Hard Drives Essays - Computer Storage Media,

Hard Drives Hard Drives In this day and age of faster computers and high-speed processors, it should only stand to reason that hard drives meet the same requirements as the rest of the computer technology world. A technological look and some tips on maintaining or troubleshooting hard drives is included below. By keeping up with the standard of needs of the industry we can be assured that our personal computers will have all the necessary space and the ability to access and save the data as required and in an efficient manner. The new DiamondMax? Plus 40 series from Maxtor can unleash your computer power with advanced technology and performance. Available in capacities up to 40 GB, these 7,200 RPM drives include Maxtor's unique DualWave? twin processor technology for a 10x boost in host command processing speed. Coupled with 2 MB of high speed 100 MHz SDRAM for the cache buffer and an UltraDMA 66 interface, give our DualWave-equipped hard drives superior benchmark performance and maximum throughput. As a result, they're an ideal choice for consumers working with large files, including audio and video applications. No matter how demanding your application, the new DiamondMax Plus 40 series delivers the ultimate in performance and capacity. With the popularity of multimedia, Internet and audio/video applications, more performance is demanded from desktop PC systems than ever before. System vendors are looking at all sub-components, including hard drives, as critical elements in increasing system speed and performance. As we go forward every part of the system will be called upon to improve throughput. The hard drive is a critical element in system performance, influencing how fast windows or Mac OS boots, how quickly applications launch, and the speed of loading large data or graphics files. Any operation that involves moving large amounts of information on or off the disk will reveal the importance of a high-performance hard drive. Many top PC manufacturers are expanding the use of 7200 RPM drives across all platforms and market segments. The performance achieved by 7200 RPM IDE drives also have made these drives a viable alternative to SCSI in traditional SCSI applications such as server and entry-level RAID. According to analysts at IDC, total worldwide shipments of 7200 RPM IDE drives is expected to be 16% of all IDE drives by the end of this year. This number is expected to be approximately 75% by the year 2002. The newly introduced DiamondMax? Plus 40 hard drives feature a 7200 RPM rotational speed along with other performance-enhancing features that generate faster overall system response times and performance. A Viable Alternative to SCSI,IDE 7200 RPM drives have made their way into the storage-intensive environment of graphic and video applications. The ability to achieve fast-sustained throughput is essential in high-end graphics and digital video content creation. 7200 RPM drives establish a new price/performance ratio in the professional graphic and digital video marketplace when compared to the SCSI alternative. Maxtor's 7200 RPM IDE drives incorporate a larger buffer to provide high-sustained data transfer rates that are important when working with large files such as multimedia and video. Maxtor is a leader in caching technology, employing sophisticated algorithms similar to those found in high-end SCSI drives. Maxtor's drives feature a 2 MB cache buffer incorporating a high-speed 100 MHz SDRAM memory, the same sort of memory found on today's high performance systems. Maxtor's 7200 RPM drives were the first IDE drives to be featured in a RAID level 5 configuration in an uncompressed nonlinear video editing system. The drive's high storage capacity, reliability and performance are well suited for this application. RAID level 5 provides protection against drive failures because in the event of a failure, the drive can be replaced without loss of data. This is especially critical in the video editing process, where 1 GB of storage typically holds approximately 1 minute of uncompressed video. The new DiamondMax Plus 40 drives include Maxtor's MaxSafe and ShockBlock reliability feature set for added protection against surface scan errors and shock and handling damage. This reliability set, when incorporated into a RAID level 5 configuration provides users in this market with unsurpassed protection against drive failures and potential loss from expensive downtime and data loss. The editorial community is taking notice of the SCSI-level performance that is achieved by today's 7200 RPM IDE drives. In a recent product evaluation of Maxtor's 7200 RPM drive published at Winmag.com, the reviewers tested the drive's performance using an internally-developed benchmark. The results were impressive. In the copy test, the drive copied at 3.29 MB/sec., surpassing the results of a competitive SCSI-2

Critical Reaction Paper #3 Essays - Christian Eschatology

Critical Reaction Paper #3 Essays - Christian Eschatology Critical Reaction Paper #3 26 April 2015 REL 107 Dr. Zaelot Critical Reaction Paper #3 Growing up in the Catholic Church, the Apostles Creed was a prayer/statement of faith that all young parishioners dreaded. Unlike the easily memorized Our Father, and Hail Mary, the Apostles Creed was the prayer that tripped up me and my fellow constituents when it came time to recite it in for of our Sunday school teacher. Up until now I never gave much thought to the Apostles Creed meaning or its purpose within a Catholic mass. A Creed, as defined by Catholicism for Dummies, is a statement or profession of what members of a particular church or religion believe as being essential and necessary. Within a Catholic context, the Creed makes up one of the four pillars of faith and remains the most crucial and influential part of Sacred Tradition. The Apostles Creed, which is attributed to the teachings of the apostles, is the oldest Creed believing to have originated from the first century A.D. Though its name has apostles in it, the Creed was not written by any of the apostles, contain ing the word only because it is considered to be a brief summary of the Apostles teachings. The particular aspect of the Apostles Creed that I will focus on is Article 7 of the Creed. Article 7 states, From there He will come to judge the living and the dead. This article affirms the Second Coming of Christ at the end of the world to serve as its judge. Judgment Day, or the Last Judgment, is seen as a general judgment that will reaffirm the particular judgment each of us will receive when we die. The book of Revelations tells us that this day will come about after one final assault by the powers of evil before Christs kingdom ultimately triumphs. This general judgment will decide, ultimately, whether we are destined for heaven or hell. There are various reasons as to why one must receive general judgment even though theyll receive particular judgment after. We will receive general judgment for four reasons: so, that God may be glorified, so that Jesus Christ may be glorified, so that the Saints may be glorified, so that the wicked may be confounded, and that along with body , the soul receive its eternal sentence of punishment or reward. This judgment will be based on our actions in this life, in what weve done as well as what weve failed to do, and how receptive weve been to Gods grace. One can also be sent directly to purgatory, a sentencing that guarantees ones admittance to heaven once repentance for sins has been achieved. Aside from the more literal meaning of Article 7, it can also be interpreted in a more symbolic way. A more symbolic reading of, He shall come to judge the living and the dead, suggests on a deeper level that only those who live their lives embracing and carrying out divine justice are truly alive. To awaken from the dead is to live ones life within the glory and grace of Christ our Savior and God. In my research and studying of class materials Ive learned a great deal about the Apostles Creed as whole and particularly Article 7. I never really knew that the Apostles Creed was our (Catholic) profession and statement of faith. Though I shouldve known this, I never realized why the Apostles Creed was recited or sung in the Roman Catholic Church as much as it is. The Creed is used as a teaching outline, as a guard and guide against heresy, as a summarization of faith, and as an affirmation in worship. I learned the history of the Apostles Creed as well, always under the belief that the apostles had written it, which I know now to untrue (or unproven). After having read the Apostles Creed as much as I have these past few days, Ive come to find a stronger belief and dedication in my Catholic faith and understanding as to why we believe what we do. Concerning Article 7, I chose this particular article because I never truly understood the notion of Judgment Day and what we believe wil l take place. I now know

European Union Law structure Essay Example | Topics and Well Written Essays - 1750 words

European Union Law structure - Essay Example One of the most obvious examples of a unitary state is United Kingdom. Also called a constitutional monarchy, UK is governed as one single unit. The Government is led by a Prime Minister and other cabinet ministers who enforce executive power on behalf of the Queen. The political power of UK government can transfer political powers to lower levels, regionally or locally elected assemblies, governors or mayors but the central government retains the principal right to recall such delegated power (Wikipedia Unitary State and United Kingdom) A federal State is composed of different self-governing regions often called states which are united by a federal government. The self-governing status of the states is constitutionally entrenched and can not be altered by a decision made by the central government. Even though the sovereignty of each state is constitutionally granted, a federal state is not only a group of independent states. The states do not have any power in terms of foreign policy for example which is the burden of the central government. A federal State comes from an initial agreement to come together in order to solve mutual problems or provide for mutual defense as it was the case for United States with the Articles of Confederation in 1781. (Wikipedia, Federal State) The United States are naturally the best example of a federal State. While each of the States has its own written constitution and different laws, the federal government composed of the Congress, the President and the Supreme Court. The Constitution limits the powers of the federal government to defense, foreign affairs, the issuing and management of currency, the management of trade and relations between the states, the protection of human rights, welfare and education. (Wikipedia Unites States) 3. Supranational State A Supranational State is an entity where power is held by independent appointed officials or by representatives elected by the legislatures or people of member states. All the member states still have power but they must share this power with other actors. Furthermore, decisions are made by majority votes in consequence it is possible for a member state to be forced by other member states to implement a decision against its will. (Wikipedia Supranationalism) In the following part of our essay, we will try to analyze The European Union through different perspective in order to approach our findings with one type of state that we have described in the previous paragraphs. II. How is the European Union composed The father of the European Union is the European coal and Steel Community (ESCS) which was created in 1951 following a proposition by the French Foreign Minister Robert Schuman which he made in 1950 in a speech inspired by Jean Monnet. Composed of six members, Belgium, West Germany,

Billy Elliot Essay Example | Topics and Well Written Essays - 500 words

Billy Elliot - Essay Example In the scene, he tap dances away his frustration to the music of ‘a town called malice’ by the jam. Dancing appears as a vocation for Billy as he fights stereotypes from his father and brother to pursue dancing rather than the coalmining embraced by his family. Billy’s tap dance scene is significant as the dialogue between the four characters in the scene collide. The scene witnesses Billy’s brother, father, himself, and Mrs. Wilkinson. The dialogue of the four characters on Billy’s future informs the audience much about them. Mrs. Wilkinson and Tony hurl abuse at each other showing both their concern and love for Billy, although from varying perspectives (Daldry). Their abuse shows that they both care for Billy’s future albeit from their own narrow views of what he should become and pursue. Both characters are frustrated about each other’s view on Billy’s future yet they all want the best for him. The scene opens up in the kitchen which provides the audience with a claustrophobia feeling. This setting is vital in displaying Billy’s internal conflict at the time. He struggles to deal with societal and familial expectations placed on him. Mrs. Wilkinson, his dance teacher expects him to becom e a potential success while he also gets tasked with caring for her grandmother suffering from dementia. He also struggles against the gender role stereotypes entrenched in society. The camera shots during the scene also indicate the difference in class and discourse between Billy and the three adults at the table. The camera moves back and forth from the high angle of Billy perspective to the eye level shots of the adults. The difference in points of view in the scene represents the discourse on Billy’s perception about himself and what the adults think of him. When Billy tap dances angrily in the scene, it represents that dancing is a vocation for him. His dance alludes to the fact that he can dance his pain away (Daldry). This shows that

Can a company strive for large profits while truly caring to the well Literature review

Can a company strive for large profits while truly caring to the well being of the general population - Literature review Example Responsible business enterprises strive to improve business performance, make profits, and contribute to the economic progress in the community. However, several business leaders are only interested in community activities that increase their profits. Social responsibilities of businesses are not restricted to profitable ventures. The organization can participate in activities that improve the conditions of the general population without direct or indirect profits. The big question is whether a business can remain profitable while caring for the wellbeing of the general population. Hill, R.P., Ainscough, T., Shank, T., and Manullang, D. 2007. Corporate social responsibility and socially responsible investing: A global perspective. Journal of Business Ethics, 70, 165-174. The current economies face issues of responsible business conduct such as product quality, health and safety, environmental protection, and compliance with laws and industry standards. These responsibilities originat e from the desire to make profits, which is determined by the relationship between the business and the society. Businesses rely on customer satisfaction to improve their profits margins. Customer satisfaction is caused by the attractive business activities such as services offered, environmental conservation, and product quality. These activities portray responsibility on the side of the business. The wellbeing of the general population is determined by responsible activities by the business. The standards of responsible business conduct go beyond the traditional expectations of maintaining morality. Business enterprises are members of the community, and they must enrich the economic and social conditions of the community. Improving the social and economic conditions of the community improves the wellbeing of the population (Porter and Kramer, 2006). Pursuing profits and economic superiority does not license ignorance or break of community norms, values, integrity, and respect. The business must engage in activities that uphold the morals and values of the society. Some activities such as advertisements may compromise the norms and beliefs of the society. Communities such the Chinese are conservative and are affected advertisements that involve body exposure and romance. Violent and immoral advertisements destroy the moral values of the community. Violence and immorality affect the wellbeing of the community and businesses participating in such activities may experience disapproval by the community. The general population provides market for products and businesses that overlook community norms and values are likely to make losses. Global business organizations have to uphold and respect different societal values and norms depending on the traditions of the community they operate. This determines the amount of profits acquired by business units across the globe (Gege, 2004). The objective of social responsibility of businesses is to generate the capital requi red for operations. Success for any business is measured in terms of profits and losses incurred. Businesses must cover the cost of capital, cover risks and uncertainties, and the needs of workers and pensioners. Businesses may be forced to compromise the quality of their products in order to maximize their revenues. This involves altering the material quality of products

Clinical Outcome after DMT Discontinuation

Clinical Outcome after DMT Discontinuation Background: Stable disease course may prompt consideration of disease-modifying treatment (DMT) discontinuation in relapsing-remitting multiple sclerosis (RRMS). Objective: To investigate the clinical outcome after DMT discontinuation and to identify predictive factors supporting decision-making. Methods: We included 221 RRMS patients, who discontinued DMT after à ¢Ã‚ ©Ã‚ ¾12months and had documented follow-up à ¢Ã‚ ©Ã‚ ¾2years after discontinuation. Hazard ratios (HRs) with 95% confidence intervals (CIs) regarding relapse and disability progression after DMT discontinuation were calculated from Cox regression models. Results: Age >45 years at discontinuation (HR=0.47, CI=0.23-0.95, p=0.038), absence of relapses for à ¢Ã‚ ©Ã‚ ¾4years on DMT before discontinuation (HR=0.29, CI=0.10-0.82, p=0.020) and absence of contrast enhancing lesions (HR=0.46, CI=0.28-0.78, p=0.004) were independent predictors of absence of relapse after discontinuation. Age >45years and absence of relapses à ¢Ã‚ ©Ã‚ ¾4years on DMT combined had an HR of 0.06 (CI=0.01-0.44, p45 years and longer disease duration were significantly associated with disability progression after discontinuation. Conclusion: While freedom from further disease activity is generally unpredictable, there is a subset of patients (age à ¢Ã‚ ©Ã‚ ¾45years, DMT intake à ¢Ã‚ ©Ã‚ ¾4years without evidence of clinical or radiological disease activity) having a high likelihood of remaining relapse-free after DMT discontinuation. However, close clinical monitoring for recurrent disease activity is mandatory after discontinuing treatment. MS is an autoimmune, demyelinating, inflammatory neurological disease that develops from a complex interplay of both genetic and environmental factors. The mechanism of demyelination in multiple sclerosis may be activation of myelin-reactive T cells in the periphery. T cells are activated following antigen presentation by antigen-presenting cells such as macrophages and microglia, or B cells. These T cells then express adhesion molecules, allowing their entry through the blood-brain barrier (BBB). These invasive perivascular T cells can secrete proinflammatory cytokines, including interferon gamma and tumor necrosis factor alpha which contribute to the inflammatory processes in the central nervous system. Furthermore, antibodies against myelin also may be generated in the periphery or intrathecally by activated B cells. Ongoing inflammation leads to epitope spread and recruitment of other inflammatory cells (ie, bystander activation). Activated microglia may release free radicals, ni tric oxide, and proteases that may contribute to tissue damage. In summary, MS has 3 characteristic features; Inflammation leading to the infiltration of Perivascular lymphocytes into the central nervous system, demyelination of neurons and the subsequent formation of Central Nervous System lesions (Plaques) The CNS lesions mainly affect the white matter and they are both disseminated in time (DIT) and in space (DIS). White matter help transmit information between regions of grey matter, where the processing occurs. Therefore symptoms of MS are highly dependent on the location of the lesion in the CNS. In 1996, 4 main types of MS were defined, be the National Multiple Sclerosis Society, according to the clinical course of the disorder; Relapsing Remitting Multiple Sclerosis (RRMS) Secondary Progressive Multiple Sclerosis (SPMS) Primary Progressive Multiple Sclerosis (PPMS) Progressive Relapsing Multiple Sclerosis (PRMS) The treatments for MS are split into 3 main types that target 3 different aspects of the disease, namely treatments for MS exacerbations/attacks, treatments for specific MS symptoms and treatments to prevent relapses and disease progression. The last group of treatments are the focus of this study. Despite having no cure for MS there are treatments that significantly reduce both the frequency and severity of relapses in some patients and slow the progress of neurological deficits in MS. These are called Disease Modifying Therapies(DMT). The goal of these therapies is to decrease the extent of damage and scarring to the myelin sheath associated with relapse and in doing so prevent the progression of disease and are especially useful for patients with RRMS. This study focuses on the first line injectable treatments, Beta interferons and Galatiramer Acetate. Interferon beta balances the expression of pro- and anti-inflammatory agents in the brain, and reduces the number of inflammatory cells that cross the blood brain barrier therefore it also improves nerve regeneration. Galatiramer acetate resemles myelin basic protein, thus acting as a decoy for the immune system to target and in doing so protects the myelin surrounding axons in the CNS. Despite their usefulness, DMTs are not suitable for all MS patients due to their side effects. Thus they are only prescribed to patients with RRMS or SPMS who meet certain criteria. Specifically, Beta interferon give rise to headache, chills, fever and pain and redness at injection site while, Glatiramer acetate results in redness and hardening of skin at injection site and rarely palpitations or flushing after injection. Due to these many side effects many patients who experience few or no relapses over a long period of time and have a stable disease course frequently enquire if they can discontinue their DMT without the risk of relapses coming back and the disease and disability progression of MS getting worse. Therefore this study was designed as an observational cohort study that aimed to understand the effects of discontinuation of DMTs on the primary and secondary endpoints; occurrences of relapses after discontinuation of DMTs and disability progression after discontinuation o f DMTs respectively and thus and thus provide predictive criteria that may help clinicians and patients make the decision to discontinue DMTs 0-What is the research question? What is the Primary Outcome? The primary outcome of the study is understanding the effects of discontinuation of DMTs on the primary and secondary endpoints; occurrences of relapses after discontinuation of DMTs and disability progression after discontinuation of DMTs respectively. What are the Secondary outcomes? The secondary outcome of the study was to use and analyse the findings derived from outcome one to discern any factors that would minimize the adverse effect of discontinuation of DMTs and thus provide predictive criteria that may help clinicians and patients make the decision to discontinue DMTs. Is the research question clear and properly addressed? Yes it is as the paper aims to answer the question of whether discontinuation of DMTs in patients with RRMS would largely affect the clinical outcomes in any adverse manner and through that discern any predictive factors that may help clinicians and patients make the decision to discontinue DMTs. 1 Are the methods valid? 1a Details of Assignment of patients Are the inclusion and exclusion criteria clear? Patients for the study were selected form the Innsbruck MS database (IMSD), which contained 1708 patients, through a careful screening process. The exclusion criteria included patients with PPMS or SPMS, patients who received DMT for less than 12 months, patients who discontinued DMT for less than 6 months, patients with less than 2 years of follow up available and patients with a documented pregnancy during the follow-up period. After all these exclusion criteria were applied, the patients who still remained were included in the study, thus 221 patients were included in the study Was randomisation done properly? Randomising before the aforementioned selection process selection process could have influenced the decisions about eligibility and introduced a source of bias and if a large number of randomly selected patients turned out to be ineligible it would have led to a very small sample size and thus significantly lowered the power of the study. Randomisation after the aforementioned selection process was not carried out for this study since this study was designed as an observational cohort study and all the patients in the inclusion list were discontinuing DMTs due to one of 3 reasons indicated in the study; namely adverse events, patients decision (including desire of pregnancy) or (3) stable disease course (subjectively defined by the treating physician and/or patient). Randomisation would have been more essential in a case control study that compared the effects of DMT discontinuation in one group against a matched control group of MS patients who continued taking DMTs. This is explored further in the future works section as a possible continuation from and improvement on this study. Was assignment concealed from Drs? (at the assignment stage) Due to the fact that the study was designed as an observational cohort study and the highly specific inclusion criteria the assignment was not concealed from Drs. Was the sample size big enough? The sample size for this study comprised all the 221 patients in the inclusion list. This was a relatively small sample size for a cohort study. However considering the large numbers of exclusion criteria and the fact that the study focused on a specific subset of MS patients; namely patients with RRMS who were being treated with either Interferon Beta or Galactemer Acetate for more than 12 months, who are not pregnant and had a greater than 2 year follow up, the study does have a high predictive power. For this subset of MS patients the studys results provide a good predictive power yet this does not extend to any MS patients outside this subset. The usefulness of this study is further undermined by the fact that just a month before this was published a similar study was done by the MSBase Registry with a case control design looking at 426 DMT stoppers, which is almost double the sample size in this study thus providing a far larger power. 1b Accounting for patients entered into the trial How complete was the follow up? The median follow up period was 3.8 years with maximum follow up period being 26.9 years and minimum follow up being 2 years. How were patients lost to follow up dealt with? As part of the exclusion criteria, patients who were lost to follow up either due to discontinuation of DMT for less than 6 months or because patients had less than 2 years of follow up available or because patients had a documented pregnancy during the follow-up period were excluded from the study and thus also excluded from the calculation on the results of the study. How were patients not receiving assigned treatment (non-compliers) dealt with ? During the follow up period 69 of the 221 patients restarted DMTs after the 6 month cutoff imposed in the exclusion criteria. If DMT was restarted during this observation period, the primary endpoint was considered to be reached at the time point of reinitiation of DMT and thus the patients were still used for calculating the final results. Is there likely to be residual bias because of any of the above? Since data for the study was collected retrospectively at the first visit this does introduce a potential source of bias due to the lack of data completeness for some variables. Moreover, since this study was not conducted in a case control manner there is a possibility that important unmeasured variables could have had a confounding effect on the observed results. However, since data was collected prospectively from then on it serves to minimize any sources of residual bias by attempting to correct for any confounders. The fact that all the patients were selected from the Innsbruck MS database, which mainly represents the demographics of western Austria and its geographical catchment areas and the fact that there was no randomization carried out also introduces a potential source of selection bias and restricts the predictive power and usefulness of this study 1c Blinding How far was it carried out for patients, doctors, other study personnel? In this study blinding was not carried out as all eligible patients in the inclusion list underwent the same intervention which was the discontinuation of DMT. Furthermore, the fact that this study was designed as an observational cohort study meant that blinding was not entirely necessary 1e Apart from experimental intervention were the groups treated equally? Apart from the discontinuation of DMTs all the other decisions about the patients care was left up to their respective doctors and any MS specific interventions or healthcare concerns, such as pregnancies, were noted in the regular follow ups. 2. What are the results? 2a Were outcomes measured in a standard valid reliable way ? The primary and secondary endpoints of this study were the occurrences of relapses after discontinuation of DMTs and disability progression after discontinuation of DMTs respectively. A relapse was defined as patient-reported symptoms or objectively observed signs typical of an acute central nervous system (CNS) inflammatory demyelinating event, current or prior to the visit, with duration of at least 24 hours in the absence of fever or infection, separated from the last relapse by at least 30 days.27 Disability progression was defined as a confirmed EDSS increase in 0.5 sustained for 6months. MRI was only included in analysis if performed within a maximum of 6months prior to discontinuation of DMT (MRI at discontinuation) and if there was another MRI available for comparison performed 1-24months prior to MRI at discontinuation (MRI before discontinuation). MRI parameters obtained were increase in T2 lesion load and presence of gadolinium-enhancing lesions. Increase in T2 lesion load was defined as à ¢Ã‚ ©Ã‚ ¾1 either new or size-enlarged T2 lesion in MRI at discontinuation compared to MRI before discontinuation. 2b Are results comparable at different sites ? These crietria for measurement and reporting of data helped standardize the measurement of the outcomes among the multiple study sites. 2c How large was the treatment effect ? Relapses Primary Outcome: Bivariate testing showed a correlation between absence of relapses after DMT discontinuation and younger age at discontinuation (r=à ¢Ã‹â€ Ã¢â‚¬â„¢0.352, p There was no association with disease duration (p=0.327). Secondary Outcome: ROC analyses indicated best possible cutoff values of 45 years for age at discontinuation (sensitivity: 65%, specificity: 85%) and 4 years for duration of DMT intake without a relapse (sensitivity: 60%, specificity: 81%) 14/56 (25%) patients aged à ¢Ã‚ ©Ã‚ ¾45 years at discontinuation suffered a relapse after discontinuation of DMT compared to 84/165 (50.9%) of patients Age >45 years and absence of gadolinium-enhancing lesion before discontinuation of DMT were found to be independent predictors of absence of relapse after discontinuation of DMT, each about cutting the risk for future relapse in half. Absence of relapses for a period of 4 years or longer on DMT reduced the risk of future relapse to under a third. Sex and EDSS at discontinuation did not have any significant impact. Patients aged >45 years with absence of relapses for a period of 4years on DMT had a cumulative hazard ratio (HR) of 0.06 (CI=0.01-0.44, p Disability Progression Primary Outcome: Bivariate analysis exhibited a statistically significant correlation between disability progression and EDSS at discontinuation (r = 0.212, p = 0.002), disease duration (r = 0.172, p = 0.004) and age at discontinuation (r = 0.123, p = 0.042), but not for duration of DMT, occurrence of relapses on DMT and presence of gadolinium-enhancing lesions. Secondary Outcome: After inclusion of these variables in a multivariate cox regression model, higher EDSS at discontinuation, age >45 years at discontinuation and longer disease duration were the only significant independent predictors of disability progression after discontinuation. Patients aged à ¢Ã‚ ©Ã‚ ¾45 years with absence of relapses for a period of 4 years on DMT did not have a significant reduction in their risk for disability progression How precisely is it measured (95% CIs)? Categorical variables were expressed in frequencies and percentages, parametric continuous variables as mean and 95% confidence intervals (95% CIs) and nonparametric variables as median and range. Comparisons regarding primary and secondary endpoints were made by bivariate correlations (Kendalls tau) and Fishers exact or chi-square tests as appropriate. Receiver operating characteristic (ROC) analyses were conducted to define the best possible cut-off values of continuous variables for prediction of the primary endpoint. Survival analyses were performed using cox regression models for comparison of prognostic factors over time and assessment of possible confounders. A two-tailed p-value 2d What is the clinical significance of the results and how precisely is it measured?  Ãƒâ€šÃ‚   The secondary outcome of this study has a higher clinical significance than the primary outcome. The results show that 3.   Are the results applicable to your patient(s)? 3a Are your patients similar to the study patients? 3b Were all the outcomes that are of interest to your patients considered in the trial? 3c Are the benefits worth the potential harms and costs? In the future a different study design can be used to tackle the same research question. A further case control study, like the one done by the MSBase Registry, that compared the effects of DMT discontinuation in one group against a matched control group of MS patients who continued taking DMTs could be carried out to minimize any effects of confounders and biases that may have affected the results of the cohort study. A future cohort study could include a larger sample size that would be more representative of a larger proportion of the patients with MS. Choosing from a more diverse patient demographic would also provide a greater amount of predictive power over the cultural diverse population of MS patients that are found in the local London boroughs. A similar study could be repeated with a fully prospective design so as to eliminate any selection biases that may have arisen due the retrospective nature of initial data collection. Furthermore, the retrospective nature of this study also led to only 168 of the 221 selected patients having MRI data available within 6 months before discontinuation of DMT thus reducing the predictive and representative power of many conclusions derived from MRI comparison data. Thus, more detailed and complete analysis using MRI data could have been obtained if the study was designed to be entirely prospectively conducted without the retrospective data collection. Focus on newer DMTs Since this study only focused on the first line DMTs which only account for a portion of the RRMS patients receiving DMT future work can focus on the other available newer DMTs. The data on the post-injectable DMT disease course may not be generalisable to the newer agents thus it is essential to conduct DMT discontinuation studies on other oral or intravenous DMTs available to patients which have a larger range of side effects and arguably have more severe side effects. Furthermore even though this study provides some predictive criteria that may help clinicians and patients make the decision to discontinue DMTs, To definitively answer the question about safety of DMT discontinuation in this patient subset, a randomised trial is required. The first randomised DMT discontinuation trial in MS is was scheduled to start recruitment in 2016 and its findings should provide more conclusive evidence about the safety and viability of DMT discontinuation in the patient subsets identified in this study both in terms of number of relapses and disability progression.

The Parallels of Jesus and Hercules Essay -- Mythology

Myths and religious doctrine are generally recognized as two entirely different things. Myths are usually referred to as a fictitious story or a half-truth; often they are stories shared between groups of people that are part of a cultural society. Religion is a set of beliefs concerning the cause, and purpose of the universe, and often containing an ethical code dictating appropriate human conduct. Although they differ in certain aspects, they still hold similarities. Comparable to parables within the Bible, myths have different versions which are both motivating, as well as entertaining. There are not only parallels to the idea of the stories but specific tales hold similar morals and equivalent characters. "And the Word became flesh, and dwelt among us, and we beheld His glory, glory as of the only begotten from the Father, full of grace and truth."(New Revised Standard Version, John 1:14) As the only son of God in the Christian theology, Jesus Christ was tasked with a multitude of trials, and horrors the common man would have rebuked and refused to undertake. However, as a demi-god born of the divine Christian deity and the mortal, virgin Mary, Jesus was not the average mortal man. Jesus was not the first in history to boast such a birth lineage many examples exist within ancient tales; however Hercules, the illegitimate son of Zeus (supreme god of the Greek pantheon) and Alcmene (a mortal woman) is perhaps one of the most well-known. While the birth of Jesus was with consent and acknowledgement of Mary, Alcmene was tricked into a relationship with Zeus; it is interesting to note, however, neither conception was of traditional coupling. Both Jesus and Hercules were marked for death directly from birth. Hera, Hercules’ st... ...ation that would be interchangeable with the assessments. Is it a coincidence that many cultures share certain aspects of a hero? No, all societies wish for their champions to hold certain values; such as valor, strength, determination and the ability to overcome when faced with horrible adversities. I believe these traits transcend culture, religion and time; the only difference is that most of the ancient religions are now relegated to mythology. Works Cited Graves, Kersey. The World's Sixteen Cruicified Saviors Or, Christianity Before Christ. Web. BookTagsEditDelete "MythNET - Hercules." Classics Unveiled. Web. 01 Apr. 2012. . WebsiteTagsEditDelete "New Revised Standard Version of the Bible." Daily Devotions. Web. 01 Apr. 2012. . Website

Analysis of Sonnet 18 by William Shakespeare Essay

In â€Å"Sonnet 18† by William Shakespeare and â€Å"Death† by John Donne, both poems describe how death is escaped. Both writers suggest that we shouldn’t fear death, because with death comes life. The use of imagery, metaphors, and personification are used to develop these themes of the sonnets. However, each sonnet addresses how they view immortality in different ways. While â€Å"Sonnet 18† focuses on immortality by capturing beauty, immortality in â€Å"Death† is viewed through a religious perspective. The speaker of the poem â€Å"Death† shows fearlessness in the first stanza of the poem. â€Å"Death be not proud, though some have called thee/Mighty and dreadful, for thou art not so† (1-2). Here death is being personified and confronted about his arrogant ways. The speaker lets death know that he is not as strong and scary as people perceive him to be. In the following lines death is brought down even more. The speaker reveals that death can’t really end our life because when we die we would then begin living eternally. John Donne uses his belief in Christianity to suggest to the reader there is life after death. The writer uses a metaphor in line five to compare death to â€Å"rest and sleep† to make matters worse. â€Å"From Rest and Sleep, which but thy picture be† (5). Rest and sleep are two things that are peaceful and calm, and are things we aren’t scared of at all. Sleep is interpreted as a temporary death which we wake up from in t his poem. The speaker talks about how death is doing people a favor by ending their life. â€Å"And soonest our best men with thee do go-/Rest of their bones and souls’ delivery† (7-8). These two stanzas propose that when death presents itself to us, we will finally be relieved of the pain, agony, and troubles of the world. Within stanza nine, imagery is used to describe the true image of death. Death is characterized as a servant who follows the rules of fate, chance, and kings as they are the only ones who make the calls on who dies or not.â€Å"Thou’rt slave to fate, chance, kings, and desperate men† (9). While death tries to fool us into to thinking he is the one who controls us, we realize that Death is really the one who is being controlled. As we read through the poem, we find out things about Death like who he associates with. The writer makes Death seem like someone we should not be afraid of when he affiliates him with poison, war, and sickness. In contrast the speaker’s beloved escapes death in â€Å"Sonnet 18† because he is written about in a poem. The poem starts off showing appreciation towards beauty by asking if he should compare his friend to a summer’s day (1). Within this stanza development, the speaker uses imagery to describe his beloved to a summer day. When we talk about summer time, we think of nice weather, nature’s beauty, and sunshine, all things which are compared to his beloved. Shakespeare repeatedly uses the word â€Å"more† in the second stanza to further suggest how beautiful this person is. He continues to going into detail about his friend, and how â€Å"Sometime too hot the eye of heaven shines, and often is his gold complexion dimm’d† (5-6). Here the eye of heaven is a metaphor that is represented as the sun. The writer comments on summer’s imperfections to remind the reader that summer isn’t always perfect. Sometimes summer is too hot, and other times the sun is dimmed by the clouds. We capture the temporariness of summer’s season in Shakespeare’s sonnet as well. Stanzas seven through nine emphasize how everything eventually comes to an end as time goes on (7-9). We know that as fall approaches and the weather becomes colder, nature becomes vulnerable. Leaves begin to fall from the trees and flowers begin to die. The writer makes a contradiction about the mortality of his beloved though. â€Å"But thy eternal summer shall not fade† (9). This suggests that his beloved’s beauty will not end like the season of summer does. Finally the writer explains that as long as people are alive to read poems, his beloved will be immortal because the sonnet brings life to the person he is referring to (13-14). These last stanzas reveal a metaphor that argues his beloved is better than a summer day because unlike summer, his beloved’s beauty will never fade. Both sonnets escape the inevitable because of their different views on death. While the writer of â€Å"Sonnet 18† defeats death by capturing beauty in a poem, John Donne defeats death by belief of what is to come after this life. These two poems suggest that we shouldn’t fear mortality because it only reveals life after death. Work cited Donne, John. â€Å"Death.† The Giant Book of Poetry. Ed. William Roetzhem. San Diego: Level Four Press, Inc.2006. 21. Print. Shakespeare, William. â€Å"Sonnet XVIII.† The Giant Book of Poetry. Ed. William Roetzhem. San Diego: Level Four Press, Inc.2006. 13.Print.

Cause of Industrialization essays

Cause of Industrialization essays What appears to be the necessary conditions for Industrialization? Give examples in Britain, Germany, US, Russia, and Japan. Britain: Population growth, Migrants flocked from countryside homes to the city slums to make money, a strong middle class and difficult political, economical, and social circumstance, and the decrease of death rate in infants. Germany: Coal and iron production on the rise in the 1840's, extensive rail works, the unification of Germany, and Bismarck and his encouraged development of heavy industry and its effects on the army. USA: Many European immigrants, a strong middle class, the decrease of death rate in infants, British introduction of cotton textile factories, the emergence of steel and iron mining, and the mass production of railways. Russia: Social reform based on the Communist manifesto, Czarist government encouraged railway development, reformed commercial laws helped developing companies, and the production of oil armaments, and iron. Japan: The hiring of foreign experts to help develop modern industry, government founded industries, government the sold those business to non-governmental merchants, and the increase of technology. ...

gender anylsis essays

gender anylsis essays He strides toward us in navy and whit, his body muscled and heavy-set, one arm holding his casually flung jeans jacket over his shoulder. A man in his prime, with just the right combination of macho and sartorial flair. She is curled and giggling upon a chair, her hair loose and flowing around her shoulders, leaning forward innocently; the very picture of a blossoming, navy flower. They are each pictured on a magazine page of their own, situated opposite each other in a complementary two-page layout. They are stationed in front of a muted photograph which serves as a background for each one. They both merit their own captions: bold indigo letters presiding over them in the outer corners of each page. His says: Some Like Their Blues Hard. Hers says: Some Like Their Blues soft. His background depicts a thrusting struggle between a quarter back and leaping defender, a scene of arrested violence and high tension. Her background is a lounging, bikini-clad goddess, who looks at the camera with intriguing, calm passion. She raises her hand to rest behind her head in in a languid gesture as she tries to incite passion within the viewer. At the bottom of the page blazes the proud emblem of the company that came up with this ad: FILA JEANS This advertisement blatantly uses stereotypes of men and women to sell its product. It caters to our need to fit into the roles that society has deemed right for the individual sexes ever since patriarchal rule rose up and replace the primitive worship of mother goddess and reverence for woman. These stereotypes handed down to us throughout the centuries spell out to us that men are violence and power incarnate, and that the manly attitude has no room for weakness or softness in nature. We find our role model of women in the compliant and eager female who obeys her man in all things, who must not say no to a male, and who is not very bright; someone ...

The Manager as a Critical Thinker Case Study Example | Topics and Well Written Essays - 1750 words

The Manager as a Critical Thinker - Case Study Example By doing so, author aims to broaden the level of critical thinking as well as communication skills. There is one basic issue which is being discussed in this memo which is basically the outsourcing of the information systems of the State's department of transport. Apart from the main issue, other issues which are discussed include lowering wages, jobs lost by the workers, giving access of information systems to third parties, as well as supporting in next elections if the idea of outsourcing the existing systems is opposed at the appropriate level. While concluding, Glenn, Barbara, outlined that the proposal for outsourcing is not only against the interests of the current employees, but it is also against the State and shall be abandoned in order to save the jobs of many who may be rendered jobless due to relocation of their jobs as well as of their job skills may become obsolete. There are different reasons which are being cited as potential harms of the process of privatizing the information systems. While discussing such impacts, memo discusses following reasons for opposing the move by Governor to outsource the Information systems: 3. By dispersing employees to new locations for jobs, not only their skills will become inferior, but they may find it difficult to cope with the change. Such employees who are nearing their superannuation may find it extremely difficult to learn new skills therefore may be shown the door due to lack of skills and competencies. 4. The proposed outsourcing of the job therefore would result into the job losses for many of the employees as it has historically been witnessed that management hardly keep its promises. What words or phrases are ambiguous The memo contains following ambiguous words and phrases: 1. To outsource and privatize: Outsourcing is not privatization. It seems that the author of the memo failed to clearly distinguish between the two concepts. 2. Executive branch of government: It is ambiguous as to how those employees who are working in a purely technical job can work at an executive branch of the government. From this perspective, it may be inferred that the government may finally lay them off. 3. Proposed privatization is an assault on our union: Again this seems to be a misconception as unions successfully exist into private organizations also. 4. Anti-American: The assumption that outsourcing or privatization is anti-American may be ambiguous because America is probably the only country in the world which strongly advocates free market economies. 5. Foreign agents will bid for this privatization contract: It is not necessary that outsourcing process can only be given to foreign contractors. Local contractors can too offer such services. 6. According to the online website Wikipedia: Wikipedia may not be considered as a reliable source of information. 7. You rebut the governor's proposal: The phrase may be indicating a partial and biased opinion of author towards Governor. What are the value conflicts and

Coucelling for Divorce in Marriage Essay Example | Topics and Well Written Essays - 2000 words

Coucelling for Divorce in Marriage - Essay Example e affords scripture, (b) the authority he or she affords religious leaders, and (c) the identification of the counsellor with the religious group of reference. All clients can tolerate only limited differences from their own important values. If value differences are too great, clients may terminate counselling intervention. Probably, the clients evaluation of the counsellor on these three religious value dimensions has more effect on choice of counsellor or continuation after an initial interview than it has on the long-term satisfaction of the client after the client has made a considerable investment of time and money in counselling intervention. The Christian approach to marriage counselling intervention that advocated by the counsellors is not merely hearing confession --nor is it preaching or studying the Bible. It is not spiritual direction, which involves guided reflection about Christian living--nor is it spiritual guidance, which involves advice and direct suggestion. It is marriage counselling intervention, as is secular marriage counselling intervention. As such, like any marriage counselling intervention, it involves the assumption that basic counselling skills will be employed consonant with the personality style of the counsellor and the needs of the client. Approach to marriage counselling assumes that counsellors may employ techniques that originated in the Christian traditions when they are consonant with the personality and beliefs of the counsellor and the needs of the client and when they are deemed to contribute to the goals of marital therapy. Generally, the counsellor will not initiate a challenge to the clients Christian beliefs unless such a challenge is otherwise clinically advisable (e.g., obsessive or intrusive thoughts, compulsive religious behaviour, psychotic thinking of religious content, and the like). In all cases, good clinical judgment is presumed--as in any theory. It is to be believed that people are created in the image of