We all focused on one topic throughout 2020: Covid-19. No single day passed without news on the pandemic as we counted numbers of positive cases and the death toll while anticipating for a vaccine. In the meantime, we got more familiar with some of the medical processes, like phases, clinical trials, mutations, etc. for all this had to deal with the most precious gift we are given: life.

In our last issue, we touched upon the history of pharmacology and how modern-day drugs are made in an article titled “Pharmacology: The Journey of a Chemical Compound into a Drug.” Now, we will explore the multiple, lengthy phases of clinical trials that drugs must undergo and why they are imperative in order for new medicines to get approved for the marketplace.

Clinical trials are a way to test new methods of diagnosing, treating, or preventing health conditions. The goal is to determine whether a substance is both safe and effective. A clinical trial is only done when there is strong reason to believe that a new test or treatment may improve the care of patients.

A variety of treatment methods such as medications, medication combinations, new uses for existing medications, and medical devices are evaluated through clinical trials. In the United States, all new treatments must go through these trials before being approved for public sale by the Food and Drug Administration (FDA).

At the discovery and development stages, thousands of compounds may be potential candidates for development into a “drug”. After early testing, however, only a small number of compounds look promising and call for further study. The entire process of developing a drug from its pre-clinical research stage to its final marketing phase can take approximately 12 to 18 years and often costs well over $1 billion [3, 4].

Clinical trials show us what works and what does not in the realm of healthcare and are designed to answer some important questions such as:

• Does the new treatment work in people? If it does, how effective is it?
• Is it better than currently used treatments?
• If it is not better, is it just as good and cause fewer side effects?
• Does it work in some people who do not benefit from current treatments?
• Is the new treatment relatively safe? There is virtually no treatment or procedure that is without risk, but do the benefits of the new treatment outweigh the risks?

Answering these questions, while giving as few people as possible an unknown treatment, often requires several clinical trials in different phases. Each phase is designed to answer certain questions while keeping trial participants as safe as possible.

Preclinical phase

Before clinical trials can begin in humans, tests and treatments are assessed in pre-clinical research, which can involve extensive laboratory research over several years of testing on animals and human cells. This research may aim to learn the chemical compound of a drug [1]. If the initial laboratory research is successful, researchers send the data to health authorities for approval in order to begin research and testing on humans.

Once pre-clinical research results are approved, human testing of experimental drugs can begin and is typically conducted in four phases that are denoted by Roman numerals (Phase I, II, III and IV). Each phase is considered a separate trial and, after completion of a phase over many years, researchers are required to submit their data to, and then wait for approval from their local health agency (the FDA in the US) before continuing onto the next phase. If the drug successfully passes through Phases I, II, and III then it will usually be approved by the national regulatory authority for use in the general population. Phase IV trials are “post-marketing” or “surveillance” studies that are conducted to monitor how safe the product is over several years [2].

Phase I

This is the first clinical phase that involves humans. Phase I trials most often include healthy volunteers, however there are some circumstances when clinical patients are used, such as patients who have terminal cancer or HIV. These treatments possess a much higher risk for healthy individuals and could cause to become ill and contract serious adverse side effects.

In a Phase I clinical trial, doctors collect information on:

• The dose or treatment
• When it should be taken, and how often
• Any side effects or complications
• How the treatment affects patients and their preexisting conditions

One of the primary goals of Phase I studies is to find the highest dose of a new treatment that can be given safely without causing severe side effects. Although the treatment has been tested in laboratory and most likely been used in animal studies, the side effects in people cannot be known for sure. During Phase I of a clinical trial, researchers spend several months to evaluate safety, side effects, optimal dosage amounts, and formulation method for the drug on about 20 to 80 people who have no underlying health conditions.

In addition to evaluating safety and ideal dosage, specialists also look at the best way to administer the drug such as orally, intravenously, or topically. These trials are often conducted in a clinical trial clinic where the subject can be observed by full-time staff. Safety always remains the foremost concern in Phase I. The research team keeps a close eye on the people and watches for any severe side effects.

Researchers start by giving very low doses of the drug to a few patients while higher doses are given to other patients until side effects become too severe or desired effects are seen. The drug may help patients, but Phase I trials are to test a drug’s safety. If a drug is found to be safe enough, it can be tested in a Phase II clinical trial. According to the FDA, approximately 70 percent of medications move on to Phase II.

Phase 2

Phase II of a clinical trial usually involves anywhere from 50 to several hundred who are living with the condition that the new medication is meant to treat. They are usually given the same dose that was found to be safe in the previous phase. Investigators monitor participants for several months, or years, to see how effective the medication is and to gather more information about any side effects it might cause.

Most phase II studies are randomized trials where one group of patients receives the experimental drug, while a second “control” group receives a standard treatment or placebo. These studies are mostly “blinded” which means that neither the patients nor the researchers know who has received the experimental drug in order to avoid from bias. Doctors use a computer program to randomly sort volunteers into these two separate groups. Each volunteer has an equal chance of ending up in any of the groups and are randomly put in any group.

This allows investigators to provide the pharmaceutical company and the health authority with comparative information about the relative safety and effectiveness of the new drug. When the development process for a new drug fails, this usually occurs during Phase II trials when the drug is discovered to not to work as planned or to have toxic effects. The FDA estimates that roughly one-third of experimental drugs successfully complete both Phase I and Phase II studies.

Phase II clinical programs historically have experienced the lowest success rate of the four development phases. In 2010, the percentage of Phase II trials that proceeded to Phase III was 18% [5] and only 31% of developmental candidates advanced from Phase II to Phase III in a large study of clinical trials conducted during the period of 2006 – 2015 [6].

Phase III

Phase III of a clinical trial usually involves up to 3,000 participants who have the condition that the new medication is meant to treat. These participants must include men, women, and people of different ages and ethnic groups in many places across the country (or even around the world) at the same time. This helps doctors learn how treatment works in different people with different genetic backgrounds, races, and ethnicity. These studies tend to last longer – up to several years – than Phase I and II studies.

One of the additional purposes of Phase III is to evaluate how the new medication works in comparison to existing medications for the same condition. To move forward with the trial, investigators need to demonstrate that the medication is at least as safe and effective as existing treatment options. Due to the larger number of participants and longer duration of Phase III, rare and long-term side effects are more likely to show up during this phase.

There can be more than two treatment groups in Phase III trials. The control group may receive the current standard-of-care treatment for their illness while other groups receive the new treatment on trial. Phase III trials are usually double blinded to eliminate bias when interpreting results.

Placebos may be used in some Phase III studies, but they are never used alone if there is a treatment available that works. Sometimes, a patient who is randomly assigned to the placebo for part of the study will at some point be offered the standard treatment as well. As with other trials, patients in Phase III clinical trials are watched closely for side effects, and treatment is stopped if they become too hard to manage.

Every patient in a Phase III study is watched closely, and the study will be stopped early if the side effects of the new drug are too severe or if one group has significantly better results. Phase III clinical trials are often needed before the FDA will approve the use of a new drug for the general public. If researchers demonstrate that the medication is at least as safe and effective as others already on the market, then the FDA will usually approve the medication.

In the United States, when Phase III clinical trials (or sometimes Phase II trials) show a new drug is more effective or safer than the current treatment, a new drug application (NDA) is submitted to the FDA for approval. The FDA reviews the results from the clinical trials and other relevant information.

Based upon the review, the FDA then decides whether to approve the treatment for use in patients with the illness the drug was tested on. If approved, the new treatment often becomes a standard of care and newer drugs may be tested against it before they can be approved. If the FDA feels that more evidence is needed to show that the new treatment’s benefits outweigh its risks, it may ask for more information or even require that more studies be done. Once Phase III is complete, a pharmaceutical company can request FDA approval to begin marketing the drug. Roughly 25 to 30 percent of medications move on to Phase IV.

Phase IV

Phase IV trials test new drugs that are approved by health authorities and often are called Post Marketing Surveillance Trials. The drugs are available for doctors to prescribe to patients, but Phase IV studies might still be needed to answer important questions. In previous clinical phases the drug may not have been tested for interactions with other drugs, or on certain population groups, such as pregnant women, who are unlikely to subject themselves to trials. This phase involves thousands of participants and can last for many years. Investigators use this phase to get more information about the medication’s long-term safety, effectiveness, and any other benefits.

This is often the safest type of clinical trial because the treatment has already been studied a lot and has likely been given to many people. Phase IV studies look at safety over time. These studies may also look at other aspects of the treatment, such as quality of life or cost effectiveness.

Phase IV studies can result in a drug or device being taken off the market or restricted depending on the findings in the study. Unless an adverse effect of the approved drug is shown or the drug is accepted as safe, it will stay on the market and also in Phase IV forever.

This clinical trial algorithm has come out after many scientific studies. Every point of the clinical trials, and possible problems, have been clarified by policies which may differ from country to country. At the end, clinical trials are a very safe and cautious method of finding out the safest and most effective treatment, or diagnostic method, for people. During clinical trials, scientists are very careful about ethical issues and try not to harm any living organisms, be them animals or humans. There is an ongoing public debate over pharmaceutical companies. While some think they play a major role in the emergence of many methods and scientific developments to benefit human health, others doubt their motivations and questions their contribution to the public good. This debate will surely continue for a long time, but under the current circumstances, pharmaceutical companies are found in the center of all these clinical trials described in this article. Regardless of the truth behind these doubts, it is important to be always aware of the priceless value of life, that it has been given to us and all living things as an inalienable right and a precious gift, and that it is a major responsibility take care of it well and seek healing when needed.

• https://www.nccn.org/patients/resources/clinical_trials/phases.aspx
• “The drug development process”. US Food and Drug Administration. 4 January 2018. Retrieved 17 August 2020
• Holland J (2013). “Fixing a broken drug development process”. Journal of Commercial Biotechnology. 19. doi:10.5912/jcb588.
• Adams CP, Brantner VV (2006). “Estimating the cost of new drug development: is it really 802 million dollars?”. Health Affairs. 25 (2): 420–8. doi:10.1377/hlthaff.25.2.420. PMID 16522582.
• “New drugs failing Phase II and III clinical trials”. MedCity News. 2011-06-02.
• “Clinical Development Success Rates 2006-2015” (PDF). bio.org. Retrieved 2018-02-11.

It has been over half a year since Covid-19 swept across the world and forced many countries into quarantine. Hopes of a quick resolution of the disease in many countries have since been, unfortunately, proven to be wrong, and it is evident that the virus is here to stay for a while [1]. The virus is so difficult to deal with considering it can be transferred from person to person even if the carrier does not outwardly display symptoms. Even animals, ranging from mice to tigers, can contract and transmit it to humans [2, 3], and we cannot quarantine or force them to wear facemasks. The virus will eventually hit each person; it is just a matter of time. The virus may additionally arrive in multiple waves, as it is possible to be reinfected [4]. COVID-19 will most likely have a lifespan of a few years, much like other major virus outbreaks of the past such as the swine flu in Hong Kong or Spanish flu. It will probably come and go like a common flu in never ending waves. So, each of us need to be ready until a successful vaccine is developed, and the wisest action for each person to be ready would be to boost our immune systems and practice effective social distancing and sanitation measures, while we deal with this virus for however long it may last.

Vaccines are critical for stunting the development and spread of viruses; however, they can be costly, time-intensive to develop, and not always perfect. It is worth exploring alternative methods to help protect our bodies from these pathological invaders while vaccines are being researched. As it so happens, the best method of prevention to date for HIV infections is not a vaccine, but is instead a tradition that is as old as thousands of years: male circumcision [5]. To give a comparison, the current widely popular and heavily promoted influenza vaccine is considered “50% effective against influenza B/Victoria viruses and 37% effective against influenza A(H1N1)” [6]. On the other hand, according to an article published in the prestigious medical journal, The Lancet, circumcision is up to 88% effective in preventing heterosexual transmission of HIV [7]. Male circumcision does not have any medicinal side effects, and the only risks that are involved are those related to any minor surgery – bleeding and infection.

In the 1980s, when I first heard of HIV, I remember reading articles which claimed, quite arrogantly, that vaccines and cures for the condition would be found within two or three years [8]. Forty years later, and after spending many billions of dollars on research, we are still nowhere near an HIV vaccine. At best, we found treatments which helped keep the HIV virus at bay [9]. To date, only two people have been fully cured with a method far too expensive to be applied to the general public [10]. In the meantime, at least 30 million people have died with more than half a million in the year 2019 alone [11]. While vaccines are critical for helping to eradicate viruses, putting all of our eggs into that basket alone can be a risky public health strategy due to how difficult and time consuming they are to discover, verify, and distribute. It is impossible to know for sure how long it will take to develop a vaccine for the coronavirus. In the meantime, communities should heavily consider following the instructions of their local health officials which often include social distancing, limited size gatherings, and frequent hand washing as these methods are already proven to help reduce the spread of the virus.

Development, and even the rushed development of a vaccine, is always a very tedious and dangerous process. The science behind them is exceptionally complex, and imperfect results can have disastrous consequences upon thousands of people. This is further complicated by the fact that phase 2 and phase 3 trials can have quite diverging results [12]. In the USA, AstraZeneca’s COVID-19 vaccine trials were stopped after trial participants fell ill [13]. Third phase trials, which encompass thousands of people [14], still can give little indication of the long-term side effects to any vaccine. Besides, even though there is human life at risk, the vaccine has already become an instrument for many political and economic disputes and conspiracy theories. Some governments claim they have already developed a vaccine, while others find them unreliable, or try to lure a foreign company to work for themselves [15]. In August of this year Russia rushed registration of an unproven Coronavirus vaccine and named it, in Cold-War-like fashion, the “Sputnik V” [16]. The announcement was made by none other than Vladimir Putin himself. It was offered to the USA, but was rejected due to safety concerns stemming from a belief that the drug was not adequately researched and developed [17]. In the meantime, Russia announced the development of a second vaccine [18]. Surely enough, it was dismissed and downplayed by the West as unproven and unreliable. On the other hand, a vaccine developed by a Chinese company Sinovac proved to be the most successful in its phase 3 trials in Brazil [19]. Sao Paulo Governor João Doria purchased 47 million shots of the vaccine. However, the transaction was stopped, arguably for political reasons, by the Brazilian President Jair Bolsonaro [20]. Bolsonaro’s comments when rejecting the purchase of the Sinovac vaccine on the basis that “the Brazilian people will not be anyone’s guinea pig” are not totally without merit. Recalls of “proven and tested” vaccines have happened in the past [21].

It is important for all people to continue exploring methods to develop their immune systems and prevent the spread of the virus while we wait for a vaccine. In an article I had previously published, I discussed the benefits of fasting, vitamin C, and Wim Hof breathing methods to help protect the body from disease [22]. All of these methods are well known and quite benign with respect to side effects, however they are unable to cure Covid-19 or prevent its spread. Additionally, the Center for Disease Control (CDC) has heavily stressed practices included social distancing and the wearing of non-ventilated face masks. Our hope is that going above and beyond to protect ourselves and our neighbors will give scientists the time that they need.

One way of giving that time to scientists is fasting. Fasting, like circumcision, is a tradition that is thousands of years old. In recent studies, a three-day water fast has been shown to reset the immune system of elderly people to the level of a twenty-year old’s [23]. At this current level of emergency in the world it would be very easy to find thousands of willing volunteers to trial monthly three-day water fasts and/or to take extra doses of vitamin C, not as a cure, but as a shield against COVID-19. This kind of study would not pose much risk and would definitely be very cost-effective. We could dive straight into the third phase of trials, for any side effects of fasting are already well known. And finally, if proven effective, its uptake by the population at large would be basically cost free and readily available across the whole world.

Our world has been enduring a difficult and challenging period for the better half of a year now. Time has given us the ability to learn more about the virus, how it disrupts our bodies, and how it spreads. This knowledge has, in turn, allowed us to research it and develop effective social guidelines for limiting its spread. Still, there is much work to be done. Hysteria and haste are not conducive to producing a vaccine that is thorough, effective, and efficient. It should be the responsibility of every able-bodied citizen to do what they can to learn more about how they can protect themselves from the virus and thus prevent it from spreading even more while we wait for a vaccine.

1. https://www.wuky.org/post/beshear-next-few-weeks-will-be-critical#stream/0
2. https://www.washingtonpost.com/science/2020/09/03/coronavirus-deer-mice-spread/
3. https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/animals.html
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7326402/
5. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(99)03421-2/fulltext?_eventId=login
6. https://www.aafp.org/news/health-of-the-public/20200226interimfluve.html
7. Halperin, D. T., & Bailey, R. C. (1999). Male circumcision and HIV infection: 10 years and counting. The Lancet, 354(9192), 1813-5. doi:http://dx.doi.org/10.1016/S0140-6736(99)03421-2
8. https://www.immunology.org/publications/bsi-reports/60-years-immunology-past-present-and-future/the-hunt-for-hiv-vaccine
9. https://www.cdc.gov/hiv/basics/livingwithhiv/treatment.html
10. https://www.medicalnewstoday.com/articles/2nd-person-cured-of-hiv-thanks-to-stem-cell-transplant
11. https://www.unaids.org/en/resources/fact-sheet
12. https://www.fda.gov/media/102332/download
13. https://www.usatoday.com/story/news/health/2020/09/09/covid-vaccine-astrazeneca-trial-hold-what-does-mean/5757590002/
14. cancer.org/treatment/treatments-and-side-effects/clinical-trials/what-you-need-to-know/phases-of-clinical-trials.html
15. 15 https://www.nytimes.com/2020/03/15/world/europe/cornonavirus-vaccine-us-germany.html
16. https://www.theverge.com/2020/8/11/21363135/russia-coronavirus-vaccine-unproven-registration
17. https://www.techtimes.com/articles/251792/20200814/covid-19-us-says-no-to-russias-vaccine-sputnik-v-saying-theyll-never-use-it-on-monkeys-let-alone-people-vietnam-and-philippines-say-otherwise.htm
18. https://abcnews.go.com/Health/wireStory/russia-approves-2nd-virus-vaccine-early-trials-73614460
19. https://fortune.com/2020/10/20/covid-vaccine-china-brazil-testing-ground-safest-most-promising-sinovac/
20. https://apnews.com/article/virus-outbreak-brazil-state-governments-health-sao-paulo-b7b5b620ba54f402dbf803e26fe6b842
21. https://www.cdc.gov/vaccinesafety/concerns/recalls.html
22. https://medium.com/@arasweb/surviving-the-pandemic-370b47120d8d
23. https://news.usc.edu/63669/fasting-triggers-stem-cell-regeneration-of-damaged-old-immune-system/

Are cities the same as water? It’s possible to look at chemistry for new understandings of social dynamics.

The universe is a field where existence is transformed from state to state. The transformation of matter from one state to another is generally called a “phase transition” and each phase has its own characteristics. A phase transition is possible via the alteration of some parameters and variables. For instance, heat is one of the parameters required for the transition of ice (solid) into water (liquid) and later into vapor (gas); the increased heat causes ice to change states. The characteristic feature of each phase (ice, water, and vapor) is unique. For example, ice has a certain volume; however water and vapor take the shapes of their containers. In contrast to ice, water and vapor have flowing properties.

In a similar way, if the temperature of a ferromagnetic material displaying magnetic properties is elevated, at a certain temperature, it is observed to lose its magnetism; this is called the “Curie point.” In some materials, such as some solutions, the transition into different phases can be achieved by adding solvents.

Seasons can also be considered different phases. Each season has its own specific traits and features. Seasons are generated by the alteration of the angle between the axis of earth and its orbital plane.

As these examples show, the universe resembles an erase board where continuous transitions are taking place, new sentences are being written, and existing writings are dismissed to form new sentences with new meanings.

In a recently completed academic study, a new definition of a phase transition encountered in social life has been made and this phase transition is called “freezing by heating” [1]. It is well known in daily life that the less individuals are informed about their temper and the direction they are headed, the weaker the efficiency of cooperation among individuals. If people in a unit or group behave irregularly, a dead end or bottleneck could occur. Solving dead-end problems and bottleneck situations, or preventing them before they happen, is among the topics scientists study today. In Figure 1, cases showing the traffic stream of people moving in opposite directions obtained in this study are displayed.

It is stated that there is less “noise” in situations in which there is a reduced amount of irregular behavior taking place. The term “noise” is used to define concepts that can be disruptive human relations. The higher the noise, the more the degradation of human relationships, and as a result, a disruption or even an arrest (freezing) may happen regarding social events. The elevated temperature of a melting solid material provides it with the properties of a fluid, whereas in social events, an increase in temperature ends up with a jam and freeze in social life. In Figure 1a, a pedestrian traffic flow in which there is less noise present – in other words, a situation that characterizes ideal relations among people – is displayed. Here, it is observed that people with yellow marks have a stable flow towards the left and those with red marks move towards the right side. They do so via lanes of people going towards both directions. A stable flow indicates that the system is not frozen (not in an arrest), or free of a bottleneck. In such a flow, relations work in such a way that fluidity results.

Figure 1

An intermediate noise level causes an increase of irregular behaviors (in other terms, unpredictable human behavior) and shows the presence of serious problems that are experienced regarding the relationships among people. The corresponding situation for this case is shown on Figure 1b. Here, the pedestrian traffic is now jammed and the flow is almost halted. It is impossible for lanes to form since irregular behaviors are above a certain critical level. For a system to be rescued out of this state, oscillations of sufficient magnitude are necessary.

If the situation in Figure 1c occurs, forming a vertical interface (please note the vertical interface that separates people going left and right), this case is called a “frozen state” and much bigger oscillations are required to get out of this state. Figures 1a, 1b, and 1c exhibit before our eyes how elevated noise affects pedestrian traffic: an increase of the noise in the system (for instance, an increase in the number of people who do not stop at red lights and do not continue on green) changes it from a fluid phase to a frozen one, resulting in gridlock. It is possible to compare the increased noise of the pedestrian traffic to an increase in temperature; the elevation of temperature also causes an abundance of irregular movements inside matter. Just like that, the rise of heat in a society due to a particular issue (like turmoil or other problems) may generate an increase in chaotic behaviors. Let’s try to explain this with certain events happening right now.

Let’s think about motor vehicle traffic in any city. If every individual driver observes the rules of the road, this means a low temperature – less noise, and little traffic. Fluidity is present here. On the contrary, if there is not any consensus in terms of traffic rules among the citizens – in other terms, if majority of the people are failing to abide the rules – there will be “heat”; the noise will be high, and there will be a traffic jam. If drivers cannot assess the rules at a four way intersections, or if people with no knowledge of red, yellow, or green lights are driving, a city will have a major problem with traffic.

When a freezing event takes place, waiting becomes inevitable. Unfortunately, most people don’t like waiting. Thus, such “freezing” events should be avoided, so as to keep citizens happy. For example, public announcements of road closures due to scheduled road works limit the reactions against traffic problems on certain routes. However, if traffic is announced and no reason is given, people might still be very unhappy.

For a second example, let’s consider a judiciary system. Just like the example of motor vehicle traffic, the presence of irregular moves independent from rules can lock a legal system. If laws are insufficient, or existing laws are not universally implemented nationwide, or the laws are executed and interpreted differently according to individuals, it is inevitable for a bottleneck or a freeze in the legal system. Actors within the system may anticipate a “freeze” about to happen. People in a state of anticipation need to be convinced and satisfied pertaining to legal practices. Otherwise, they may not enforce the laws properly, and legal chaos may ensue.

Freezing by heating may also apply for certain economic processes. Some economic uncertainties or some actions of unknown cause can be considered as noise by elements of the economy, thus enforcing a behavioral change that is able to affect the entire economy. Therefore, any applied change is followed carefully by the actors of the market and these actors must be satisfied about the changes taking place. Higher noise levels and dissatisfaction of members who are waiting affects the liquidity of the market and can lead to the withdrawal of funds. Withdrawal of money negatively impacts the parties who are in need of cash in various ways and the economic system gains momentum towards a “frozen state.” Negative factors are not the only reason for a bottle neck. Conservation of balance and the fluidity of the economic system are considered as the essence of this issue.

The principles briefly given above can also be applied to socio-psychological events. It is impossible not to encounter a bottleneck for a society consisting of members who are aggressive, stressed, or have less knowledge of their destinations. If a decision can be made with a peaceful state of mind and there is no doubt present regarding current practices, patience becomes the most important parameter. Hence, until a state of balance is established, it is advised to wait with understanding and patience. Patience is a healing aid that plays a role in reducing the temperature in all bottleneck situations.

Fasting prayer is very important for people in terms of gaining this habit. Even for a person who observes fasting one day or two in a week, it becomes more possible to deal positively with any bottleneck situations encountered that week. Another way to lessen the impact of a bottleneck is living to be aware of the fact that each event may serve a purpose. As Nursi stated, each negative or positive event that has been experienced has a purpose. Every event will be over once its purpose is reached. For a sincere believer who is aware of this, realizing that patience also means to appreciate time; thus, it is possible for him to disperse the negative elements that this waiting will bring.

It is possible to expand the “freezing by heating” phase transition to various different mediums across many other disciplines. However, the only necessary element in all of them to prevent such freezes, or to break present freezes, is the reduction of noise (temperature). It’s possible to find guidance by acknowledging that this world is a place of wisdom and service, and rewards do not always come in this life.

References

1. Dirk Helbing, Illes J. Farkas, Tamas Vicsek, “Freezing by Heating in a Driven Mesoscopic System,” Physical Review Letters 84, 1240-1243 (2000).
2. H.Eugene Stanley, “Non-equilibrium Physics: Freezing by Heating,” Nature 404, 718-719 (2000).

40 percent of smokers begin between the ages of 15-19. According to researchers, the intensity of spiritual-psychological and social problems between the ages of 13 and 19 puts youths under a higher risk of starting smoking. Smoking as an adolescent can be related to low self-esteem and academic problems. It is an established fact that teenage smoking is the most influential risk factor for adult smoking. A young person looking for a role model can be influenced by one’s parents, teachers, and friends. Family structure and social environments are influential regarding smoking and other addictive behaviors. Keeping away from smokers reduces the likelihood of smoking.

It is reported that light depression increases smoking, and that regular smokers’ have higher incidences of depression and suicide when compared to non-smokers. Smoking rates are higher with those who do manual labor, who have smokers among family members or close friends, who live in urban centers, who have a high income, who work under difficult conditions, who have a history of social problems, and who are male. It is also reported that 94% of people who smoke more than three cigarettes a day at the beginning become addicted in the long run.

Why do people insist on continuing a behavior they know to be harmful or that they cannot give up easily even if they wish to? There are various reasons for this. First of all, human beings do not only make decisions and act within the control of reason, logic, willpower, and conscience. Cigarettes contain addictive chemicals that stimulate the brain’s pleasure center. Developing an addiction weakens willpower. When individuals realize how dangerous this addiction is, it is mostly too late to give up, since it takes significant willpower. We act not only based on logical information, but on intense feelings, too. Thus, a person continues to smoke in spite of knowing the dangers. A person’s degree of psychological and spiritual “hunger,” the strength of their feelings, and a failure to meet other healthy goals can be contributing factors to an addiction.

The World Health Organization defines dependence syndrome as “a cluster of physiological, behavioral, and cognitive phenomena in which the use of a substance or a class of substances takes on a much higher priority for a given individual than other behaviors that once had greater value.” Considering cigarette dependence, the person may find it really hard to break free from a vicious cycle beginning with thought, gaining velocity with feelings, and ending with the execution of a certain act.

In terms of the human brain and neurotransmitters, smoking causes nicotine to react with nicotine receptors. As a result of long-term nicotine intake, a neuro-adaptation increases the number of nicotine receptors in the brain. The brain develops tolerance to certain effects of nicotine. After a person has become neuro-physiological dependent, they begin to crave nicotine.

The effects of nicotine on the human body depend on the dose and have two aspects. The reduction of nicotine in blood causes symptoms of depravation, and its increase causes symptoms of poisoning. If a person smokes more cigarettes, and has free access to them, the amount required to achieve stimulation grows; their tolerance gets higher. Because nicotine is a psychological and spiritual stimulant, it often gives a feeling of temporary relief, which helps the smoker to forget their problems. This causes the smoker to draw a connection between smoking and a lack of worries, thus further affecting their reasoning and will power. Researches have shown that as the daily number of cigarettes increases, the habit shifts from the critical phase to the supercritical, and that psychological dependence turns into neuro-psychological dependence. 75-80 percent of smokers wish to give up smoking, and one third of dependent smokers attempted to give up smoking at least three times.

Phases of treatment

The purpose in treatment is making the smoker give up the habit in the long run. The first goal is to get the behavior under control by reducing the amount of cigarettes, and then, finally, cutting them out completely. A set of psychological thresholds smokers need to overcome are defined. Each of them is passed by overcoming different psychological and social obstacles.

1. Not being aware of the damage and not taking any steps for change: At this phase, the smoker does not calculate the possible harm of smoking and thus does not wish to give it up. When the subject is mentioned, it is dismissed by means of certain defense mechanisms. Those who wish to help the smoker must know this situation, and they should never engage in a dispute about smoking; by using soft spoken words, they should patiently try to make that person feel the grim realities of smoking.

2. Beginning to think about giving up smoking: At this phase, the person states that he or she will give up smoking whenever the subject is mentioned. The person also expresses being aware of the dangers and being in need of help to give up. However, taking action can sometimes take months, or even years. At this phase, the person should make a self-evaluation for the sake of putting one’s knowledge to real life practice, and to help them face their conscience. Those who wish to give up smoking had better prepare a list of the advantages to not smoking. Sincerity and empathy shown by the person to help the smoker are the most influential help; a single look or word might have an adverse effect and cause a relapse.

3. The preparation: The person is ready to give up smoking. At this phase, it will be useful to prepare a practical plan by benefiting from the tips of those who gave up smoking successfully. The date to give up should be set, preferably a meaningful day for the person, such as a birthday or anniversary. For spiritual support, it can be useful to previously announce the day to give up smoking to the person’s friends and family.

4. Action: The person has quit smoking. Having a small ceremony can be beneficial, as it creates a sense of psychological and social obligation; in the interest of these obligations, it’s important the person receive social support throughout the process. The person should keep away from people and places that make them feel like smoking. Exercise is a good way to combat any urges. When the person feels an urge to smoke, one must take a deep breath, and then release it slowly after holding it for some time. They should know that an intense urge to smoke only lasts for two or three minutes and soon subsides.

5. Continuing the newly acquired good behavior: At this phase, the person must be resolved not to relapse. At this point, the issue depends on the person’s freewill. It will be useful to reward ones’ self for not having started again. One of the most important components of treatment is helping the smoker develop proper interests and hobbies so that they are not tempted to start smoking again. Others around the person can provide positive psychological support. It is narrated that one drunken man came to visit Rumi, but his disciples tried to get rid of him with harsh treatment. On seeing this, Rumi remarked: “He drank the toxicant, but you have become intoxicated.” In the same way, we must also act with magnanimity, tolerance, and a feeling of responsibility to save our friends from such a dangerous habit.

Smoking is a habit that can be given up and treated

Is it a wise strategy to give up smoking all of a sudden? Is it possible? Is it advised to give it up gradually? Answers to these questions differ from patient to patient. First and foremost, giving up smoking depends on the person’s own wish, resolution, and willpower. It is possible to give up this habit. According to the WHO, treating smokers are among a doctor’s duties. It is known that as a consequence of anti-smoking campaigns and activities, millions of people gave up smoking. As the average rate of success remains under 10% for those who receive no help, we need to provide as much support as possible and encourage people to be healthy.

None of the methods for giving up smoking are 100% successful on their own. The best results are obtained when medical treatment supports the psychological, mental, and spiritual processes. Medical treatment include symptomatic treatments that target the feeling of deprivation that arise after giving up smoking and using other drugs to lessen the wish to smoke.

References

• Heatherton, Todd F. et al. 1991. “The Fagerström Test for Nicotine Dependence: a revision of the Fagerström Tolerance Questionnaire.” British Journal of Addiction 86:1119-1127.
• JC Norcross, Krebs PM, Proschaska JO. 2011. “Stages of Change.” J. Clin. Psychol. Feb. 67 (2):143-54.
• World Health Organization http://www.who.int/mediacentre/factsheets/fs310/en/index.html. Accessed March 9, 2013.

Despite advances in technology, computers still can’t come close to the power of the world’s most remarkable computer – the human brain.

Computing machines have seen three phases: the tabulating phase, the programmable phase, and now the new era of computing, the cognitive phase [1]. Tabulating machines performed a fixed task, whereas programmable machines could be reprogrammed to execute different tasks without any change in the hardware. Cognitive machines, however, promise learning and reasoning capabilities.

The possibility of such machines raises the question: is cognition the ultimate test for conscious existence? What do we know about cognition? How do we define intelligence? The questions go on and on. One thing, however, everyone seems to agree with is the fact that understanding the mechanism of human cognition is the key to developing advanced artificial intelligence, and cognitive machines.

Cognitive machines have the ability to learn, and they employ artificial intelligence to “reason.” Artificial intelligence is defined as, “The science of making machines do things that would require intelligence if done by men” [2]. The good news is that cognitive computing is no longer an esoteric pursuit of some futurists. It is, and has been, essential for the operation of many big-data driven processes. The 21st century has been flooded with data coming from almost every aspect of our lives. Technology has made it possible to generate data at an exponential rate. Temperature distribution throughout our buildings, the number of people diagnosed with cancer in the last six months, real-time changes in customer preferences, ethnic profiles of college applicants, and the top three words trending in online conversations at this very moment, are some examples of the kind of data available today.

As the amount of data generated increases, it also becomes harder and harder to process and make sense of the data collected. Our “greedy and ambitious” human nature does not want to waste, and it wants to use every bit of available data. This is where it becomes imperative to have a computing machine that goes beyond performing pre-programmed tasks and learns as it goes, without human interference. For this kind of computing, we need cognition.

The biggest challenge in imitating human cognition is to understand how cognition happens in the brain. It is obviously beyond our ability to monitor such activity that is constantly taking place in our brains, let alone recreating such marvels in the first place. Nevertheless, it will be a great achievement if we can manage to somewhat imitate human cognition, even partially. It would open a whole new era in terms of what can be achieved from a computing standpoint. For instance, the entire curriculum of a college degree can be processed by a cognitive machine in a fraction of a second; such machine can digest the whole of medical literature in a short period of time, provide human doctors with second opinions on their diagnoses [3].

Despite the fact that there have been substantial improvements in designing “intelligent” computing machines, mimicking the hardware of the human brain and simulating its decision-making processes, have posed three fundamental challenges: a hardware with comparable processing power and memory, a software algorithm to implement intelligent behavior, and the necessity of both being self-adapting and self-improving.

First of all, human intelligence has not been fully characterized – its capabilities and limitations are still unknown. This lack of knowledge makes it difficult, and perhaps even impossible, to reduce such intelligence to smaller, or simpler, modules. Therefore, we don’t have a good handle on how to mimic the human brain in a behavioral sense.

The second major problem is that we are still far away from having the hardware on which our “intelligence” software could run. Implementing intelligence in conventional computing machines, evidently, seems to be a futile undertaking. Programmable machines are no match for human brains; even the fastest supercomputers, taking advantage of thousands of processors, is able to mimic just one percent of one second worth of human brain activity-and even that takes 40 minutes [4]. Therefore, cognitive computing machines must incorporate different hardware architecture from conventional computers to achieve cognition comparable to humans. IBM’s SyNAPSE chip is one example of hardware inspired by the brain, and it has the potential to carry out the required, intense computations.

Lastly, the human brain and its cognitive power are constantly changing. Depending on various factors and experiences, our brains can improve or deteriorate; this is also true of our cognitive power. However, such improvement or deterioration could be in the form of a change in the physical structure or the amount of capacity utilized [5]. Such dynamic flexibility, also called Brain Plasticity [6], is essential to our intelligence. At this time, no self-evolving computing hardware has been worked out. However, promising developments have been reported with respect to cognitive computing machines that can learn – that is, they can make deductions and reach conclusions that are not preprogrammed.

Along the way, human supervision will be the ultimate guide in perfecting such imitation. Therefore, human cognition, taken for granted in our daily lives, remains to be the final frontier for our thousands-years long technological journey. Once again, the creation set the boundaries for human development.

Adem G. Aydin holds a Phd degree in Electrical and Computer Engineering. He works as an engineer scientist at IBM.

References

[1] Virginia Rometty, 2013, http://smarterplanet.tumblr.com/post/32816006311/i-b-m-chief-on-watson-cognitive-computing-and-her

[2] Marvin Minsky, 1968, http://www.akri.org/ai/defs.htm

[3] “WellPoint and IBM Announce Agreement to Put Watson to Work in Health Care”, http://www-03.ibm.com/press/us/en/pressrelease/35402.wss

[4] “Largest neuronal network simulation achieved using K computer” http://www.riken.jp/en/pr/press/2013/20130802_1/

[5] William James, The Principles of Psychology

[6] Bryan Kolb and Ian Q. Whishaw, Brain Plasticity and Behavior, Annual Review of Psychology, Vol. 49: 43-64

Scientists restrict the concept of life to the conditions that obtain on or beneath the outer surface of our planet. Therefore, when they have looked for extra-terrestrial life what they have looked for is conditions which are the same as or similar or closely correspondent to the conditions in which life is evident on the surface of earth. But surely, if they had retained a sufficient sense of the absolute wonder of life (and that absolute wonder is an aspect of life’s being a direct manifestation of the Ever-Living) they should not have ruled out forms and conditions of life which are at present beyond their understanding. In their view, the arguments put forward by Said Nursi, a Muslim scholar from Turkey who wrote mostly in the first half of this century, for the existence of angels and other spirit beings may not be worthy of consideration. However, the latest discoveries in deep sea biology may persuade them to review Nursi’s arguments. Said Nursi wrote at the beginnings of I 930s:

Reality and the wisdom [purposiveness] in the existence of the universe require that the heavens should have conscious inhabitants of their own as does the earth. These inhabitants of many different kinds are called angels and spirit beings in the language of religion.

It is true that reality requires the existence of angels and other spirit beings because the earth, although insignificant in size compared with the heavens, is continually being filled with and emptied of conscious beings. This clearly indicates that the heavens… are filled with living beings who are the perfect class of living creatures. These beings are conscious and have perception, and they are the light of existence; they are the angels, who, like the jinn and mankind, are the observers of the universal palace of creation and students of this book of the universe and heralds of their Lord’s kingdom.

The perfection of existence is through life. Moreover, life is the real basis and the light of existence, and consciousness, in turn, is the light of life. Since life and consciousness are so important, and a perfect harmony evidently prevails over the whole creation, and again since the universe displays a firm cohesion, and as this small ever-rotating sphere of ours is full of countless living and intelligent beings, so it is equally certain that those heavenly [realms] should have conscious, living beings particular to themselves. Just as the fish live in water, so those spirit beings may exist in the heat of the sun. Fire does not consume light, rather, light becomes brighter because of fire. We observe that the Eternal Power creates countless living beings from inert, solid substances and transforms the densest matter into subtle living compounds by life. Thus it radiates the light of life everywhere in great abundance and furnishes most things with the light of consciousness.

From this we can conclude that the All-Powerful, All-Wise One would certainly not leave without life and consciousness more refined, subtle forms of mater like light and ether, which are close to and fitting for the spirit; indeed He creates animate and conscious beings in great number from light, darkness, ether, air and even from meanings and words. As He creates numerous species of animals He also creates from such subtle and higher forms of matter numerous different spirit creatures. One kind … are the angels, others are the varieties of spirit beings and jinn. (The Words I, Truestar l993,pp.113-12)

Half a century after Said Nursi wrote this, nearly 300 animal species, almost all of them previously unknown, have been discovered living around hydrothermal vents which form when sea-water leaking through the ocean floor at spreading ridges is heated by the underlying magma and rushes into the cold ocean. Verena Tunniclife writes:

All life requires energy, and nearly all life on earth looks to the sun as the source. But solar energy is not the only kind of energy available on the earth. Consider the energy that drives the movement and eruption of the planet’s crust. When you look at an active volcano, you are witnessing the escape of heat that has been produced by radioactive decay in the earth’s interior and is finally reaching the surface. Why should there not be biological communities associated with the same nuclear energy that moves continents and makes mountains? And why could not whole communities be fuelled by chemical, rather than, solar energy?

… Most of us associate the escape of heat from the interior of the earth with violent events and unstable physical conditions, with extreme high temperatures and the release of toxic gasses-circumstances that are hardly conducive to life. The notion that biological communities might spring up in a geologically active environment seemed fantastic. And until recently, few organisms were known to survive without a direct or indirect way to tap the sun’s energy. But such communities do exist, and they represent one of the most startling discoveries of 20th-century biology. They live in the deep ocean, under conditions that are both severe and variable.

This ‘startling’ discovery of biology contains clues to some other realities, which sciences should consider. The Prophet Muhammad, upon him be peace, states that angels are created from light. We read in the Qur’an that God created man from dried earth, from wet clay and, from an extract of clay. According to the Qur’an, man has been made a khalifa on the earth. Khalifa means one who succeeds. Many interpreters of the Qur’an have concluded from this that the jinn once ruled the earth and they were succeeded by men.

Starting from the clues above, it should be possible to do formal studies to determine the worth of conclusions such as these:

God first created pure light (nur) and then light. The process of creation followed a gradual, regular accumulation of identities and/or a saltational sequence of abrupt leaps. Fire followed light and then came water and earth. God spread one existence through another, compounding and interweaving. He also created living beings in every phase of creation appropriate for each phase. While the universe was in a state of pure fire or some other high energy, He created the appropriate life-forms. And when the earth became conducive to life, He created plants, animals and man. He adorned every part and phase of the universe with creatures, among them living ones, that are appropriate for that part and phase.

Finally, just as He created innumerable beings from light, ether, air, fire, water and earth, so too, from every word and deed of man, He forms either his paradise or hell. In other words, as He grows a tree from a tiny seed through particles of earth, air and water, so He will build the other world from the material of this world which He will adapt for the other world during the convulsions of Doomsday. And He will use the words and actions of human beings in preparing the paradise or hell of each.