. Yet, as the apprentice proceeds in her/his training, s/he realizes how vital those chores have been in acquiring the necessary skills as well as attitudes, such as stamina, perseverance, and patience. Only then does s/he realize that it should be the master, not the apprentice, who defines the format of the master-apprentice relationship.

The more learners see knowledgeable people as only “depositories of information”, the more damage is done to a productive and meaningful teacher-learner relationship. Learners start to think that the second they acquire the information they lack, they become “even” with their teachers. And this exactly is the way of thinking that is a major source of the third power of ignorance.

Let us give a simple and practical example to illustrate this phenomenon. Think of a learner who wants to cook a dish. In response, the teacher provides the learner with the full list of ingredients for the dish. The learner, in turn, adds this to her/his library of information. As a second step, the teacher attempts to explain how and when each ingredient should be added to the pot, at what heat the dish should be cooked, and suggestions to add more flavor, etc. However, the learner declines this offer, claiming that s/he can handle these by herself/himself. Just like in this example, obtaining information about a topic is just the beginning. Applying this information to various situations, analyzing or synthesizing it, and comparing it with similar information are examples of tasks that require experience and are more important than simply depositing unprocessed information into one’s library. What is needed is to continue the learning process during these stages as well. This is only possible if the learner exhibits humility through awareness that s/he has yet learned little and keeps the channels of learning open.

Two disclaimers are in order here. First, this article is not to discredit learner-centered learning; rather, it seeks to highlight some points during the process where the teacher’s guidance and vision should play a critical role in the learner’s healthy progress in acquiring, digesting, and internalizing information. Second, it is not the intent here to imply that it should be the teacher alone who shapes the format of the learning-teaching process, and that the student should only be the object of it, as has been the case in many traditional educational systems. There is no doubt that a successful teacher will continually gauge the learner’s progress and gather constant feedback about the strengths and weaknesses of the learner and use these to provide proper guidance and vision.

It is crucial to help learners acquire the right attitude towards learning and knowledge. In an era where individuals are flooded with information and asked to mostly make pragmatic use of it, it is of the utmost importance to caution learners against the pitfalls of this approach and guide them towards successfully turning it into internalized knowledge. That would also bring about the wisdom and humility necessary for learners to continue to build their wonderful palaces of knowledge.

Sometimes unexpected things happen to us in life. We encounter situations that have almost no place in probability calculations. It’s like when the evil Star Wars character Darth Vader declares to the heroic Luke Skywalker, “I am your father.” The revelation is unexpected, and audiences are surprised.

Sometimes, life can feel that way.

This scenario can have different connotations for everyone, and it reminded me of a classical physics question. Suppose you pour a glass of tap water into the ocean. If you think about the size of the ocean, you will also imagine that a glass of water will disappear in it immediately. Five years later, fill a glass of water from another ocean shore on the other side of the world. The question is this: how many water molecules in the second glass came from the first glass? Assuming that there are around a billion cubic kilometers of water in all the world’s oceans, a glass of water is nothing compared to this total volume. Or, to put it mathematically, the probability of a molecule from the first glass being in the second glass is two chances in 1 followed by twenty-two zeros.

But then, there are an incredible number of molecules in a glass of water: they can have molecules totaling 1 followed by twenty-five zeros. Assume that a thousand molecules from the first glass are in the second. The probability decreases to only two out of 10¹⁹. That is still practically impossible. Going back to Star Wars, what is the probability that the enemy you encounter in the whole galaxy is your father?

We’d be surprised at the possibility that Darth Vader is Luke’s father, but we wouldn’t be surprised at the birth of a baby. The fact that four babies are born every second all over the world is important here. However, the probability of a baby being born is much lower than that Darth Vader is Luke’s father.

Let’s think of an ordinary person; his name is Joe, and Joe has 46 chromosomes like everyone else. Otherwise, there would be an anomaly in Joe, and then Joe would not be an ordinary person. As everyone remembers from basic biology classes, half of Joe’s chromosomes miraculously come from his mother (Mary) and half from his father (Jacob). Let’s not forget that his parents, like Joe, have 46 chromosomes from 23 pairs each. Thus, one of the chromosome pairs of each of his parents was chosen for Joe. Twenty-three chromosomes from both sides form the building blocks of Joe.

If the probability of 23 chromosomes coming from his mother is calculated, the number (0.5)²³ is obtained. How so? Well, the probability of a chromosome being selected is one in two. There are 23 pairs of chromosomes; Since the probability of being selected from the first couple is ½, the probability of being selected from the second couple is ½, the probability of being selected from the third couple is ½, and the probability of being selected from the fourth couple is ½, the probability of 23 independent events is calculated: as 1/2 x 1/2 x 1/2…1/2= (1 /2)²³. This calculation means that the probability of being Joe with the chromosomes from his mother is about one in ten million. This probability is equal to a big jackpot for a single ticket purchased in the national lottery.

The same probability applies to the father’s side, too. Then the probability of being Joe by chance drops to one in a hundred trillion this time. 10⁷ x 10⁷ = 10¹⁴ or 1 in 100,000,000,000,000. As such, the probability of Joe being born as the Joe we know is 10⁷ times more difficult than winning the jackpot in a single ticket from the national lottery. In other words, the probability of Joe is ten million times less than winning the national lottery jackpot.

Let’s imagine that Mary and Jacob met in a medium-sized settlement where there is a population of at least 10,000 men and 10,000 women. Then the odds of meeting these two people would be one in ten thousand. The probability calculations for Joe’s birth then fall to one in one quintillion. The fertilization of the mother’s egg can only be achieved through an average of 15 million sperm. This situation gradually decreases the probability of Joe being born: 15 x 10⁶ x 10¹⁸ = 15 x 10²⁴—or, one chance in fifteen septillion.

Joe’s mother did not come down from out of space. The probability of Joe’s mother, Mary, is also one in 15 Septillion. Identically, if we consider that the probability of his father is the same, the probability of being Joe is 225 x 10²⁴ x 10²⁴. One in 225 Kendecillion.

Here I must add: all assumptions take place in ideal circumstances. Before knowing each other, the possibilities of the mother or father’s death, the infertility of one or both, and the like are not included. The probability is very, very low, but must not be ignored.

Mary’s parents or Jacob’s parents and their families—and their families—and all other previous families must have existed since the beginning of human life. When you consider all the possibilities, the probability becomes sooooo infinitesimal. To describe such a possibility, we can only call it a probability in infinity. This possibility is valid for every ordinary Joe. Considering that there are 7 billion people in line, it is not difficult to say that life is a miracle of creation.

The last estimated human population in the world is about 7.7 billion. Considering that four babies are born every second and two people die (according to the data in 2019), it can be predicted that the human population will increase day by day. Thinking of this complicated probability calculations, we can only conclude how precious each human being is.

People have better understood the value of life during these COVID times. Since spring 2020, nearly a million Americans have died from COVID, leaving many millions grieving. A March 2021 poll from the Associated Press–NORC (AP-NORC) Center for Public Affairs Research found that about 20 percent of people surveyed in the U.S. had lost a relative or close friend to COVID. That means a potential bereaved population of about 65 million. That number has certainly increased. Death also reminds us that life is precious, as each birth is a unique gift. Again, considering all the probabilities, the chance of a baby coming into the world healthy is much lower than the chance of coming into the world unhealthy.

The large human population is not evidence of the simplicity and mediocrity of life but rather the perfection in the creation of the universe. When considering this, it is undeniable that there is a hand of power in this magnificent functioning. Is it a coincidence, or are we living and breathing in a superb and controlled system?

And should you attempt to count God’s blessings, you could not compute them. God is indeed All-Forgiving, All-Compassionate (16:18)

Source: https://www.medindia.net/patients/calculators/worldpopulation.asp

On my sixteenth birthday, my mother gave me a leather-bound journal with my name embossed in gold on the front cover. I stared blankly at the blank pages with pale pinstripe lines traveling end to end, crowned with a fleur-de-lis watermark. 

I sat in my oversized wicker butterfly chair, my legs crisscrossed tightly and forming a natural table, trying to think of something to write, only to end up tossing the journal on the top shelf of my closet, waiting for dust to cover it.

When the pandemic first made headlines, I thought, “now what?” I had already been through so much.

Fewer than four years before, my husband had died from pancreatic cancer. Initially, his prognosis was grim. He was given one year to live, an overwhelming reality for a man in the prime of his life. Five weeks later, he collapsed and passed away in our living room in the middle of the night. 

There is a type of silence that permeates the air in the aftermath of a tragedy. It’s palpable. In those first few minutes, that silence engulfed me. I felt a pain as if something had been physically drawn out of me. All alone, I kissed him for the last time before dropping my head and crying, “What do I do, now?” 

I needed to find a strength that was not in my nature. We had three children. My priority was never to let this define their character, never to use their father’s death as a crutch or have it hang like an anchor around their necks. 

Losing my spouse left me confused. How does the coffee maker work? Is today trash day? I had not realized how much I depended upon him. It’s not that I was subservient to him—quite the opposite. We were equals. But I had gotten lazy. It was easier to let him handle it all. Honestly, the right hand didn’t know what the left was doing. I didn’t know the individual passwords to our accounts, making it impossible to pay the bills. Without a paper trail, I didn’t know what bills we owed. I’m embarrassed to say I was unaware of the amount of money we had in our savings account. I found out it wasn’t very much.

From that day forward, I busied myself, often to the point of exhaustion. I functioned at high speed; I had a job to do. As a single mother, time rapidly became my enemy. I was trying to cram too many things into a day, coming up short, always late to games and social events. Notorious for being on the phone during my kids’ games, multi-tasking was my mantra. Everything got my full 25% attention. I took pride in walking the dog while talking on the phone and still listening to a podcast. My mind was always somewhere else, daydreaming of a different situation.

Even if you have never lost someone, you can imagine how it feels. We have all seen enough Hallmark movies. What I was not prepared for was getting smacked when I least expected it. There I was standing in the local market’s produce section when our wedding song played over the loudspeaker. Suddenly, I burst into gut-wrenching sobs, so severe I had to rush out of the store, pushing my way through the sea of pitying stares. I still had to go back inside because I needed milk and eggs. 

Eventually, without his income to support us, my children and I had to move back into my childhood home. My mother had passed away years ago, but I still looked for her to protect us. It was a rough time in our lives. We yearned for life to be the way it had been.

It took all three years, but we healed. I went back to working full time. Our aching hearts lessened; this house took on our personalities. In February, my daughter celebrated her sixteenth birthday in grand style with a party. My son had graduated college and launched his new life. I felt joy for the first time, realizing we had come through that dark time, and we were back on track.

Then the pandemic hit. Like some at first, I believed it was just the flu—that it couldn’t hurt me.

Major work events were canceled, cities went into lockdown, the numbers staggering. Friends were testing positive. Some were getting sick. I was laid off from my job. My oldest son moved back home, putting his life on hold, and at-home virtual learning became a real thing. I felt like we were spiraling backward, our arms and legs flailing. Once again, I was overcome with a fear I hadn’t felt for years. The ground beneath us that we had worked so hard to strengthen was giving way. 

I was living from my paycheck to paycheck, with very little savings as a cushion. 

On the evening news, a woman about my age, with long blonde hair and blue eyes, was interviewed in her car while waiting in a food line, her kids in the back seat. “I have never needed to do anything like this before,” she told the interviewer.

The resemblance to me was uncanny. Our closeness to that situation made me quiver. I knew the look on my face registered my horror just by my kids’ frightened expressions. 

“We’re okay,” I reassured them. 

The pandemic wasn’t the only crisis looming over me. Without carpools, activities, and events, I was faced with an abundance of time. I didn’t know what to do with myself.

I embraced being able to spend time with my children, and they had to spend time with me, trapped on this island together. We streamed shows and played games—board and VR, which frankly made me want to throw up. We laughed. More than that, we talked, we talked about their Dad and the old house and this house. I was relieved to hear they liked this house just as much. We remembered the fun times in this house with their grandmother. I had never taken the time to sit quietly and listen to them before.

I was not the type to put together a puzzle, nor could I create international meals or strive to bake the perfect sourdough bread. I did like to garden. 

Although everyone thought I was crazy, I was inspired to build a vegetable garden on our hill. The hillside was transformed from a downward slope to terraced, level areas. We built raised planting beds, filled them with soil, planted seeds in neat rows, and marked each row with hand-painted signs nailed onto old pieces of wood. 

Every night my body ached; my arms were sore. The sun had tanned my skin in odd patterns depending on what clothes I wore. My manicured nails were becoming those of a gardener with the paint chipped, broken, and cracked. When I was putting gas into the tiller, some dripped on my hand, removing what little polish was left. I soaked a rag and finished the job.

And yet, I always felt fearful of what could happen to us. Would we end up in long food lines? I found myself up nights, bombarded by a litany of what-ifs: What if we get sick? What if we become homeless? What if? What if? Always circling back to the same belief: if only my husband were here, he would know what to do.

My mother used to say, “if the same thing keeps happening, it’s because you didn’t learn your lesson.”

One hot afternoon while I was sitting outside, my sixteen-year-old daughter handed me that old journal of mine. “Here, I found this in my room,” she said.

Having forgotten all about its existence, I opened it to the first page. In my mother’s handwriting was this:

You are stronger than you think you are.
When you experience and survive your biggest fear, you will become stronger. If what you thought would break you didn’t break you, then you will be prepared for another storm.

The pandemic was the perfect storm.

The words my mother had written may have meant nothing to me when I first read them, but on that afternoon, they meant everything to me. What were the chances of this journal showing up? 

I sat in my backyard, without a to-do list at hand, without the responsibility of watching kids in the pool. I. Simply. Sat. In. My. Yard. Quiet. 

There were hummingbirds, large ones that sounded like helicopters as they hovered in my backyard. Was I that hummingbird, continually moving, only stopping for a second to eat?

When you can’t go out to dinner, you can’t go to people’s houses, and friends can’t come to your home, the only place you can go is inside. And that’s precisely where I went, inside my mind. The scariest place I’ve ever been. Stopping frightened me. On the outside, I appeared strong, but why not on the inside? 

I had already experienced and survived my biggest fear with my husband’s death and losing our house. I asked myself over and over, “Am I prepared for this storm? Am I strong enough?” 

That’s when it hit me. Trust in yourself. Your strength has been inside you all along. You have it in you to thrive.

If I hadn’t been forced to be quiet, I never would have heard what I needed to hear or learn what I needed to know or take stock of myself. I’m not naïve to think bad things won’t happen again, but now I have the tools to handle them.

Like my garden, it was time to plant seeds and sow a new life for when all this passes and things return to normal.

This pandemic has given me a gift, a second chance. I opened the journal to a clean page and wrote one sentence:

I am present.

According to people of the heart, mujahada (striving) means doing what is required by having been endowed with will-power. It includes struggling against the car­nal soul and seeking ways to defeat it, always preferring to fulfill the religious obligations without neglecting even the secondary ones when they clash with carnal appetites; never being satisfied with one’s worshipping, acts of obedience to God and doing good, yet being content with what is absolutely required for wor­ship and obedience by way of disciplining one’s eating, drinking, sleeping and speaking.

Those having a certain degree of knowledge of God have always dealt with striving in two categories: one, the major or greater striving (al-jihadu’l-akbar) and the other, the minor or lesser one (al-jihadu’l-asghar). The former means struggling against the carnal soul and Satan and striving to have a sound belief and to be endowed with virtues or good morals, being able to worship God well, and struggling against evil morals, bad hab­its and tempers, while the latter denotes being alert against and, when necessary, fighting the enemy. Our serving people with knowledge and thoughts, by imbibing and internalizing belief, the truths of Islam and the morality of Muhammad, upon him be peace and blessings, and by representing them in our daily lives and conveying to others, encompass both kinds of striving, and therefore need to have the “endowment” necessary to fulfill both.

In every work or article written on austerity, communication of the Divine messages, and physical or minor striving (jihad), the subject is discussed in the light of relevant verses such as Strive in God’s cause in the way that striving for His sake requires (22:78). Here we are interested only in major striving.

Major jihad, or striving, in the language of Sufism, denotes that in the face of the mean impulses of the carnal soul, the whisperings of Satan, and the excessive desires and pressures of the body or corporeality, we should demonstrate that we are beings endowed with will-power. We should also try to show due respect for the heavenly faculty that we have as human beings, which is a composition of the mechanism of feeling, consciousness, perception, and heart. Jihad in this meaning is the greatest of all strivings, and one who performs it is great and esteemed in God’s sight; such a person is favored with His company. It can be said that it is more difficult to rebel against the impulses and desires of the carnal soul and to lead a life in worshipping and performing other acts of obedience to God in piety, sincerity and abstinence in order to obtain God’s approval and good pleasure, than to fight against the enemy under a shower of bombs and shells at the front. It is because of its difficulty that God’s Messenger told the soldiers returning from fighting, Now you have turned from the minor jihad to the major one (Hatibu’l-Baghdadi, Tarikhu’l-Baghdad, 13:523). It was in this way that he instructed his Companions in such a vital matter. On another occasion, saying, A true fighter is one who fights against his carnal soul for God’s sake, (at-Tirmidhi, “Fada’ilu’l-Jihad,” 2.) he taught that the major or greater jihad consists in the struggles against Satan and the impulses of the carnal soul.

While the minor striving can occasionally be necessary or compulsory, a believer must continuously fulfill the major one. In addition, success in the minor striving depends on success in the major one. For this reason, everyone must purify their inner world, so that they may acquire harmony and accord in all their acts—sitting, rising, thinking, speaking, working, etc.—doing these for the sake of God. It is only by success in this striving that one can be supported by God’s Will, which is the real factor in making human endeavors on God’s way beneficial and fruitful.

For those whom belief has not guided to an appointed goal, who have not disciplined themselves with Islamic principles of spiritual training, who have not deepened in doing good consciously so that God sees them, who cannot lead a life of unwavering sincerity nor live in the consciousness of God’s constant supervision, it is not possible to be people of the truth; they cannot restore rights nor display coherent attitudes in social relations. Those imprisoned in the cycle of eating, drinking, and sleeping can neither keep their corporeality under control nor direct their spirits to lofty ideals for spiritual victories nor keep the doors of their consciousness open to God to be rewarded with His company. What is most impossible for them is to free themselves from hatred, rancor, and other malicious feelings in order to embrace all existence only because of God.

A perfect society can only be made up of perfect individuals, and an individual cannot be perfected without spiritual training. It is therefore useless to try to build a sound community with individuals who suffer from mental and spiritual shortcomings. The perfect individuals needed to compose a perfect community are shaped in the crucible of striving.

Such a striving is based on controlling carnal desires and impulses and on having an operative mechanism of conscience. A spiritual journey is the safest way of striving. Concerning what a mortal enemy the carnal soul is, Hakim Busayri says:

How many lethal delights there are that
the carnal soul presents to humankind as pleasant.
Almost no one has ever been able to perceive that
it presents poison within the butter.

It would be appropriate to end this section with a poem by Huda’i [1], which is regarded as a bridge to the spiritual journey:

O carnal soul! Give up your mistakes and errors,
relent and be just and fair from now on!
Abandon cherishing these long-term ambitions,
relent and be just and fair from now on!
Why do you have these habits and innovations?
Why such fondness for fame and adornment?
Why expend so much effort that way?
 Relent and be just and fair from now on!
One day the wind of death will blow,
to ruin the garden of the body;
so fulfill your obligations in sincerity;
relent and be just and fair from now on!
Do not be obstinate, O Huda’i!
Submit yourself to Divine orders.
Come and mention the Master,
relent and be just and fair from now on!

O God! I ask You for Your forgiveness, health, and Your approval, regard, breezes of favor, friendship, and nearness to You. And bestow blessings and peace on our master Muhammad, the master of those near-stationed to You, and Your beloved and Messenger, and on his Family and Companions, who had great yearning to meet with You.

Note

1. Huda’i was the father of Ibrahim Shahidi Dede. He was from Mugla in the western Turkey and lived in the 15th century. He was a member of the Mawlawi Order.

When someone has a headache, they take a pain reliever; usually, the pain soon goes away. If a child has a fever, its parents will give them an antipyretic to reduce the fever. How do these drugs work? What effects do they have on the body? In the previous issue of The Fountain, we covered Pharmacokinetics and explored what our body does to a drug when we take one. In this issue we will explore pharmacodynamics, in other words, what a drug does to our body.

Pharmacodynamics is the study of the biochemical, physiological, and molecular effects of drugs on the body. It comes from the Greek words “pharmakon,” meaning “drug,” and “dynamikos,” meaning “power.” Dynamo typically refers to energy or power. But in terms of pharmacodynamics, it refers to how the drug works and how it exerts its power on the body.  Pharmacodynamics describes how biological processes in the body respond to or are impacted by a drug. Understanding the basics of pharmacodynamics provides answers to questions such as, “how does this drug work?” and, “how much of a drug is needed to safely treat the patient?”

All drugs produce their effects by interacting with biological structures or targets at the molecular level, inducing a change in how the target molecule functions in regard to subsequent intermolecular interactions. These interactions include receptor binding, post-receptor effects, and chemical interactions. The pharmacological response depends on the drug binding to its target. The concentration of the drug at the receptor site also influences the drug’s effect. By testing large concentrations of a drug in a lab, a drug’s maximum effect can be determined.

Receptor principle

The most common way a drug works is by interacting with tissue receptors located either in cell membranes or in the intracellular fluid. Receptors respond to specific neurotransmitters, hormones, antigens, chemicals, or substances. A chemical (ligand) binds to a specific site (receptor) and triggers a response (signal) in the cells. The intracellular changes initiated by the ligand–receptor complex can be through direct or indirect action; however, the ligand generally functions as either an agonist or an antagonist. An agonist will mimic the endogenous ligand to produce a similar response (e.g., morphine is an agonist for opioid receptors), whereas an antagonist blocks the usual ligand and thus inhibits the physiologic response (e.g., naloxone is an antagonist for opioid receptors).

When drug molecules bind with receptor molecules, the drug–receptor complex initiates physiochemical reactions that stimulate or inhibit normal cellular functions. One type of reaction involves activation, inactivation, or other alterations of intracellular enzymes. Because almost all cellular functions are catalyzed by enzymes, drug-induced changes can markedly increase or decrease the rate of cellular metabolism.

A second type of reaction involves changes in the permeability of cell membranes to one or more ions. The receptor protein is a structural component of the cell membrane, and by binding to a drug molecule, it may open or close ion channels.

A third reaction may modify the synthesis, release, or inactivation of the neurohormones (e.g., acetylcholine, norepinephrine, or serotonin) that regulate many physiological processes.

There are some additional characteristics to keep in mind about drug-receptor bindings:

1. The site and extent of a drug’s effect on the body’s cells is determined primarily by the specific characteristics of receptors and drugs. Receptors vary in type, location, number, and functional capacity.
2. The number of receptor sites available to interact with drug molecules also affects the extent of a drug’s effect. A minimal number of receptors must be occupied by drug molecules to produce pharmacological effects. If many receptors are available but only a few are occupied by drug molecules, few drug effects occur. In this instance, increasing the drug dosage increases the pharmacological effects. Conversely, if only a few receptors are available for many drug molecules, receptors may be saturated. In this instance, if most receptor sites are occupied, increasing the drug dosage produces no additional pharmacological effect.
3. Once a drug action occurs, drug molecules may detach from receptor molecules (i.e., the chemical binding is reversible), return to the bloodstream, and circulate to the liver to be metabolized and the kidneys for excretion.
4. Receptors are dynamic cellular components that can be synthesized by body cells and altered by endogenous substances and exogenous drugs. For example, prolonged cellular stimulation by an agonist usually reduces the sensitivity of the receptors. As a result, the cell becomes less responsive to the agonist (a process called receptor desensitization or down-regulation). Prolonged inhibition of normal cellular functions with an antagonist may increase receptor sensitivity. If the antagonist is suddenly reduced or stopped, the cell becomes excessively responsive to an agonist (a process called receptor upregulation). These changes in receptors may explain why some drugs must be tapered in dosage and discontinued gradually if withdrawal symptoms are to be avoided.

Some drugs acting at the same receptor (or tissue) differ in the magnitude of the biological responses that they can achieve (efficacy) and the amount of the drug required to achieve a response (potency). Drug receptors can be classified on the basis of their selective response to different drugs. Constant exposure to drugs sometimes leads to a reduced response (desensitization).

How can a drug’s pharmacodynamics be affected?

A drug’s pharmacodynamics can be affected by physiological changes due to

• A disorder or disease
• Aging
• Other drugs

Disorders that affect pharmacodynamic responses include genetic mutations and different diseases. These disorders can change receptor binding, alter the level of binding proteins, or decrease receptor sensitivity. Aging tends to affect pharmacodynamic responses through alterations in receptor binding or in post-receptor response sensitivity. Pharmacodynamic drug–drug interactions result in competition for receptor binding sites or alter post-receptor responses.

A drug’s action may be increased or decreased by its interaction with another drug. Most interactions occur whenever the interacting drugs are present in the body; some, especially those affecting the absorption of oral drugs, occur when they are given at or near the same time. The basic cause of many drug–drug interactions is altered drug metabolism. For example, drugs metabolized by the same enzymes may compete for enzyme binding sites, and there may not be enough binding sites for two or more drugs. Also, some drugs induce or inhibit the metabolism of other drugs.

Protein binding is also the basis for some important drug–drug interactions. A drug with a strong attraction to protein-binding sites may displace a less tightly bound drug. The displaced drug then becomes pharmacologically active, and the overall effect is the same as taking a larger dose of the displaced drug.

At pharmacodynamic level, there are four kinds of drug interactions:

1. Additive: occurs when two or more drugs combine to produce an effect greater than the effect of either drug taken alone. (Additive: 1 + 1 = 2).
2. Synergistic (hyper additive: 1 + 1 = 6).
3. Potentiation: a drug with no effect is combined with another drug to cause a greater effect (1 + 0 = 2)
4. Antagonistic: one drug weakens or cancels out the effect of another drug.

Drugs and humans: an analogy

Interactions between drugs are similar to interactions between humans. Sometimes the person who comes into our life adds value to our lives only as much as their own value but does not change our potential. Some people, on the other hand, help us go beyond our own potential by adding synergy to our lives. Some people are not our equal, although they allow us to exceed our potential, and it may be necessary to carry such people as a burden. Some other completely block our lives and prevent us from having a positive effect, just as they do not produce any effect themselves. Since we will encounter all types of people throughout our lives, we must be prepared for all of them. And we should keep this in mind the next time we put a drug into our body.

Figure 1. The receptor theory

References

• https://www.merckmanuals.com/professional/clinical-pharmacology/pharmacodynamics/overview-of-pharmacodynamics
• https://en.wikipedia.org/wiki/Pharmacodynamics
• Pharmacodynamics Mark Marino; Zohaib Jamal; Patrick M. Zito.
• http://www.pharmacologyeducation.org/clinical-pharmacology/clinical-pharmacodynamics
• Clinical Drug Therapy: Rationales for Nursing Practice – Seventh 7th Edition, Lippincott Williams &Wilkins.

One of the reasons for widespread Islamophobia is the wrong understanding of the Qur’an, Islam’s Holy Book. There is a general perception that the Qur’an contains references to war and violence, inciting Muslims to take up arms against non-Muslims. Ironically, most people who criticize the Qur’an are those who have not read it. They mislead the ignorant by quoting cherry-picked verses to incite Islamophobic feelings.

Still, it’s worth asking: why does the Qur’an contain references to battles and the battlefield? The answer is simple. War has been a part of human civilization since dawn of humanity. The history of pre-Islamic Arabia also reflects the same reality. It is a well-known fact that the ancient Arab tribal system lacked any central government or political institutions, such as courts or police. As a result, warfare was the only institution for settling scores [1]. The enmity between tribes over trivial issues could exist for decades, resulting in seemingly endless wars. Battlefield atrocities and inhuman war practices were also part of Arab culture before the advent of Islam. It is not an exaggeration to say that fighting was a kind of sport for Arab tribes [2]. Keeping this in mind, many verses in the Qur’an propose strategies for conflict prevention, ethics for defensive battle, and guidelines for humanitarian interventions—and these were revolutionary at the time.

A deep study of the Qur’an reveals that the verses 4:140 and 6:68 relate to conflict prevention in the case of a blasphemous encounter. Verse 140 of Surah Nisa states, “When you hear the Revelations of God being rejected and mocked, no longer sit with them until they engage in some other talk” (4:140). The same theme is discussed in Surah Anam verse 68: “When you meet such as indulge in (blasphemous) talk about Our Revelations, turn away from them until they enter into some other discourse” (6:68).

By commanding Muslims to stay away, the Qur’an suggests a pragmatic strategy for diffusing the situation in order to prevent anger and aggression. However, a general message from the above verses is to control one’s negative emotions and make all efforts to prevent a possible conflict. It is true that the Qur’an sanctions fighting in self-defense, but only as the last resort to survival.

It’s unfair to analyze battle-related Quranic verses without knowing the context of these verses. In the early years of Islam, Prophet Muhammad (peace be on him), his family, and his followers faced deadly opposition from the pagans of Mecca, who prohibited Muslims from practicing their religion. The non-Muslim chieftains tortured the new Muslims beyond the limits of human endurance. They were brutally beaten, dragged with ropes around the neck, and forced to lie down on burning sand in the very hot desert climate. The pagans left no stone unturned in their harassment of the Prophet Muhammad (peace be upon him) [3]. At one point, they hatched an unsuccessful conspiracy to murder him. They also imposed a brutal social and economic boycott on the Prophet and his followers, who were forced to eat tree leaves for months. The cries of the hungry children and suckling babies could not move the heart of the pagans [4]. The Prophet and his companions non-violently bore these hardships for 12 years and did not retaliate. To avoid the devastating persecution, the Muslims migrated first to Abyssinia and then finally to Medina. However, the pagans of Mecca kept chasing the Muslims and put all their efforts into destroying them in Medina. Consequently, the Muslims were left with no other option than to perish or to fight back. In this context, the permission to fight back in self-defense was granted in the Qur’an and the battle-related verses were revealed [5].

Islam sanctions fighting when the opponent violates peace agreements, disrespects the sovereignty of a state by carrying out an aggressive attack, or persecutes a weak and helpless community. The verse 190 of Surah Baqara clearly highlights this defensive mode: “Fight in God’s cause against those who fight against you, but do not exceed the bounds (set by God), for surely God loves not those who exceed the bounds” (2:190). In addition, the following verses clearly mention the legitimate reasons for fighting:

“The believers against whom war is waged are given permission to fight in response, for they have been wronged” (22:39).

“Will you not fight against the people who have broken their pledges and have done all they could to drive the Messenger, and initiated hostilities against you?” (9:13).

“The route (of blame and retaliation) is only against those who wrong people and behave rebelliously on earth, offending against all right” (42:42).

“…. drive them out from where they drove you out; disorder is worse than killing.” (2:191).

Article 51 of the UN Charter also sanctions the same rights by explaining that: “Nothing in the present Charter shall impair the inherent right of collective or individual self-defense if an armed attack occurs against a member of the United Nations” [6].

Islam not only sanctions the right to self-defense but also ordains the protection of persecuted populations. The Qur’an’s idea of war and peace hinges upon the ideal of social justice. Peace and justice are inseparable in the Qur’an. Leaving a persecuted population at the mercy of the aggressors is contrary to the concept of social justice the Qur’an propagates. How can peace prevail if a large number of people are ill-treated or tormented? Hence, the Qur’an does not support leaving the helpless at the mercy of oppressors, which is explicit in Surah Nisa: “Why, then, should you not fight in the cause of God and of the oppressed, helpless men, women, and children, who cry out: ‘O Lord! Bring us out of this land whose people are oppressors, and appoint for us from Your Presence a protector, and appoint for us from Your Presence a helper!’” (4:75). This highlights the circumstances when humanitarian intervention becomes a moral obligation. Furthermore, the phrase “fight in the cause of Allah” should not be mistaken as fighting to promote Islam; the above verse clearly states that fighting in the way of Allah is synonymous with fighting for the rights of the weak and vulnerable.

The Qur’an does not differentiate between Muslims and non-Muslims as far as justice is concerned. It says, “If two parties of believers fall to fighting, make peace between them (and act promptly). But if one of them aggressively encroaches the rights of the other, then fight you all against the aggressive side until they comply with God’s decree (concerning the matter). If they comply, then make peace between them with justice and be scrupulously equitable. Surely God loves the scrupulously equitable” (49:9).

Another crucial matter is that, in Islam, only a state has the right to fight external aggression. Non-state actors cannot lead such expeditions [7]. Furthermore, peace must be given preference and sought at every step. The Qur’an prohibits continuing the battle if the opponent inclined to peace: “Then if they desist (from fighting), surely God is All-Forgiving, All-Compassionate” (2:192).

 “If they desist, then there is no hostility except to the wrongdoers” (2:193).

 “And if they (the enemies) incline to peace, incline to it also” (8:61).

Seeking peace is more important than winning a war.

As for battle, the Qur’an clearly states that all noncombatants need to be treated kindly and justly. It is clearly stated: “God does not forbid you, as regards those who do not make war against you on account of your Religion, nor drive you away from your homes, to be kindly to them, and act towards them with equity. God surely loves the scrupulously equitable” (60:8).

It is clear that Islam does not approve of war for selfish motives, worldly gain, and satisfaction of the ego. Verse 190 of Surah Baqarah says, “fight those who fight you,” clearly highlighting two important points: the first is that fighting is only allowed in self-defense or against persecution; and second, war can only be waged against enemy combatants. The nonbelligerent, civilians, and non-combatants belonging to the enemy group cannot be harmed as it goes against the Qur’anic and Islamic conception of justice. Islam warns its believers that “by no means let your detestation for a people (or their detestation for you) move you to (commit the sin of) deviating from justice” (5:8). Furthermore, the verse 5:32 describes the sanctity of an innocent human life, leaving no room for terrorism, genocide, massacres, or activities which cause harm to civilian populations. According to the verse, “He who kills a soul unless it be (in legal punishment) for murder or for causing disorder and corruption on the earth will be as if he had killed all humankind; and he who saves a life will be as if he had saved the lives of all humankind” (5:32).

In Islam, nothing can legitimize the killing of civilians, regardless of the community or religion they belong to. From an Islamic perspective, everything is not fair in war: Qur’an sets very strict rules for battle.

Modern warfare

Fourteen centuries ago, the wars were fought with swords, and the Muslims under Prophet Muhammad (peace be on him) not only ensured the safety of non-combatants but also took special care to protect the environment from the hazards of war. Unfortunately, this seems impossible in modern warfare. With the invention of gunpowder, wars often result in the indiscriminate killing of combatants and noncombatants. As military industries grew and produced advanced weapons—like nuclear bombs, missiles, and drones—civilian deaths increased to unprecedented levels. It is almost impossible to ensure the safety of a civilian population, which is one of the integral Islamic ethics of war. Hence, it goes without saying that modern warfare has no place in Islam, which is implicit in the Qur’an (2:190, 5:32 and 60:8).

Islam taught the ancient nomadic Arab tribes the ethics of war and the sanctity of innocent human life. If verse 5:32 alone were implemented, it could save the world from destructive warfare and the madness of nuclear weapons. Unfortunately,  Muslims and non-Muslims alike are deaf to the Qur’an’s message.

Endnotes

1. Sayyid Ali Asghar Razwy,“A Restatement of the History of Islam and Muslims”. Al-Islam. Accessed October 15, 2021. https://www.al-islam.org/restatement-history-islam-and-muslims-sayyid-ali-asghar-razwy/arabia-islam#political-conditions-arabia
2. Marisa Farrugia, “War and peace in pre-Islamic Arabic poetry,” Humanitas: Journal of the Faculty of Arts, 2 (2003): 143-153.
3. Ibn Ishāq, Sīratu Rasūlillāh, trans. Alfred Guillaume (Oxford: University Press, 2004), 146.
4. Safiurrahman. Al-Mubarakfuri, Ar-Raheeq Al-Makhtum, trans. The Sealed Nectar (Al-Riyadh: Dar-us-Salam Publications 1996), 75.
5. Al-Mubarakfuri, 125-126.
6. United Nations, “The Charter of the United Nations,” 51 (VII) A (Paris, 1945), https://www.un.org/en/about-us/un-charter/chapter-7
7. Niaz A. Shah, “The Use of Force under Islamic Law,” European Journal of International Law 24, no. 1(2013):343-65.

Spices, generally used for seasoning foods, can also be used for killing microbes. As people opt for foods that are less processed—and may even contain no chemical additives—the protective value of spices has increased. In addition, the use of spices in foods has become more prevalent thanks to research into the various benefits of spices.

For generations, spices have been used to treat disorders. Scientific research indicates that the majority of spices have medicinal properties that either relieve the symptoms of illnesses or prevent their onset. One such property is related with how spices are effective against formation of biofilms.

Spices fighting biofilms

A biofilm is a micro-ecosystem created for various microbial species that protects them from environmental factors, allowing them to stay in a propitious environment [1]. Biofilms are silent aggregates of microorganisms, in which microbes are embedded in an extracellular polymeric substance. They therefore exhibit high rates of resistance to antibiotics and antimicrobial substances. Almost all species of microorganisms appear to form clusters of biofilms, on both biological and non-biological surfaces. With the increase in the incidence of biofilm-implicated infections, research into the control and prevention of biofilm formation has also gained momentum. Some types of bacteria that may develop into biofilms include Pseudomonas, Enterobacter, Flavobacterium, Alcaligenes, Staphylococcus, and Bacillus. Biofilm formation occurs in three stages: attachment of bacteria to a surface, colonization through reproduction on the surface, and developing irreversible exopolysaccharide matrices [2].

Because biofilm formation might be induced by some antibiotics, many researchers have begun investigating the antimicrobial and anti-biofilm properties of various natural substances.

The efficacy of commonly used spices to prevent biofilm formation is of great significance. Many spices act as natural antimicrobial agents with high anti-biofilm properties. Studies have shown that ginger, curcumin, cinnamon, and black pepper, which are widely used especially in many Asian countries, have antimicrobial and anti-biofilm properties [3]. The interaction among some of the spices, which causes deformations in biofilm formations, is also important. As the interaction between the spices increases, their capacity to isolate biofilm formation also increases. Certain spices isolate microorganisms by preventing them from being attached to a surface or to each other [4].

Along with its anti-inflammatory (preventing inflammation), antioxidant (slowing the reaction of oils with oxygen), anti-angiogenesis (inhibiting the formation of new vessels so that a tumor does not spread), anti-atherosclerosis, and cancer-preventing properties, ginger also has antimicrobial properties. Thus, its use in the treatment of bacterial infections has become widespread. It’s also been determined to be a digestive stimulant [5].

Turmeric, especially its main component curcumin, has a wide range of pharmacological properties, including anti-microbial, anti-diabetic, anti-inflammatory, antioxidant, and anticarcinogenic (preventing cancer) ones. It can prevent certain bacteria from forming biofilm. Curcumin is known to reduce the occurrence of such diseases as multiple sclerosis (MS), Alzheimer’s disease, and Parkinson’s disease [6].

Cinnamon, another medicinal herb, is commonly used in cosmetics as well as in food products. According to traditional Chinese medicine, cinnamon has been used as a healing agent in case of nerve injury. A 2004 clinical study found that cinnamon can be an effective diabetes treatment: it reduced the rate of fasting blood sugar by 18-30% [7]. Although no definite conclusions have been reached regarding the effect of cinnamon as an anti-diabetic treatment, it has been found to have the potential to lower postprandial blood sugar levels [8]. With its antimicrobial properties, cinnamon acts as an antibacterial agent and is used against inflammation. In addition, it is known to have beneficial effects on oral health. It has been used to treat toothaches, oral infections, and bad breath [9].

Black pepper is another spice widely used in folk medicine. Piperine, an important alkaloid component in black pepper, exhibits a preventive effect for some types of cancers, particularly breast, prostate and colon cancers [10]. It was found that piperine inhibits some of the proteins produced by tumor cells by interfering with their signaling mechanisms, thereby reducing tumor progression [11]. In studies regarding the use of black pepper, particularly its essential oils, to treat Type-2 diabetes, it was observed that it inhibits the two enzymes that convert starch into glucose. It thereby helps manage blood sugar and delays glucose absorption [12].

Experts investigating the worldwide incidence rates of cancer determined that Indians are five times less likely to get breast cancer, eight times less likely to get lung cancer, nine times less likely to get colon cancer, and fifty times less likely to get prostate cancer than Americans. These rates are remarkable considering the fact that Indian people are exposed to more carcinogens due to their environmental and living conditions. It has been estimated that the difference in the rates stems from the common use of spices by Indians. Thus, new research investigating the topic have been launched [13].

Spices are more effective when used together. For instance, the intake of curcumin in turmeric together with the piperine in black pepper increases the absorption of curcumin twenty-fold [14]. Knowing when to use them to increase their absorption—such as with fatty foods, or hot and cool foods—also enhances their effects [15].

The preventive or healing effects varies according to the course of a disease, as well as how spices are used. It should be borne in mind that spices can also have some side effects. Some include: indigestion problems for people with ulcers (caused by the ingestion of excess black pepper) [16]; excessive bleeding due to the salicylates in ginger (the same blood thinner used in aspirin) [17]; nausea and gastrointestinal complaints due to the consumption of excess curcumin [18].

Relationship between nutrition and healing

Nutrition and healing are interrelated in many aspects according to the causal laws we observe in creation. Life is being created by God “without veil,” i.e., without His need for any causal factor. Similarly, although there are causal intermediaries we use for healing, still for believers it is He who is the source of ultimate healing (All-Healing). Just as we seek to be cured with spices in nature He created, we pray to Our Lord to be the recipient of the meaningful, wise manifestations of His name, All-Healing. Spices are an example of the infinite blessings bestowed by our All-Munificent Lord.

Notes

1. Jamal, M. et al. (2015). Bacterial biofilm: its composition, formation and role in human infections. RRJMB, 4(3), 1–15.
2. earsiv.hitit.edu.tr/xmlui/bitstream/handle/11491/5393/merve-bicer2018.pdf?sequence=1&isAllowed=y
3. Kaplan, J. B. (2011). Antibiotic-induced biofilm formation. The International Journal of Artificial Organs, 34(9),
4. Mah, T. et al. (2001). Mechanisms of biofilm resistance to antimicrobial agents. Trends in Microbiology, 9(1), 34–39.
5. Jahid, I. K., S. D. Ha (2012). A review of microbial biofilms of produce: future challenge to food safety. Food Science and Biotechnology, 21(2), 299–316.
6. Chainani-Wu, N. (2003). Safety and anti-inflammatory activity of curcumin: a component of turmeric (Curcuma longa). The Journal of Alternative & Complementary Medicine, 9(1), 161–168.
7. www.eczaakademi.org/images/upld2/ecza_akademi/makale/20110325013735diyabet_tedav_kul_bitk_urunler.pdf
8. Kirkham, S. et al. The potential of cinnamon to reduce blood glucose levels in patients with type 2 diabetes and insulin resistance, Diabetes Obes Metab. 2009 Dec; 11(12):1100–1113.
9. Rao, P. V. et al. (2014). Cinnamon: a multifaceted medicinal plant. Evidence-Based Complementary and Alternative Medicine, 2014.
10. Gould I.M., A.M. Bal. New antibiotic agents in the pipeline and how they can overcome microbial resistance. Virulence. 2013;4(2):185–191.
11. Arun Kumar Srivastava, Vinay Kumar Singh Malacology Laboratory, Department of Zoology Biological action of Piper nigrum the king of spices, DDU Gorakhpur University. 2017.
12. Oboh, G. et al. (2013). Antioxidative properties and inhibition of key enzymes relevant to type-2 diabetes and hypertension by essential oils from black pepper. Advances in Pharmacological Sciences, 2013.
13. Shan, B. et al. (2007). The in vitro antibacterial activity of dietary spice and medicinal herb extracts. International Journal of Food Microbiology, 117(1), 112–119.
14. Singh, G. et al. (2002). Chemical and biocidal investigations on essential oils of some Indian Curcuma species. Progress in Crystal Growth and Characterization of Materials, 45(1-2), 75–81.
15. Cui, H. et al. (2016). Liposome containing cinnamon oil with antibacterial activity against methicillin-resistant Staphylococcus aureus biofilm. Biofouling, 32(2), 215–225.
16. www.diabetesselfmanagement.com/blog/spice-it-up-boosting-your-health-with-spices-and-herbs-part-5
17. www.healthline.com/health/food-nutrition/ginger-tea-side-effects#benefits
18. examine.com/supplements/curcumin/