Overview of Sarcopenia

Overview of Sarcopenia Background Sarcopenia is age related disease with symptoms of loss of muscle mass, strength and function. Elderly over the age of 65 years are vulnerable to sarcopenia [6]. It is estimated that approximated 5-13% of older people aged 60–70 years are suffered from sarcopenia [8]. The proportion is about twice higher among elderly at the age of 80 or above [8]. Studies also found that sarcopenia is more likely seen in older men than older women [16,26]. Sarcopenia gains intensive attention from public and increasing researches indicated that it is a major clinical problem for older people. Risk factors of sarcopenia Current research found that lifestyle factors, including physical inactivity, smoking and alcohol consuming [3]; and biological factors, including older age, gender, decreased hormone level, motor unit remodeling and reduced protein synthesis [3,25], contribute to development of sarcopenia. Motor unit remodeling comes up of age and leads to replacement of fast twitch motor neuron[22,25] which results in less precise control of movements, less force production and slowing of muscle mechanics[22,23,25] as remodeled motor unit are smaller in size and slower to contract. Therefore, loss of fast twitch fibers increases risk of having sarcopenia. In addition, protein synthesis, growth hormone (GH), testosterone (T) and insulin-like growth factor (IGF-1) are considered to be associated with sarcopenia as well [25]. It is well known that protein is important in muscle repairmen. And GH, T and IGF-1 are involved in protein metabolism and maintenance [23]. Different studies agreed that protein synthesis rate decreases throughout the natural aging process [24] and leads to loss of muscle mass. Thus, low protein synthesis rate, along with decrease in these hormones level provide possible occurrence of sarcopenia [25]. Consequences of sarcopenia Sarcopenia causes serious consequences not only at individual level but also at societal level. On the one hand, loss of muscle mass, strength and function lead to adverse health outcome in terms of frailty, disability, morbidity and mortality [8]. Essentially, sarcopenia is about twice as common as frailty [9]. Also, sarcopenia occurs with other morbidity in some times. Some of the co-morbidity are obesity [4,13], hypertension, osteoporosis [12] and type II diabetes [5,14,15]. Moreover, research suggests that loss of skeletal muscle strength may predict future mortality in middle-aged and elderly [2]. On the other hand, sarcopenia is linked with increased healthcare expenditure. In United States, the estimated direct healthcare attributable to sarcopenia represented about 1.5% of total healthcare expenditure in 2000 [21]. Diagnosis of sarcopenia according to different consensus panels Although research working in the area of sarcopenia is expanding exponentially, a universal definition is still under development. On average, current definitions are including muscle mass, muscle strength or even physical function. In 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) published guidelines to help identify sarcopenia [1,9]. According to the EWGSOP, a person will be classified as having sarcopenia when two of three follow criteria were statisfied: (A) low muscle mass and (B) low muscle strength and/or (C) low physical performance [1]. Low muscle mass is defined as muscle mass ≠¥2 standard deviations below the mean of reference population [8], calculating by equipment such as DEXA-scanners. Low physical performance is defined as gait speed ≠¤ 0.8 m/s in the 4 meters walk test for both males and females [8]. International Working Group on Sarcopenia (IWGS) suggested diagnosing sarcopenia when the following criteria are fulfilled: (a) gait speed was < 1 m/s and (b) low muscle mass (cutoff value is similar to EWGSOP) [8]. The European Society of Parenteral and Enteral Nutrition Special Interest Groups carried out that the cut off values for low muscle mass is defined as percentage of muscle mass > 2 SDs below the mean of reference individuals; for walking speed is < 0.8 m/s in the 4 meters walk test [1]. Measurement of muscle mass and muscle strength Muscle strength is mainly assessed by handgrip. While physical performance can be measured using simple tests such as the short physical performance battery test, usual gait speed or the timed get-up-and-go test; it is difficult to assess muscle mass in practice. Dual-energy X-ray absorptiometry (DEXA) is recently proposed as the gold standard for muscle mass measurement. Other methods include bioelectrical impedance, computed tomography, magnetic resonance imaging, urinary excretion of creatinine, anthropometric assessments, and neutron activation assessments can be used for measurement of muscle mass as well [8]. The process is complicated and need participation of professionals. Prevalence of sarcopenia varies as use of cut-off points relies on different instruments used for assessing muscle mass and strength and function. SARC-F, a newly developed simple questionnaire, has been regarded as rapid diagnosis test for sarcopenia. It contains five components: strength, assistance in walking, rise from a chair, climb stairs and falls. A question will be asked to assess each component variable. Scores range from 0-10, with 0-2 for each component [7]. Details of SARC-F are shown in table 1. Cut-off score A research conducted in Hong Kong tests the validation of SARC-F as a screening tool for sarcopenia in community. It found that SARC-F is able to predict future adverse outcomes with comparable power to other criteria. It also found that SARC-F has excellent specificity (94.4%) and negative predictive value but poor sensitivity. With high specificity, SARC-F is useful for screening out older adults with sarcopenia. Poor sensitivity may due to the number of participants classified as having sarcopenia represent only a small proportion of the total population studied [10]. Another research applied SARC-F in mainland China to screen sarcopenia and physical disability. It published that poor physical performance and grip strength were associated with SARC-F defined sarcopenia. But there was a very weak correlation to muscle mass in physically active outpatients. It pointed out potential explanation that the weak correlation may partly due to only small sample measured by DXA or BIA [11]. Relevance to Public Health Sarcopenia is coming of age. Elderly population is expected to remain on a rising trend in most of developed countries. In Hong Kong the proportion of the population aged 65 and over is projected to rise markedly from 13% in 2012 to 30% in 2041 []. It means that increasing population will suffer from sarcopenia. It is not surprise that sarcopenia increase the risk of physical disability. The risk of disability is 1.5 to 4.6 times higher in older persons with sarcopenia than in older persons with normal muscle. Men are at greater risk of sarcopenia related disability than women [16]. Recent estimates indicate that approximately 45% of the older U.S. population is sarcopenic and that approximately 20% of the older U.S. population is functionally disabled [21]. It is important to note that physical disability is associated with an increased risk of nursing home placement, home healthcare and hospital use [21]. And these healthcare services need extra healthcare expenditure to support. To sum up with information above, sarcopenia is becoming big challenge in public along with the rise of older population. It is cause serious health consequences in persons and make economic burden in countries.

What would Jesus Do? Canteberry Tales Essay :: essays research papers

What Would Jesus Do?   Ã‚  Ã‚  Ã‚  Ã‚  Between 1951 and 1991, forty-one Catholic priests in Chicago alone were charged with sexual misconduct (Philip Jenkins). This number has only increased over the past ten years, with the recent valiancy among Catholic women and children to come forth about sexual indecencies committed against them. But while the charges against the priests may be relatively new, the corruption within the clergy is certainly not. Priests’ abuse of their position can be traced back to the origin of the church itself through both stories and historical documents. In The Canterbury Tales, Geoffrey Chaucer exposes immorality in the church (both sexually and otherwise) through his introduction of various fictional characters. Together, these characters demonstrate the ways in which the church has fallen away from its original purpose and design—to make disciples of God through church members’ imitation of Jesus’ character.   Ã‚  Ã‚  Ã‚  Ã‚  In efforts to inspire Christians to act righteously, as well as instill a sense of religious pride among young people, Christians have cleverly coined the phrase, â€Å"What Would Jesus Do† or simply, â€Å"WWJD.† Although the expression may be overused and somewhat childish, in the meaning behind the phrase lies the entire mission statement of Christian dome. The apostle Peter describes it by saying, â€Å"To this you were called, because Christ suffered for you, leaving you an example, that you should follow in his steps,† (1 Peter 2:21). The message is simple; try to live as Christ lived. Of all people, most would expect the leaders of the church to strive the hardest for this level of Godliness. Quite ironically, however, Chaucer points out that the clergy possesses qualities opposite to those of Jesus—namely impurity, selfishness, and greed.   Ã‚  Ã‚  Ã‚  Ã‚  The dictionary defines the word ‘pure’ as being free of dirt, defilement, or pollution, and most Christians would agree that when the term is used in the bible, it means just that: being free of the dirt, scum, corruption, and sin in the world. According to Paul, the grace of God and the teachings of Jesus â€Å"teach us to say ‘No’ to ungodliness and worldly passions, and to live self-controlled, upright and godly lives,† (Titus 2:12). In The Canterbury Tales, Chaucer shows that the clergy is doing anything but seeking after purity. The Friar is the best example of this defilement of Christianity with his fulfillment of worldly pleasures in the areas of women and alcohol. Because of the attachment humans have to sex and their sexual partners, the Catholic Church is structured so that the leaders of the church remain celibate their entire lives.

America Before and After Revolution

The way of life in the colonies before the Revolution was far more different than the way of life after the war. The colonies were completely run by Britain and didn't have to fend for their own needs. Trading, taxing, and other parts of the economy were run by the mother-country. However, during the Revolutionary War, idealists like Thomas Paine produced concepts that fruited the idea for a more republican society. These new beliefs were reflected in the Declaration of Independence, after the war it played a huge part in the Articles of Confederation, and it was later the ideas established in the American Constitution. In the years before the Revolution, the colonies were still growing. The New World was a melting pot for different European cultures and social status played a huge part in how people viewed each other. Even though the colonists left Britain to escape social structure, they found themselves once again ranking people by how educated they were or how much money or land they had. The landowners were better off than the widowed, the poor and the indentured servants. But it was possible for citizens to earn their way into a higher class. Much like after the Revolution, the slaves had no worth and were at the bottom of the pyramid. Education was only offered for men to prepare them for ministry and it taught them the dead language of Latin that was important for interpreting the Bible’s scriptures. The link to religion was prominent in politics as well. A majority of the colonies were run by Parliament appointed officials that had close ties to the established churches of the colonies. The early years of the colonies were revolved around religion and were greatly affected by how England ran their government. England’s hierarchical society was all that the colonist knew and it wouldn’t be for a hundred years before they would find new ways to establish the colonies. Trading in the colonies was heavily intertwined with Britain. No trading with other countries was permitted unless it went through England’s ports first. The  British Empire  used them as a source of raw resources and as a source of taxes to pay for  Britain's many wars and ventures. However, agriculture, fishing, lumbering and other industries had a large impact on the development of the Americas. It was the first time that the colonies were producing things by themselves and providing their own goods helped instill confidence in the colonists. The American Revolution forever changed the colonies. The colonies were now a loosely united group of states, called the United States of America, and colonists now considered themselves American instead of English. The common man was given more rights and control. Laws like primogeniture were abolished and people were able to tend to their affairs freely. The institution of slavery was weakened and some Northern states even abolished it. After the American Revolution, America was free to industrialize and sell goods to other countries at more favorable prices, no longer being locked into an unfair trading monopoly with the British. Industry and manufacturing increased because of the high demand from other countries, thus broadening their amount of trade. Financial wizards like Alexander Hamilton led the States into what would be one of the most economically dominant countries of the world.

The Seleucids and Their Dynasty

The Seleucids and Their Dynasty The Seleucids were the rulers of the eastern part of Alexander the Greats empire from June 312 to 64 B.C. They were Hellenistic Greek kings in Asia. When Alexander the Great died, his empire was carved up. His first generation successors were known as the diadochi. [See map of the Kingdoms of the Diadochi.] Ptolemy took the Egyptian part, Antigonus took the area in Europe, including Macedonia, and Seleucus took the eastern part, Asia, which he ruled until 281. The Seleucids were the members of the dynasty that ruled Phoenicia, Asia Minor, northern Syria and Mesopotamia. Jona Lendering names the modern states that comprise this area as: Afghanistan,Iran,Iraq,Syria,Lebanon,parts of Turkey, Armenia, Turkmenistan, Uzbekistan, and Tajikistan. The followers of the eponymous Seleucus I were known as the Seleucids or the Seleucid Dynasty. Their actual names included Seleucus, Antiochus, Diodotus, Demetrius, Philip, Cleopatra, Tigranes, and Alexander. Although the Seleucids lost parts of the empire over time, including Transoxania, lost to the Parthians in about 280, and Bactria (Afghanistan) around 140-130 B.C., to the nomadic Yuezhi (possibly the Tocahrians) [E. Knoblochs Beyond the Oxus: Archaeology, Art and Architecture of Central Asia (1972)], they held on to parts. It was only in 64 B.C. that the era of Seleucid rule ended when the Roman leader Pompey annexed Syria and Lebanon.

Is Vertical Conveyor integrated with horizontal conveyors Essays

Is Vertical Conveyor integrated with horizontal conveyors Essays Is Vertical Conveyor integrated with horizontal conveyors Essay Is Vertical Conveyor integrated with horizontal conveyors Essay Conventional vertical conveyors, who is like the spiral conveyor, have the restriction that the input and output of material loads must have the same direction. By using forks many combinations of different input- and outputlevels in different directions are possible. Vertical lift conveyors can be manually or automatically loaded and controlled. Almost all vertical conveyors can be systematically integrated with horizontal conveyors, since both of these conveyor systems work in tandem to create a cohesive material andling assembly line. In order to provide power for small shops and light industry, specially constructed power buildings were constructed. Power buildings used a central steam engine and distributed power through line shafts to all the leased rooms. The advantages included less noise and less wasted energy in the friction losses inherent in the previously common drive shafts and their associated gearing. Also, maintenance was simpler and cheaper, and it was a more convenient method for the arrangement of ower drives such that if one part were to fail then it would not cause loss of power to all sections of a factory or mill. These systems were in turn superseded in popularity by rope drive methods. Henan HXJQ Minging Machinery Co. , Ltd, is a professional manufacturer and trader specializing in the research, development and production of construction machinery for nearly 50 years. Our main products are as follows: mobile diesel Jaw crusher,vertical mill, army type Jaw crusher, mini Jaw crushing plant with screen, cement packing machine,etc. We will provide you with the best product and service. In similarity to vertical conveyors, spiral conveyors raise and lower materials to different levels of a facility. Most spiral conveyors also have a lower angle of incline or decline (1 1 degrees or less) to prevent sliding and tumbling during operation. Almost conveyor belt system: chinaquarry. com/products_show/ belt_conveyor. html jaw crusher: china-crusher. com/ Is Vertical Conveyor integrated with horizontal conveyors By fengyanyanl 990

What led to US military action in the Vietnam Research Paper

What led to US military action in the Vietnam - Research Paper Example China would continue to rule there for the next 1,000 years, until 939 AD when Vietnam would regain some measure of independence (Bureau of East Asian and Pacific Affairs). Following this, two families fought for control of the country, and civil war was common until the late 18th century (Bureau of East Asian and Pacific Affairs). A peasant revolt in 1802 again unified the country under one governor, but was beaten down by an emperor who ruled as Gia Long (Bureau of East Asian and Pacific Affairs). The Vietnamese, by the time of the entry of American troops into their country, were most likely used to seeing foreigners in their country. The Americans, however, were still about 150 years away. First were the French in 1855, which ruled Vietnam as a colony, along with Cambodia and Laos, and called it French Indochina (Bureau of East Asian and Pacific Affairs). The emperor of Vietnam remained in the country at Hue and was given very limited authority, but that was all (Bureau of East Asian and Pacific Affairs). In 1919, a young man known as Ho Chi Minh joined the French Socialist Party, and became fascinated by the teachings of V.I. Lenin (Lawrence). Lenin, while adamant that full-blown Communist revolution could only occur in countries with high industrialization, encouraged agrarian societies to form small cells of communist supporters (Lawrence). Ho Chi Minh not only believed in this principle, but believed that it formed a road map for him to carry out revolution and free Vietnam from colonial rule forever (Lawrence). The path to the Vietnam War had, in some ways, begun with his thoughts. Vietnam faced further occupation during World War II. The Japanese entered and quickly took over for France, forcing them to concede French Indochina (Lawrence). In the confusion of the final year of the war, Ho Chi Minh took advantage of the opportunity to bring his party to the forefront of politics by relieving a famine and feeding the starving masses of Vietnamese

Global Environmental Change Essay Example | Topics and Well Written Essays - 2000 words

Global Environmental Change - Essay Example Serious threat from oil exploration on the eastern slopes of the Andes and the adjacent Amazonian lowlands of Colombia, Ecuador, Peru, and Bolivia have led to a conflict between hydrocarbon hotspot and biodiversity hotspot. Loss of biodiversity and associated ecosystem services is one of the most challenging problems ecologist face. Advances in information technology, featuring computer simulation models built on digital databases and satellite imagery incorporating GPS and GIS can go a long way to identify problems, evaluate risks and design counter measures. Accurate maps are created using remote sensing technology that can play an important role to monitor the environmental effects of human activities on land and water resources. We are passing through the defining moments of human development challenges of the 21st century. Failure to respond will not only stall but also reverse international efforts to reduce poverty. The earth's ecosystems and the biosphere's life-supporting sy stems need to be understood for survival of mankind. The poorest countries are most vulnerable and will be the first to suffer from global environmental change, though they have contributed least to the problem. Large-scale global environmental hazards to human existence include climate change, stratospheric ozone depletion, biodiversity loss, changes in hydrological systems and the supply of freshwater, land degradation and stresses on food-producing systems (WHO, 2008) 1. Their influence on the earth's ecosystems and the biosphere's life-supporting systems needs to be understood for survival of mankind. It also brings the complexity of the systems upon which we depend. Though there are many factors affecting global environmental changes, in this paper we shall discuss the impact of "desertification" and "dwindling biodiversity" on the earth. Desertification Approximately one-third of the earth's land surface is arid desert land with scanty rainfall, sparse vegetation and limited population (Walker, 1997) 2. Deserts are formed by a combination of factors that change over a period of time and will vary with locations. Unscientific land use practices leads to deterioration in vegetation, soil erosion and salinity directly affecting soil fertility and leads to soil compaction and crusting. Population pressure, socioeconomic factors, globalization, unbridled urbanization and merciless mining indirectly induce desertification. The inability to logically and technologically respond to such demands sets off a downward spiral of land degradation. It is very difficult to distinguish whether desertification was caused by reckless land management practices or from climatic turbulence. Due to its vastness, discussing desertification on a global scale require copious deliberations. This discussion is, therefore, being confined to China, which is big enough and favorably positioned in the northern mid latitudes for such a study. China also suffers from a very patchy distribution of water resources 3. China's Environmental Protection Agency has reported that Gobi Deserts expanded by 52,400 km2 during 1994-99 and is now within striking distance from Beijing. Scientists fear if this rate continues complete desertification will arrive within 15 years. Satellite pictures forewarns how two deserts in North central China are