Serum neurofilament light in MS: The first true blood-based biomarker?

A simple blood-derived biomarker is desirable in the routine management of multiple sclerosis (MS) patients and serum neurofilament light chain (sNfL) is the most promising candidate. Although its utility was first shown in cerebrospinal fluid (CSF), technological advancements have enabled reliable detection in serum and less frequently plasma, obviating the need for repeated lumbar punctures. In this review, after defining the knowledge gap in MS management that many hope sNfL could fill, we summarize salient studies demonstrating associations of sNfL levels with outcomes of interest. We group these outcomes into inflammatory activity, progression, treatment response, and prediction/prognosis. Where possible we focus on data from real-world perspective observational cohorts. While acknowledging the limitations of sNfL and highlighting key areas for ongoing work, we conclude with our opinion of the role for sNfL as an objective, convenient, and cost-effective adjunct to clinical assessment. Paving the way for other promising biomarkers both blood-derived and otherwise, sNfL is an incremental step toward precision medicine for MS patients.

A Country (Still) Divided

Supernatural shows by their nature often incorporate themes such as survival, community, revenge, resurrection, and (the dark side of) humanity -- themes which take on a new meaning in the post-9/11 period. Chapter Six analyzes how these are incorporated into 21st century vampire narratives, such as HBO's True Blood (2008-2014), CW's The Vampire Diaries (2009-2017), and the film adaptations of Stephenie Meyer's Twilight Saga (2008, 2009, 2010, 2011, 2012). Through a recurrent focus on "us versus them," these storylines bring attention to the cultural divides within the United States caused by things such as continued racial conflict, progress in the LGBTQA rights movement, and ongoing (religious and political) debates concerning family values. This essay also analyzes the ways in which the Civil War backstories present within each of these narratives reflect problematic nostalgia for bygone eras (and societal orders).

Neoliberal Gothic

This chapter engages with the geopolitical context of the Gothic’s migration from the periphery to the fast-beating heart of popular culture – specifically the rise to economic and cultural predominance of global neoliberalism. I contend that the Gothic texts of the neoliberal age can be seen to undertake the same kind of cultural work that was carried out by the Gothic mode in earlier periods of socio-economic turbulence. And, as in earlier periods, we can see a variety of ideological allegiances at play in Gothic texts of the neoliberal age – ranging from the revolutionary to the radical to the downright reactionary. The chapter ranges across texts and media including novels – i.e. Justin Cronin’s The Passage (2010), Hemlock Grove (2013–15), The Strain (2012–17), True Blood (2008–14), World War Z (2006) and In the Flesh (2013–14).

Contemporary Vampires

This chapter tracks the trends of the contemporary vampire in the twenty-first century, from the vampire’s popular representation as an outsider and anti-hero, a carrier of a fatal plague, through to an idealised figure of desire in Gothic romance. Vampires in literature, film and television evidence their continued struggle as displaced figures caught between the ancient and the modern while remaining perfectly in tune with the zeitgeist. This chapter analyses the cultural assimilation and aggressive marketisation of the vampire narrative into separate strands for multiple audiences and generic configurations (from the Gothic romance to the action film), exposing the plurality of vampiric representation in the twenty-first century, including the tamed Gothic lover of the Twilight saga (2008–12), the ubiquitous and the synthetic nature of contemporary vampire society (HBO’s True Blood(2008–14)), and the persistent updating of popular twentieth-century vampire narratives, including Bram Stoker’s novel Dracula(1897), for a new century.