By J. Miguel. Southwest Minnesota State University.
The ordinary world is almost instantaneously replaced discount kamagra chewable 100 mg with mastercard, not only with a hallucination order kamagra chewable overnight delivery, but a hallucination whose alien character is its utter alienness buy generic kamagra chewable 100mg on-line. Species of toad you need: Bufo alvarius (Sonoran Desert or Colorodo River Toad) generic kamagra chewable 100mg without a prescription, and only this. Note: Also if you can’t find any of these species, your best hope is to do this extraction from a tree toad. Warning: I would not try the tree toad way, unless you are sure that it’s venom is not a deadly poison! Where to get Bufo alvarrius toad (Sonoran Desert or Colorodo River Toad) vemon: Collect two to four Bufo alvarius toads, any other toad will not work. Use a flat glass plate or any other smooth, nonporous surface at least 12-inches square. In this manner, the venom can be collected on the glass plate, free of dirt and liquid released when the toad is handled. When you are ready to begin, hold the toad firmly with one hand and, with the thumb and forefinger of your other hand, squeeze near the base of the gland until the venom squirts out of the pores and onto the glass plate. Use this method to systematically collect the venom from each of the toad’s granular glands: those on the forearm, those on the tibia and femur of the hind leg, and, of course, the parotids on the neck. Each gland can be squeezed a second time for an additional yield of venom if you allow the toad a one-hour rest preiod. After this the glands are empty and require four to to six weeks for regeneration. The venom is viscous and milky-white in color when first squeezed from the glands. It begins to dry within minutes and acquires the color and texture of rubber cement. Scrape the venom from the glass plate, dry it thoroughly, and store it in an airtight container until you are ready to smoke it. Due to its bad taste you can mix it with a more fragrent smoking medium like tobacco, cloves, or marijuana. When the plant is grown, you strip the roots of their bark and grind them up and make a tea. This can be a problem if you load a full dose at a later date and unknowingly have an additional 20 mg left in the pipe. Just follow my very simple instructions and in no time you will be making your own ture to god hard alcohol. Though every supermarket should have it, they started to use isopropyl instead of ethanol which is a poison if you drink to much. It may not be the fine wine you can buy for 300 dollars, but do you want to get drunk or what? Now, go down to the local wal-mart or some place like that and ask where the rubbing alcohol is. When you get the the rubbing alcohol section look on the back of every bottle looking for one that has ethanol or ether alcohol. Empty wine bottle (You can use a plastic kool-aid container it really does not matter as long as it can hold liquid) 4. Fill the wine bottle (or container) up 7/10 of the way with rubbing alcohol (ethanol). Getting high on Poppie Seeds: Get about 300g of poppy seeds from your good old supermarket (really cheap) and crush them. Add the crushed seeds to the juice of about 3 lemons in a bowl and let them soak for about 10 mins. Then add some warm water so that they are covered by about a couple of cm and again leave them for about 10 mins. Getting High off of Nutmeg: All you do is look in your pantry and look for a bottle of whole or ground nutmeg. Growing an outdoor crop has been the favored method over the years, because grass seems to grow better without as much attention when in its natural habitat. Of course, an outdoors setting requires special precautions not encoun- tered with an indoors crop; you must be able to avoid detection, both from law enforcement freaks and common freaks, both of whom will take your weed and probably use it. One says you should start the seedlings for about ten days in an indoor starter box (see the indoor section) and then transplant. Fewer plants will come up with this method, but there is no shock of transplant to kill some of the seedlings halfway through. The soil should be preprepared for the little devils by turning it over a couple of times and adding about one cup of hydrated lime per square yard of soil and a little bit (not too much, now) of good water soluble nitrogen fertilizer. The plants should be planted at least three feet apart, getting too greedy and stacking them too close will result in stunted plants. This is especially true around the roots, as too much water will rot the root system. Grass grows well in corn or hops, and these plants will help provide some camouflage. It is probally a good idea to plant in many small, broken patches, as people tend to notice patterns. In a good crop, the male will still be plenty smokable and should not be thrown away under any circumstances. Marijuana can reach a hight of twenty feet (or would you rather wish on a star) and obtain a diameter of 4 ½ inches. If normal, it has a sex ratio of about 1:1, but this can be altered in several ways. Marijuana soil should compact when you squeeze it, but should also break apart with a small pressure and absorb water well. A nice test for either indoor or outdoor growing is to add a bunch of worms to the soil, if they live and hang aroung, it is good soil, but if they don’t, well, change it. The seeds should be virile, that is, they should not be grey and shiriveled up, but green, meaty, and healthy appearing. The sprouting soil should be a mixture of humus, soil, and five sand with a bit of organic fertilizer and water mixed in about one week before planting. When ready to transplant, you must be sure and leave a ball of soil around the roots of each plant. If you are growing/transplanting indoors, you should use a green safe light (purchased at nurseries) during the transplanting operation. If you are transplanting outdoors, you should time it about two hours befor sunset to avoid damage to the plant. It is also a good idea to use a commercial transplant chemical (also purchased at nurseries) to help then overcome the shock. If growing in a room, you should put tar paper on the floors and then buy sterilized bags of soil form a nursery. As you increase the light, the plants grow faster and show more females/less males. Sixteen hours of light per day seems to be the best combination, beyond this makes little or no appreciable difference in the plant quality. The walls of your growing room should be painted white or covered with aluminum foil to reflect the light. The female plant is shorter and has a small pistillate flower, which really doesn’t look like a flower at all but rather a small bunch of leaves in a cluster. If you don’t want any seeds, just good dope, you should pick the males before they shed their pollen as the female will use some of her resin to make the seeds. After another three to five weeks, after the males are gone, the females will begin to wither and die (from loneliness? You must have a heat source (such as an electric heater) which will make the box/room each 130 degrees. The box/room must be ventilated to carry off the water-vapor-laden air and replace it with fresh. A good box can be constructed from an orange crate with fiberglass insulated walls, vents in the tops, and screen shelves to hold the leaves. A quick cure for smaller amounts is to: cut the plant at the soil level and wrap it in a cloth so as not to loose any leavs. Place all the leaves on a cookie sheet or aluminum foil and put them in the middle sheld of the oven, which is set on “broil.
In the study by Schroeder and Hunt (119) kamagra chewable 100 mg visa, subjects wrote selfevaluations after disapproval by a neutral source cheap kamagra chewable 100mg fast delivery. Those who gave more self-devaluating responses yielded to a significantly greater degree in the pressure situation trusted 100mg kamagra chewable. When an individual has a prior alone experience of failure buy kamagra chewable 100 mg mastercard, he is more susceptible to pressures on a second task. However, subjects are less susceptible following a group experience of failure than of success. Sherif and Harvey (124) varied familiarity with the experimental setting and with the manner of the experimenter. Subjects judged the autokinetic task initially in -246- private; two to seven days later, they judged in pairs. Comparisons were made of ranges and medians of judgments for private and pair sessioiis. The greater the uncertainty induced under private conditions, the more individuals fluctuated in the ranges and medians of their judgments, with dispersion significantly reduced in the pair sessions for those experiencing maximum uncertainty. The findings are interpreted as indicating that subjects served as "anchors" for one another when field anchorages were reduced. Pretraining has been provided on tasks with properties differing from those of the tasks used to exert pressures. By comparison with a control group, the erroneous response was given more frequently by those who had had pretraining with a confederate whose identical response was labeled "correct" in the preliminary series and "incorrect" in the second series. Luchins and Luchins (90) varied the responses of the confederate to the preliminary series of pictures. Half the subjects judged pictures of clearly delineated objects, and the other half an ambiguous set of lines. In some studies, independence has been rewarded, whereas in others conformity to a false group position has been reinforced. Comparable conditions in another study by Luchins (87) produced similar results (see above). Crutchfield (34) reports that conformity increased on a task involving perceptual judgments when the experimenter called the erroneous reports of others "right," but that subsequent responses to attitude statements by the same subjects were not influenced. Conformity effects following pretraining with reward for erroneous responses appear to be related to the content of the tasks. Scott (120) found that college debaters who were rewarded showed a significantly greater average change in the direction of their positions. A direct correlation has been reported between the degree of experimentally produced anxiety experienced prior to the pressure situation and susceptibility, with those experiencing the greatest degree of anxiety being least resistant. Properties of a prior task on which a confederate gave a false response have been found to be related to the degree of susceptibility to pressures exerted by the same confederate in a later, different task. Pretraining with reward for incorrect responses also has been shown to render a person more susceptible. Differential Historical Experience in Subjects Different childhood experiences, as revealed biographically or through questionnaires and projective measures, and their effects have been investigated. Conformity tendencies have been related by Mussen and Kagan (105) to perceptions of parents as shown in fantasy. Then they participated in judging lengths of lines as the fourth person in a group of five. A significantly greater per cent of extreme conformists perceived parents as harsh, punitive, restrictive, and rejecting. Krebs (80) tested the hypothesis that the later the age of independence training during childhood, the greater the resistance to opinion change. Greatest conformity occurred for individuals classified as late in independence training. Physiologic Characteristics and States of the Person Age and sex of the subjects, differences in amount of sleep deprivation, strength of food preferences, and degree of anxiety have been related to susceptibility. Burtt (25) asked college women and men in groups of four to twenty-six persons to judge the truthfulness of a person recounting an intaginary crime, once prior to and once after the discussion. Analysis of the data revealed only small and insignificant differences between men and women in degree of shifting as a function of discussion, with a tendency for women to shift more than men. Crutchfield (34) has summarized unpublished results by other investigators who have tested women on the same battery of items that he has employed with men. By contrast with college men, responses by college women showed a significantly higher degree of conformity, and that, by comparison with adult men, a sample of college women alumnae in their early forties showed significantly lower conformity scores. The highly selected composition of the alumnae group means that the findings cannot be easily interpreted as indicating that older women are less compelled to conformity than men. Kirkpatrick (79) has compared frequency of shifting by men and by women toward responses given by the opposite sex. The BeliefPattern Scale of attitudes toward feminism was administered individually to college students, then to one man and one woman as a committee, and again individually. Although women changed their positions less than men in the group situation, they were less inclined to revert to their original position. The finding by Coleman, Blake, and Mouton (31) (see foregoing), indicating differential susceptibility of men and women as a function of the material being judged, makes it mandatory that the nature of the task be considered in future work. Duncker (38) has reported that children under two and two-thirds years of age did not respond to food preferences expressed by others, thus demonstrating a lack of susceptibility for the task employed. Luchins (89) used ten- to thirteen-year-old children as subjects in one series and male college students in another series. Fisher and Rubinstein (42) found that subjects who had been awake continuously for 48 to 52 hr showed significantly greater changes in autokinetic judgments, both between trials and within trials, than control subjects. Kimbrell and Blake (78) experimentally created two degrees of inducement to thirst: strong and moderate. Subjects then were asked to wait for the remainder of the experiment near a drinking fountain with a sign forbidding its use. Under conditions of moderate thirst, the naive subject was significantly influenced by the confederate who violated the sign. Four- to six-year-old kindergarten children were placed by Marinho (95) in two groups, one showing a preference for one of two kinds of fruit paste, and the other, with indefinite preferences. Lawson and Stagner (82) tested the hypothesis that attitude change during group discussion is accompanied by increases in anxiety, and that amount of change is proportional to the amount of anxiety. Male undergraduate college students were preselected by attitude scales to represent extreme positions toward nationalism or internationalism. Anxiety was measured by palmar sweat both before and after each subject participated in the pressure situation. Two naive subjects interacted with an instructed majority who took the opposite point of view. Attitude shifts were found to be accompanied by decreases in palmar sweat, particularly for those initially holding nationalistic opinions. Hoffman (64) used selected items from the F-scale to differentiate students with high and low inner conformity needs. Unexpectedly, both groups shifted significantly toward the false norms, with conformity producing less anxiety than resistance, although the differences were significant for high conformity subjects only. A consistent finding is that younger people are more responsive to social pressures than older individuals. Psychologic Properties of the Person Psychologic dimensions investigated have included ascendancysubmission; lack of nervous tension and self-confidence; authoritarianism; dimensions described by the Minnesota Multiphasic Personality Inventory; the Rorschach Test; the Thematic Apperception Test; intelligence; complexity-simplicity; originality; dependence on the perceptual field; pathologic tendencies of the person; and characteristics assessed by self-ratings and self-descriptive check lists. Several different personality measures have been employed to assess the effects of individual differences in ascendancy-submission. Helson, Blake, Mouton, and Olmstead (63) used the Allport-Allport A-S Reaction Study to classify subjects and then had them judge eighteen statements from the Thurstone Militarism Scale. Mouton, Blake, and Olmstead (103) also employed the A-S Reaction Study as a measure of ascendancysubmission. Under name disclosure conditions only, submissive subjects were found to conform more often as a function of the erroneous reports; of others (see preceding). Both male and female subjects responded to the Thurstone-Chave War Scale initially in private and later as the fifth person in the simulated group situation. Others, gave strongly agreeing, neutral, and strongly disagreeing responses, in random order and balanced, to the anti-, pro-, and neutral attitudes toward war statements. He found a negative rela- -251- tionship for men only between ascendancy and conformity. For women, a positive relationship was observed, with more submissive women conforming less than those in the ascendant.
Orientation in time and space structure the situation and may thus help the individual retain ego autonomy by keeping some ego functions in operation 100 mg kamagra chewable overnight delivery. Since isolation destructures the id-ego relationship purchase cheapest kamagra chewable, initial variations in the differentiation of ego boundaries may account for the individual differences seen buy kamagra chewable online pills. The increased awareness of primary process material states in psychoanalytic terminology what others have described as the heightened awareness of internal bodily states purchase 100mg kamagra chewable. A recent paper by Bruner (12) places the work on deprivation in a functional context. Perception is seen as instrumental behavior that permits the organism to manage its necessary transactions with the environment. Successful management of these transactions depends on acquiring an adequate internal model of the external world. Thus the organism becomes limited in acquiring a full range of efficient problem-solving strategies. Deprivation in adult life interferes with the perceptual-cognitive maintenance needs of the organism. Thus, it disrupts the vital evaluation process by which one monitors -88- and corrects the models and strategies used in dealing with the environment. From a neurophysiological point of view, Lindsley (51) emphasizes the function of the reticular activating system because of its role in attention, perception, and motivation. This system serves the homeostatic function of adjusting input-output relationships. Sensory deprivation is one of a class of conditions which upsets the balance and thus disturbs the regulating function of the ascending reticular activating system. With markedly reduced input, perception is disrupted; attention gives way to distractibility; interest gives way to boredom; and activity is either held in abeyance or becomes highly stereotyped and nonadaptive. He cites evidence to show that the capacity of a stimulus to evoke and maintain arousal is lost upon repeated exposure of the stimulus. Hebb (37) presents an excellent theoretical discussion of the implications of the concept of arousal and the manner in which these findings bear upon a variety of issues in motivation theory, such as the generality or specificity of drive states, the need for varied stimulation, and the intrinsically rewarding quality of cognitive activity. There are no experimental data available in the studies reviewed bearing directly on the relationship of isolation and deprivation to the amount and accuracy of information which can be obtained when under interrogation. Nonetheless, the findings reported suggest some major parameters which may facilitate or inhibit the disorganizing effects of isolation. Before considering further the implications of these studies for the interrogation problem, it may be important to point out some limitations. There has been some tendency to equate the effects of sensory and perceptual deprivation studies with those reported under conditions of solitary confinement. Several studies (21, 30, 32) explicitly control or account for the social isolation variable as contributing little to the effects observed. Schachter (66) studied the reactions of five students to social isolation without interference with ordinary sensory -89- input. He concludes that for isolation two to eight days seems to produce relatively little of the painful effects seen in the autobiographical reports of sailors and explorers. However, specific investigations of the social factors in the sensory deprivation studies will be necessary in order to make a more precise generalization. We have earlier elaborated some aspects of the differences in motivation between the experimental situations and the real life conditions. Because of these differences, and of limited data, caution in generalizing the relevance of these experimental studies is necessary. Pending clarification of these issues, some tentative implications may be suggested as relevant. The boredom, restlessness, irritability, and other mood changes observed also may well apply. The stimulus-hunger and increased suggestibility which have been observed may make an individual more vulnerable to revealing information he might otherwise withhold, particularly when accompanied by the social uncertainty induced in the interrogation situation. Unprepared for these consequences of isolation and deprivation, like many experimental subjects, an individual may become apprehensive and indeed panicked by his reactions. The appearance of hallucinatory- like phenomena and their emotional accompaniments have often been quite anxiety provoking. On the other hand, previous exposure to these circumstances, familiarity with their consequences, and training individuals in techniques of dealing with them may well increase resistance. Knowledge of the importance of retaining spatial and time orientation, and self-stimulation in concrete tasks, are two examples of techniques for reducing stress by increasing psychological structure. Schachter (66) points out that isolates who are able to keep occupied with distracting activities appear to suffer less and be more prone to the state of apathy. Schonbach (68), in an experimental study, has demonstrated that a state of deprivation is far more bearable under conditions of irrelevant and distractive thought than under conditions where thought is concerned almost wholly with the source of deprivation. Since direct research on the problem of resistance to interrogation in a realistic setting is difficult, some reliance on the type of study reviewed here is necessary. Further investigation of these problems will undoubtedly continue to shed new light on resistance to the disorganizing consequences of deprivation. However, despite their often dramatic results, these studies have remained within the limi- -90- tations posed by ethical considerations and have not pushed subjects to their ultimate limits. Indeed, polio patients survive years in respirators without psychosis, whereas prisoners, sailors, and explorers often successfully endure long months of severe deprivation and monotony. Furthermore, the autobiographical evidence, even if selfselected, implies that the long term effects are reversible and in some instances leave the individual with a sense of having achieved a new and better personality synthesis. From this point of view, the findings reviewed must be considered as suggestive, rather than spelling out in final terms the complete and precise parameters of response. Lackland Air Force Base, Texas; Air Force Personnel and Training Research Center, December 1956. The effects of sensory isolation on suggestible and nonsuggestible psychology graduate students. Sensory deprivation: (1) Effects of social contact, (2) Effects of random visual stimulation. The relation of eye movements during sleep to dream activity: An objective method for the study of dreaming. Infant development under conditions of restricted practice and of minimum social stimulation. Experimental interference with reality coiltact (perceptual isolation): Method and group results. Influence of prior verbalization and instructions on visual sensations reported under conditions of reduced sensory input. Are there common factors in sensory deprivation, sensory distortion, and sensory overload? Factors used to increase the susceptibility of individuals to forceful indoctrinations Observations and experiments. An abnormality of mental function affecting patients with poliomyelitis in tank type respirators. The effects of sensory deprivation and sensory bombardment on apparent movement thresholds. Effects of interruption of the visual pathway on the response to geniculate stimulation. The Chinese indoctrination program for prisoners of war; A study of attempted brainwashing. This problem in communication is not an unfamiliar one to the psychiatrist, who often aims to recover unconscious conflicts or memories from the neurotic or psychotic patient in the hope of producing therapeutic benefit. Coercion may be used, however, if the patient is considered to be behaving in a manner that is destructive to himself (e. Furthermore, the code of ethics, particularly of the psychiatrist, ordinarily binds the physician to keep -96- confidential the secrets that his patients impart to him, whether or not the patient has been aware or unaware of their nature. In the practice of psychiatry, the code of respecting and keeping the confidences of a patient is considered to be a tool that facilitates the confession or expression of otherwise taboo material from the patient. In this position the physician may be forced to disqualify himself as a continuing confidant for the patient until the patient has remedied his social obligation to the state.
As well as the structure–activity relationships described in the original medicinal chemistry papers cheap generic kamagra chewable uk, the compound series advanced further purchase kamagra chewable paypal, with examples also having undergone in vivo testing purchase 100mg kamagra chewable with mastercard. As with the previously described ketoamide dual inhibitors quality kamagra chewable 100 mg,153 it is not clear to what extent any improvement seen is attrib- utable to calpain inhibition alone. Three subtypes of receptor have been described: a, b/g and d, with View Online Drug Discovery Approaches for Rare Neuromuscular Diseases 297 Figure 11. Histone deacetylase inhibitors fall into the class of agents known as epigenetic modulators. Although the precise mech- anisms in play are not clear, inhibitor treatment was shown to increase levels of the myostatin antagonist follistatin in muscle satellite cells, which was suggested to contribute to the functional improvements. What was particularly encour- aging was that this activity translated into eﬃcacy in the mdx mouse Figure 11. Of note in this latter section of the experiment was that the mdx mice used were 10 weeks old when dosing was initiated. This is unusual in experiments intended to assess the eﬀect of new drugs on the mdx phenotype, because by that stage there has already been a considerable amount of muscle degen- eration and regeneration taking place; dosing from around the 3 week postnatal period is more usual. Furthermore, although the compounds were dosed orally, this was not undertaken using oral gavage, but by mixing compound with the food. Although there appeared to be a reasonably consistent amount of food intake between the various animals, gavage dosing might be expected to give more consistent dosing results. The authors speculated that the mechanism of action could involve calcium traﬃcking. Altering pH and hence transmembrane potential in turn + 2+ inuences specic ion channel activities, particularly Na and Ca. Although there are clear limitations to the screening platform, such as clarity/consistency on compound dose levels, the value of using an in vivo disease model with a dystrophin-like gene is clear. For any future screening programme, as well as identifying new lead molecules it would be important to establish the proles of previously described compounds which work through the full range of mechanisms described herein. In this manner it would be possible to assess the scope and limitations of the assay system, particularly for evaluating compound modes of action which are indepen- dent of dystrophin. A dual approach, combining myostatin knockdown with myostatin inhi- bition, has been investigated by several groups, and shown to be bene- cial. The therapeutic potential of the protein was further illustrated in studies using biglycan null mice, which were shown to exhibit reduced levels of utrophin expression, along with reduced muscle function. Histological improvement in muscle structure and functional benet were also seen. Furthermore, eﬃcacy has yet to be demonstrated using in vivo systems other than the mdx mouse. An important advantage of the approach relative to gene therapy is that the protein can be delivered systemically using intra- peritoneal injection. Fallon also demonstrated that the agent is well tolerated following chronic dosing and appears to be physiologically stable for suﬃ- cient time to provide sustained functional benet. It is under development by Tirvorsan, a spin-out company from Brown University co-founded by Fallon. Using this assay the Prestwick Chemical Library (1120 compounds) was screened, and seven compounds found to give a bire- fringement readout equivalent to wild-type, although further analysis using an antibody to dystrophin established that this eﬀect was not due to resto- ration of dystrophin production. These results conrm the published work on sildenal in the mdx mouse (see Section 11. It is known to have in excess of 40 protein binding partners, and is found at varying levels in most tissues, with particularly high concentrations being localised in the brain and spinal cord. In the latter location it is concentrated in so-called ‘gem’ (‘Gemini of the coiled bodies’) structures. Stem cell therapies, particularly those intended to replace the missing cells, have been described. These and any other allogenic therapies also carry the attendant risk of immune rejection, or the requirement for immunosuppression, which may cause further problems in the targeted patient population. Moreover, the development of dened diﬀerentiation protocols allows for the production of specic cell types of interest in the disease pathology (e. This approach could be envisaged as being particularly advantageous because toxicological studies in man will have already taken place for the compounds/ agents in question. Results from a small Phase 1 clinical trial were re- ported in 2003, and although the study was not powered suﬃciently to establish signicant eﬃcacy, encouraging results were noted, in that several patients were still alive many months aer dosing started. View Online Drug Discovery Approaches for Rare Neuromuscular Diseases 307 Riluzole is a relatively promiscuous small molecule, having multiple pharmacological activities associated with it, including acting as an ion channel blocker and disrupter of glutamate signalling. Through these modes of action it is thought to exert its action as a neurotrophic factor, promoting the growth, survival and maintenance of motor neurons. The mode of action of the compound remains to be elucidated fully, but was suggested as being at least in part due to a neuroprotective eﬀect. One of the more recent publications in this thera- peutic compound class, involving studies using both in vitro and patient dosing, has described the use of the bronchodilatory drug salbutamol 11. Whether this will indeed prove to be the case remains to be seen following appropriately designed long-term studies. Encouraging results have been reported in various animal studies, although no clinical evaluation has yet taken place in human patients. While only limited data has been published to date,246,247 Phase 3 clinical trials with valproic acid and carnitine co-dosing at least appear to be planned. Furthermore, the use of agents originally designed for oncology indications in a potentially chronically dosed paediatric indi- cation seems optimistic, and will in all likelihood require more selective compounds with a signicantly cleaner toxicological prole than that seen with compounds thus far. Interestingly, despite the presence of reactive electrophilic functional groups such as the triepoxide and butenolide motifs, no apparent toxicity was noted. Initially, researchers designed a reporter-based screening assay to identify compounds such as the anthracycline aclarubicin (11. No details of the criteria which qualied these six classes as preferable for further evaluation were described. Although both series were felt to represent viable start points for medicinal chemistry optimisation, only work on the latter series appears to have been undertaken. Optimisation of the 2,4-diaminoquinazoline analogues has been pub- lished recently, and described the structure–activity studies which led to the discovery of lead candidate D156844 (11. Most notably, and (so far) uniquely for this disease, other key compound data were described including pharmacokinetic parameters, and systemic and central plasma and tissue compound levels, all of which were found to be extremely encouraging. Illustrating a typical challenge faced during a drug discovery programme, the oﬀ-target pharmacology of compounds was also assessed, and examples of the 2,4-diaminoquinazoline View Online 316 Chapter 11 Figure 11. Of particular note was the additional publication of exposure and eﬃcacy data for several analogues in the series. This compound has been described as having a similar chemical structure to quinazoline 11. Repligen has very recently announced that it has signed a licensing agreement with Pzer to further develop the programme. Because a molecular target for the compound has now been identied and crystal structures are available, it could reasonably be anticipated that development of next-generation View Online Drug Discovery Approaches for Rare Neuromuscular Diseases 317 compounds using both screening and computational drug discovery plat- forms will follow. In contrast, the groups previously reported assay measured increases based on splicing alone. Using this novel assay a collection of 115 000 compounds were screened, which resulted in the identication of 462 hits. Conrmatory screening removed a signicant proportion of hit molecules, leaving 294 compounds which fell into 19 structural classes. In order to assess the specicity of the mode of action of the various compounds (i. The authors proposed that these results indicated diﬀering mechanisms of action were in play for the diﬀerent structural classes, with 11. For any future studies it would be useful to investigate these in more detail, particularly whether they translate to non-genetically modied cells such as patient-derived broblasts as there are important implications for future progression of compounds, for example they may act in an additive manner and oﬀer possible co-treatment options. Secondly the eﬀect on ‘gem’ formation (localisation of protein to nuclear bodies) at lower compound concentration was assessed. Because it had been hypothesised that the compound classes may have diﬀering modes of action, a novel experiment undertaken in these studies was an evaluation of combination eﬀects. Evidence of improved eﬃcacy was View Online Drug Discovery Approaches for Rare Neuromuscular Diseases 319 seen with several combinations of 11. Animal lifespan was increased relative to controls, by approximately 180%, which is also impressive. Approximately 1000 compounds were identied as hits in the primary À1 assay, following single concentration screening (5. Following conrmatory screening using Western blot analysis, three compounds were found to do this (11.